Liberation of daidzein by gut microbial β-galactosidase suppresses acetaminophen-induced hepatotoxicity in mice

Cell Host Microbe. 2023 May 10;31(5):766-780.e7. doi: 10.1016/j.chom.2023.04.002. Epub 2023 Apr 25.


Acetaminophen (APAP) overdose is a leading cause of drug-induced liver injury (DILI). The impact of the gut microbiota and associated metabolites on APAP and liver function remains unclear. We show that APAP disturbance is associated with a distinct gut microbial community, with notable decreases in Lactobacillus vaginalis. Mice receiving L. vaginalis showed resistance to APAP hepatotoxicity due to the liberation of the isoflavone daidzein from the diet by bacterial β-galactosidase. The hepatoprotective effects of L. vaginalis in APAP-exposed germ-free mice were abolished with a β-galactosidase inhibitor. Similarly, β-galactosidase-deficient L. vaginalis produced poorer outcomes in APAP-treated mice than the wild-type strain, but these differences were overcome with daidzein administration. Mechanistically, daidzein prevented ferroptotic death, which was linked to decreased expression of farnesyl diphosphate synthase (Fdps) that activated a key ferroptosis pathway involving AKT-GSK3β-Nrf2. Thus, liberation of daidzein by L. vaginalis β-galactosidase inhibits Fdps-mediated hepatocyte ferroptosis, providing promising therapeutic approaches for DILI.

Keywords: DILI; Lactobacillus vaginalis; daidzein; ferroptosis; β-galactosidase.

MeSH terms

  • Acetaminophen / pharmacology
  • Animals
  • Chemical and Drug Induced Liver Injury* / metabolism
  • Chemical and Drug Induced Liver Injury* / prevention & control
  • Gastrointestinal Microbiome*
  • Isoflavones* / pharmacology
  • Liver / metabolism
  • Mice
  • Mice, Inbred C57BL
  • NF-E2-Related Factor 2
  • beta-Galactosidase / metabolism


  • Acetaminophen
  • beta-Galactosidase
  • daidzein
  • Isoflavones
  • NF-E2-Related Factor 2