The role of damage associated molecular pattern molecules in acetaminophen-induced liver injury in mice

Toxicol Lett. 2010 Feb 15;192(3):387-94. doi: 10.1016/j.toxlet.2009.11.016. Epub 2009 Dec 1.


The idiosyncratic nature, severity and poor diagnosis of drug-induced liver injury (DILI) make these reactions a major safety issue during drug development, as well as the most common cause for the withdrawal of drugs from the pharmaceutical market. Elucidation of the underlying mechanism(s) is necessary for identifying predisposing factors and developing strategies in the treatment and prevention of DILI. Acetaminophen (APAP) is a widely used over the counter therapeutic that is known to be effective and safe at therapeutic doses. However, in overdose situations fatal and non-fatal hepatic necrosis can result. Evidence suggests that the chemically reactive metabolite of the drug initiates hepatocyte damage and that inflammatory innate immune responses also occur within the liver, leading to the exacerbation and progression of tissue injury. Here we investigate whether following APAP-induced liver injury (AILI) damaged hepatocytes release "danger" signals or damage associated molecular pattern (DAMP) molecules, which induce pro-inflammatory activation of hepatic macrophages, further contributing to the progression of liver injury. Our study demonstrated a clear activation of Kupffer cells following early exposure to APAP (1h). Activation of a murine macrophage cell line, RAW cells, was also observed following treatment with liver perfusate from APAP-treated mice, or with culture supernatant of APAP-challenged hepatocytes. Moreover, in these media, the DAMP molecules, heat-shock protein-70 (HSP-70) and high mobility group box-1 (HMGB1) were detected. Overall, these findings reveal that DAMP molecules released from damaged and necrotic hepatocytes may serve as a crucial link between the initial hepatocyte damage and the activation of innate immune cells following APAP-exposure, and that DAMPs may represent a potential therapeutic target for AILI.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acetaminophen / adverse effects*
  • Analgesics, Non-Narcotic / adverse effects*
  • Animals
  • Cell Line
  • Chemical and Drug Induced Liver Injury / metabolism*
  • Female
  • HMGB1 Protein / biosynthesis
  • HSP70 Heat-Shock Proteins / biosynthesis
  • Immunoblotting
  • Interleukin-1beta / biosynthesis
  • Interleukin-6 / biosynthesis
  • Liver / cytology
  • Liver / drug effects
  • Liver / metabolism
  • Macrophage Activation / drug effects
  • Mice
  • Mice, Inbred C57BL
  • Reverse Transcriptase Polymerase Chain Reaction
  • Tumor Necrosis Factor-alpha / biosynthesis


  • Analgesics, Non-Narcotic
  • HMGB1 Protein
  • HSP70 Heat-Shock Proteins
  • Interleukin-1beta
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Acetaminophen