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Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update
Open accessAbstract
Hepatic injury and subsequent hepatic failure due to both intentional and non-intentional overdose of acetaminophen (APAP) has affected patients for decades, and involves the cornerstone metabolic pathways which take place in the microsomes within hepatocytes. APAP hepatotoxicity remains a global issue; in the United States, in particular, it accounts for more than 50% of overdose-related acute liver failure and approximately 20% of the liver transplant cases. The pathophysiology, disease course and management of acute liver failure secondary to APAP toxicity remain to be precisely elucidated, and adverse patient outcomes with increased morbidity and mortality continue to occur. Although APAP hepatotoxicity follows a predictable timeline of hepatic failure, its clinical presentation might vary. N-acetylcysteine (NAC) therapy is considered as the mainstay therapy, but liver transplantation might represent a life-saving procedure for selected patients. Future research focus in this field may benefit from shifting towards obtaining antidotal knowledge at the molecular level, with focus on the underlying molecular signaling pathways.
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“Examples include alcohol148 and paracetamol,149 which damage pericentral hepatocytes and are responsible for the majority of fatal acute liver injury cases.”
From Distinct hepatocyte identities in liver homeostasis and regeneration (2023) · cites this paper as [149]
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Metadata
- Authors
- Yoon, E. D., Babar, A., Choudhary, M. M., Kutner, M., & Pyrsopoulos, N.
- Affiliations
- University Hospital, Newark (US)
- Venue
- Journal of Clinical and Translational Hepatology
- Publisher
- Xia & He Publishing
- Published
- 2016-06-17
- Volume
- 4
- Issue
- 2
- Pages
- 131-42
- ISSN
- 2225-0719 (ISSN-L)
- 2310-8819
- PMC
- PMC4913076
- OpenAlex
- W2461975652
- Cited by
- 744
- References
- 78
- Citations by year
- 2026: 25 · 2025: 62 · 2024: 97 · 2023: 92 · 2022: 96 · 2021: 90 · 2020: 86 · 2019: 78 · 2018: 68 · 2017: 40 · 2016: 8
- FWCI
- 11.42
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Clinical and Translational Hepatology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Keywords
- acetaminophen hepatotoxicity, acetaminophen overdose, acute liver failure, liver transplantation, molecular pathways, antidotes
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