Due to its widespread availability, acetaminophen (APAP) is the leading cause for drug-induced liver injury in many countries including United States and United Kingdom. When used as recommended, APAP is relatively safe. However, in overdose cases, increased metabolism of APAP to N-acetyl-para-benzoquinoneimine (NAPQI), a reactive metabolite, leads to glutathione (GSH) depletion, oxidative stress, and cellular injury. Throughout this process, a variety of factors play important roles in propagating toxicity, including c-Jun N-terminal kinase (JNK), a member of the mitogen-activated protein kinase (MAPK) family. Because of its involvement in multiple cellular processes, biomarkers associated with MAPK signaling have generated interest as a mechanistic target for protecting against APAP-induced liver injury and hepatocellular injury, in general. This review summarizes mechanistic details by which natural products, specifically those containing polyphenolic moieties, are capable of attenuating APAP-induced toxicity, at least in part through an ability to modulate MAPKs. These compounds include carnosic acid, chlorogenic acid, davallialactone, extracts from Hibiscus sabdariffa, quercetin-based compounds, and resveratrol. Despite variations in the experimental designs across these studies, common pathways and biomarkers were implicated in cytoprotection when polyphenolic compounds were given with APAP, such as enhanced antioxidant gene expression and reversal of APAP-induced changes in oxidative stress markers and MAPK signaling. Overall, an emphasis should be placed on method standardization for future studies if we are to gain a more in-depth understanding of how polyphenolic moieties contribute to cytoprotection during an APAP overdose event.

译文

由于对乙酰氨基酚 (APAP) 的广泛使用,在包括美国和英国在内的许多国家/地区,对乙酰氨基酚 (APAP) 是药物性肝损伤的主要原因。按推荐使用时,APAP相对安全。然而,在过量的情况下,APAP向活性代谢物N-乙酰基对苯醌亚胺 (NAPQI) 的代谢增加会导致谷胱甘肽 (GSH) 消耗,氧化应激和细胞损伤。在整个过程中,多种因素在繁殖毒性中起着重要作用,包括有丝分裂原活化蛋白激酶 (MAPK) 家族成员c 6月N端激酶 (JNK)。由于其参与多个细胞过程,与MAPK信号相关的生物标志物已引起人们的兴趣,通常作为预防APAP诱导的肝损伤和肝细胞损伤的机制靶标。这篇综述总结了机理细节,通过这些机理,天然产物,特别是含有多酚部分的天然产物,至少部分通过调节MAPKs的能力,能够减弱APAP诱导的毒性。这些化合物包括肌糖酸,绿原酸,davalalactone,木槿提取物,槲皮素基化合物和白藜芦醇。尽管这些研究的实验设计存在差异,但当使用APAP给予多酚化合物时,常见的途径和生物标志物与细胞保护有关,例如增强的抗氧化剂基因表达和逆转APAP诱导的氧化应激标记物和MAPK信号传导的变化。总体而言,如果我们要更深入地了解多酚部分如何在APAP过量事件中促进细胞保护作用,则应将重点放在方法标准化上,以用于未来的研究。

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