A recent study suggests that B-oxidation inhibition may play a role in initiation of hepatotoxicity after this commonly used xenobiotic?
Ganetsky M et al. performed a metabolomic analysis of acetaminophen induced subclinical liver injury to attempt to determine the role of 2E1 inhibition on the development of subclinical liver injury. Interestingly, inibition of CYP 2 E1 did not decrease the incidence of elevated ALT levels despite demonstrating reduction in CYP2E1 derived metabolite levels. This study showed a decrease in circulating acycarnitines suggesting a role of B-oxidation inhibition in initiation of APAP-hepatotoxicity. (Ganetsky M et al. Metabolomic analysis of acetaminophen induced subclinical liver injury. Clin Tox 2019; 58(8): 804-812. doi: 10.1080/15563650.2019.1696970)