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Acetaminophen toxicity in children: diagnostic confirmation using a specific antigenic biomarker
P A Webster1, D W Roberts, R W Benson
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA.
Journal of Clinical Pharmacology
|May 1, 1996
Summary
A new biomarker, 3-(cystein-S-yl)-APAP protein adducts (3-Cys-A), can diagnose chronic acetaminophen (APAP) toxicity. This finding aids in identifying APAP-induced liver injury when ingestion history is unclear.
Area of Science:
- Toxicology
- Biochemistry
- Clinical Chemistry
Background:
- Chronic acetaminophen (APAP) toxicity presents diagnostic challenges due to nonspecific symptoms.
- Current laboratory tests cannot definitively confirm APAP as the cause of liver injury.
Observation:
- An antigenic biomarker, 3-(cystein-S-yl)-APAP protein adducts (3-Cys-A), was investigated for diagnosing APAP toxicity.
- Serum samples from two children with suspected chronic APAP toxicity were analyzed for 3-Cys-A levels.
Findings:
- Quantitation of 3-Cys-A using a competitive inhibition enzyme-linked immunosorbent assay (ELISA) revealed significant levels (1.97 and 2.77 nmol/mg protein).
- These levels are comparable to those seen in adults with acute APAP overdose-induced liver injury.
- No detectable 3-Cys-A was found in individuals without APAP exposure.
Implications:
- 3-Cys-A serves as a valuable marker for identifying APAP intoxication, particularly in cases of chronic ingestion with uncertain dosage or timing.
- This biomarker may become an important clinical and investigative tool for studying APAP toxicity.
