Acetaminophen‐Induced Liver Damage in Hepatic Steatosis

One of the most used painkillers is acetaminophen (APAP), which is safe at the right dose. However, several studies have described populations susceptible to APAP‐induced liver damage, mainly in livers with steatosis. Thus, clinicians should consider the presence of obesity and other chronic liver d...

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Bibliographic Details
Published in:Clinical pharmacology and therapeutics 2020-05, Vol.107 (5), p.1068-1081
Main Authors: García‐Román, Rebeca, Francés, Rubén
Format: Article
Language:English
Subjects:
Acetaminophen - administration & dosage
Acetaminophen - adverse effects
Acetaminophen - pharmacokinetics
Animals
Chemical and Drug Induced Liver Injury - etiology
Chemical and Drug Induced Liver Injury - physiopathology
Glutathione - metabolism
Hepatocytes - pathology
Humans
Non-alcoholic Fatty Liver Disease - complications
Obesity - complications
Risk Factors
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Summary:One of the most used painkillers is acetaminophen (APAP), which is safe at the right dose. However, several studies have described populations susceptible to APAP‐induced liver damage, mainly in livers with steatosis. Thus, clinicians should consider the presence of obesity and other chronic liver diseases like nonalcoholic fatty liver disease (NAFLD) when indicating treatment with APAP. Liver damage from this drug is generated through its metabolite N‐acetyl‐p‐benzoquinone imine, which is detoxified with glutathione (GSH). Prior depletion of GSH in steatotic hepatocytes plays a key role in APAP‐induced hepatotoxicity in people with obesity and NAFLD. The knowledge about the damage to the liver or APAP in susceptible people like the obese and those with NAFLD is of great relevance for the sanitary sector because it would imply strategies of different therapeutic approach in such patients. This paper reviews the role of APAP in liver damage in the presence of obesity, NAFLD, and nonalcoholic steatohepatitis.
ISSN:0009-9236
1532-6535
DOI:10.1002/cpt.1701