Acetaminophen hepatotoxicity.
Acetaminophen hepatotoxicity.
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DOI：
10.1016/0016-5085(80)90593-4
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发表时间：
1980
期刊：
影响因子：
29.4
通讯作者：
M. Black
中科院分区：
文献类型：
--
作者：
M. Black
在过去的五年或更长时间里，实验室和临床研究旨在阐明对乙酰氨基酚诱导的肝细胞坏死的发病机制，在相当程度上解决了所涉及的生化机制方面取得了显著的成功，并确定了治疗这种疾病的新方法。幸运的是，这些调查还服务于一些超出其主要目标的目的。他们特别负责在生物医学科学家之间开辟沟通渠道，这些科学家以前很少有交集。普通内科医生、胃肠病学家、临床肝病学家、药理学家、毒理学家、实验病理学家、化学家、生物化学家、药剂师和其他相关领域的医生越来越多地寻求彼此的建议，因为对乙酰氨基酚肝毒性的可用信息超出了他们各自的专业领域。从对乙酰氨基酚肝毒性中吸取的教训也可能影响未来胃肠病学家和其他内科医生看待药物与肝脏之间相互作用的方式。在对乙酰氨基酚的经历之后，药物引起的肝损伤似乎不太可能像完全不可预测的免疫事件那样容易被忽略，这种免疫事件的实验病理存在于循环或组织结合的免疫复合物中，这些免疫复合物以某种形式含有冒犯性药物，其治疗不可避免地包括皮质类固醇。现代药物通常被认为是强效化合物，其毒性（以及作用）在许多情况下是由药物（或代谢物）与细胞内结构（受体）之间的化学反应引起的。当海曼·齐默尔曼的信息在
Over the past five or more years, laboratory and clinical investigations aimed at elucidating the pathogenesis of acetaminophen-induced liver-cell necrosis have achieved a striking degree of success in considerably resolving the biochemical mechanisms involved, and they have identified novel therapeutic approaches to the management of the disorder. Fortuitously, these investigations have also served a number of purposes beyond their primary objectives. They have been singularly responsible for opening lines of communication between biomedical scientists whose paths had infrequently crossed previously. General internists, gastroenterologists, clinical hepatologists, pharmacologists, toxicologists, experimental pathologists, chemists, biochemists, pharmacists, and others from allied fields have increasingly sought each other’s counsel as the available information on acetaminophen hepatotoxicity extended beyond their respective areas of expertise. The lessons learned from acetaminophen hepatotoxicity also may affect the future way gastroenterologists and other internists view interactions between drugs and the liver. In the wake of the acetaminophen experience, it appears less likely that drug-induced liver injury will be as readily written off as an entirely unpredictable immunologic event whose experimental pathology resides in circulating or tissue-bound immune complexes containing the offending drug in some form or other, and whose therapy inexorably includes corticosteroids. Modern day drugs are now being recognized as often-potent compounds whose toxicities (as well as their actions) in many cases result from a chemical reaction between the drug (or metabolite) and structures(receptors) within a cell. The time may have come when Hyman Zimmerman’s message on