Ethyl pyruvate for the treatment of acetaminophen intoxication: alternative to N-acetylcysteine?

Critical Care : the Official Journal of the Critical Care Forum
Florian WagnerKatja Wagner

Abstract

N-acetylcysteine is the classical antidote for acetaminophen overdose-induced hepatotoxicity, but its efficacy is limited by the need for early and only temporary treatment. Therefore, Yang and colleagues tested the hypothesis of whether ethyl pyruvate--another anti-inflammatory and antioxidant compound, which they had previously shown to protect against liver injury of various other etiologies--may allow circumventing these limitations. While ethyl pyruvate improved liver regeneration when administered early and during a limited period only, the opposite response was present both after delayed as well as prolonged treatment. The authors concluded that prolonged anti-inflammatory treatment is detrimental after acetaminophen intoxication-induced liver damage. On the one hand, this research paper confirms the need for biomarkers to monitor organ recovery after acetaminophen. On the other hand, this paper adds to the ongoing discussion on the usefulness of ethyl pyruvate as a resuscitation fluid in the critically ill.

References

May 3, 2000·Lancet·B Halliwell
Jun 18, 2002·American Journal of Physiology. Gastrointestinal and Liver Physiology·Runkuan YangMitchell P Fink
Sep 5, 2002·Proceedings of the National Academy of Sciences of the United States of America·Luis UlloaKevin J Tracey
Feb 14, 2006·Critical Care : the Official Journal of the Critical Care Forum·Sheldon Magder
Feb 21, 2007·Archives of Surgery·Fuhong SuJean-Louis Vincent
Apr 11, 2009·Critical Care : the Official Journal of the Critical Care Forum·Runkuan YangMitchell P Fink
Jun 6, 2009·Critical Care : the Official Journal of the Critical Care Forum·T Nimmi C Athuraliya, Alison L Jones
Sep 29, 2009·Toxicological Sciences : an Official Journal of the Society of Toxicology·Daniel J AntoineB Kevin Park
Jan 18, 2012·Critical Care : the Official Journal of the Critical Care Forum·Runkuan YangJyrki Tenhunen

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