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Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
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5-Oxoproline concentrations in acute acetaminophen overdose.
Michael E Mullins1, Mary S Jones1,2, Robert D Nerenz3,4
1Section of Medical Toxicology, Division of Emergency Medicine, Washington University School of Medicine, Saint Louis, MO, USA.
Clinical Toxicology (Philadelphia, Pa.)
|May 4, 2019
Summary
Acetaminophen overdose typically does not elevate 5-oxoproline (5-OP) levels. While some patients show slightly increased 5-OP, this study suggests inherited conditions are more likely causes of 5-oxoprolinemia.
Area of Science:
- Toxicology
- Biochemistry
- Metabolic Disorders
Background:
- High anion gap metabolic acidosis linked to 5-oxoproline (5-OP) has been reported following acetaminophen exposure.
- The underlying mechanism may involve disruptions in glutathione metabolism.
Purpose of the Study:
- To investigate whether acute acetaminophen overdose consistently elevates plasma 5-oxoproline concentrations.
- To explore potential correlations between 5-oxoproline levels and other clinical markers in overdose patients.
Main Methods:
- Plasma samples from 23 adult and adolescent patients with acute acetaminophen overdose were analyzed for 5-oxoproline using GC/MS.
- Collected plasma was residual from routine clinical care laboratory tests.
- 5-oxoproline concentrations were compared with acetaminophen levels and liver/kidney function markers.
Main Results:
- Eighteen patients exhibited non-detectable or normal (<100 μmol/L) 5-oxoproline levels.
- Six patients had mildly elevated concentrations (100–300 μmol/L).
- No significant correlations were found between 5-oxoproline and acetaminophen, AST, ALT, creatinine, anion gap, INR, or total bilirubin.
Conclusions:
- Acute acetaminophen overdose generally leads to normal plasma 5-oxoproline concentrations.
- Slightly elevated 5-oxoproline levels may occur in some overdose cases.
- Inherited enzyme deficiencies are considered more probable causes for significant 5-oxoprolinemia.
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