A Cytochrome P450-Independent Mechanism Of Acetaminophen-Induced Hepatocellular Injury

Acetaminophen (APAP) hepatotoxicity in mice resembles in most ways that which occurs in humans. Primary mouse hepatic parenchymal cells (HPCs) are the most frequently used cell type in vitro to study mechanisms of APAP hepatotoxicity. It is widely accepted that APAP hepatotoxicity requires bioactivation by cytochromes P450 (CYPs), but this remains unproven in HPCs over the wide range of concentrations that have been used in published reports. Accordingly, we tested the hypothesis that APAP‐induced HPC death in vitro depends solely on CYPs. We evaluated APAP cytotoxicity and bioactivation (formation of APAP‐protein adducts) in the presence and absence of the CYP inhibitor 1‐aminobenzotriazole (1‐ABT). 1‐ABT abolished formation of APAP‐protein adducts at all concentrations tested (0.1‐14mM) but only eliminated cytotoxicity at small APAP concentrations (0.1‐5mM), indicating the presence of a CYP‐independent mechanism at larger concentrations. The APAP deacetylation product, p‐aminophenol (PAP), was detected in HPCs exposed to a large APAP concentration, and a deacetylase inhibitor significantly reduced cytotoxicity. In conclusion, APAP hepatocellular injury in vitro occurs by at least two mechanisms, a CYP‐dependent mechanism that operates at smaller APAP concentrations and a CYP‐independent mechanism that predominates at larger concentrations and is later in onset. PAP likely contributes to the latter mechanism. (Supported by NIH grant R01 DK087886)