title: Acetaminophen-induced hepatotoxicity in mice is dependent on Tlr9 and the Nalp3 inflammasome.
abstract: Hepatocyte death results in a sterile inflammatory response that amplifies the initial insult and increases overall tissue injury. One important example of this type of injury is acetaminophen-induced liver injury, in which the initial toxic injury is followed by innate immune activation. Using mice deficient in Tlr9 and the inflammasome components Nalp3 (NACHT, LRR, and pyrin domain-containing protein 3), ASC (apoptosis-associated speck-like protein containing a CARD), and caspase-1, we have identified a nonredundant role for Tlr9 and the Nalp3 inflammasome in acetaminophen-induced liver injury. We have shown that acetaminophen treatment results in hepatocyte death and that free DNA released from apoptotic hepatocytes activates Tlr9. This triggers a signaling cascade that increases transcription of the genes encoding pro-IL-1beta and pro-IL-18 in sinusoidal endothelial cells. By activating caspase-1, the enzyme responsible for generating mature IL-1beta and IL-18 from pro-IL-1beta and pro-IL-18, respectively, the Nalp3 inflammasome plays a crucial role in the second step of proinflammatory cytokine activation following acetaminophen-induced liver injury. Tlr9 antagonists and aspirin reduced mortality from acetaminophen hepatotoxicity. The protective effect of aspirin on acetaminophen-induced liver injury was due to downregulation of proinflammatory cytokines, rather than inhibition of platelet degranulation or COX-1 inhibition. In summary, we have identified a 2-signal requirement (Tlr9 and the Nalp3 inflammasome) for acetaminophen-induced hepatotoxicity and some potential therapeutic approaches.
authors.affiliation: Section of Digestive Diseases, Yale University, New Haven, Connecticut 06520-8019, USA.
authors.forename: Avlin B
authors.initials: AB
authors.lastname: Imaeda
authors.forename: Azuma
authors.initials: A
authors.lastname: Watanabe
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Sohail
authors.forename: Shamail
authors.initials: S
authors.lastname: Mahmood
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mohamadnejad
authors.forename: Fayyaz S
authors.initials: FS
authors.lastname: Sutterwala
authors.forename: Richard A
authors.initials: RA
authors.lastname: Flavell
authors.forename: Wajahat Z
authors.initials: WZ
authors.lastname: Mehal
mesh_terms: D000082:Acetaminophen / Q000633:toxicity*; D018712:Analgesics, Non-Narcotic / Q000633:toxicity*; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D001241:Aspirin / Q000494:pharmacology; D002352:Carrier Proteins / Q000502:physiology*; D061945:Caspase Inhibitors; D002460:Cell Line; D016861:Cyclooxygenase Inhibitors / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007113:Immunity, Innate; D007249:Inflammation / Q000139:chemically induced; D020382:Interleukin-18 / Q000096:biosynthesis; D053583:Interleukin-1beta / Q000096:biosynthesis; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D051379:Mice; D008810:Mice, Inbred C57BL; D000071199:NLR Family, Pyrin Domain-Containing 3 Protein; D015398:Signal Transduction; D051217:Toll-Like Receptor 9 / Q000502:physiology*
chemical_list: D018712:Analgesics, Non-Narcotic; D002352:Carrier Proteins; D061945:Caspase Inhibitors; D016861:Cyclooxygenase Inhibitors; D020382:Interleukin-18; D053583:Interleukin-1beta; D000071199:NLR Family, Pyrin Domain-Containing 3 Protein; C492716:Nlrp3 protein, mouse; C495370:Tlr9 protein, mouse; D051217:Toll-Like Receptor 9; D000082:Acetaminophen; D001241:Aspirin