Acetaminophen nephrotoxicity in the rat: quantitation of renal metabolic activation in vivo.

Renal cortical necrosis induced by acetaminophen (APAP) may be related to generation of reactive intermediates by two mechanisms of metabolic activation, direct P-450 dependent metabolic activation (P-450) or metabolic activation subsequent to deacetylation of APAP to p-aminophenol (PAP). Generation of arylating intermediates by both pathways of metabolic activation was quantified in cyclohexamide (HEX)-pretreated or naive rats in vivo with specifically labeled [14C]APAP. The association of each type of metabolic activation with APAP-induced nephrotoxicity was determined in Fischer 344 (F344) and Sprague-Dawley (SD) rats, strains that are susceptible and resistant to APAP-induced nephrotoxicity, respectively. Covalent binding of [ring-14C]APAP to renal cortex was approximately four times greater than [acetyl-14C]APAP in HEX-pretreated F344 rats. In contrast, in SD rats pretreated with HEX covalent binding of [ring-14C]APAP and [acetyl-14C]APAP in the renal cortex was not different. Furthermore, covalent binding of [ring-14C]APAP to renal cortical protein was approximately four times greater in F344 rats than in SD rats. Arylation of hepatic protein by either [ring-14C]APAP or [acetyl-14C]APAP was similar regardless of strain or pretreatment regimen. These studies demonstrated arylation of renal macromolecules in vivo by reactive intermediates resulting from PAP in F344 but not SD rats. Since F344, but not SD, rats are susceptible to APAP-induced nephrotoxicity, it appears the formation of arylating intermediates by PAP is a requisite step in APAP-induced nephrotoxicity.