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Subliminal Fas stimulation increases the hepatotoxicity of acetaminophen and bromobenzene in mice

The hepatotoxicity of several drugs is increased by mild viral infections. During such infections, death receptor ligands are expressed at low levels, and most parenchymal cells survive. We tested the hypothesis that subliminal death receptor stimulation may aggravate the hepatotoxicity of drugs, which are transformed by cytochrome P‐450 cytochrome P‐450 into glutathione‐depleting reactive metabolites. Twenty‐four‐hour‐fasted mice were pretreated with a subtoxic dose of the agonistic Jo2 anti‐Fas antibody (1 μg per mouse) 3 hours before acetaminophen (500 mg/kg) or 1 hour before bromobenzene (400 mg/kg) administration. Administration of Jo2 alone increased hepatic inducible nitric oxide synthase nitric oxide synthase but did not modify serum alanine aminotransferase (ALT), hepatic adenosine triphosphate (ATP), glutathione (GSH), cytochrome P‐450, cytosolic cytochrome c, caspase‐3 activity or hepatic morphology. However, pretreating mice with Jo2 further decreased both hepatic GSH and ATP by 40% 4 hours after acetaminophen administration, and further increased serum ALT and the area of centrilobular necrosis at 24 hours. In mice pretreated with the Jo2 antibody before bromobenzene administration, hepatic GSH 4 hours after bromobenzene administration was 51% lower than in mice treated with bromobenzene alone, and serum ALT activity at 24 hours was 47‐fold higher. In conclusion, administration of a subtoxic dose of an agonistic anti‐Fas antibody before acetaminophen or bromobenzene increases metabolite‐mediated GSH depletion and hepatotoxicity. Subliminal death receptor stimulation may be one mechanism whereby mild viral infections can increase drug‐induced toxicity. (HEPATOLOGY 2004;39:655–666.)