title: Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update.
abstract: 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.
authors.affiliation: Rutgers New Jersey Medical School, University Hospital, Newark, New Jersey, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Yoon
authors.affiliation: Rutgers New Jersey Medical School, University Hospital, Newark, New Jersey, USA.
authors.forename: Arooj
authors.initials: A
authors.lastname: Babar
authors.affiliation: Rutgers New Jersey Medical School, University Hospital, Newark, New Jersey, USA.
authors.forename: Moaz
authors.initials: M
authors.lastname: Choudhary
authors.affiliation: Rutgers New Jersey Medical School, University Hospital, Newark, New Jersey, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kutner
authors.affiliation: Rutgers New Jersey Medical School, University Hospital, Newark, New Jersey, USA.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Pyrsopoulos
keywords: APAP; Acetaminophen toxicity; Acute liver failure (ALF); Hepatotoxicity; Paracetamol