PGE2-regulated wnt signaling and N-acetylcysteine are synergistically hepatoprotective in zebrafish acetaminophen injury

North, T.E., Babu, I.R., Vedder, L.M., Lord, A.M., Wishnok, J.S., Tannenbaum, S.R., Zon, L.I., and Goessling, W.
Proceedings of the National Academy of Sciences of the United States of America   107(40): 17315-17320 (Journal)
Registered Authors
Goessling, Wolfram, Lord, Allegra, North, Trista, Vedder, Lea, Zon, Leonard I.
acetaminophen liver toxicity, chemical screen
MeSH Terms
  • Acetaminophen/toxicity*
  • Acetylcysteine*/pharmacology
  • Acetylcysteine*/therapeutic use
  • Analgesics, Non-Narcotic/toxicity
  • Animals
  • Animals, Genetically Modified
  • Chemical and Drug Induced Liver Injury*/drug therapy
  • Chemical and Drug Induced Liver Injury*/metabolism
  • Chemical and Drug Induced Liver Injury*/pathology
  • Dinoprostone/metabolism*
  • Genes, Reporter
  • Glutathione/metabolism
  • Liver/drug effects
  • Liver/metabolism
  • Liver/pathology
  • Liver Failure, Acute*/drug therapy
  • Liver Failure, Acute*/metabolism
  • Liver Failure, Acute*/pathology
  • Proteome/analysis
  • Signal Transduction/physiology*
  • Zebrafish*/anatomy & histology
  • Zebrafish*/physiology
20855591 Full text @ Proc. Natl. Acad. Sci. USA
Acetaminophen (APAP) toxicity is the most common drug-induced cause of acute liver failure in the United States. The only available treatment, N-acetylcysteine (NAC), has a limited time window of efficacy, indicating a need for additional therapeutic options. Zebrafish have emerged as a powerful tool for drug discovery. Here, we developed a clinically relevant zebrafish model of APAP toxicity. APAP depleted glutathione stores, elevated aminotransferase levels, increased apoptosis, and caused dose-dependent hepatocyte necrosis. These outcomes were limited by NAC and conserved in zebrafish embryos. In a targeted embryonic chemical screen, prostaglandin E2 (PGE2) was identified as a potential therapeutic agent; in the adult, PGE2 similarly decreased APAP-associated toxicity. Significantly, when combined with NAC, PGE2 extended the time window for a successful intervention, synergistically reducing apoptosis, improving liver enzymes, and preventing death. Use of a wnt reporter zebrafish line and chemical genetic epistasis showed that the effects of PGE2 are mediated through the wnt signaling pathway. Zebrafish can be used as a clinically relevant toxicological model amenable to the identification of additional therapeutics and biomarkers of APAP injury; our data suggest combinatorial PGE2 and NAC treatment would be beneficial for patients with APAP-induced liver damage.
Genes / Markers
Show all Figures
Mutations / Transgenics
Human Disease / Model
Sequence Targeting Reagents
Engineered Foreign Genes