To investigate the role of Cav-1 in acetaminophen-induced hepatotoxicity, Cav-1−/− mice were used. Unexpectedly, these mice were found to be less sensitive to the hepatotoxic effects of acetaminophen than wild type mice. Analysis of plasma levels of acetaminophen-glucuronide and -sulfate metabolites after acetaminophen administration, as well as hepatic cytochrome P4502E1 activity, indicated that there were no major differences in acetaminophen metabolism or the capacity to metabolize acetaminophen between Cav-1−/− mice and wild type mice. This is supported by findings that levels of NQO1, which is important in detoxification of NAPQI, were generally similar in the two mouse strains.
Antioxidants play a key role in protecting against acetaminophen-induced injury (
Nakae et al., 1990;
Ferret et al., 2001;
Chiu et al., 2003a;
Fujimoto et al., 2009;
Mladenovic et al., 2009;
Yoshikawa et al., 2009). Consistent with previous studies (
Gardner et al., 2002;
Chiu et al., 2003a), we observed a significant reduction in whole liver GSH levels in wild type mice following acetaminophen administration. Similar results were observed in Cav-1
−/− mice. GSH is known to be present at high levels in hepatocytes (
Yuan and Kaplowitz, 2009). In addition to scavenging reactive oxygen species, it plays a key role in detoxification of the cytotoxic acetaminophen metabolite, NAPQI (
Jaeschke, 1990). Interestingly, baseline levels of GSH were significantly lower in livers of Cav-1
−/− mice, when compared to wild type mice. Our findings that Cav-1
−/− mice are less sensitive to acetaminophen suggest that reduced levels of GSH are not key to the pathogenesis of hepatotoxicity in these mice. As observed with GSH, no significant differences in expression of HO-1, SOD-1 or lipocalin 24p3 were noted between the genotypes following acetaminophen administration. Thus, it appears that protection of Cav-1
−/− mice against the hepatotoxic effects of acetaminophen is not due to alterations in oxidative stress or antioxidant defense.
Acetaminophen administration to both wild type and Cav-1
−/− mice was associated with up-regulation of pro- and anti-inflammatory mediators which have been implicated in the pathogenesis of liver injury and repair, including IL-1β, MCP-1, IL-10, and TNFα (
Liu and Kaplowitz, 2006;
Laskin, 2009). Of particular note are IL-10 and MCP-1 which play important roles in mediating the resolution of inflammation and initiating tissue repair following acetaminophen intoxication, in part, by recruiting and activating M2 repair macrophages (
Hogaboam et al., 2000;
Dambach et al., 2002;
Holt et al., 2008). In Cav-1
−/− mice, expression of both IL-10 and MCP-1 increased more rapidly when compared to wild type mice; moreover, expression levels were greater. Early production of these mediators may contribute to hepatoprotection in Cav-1
−/− mice against acetaminophen. We also found that TNFα mRNA expression increased in response to acetaminophen in Cav-1
−/− mice, with no effect in wild type mice. Accumulating evidence suggests that TNFα is a key mediator of hepatocyte proliferation following injury (
Bruccoleri et al., 1997;
Chiu et al., 2003b;
Okamoto et al., 2009;
Shimizu et al., 2009). TNFα also up-regulates hepatic antioxidant defense, and induces matrix remodeling and tissue repair in various models of liver injury (
Haruyama et al., 2000;
Gharaee-Kermani and Phan, 2001;
Chiu et al., 2003a). TNFα may play a similar hepatoprotective role in Cav-1
−/− mice after acetaminophen-intoxication. Previously, studies have reported increases in TNFα mRNA levels in wild type mice following acetaminophen intoxication (
Gardner et al., 2002;
Dambach et al., 2006). Differences between our findings and earlier reports are likely due to genetic distinctions between the mouse strains used (
Mayoral et al., 2007). The present studies also show that acetaminophen-induced changes in IL-1β mRNA levels were similar in wild type and Cav-1
−/− mice. This indicates that Cav-1 is not required for hepatic IL-1β expression in this model.
Arachidonic acid metabolites, including prostaglandins, leukotrienes and lipoxins are important mediators of the responses to tissue injury, contributing to both pro- and anti-inflammatory activity (
Harizi et al., 2008;
Serhan, 2008). Prostaglandins are generated from arachidonic acid via the actions of COX-2. The present studies demonstrate that COX-2 mRNA and protein are upregulated in livers of wild type mice after acetaminophen administration. Although COX-2 protein was also up-regulated in Cav-1
−/− mice following acetaminophen, levels were reduced when compared to wild type mice. Moreover, there were no significant changes in COX-2 mRNA. These data indicate that the proinflammatory activity of COX-2 may play a more prominent role in hepatotoxicity in this model. This is consistent with previous reports demonstrating that COX-2
−/− mice are protected from acetaminophen-induced hepatotoxicity (
Reilly et al., 2001).
Leukotrienes and lipoxins are produced via the sequential activation of 5-LOX and 15-LOX which are expressed in leukocytes and endothelium at sites of tissue damage (
Romano, 2006;
Kronke et al., 2009). Whereas, products of 5-LOX are generally proinflammatory, 15-LOX generates anti-inflammatory lipoxins (
Serhan, 2008). Although no significant changes were noted in 5-LOX expression after acetaminophen administration in either wild type or Cav-1
−/− mice, 15-LOX decreased in both genotypes. In Cav-1
−/− mice, this decrease occurred more rapidly and was persistent, while in wild type mice it was delayed and transient. The rapid and persistent decrease in Cav-1
−/− mice may reflect reduced need for anti-inflammatory eicosanoids due to decreased hepatotoxicity.
The outcome of the response to hepatotoxicants is determined, in part, by the ability of remnant hepatocytes to proliferate, a major step in tissue repair (
Mehendale, 2005;
Fausto et al., 2006). Cav-1 has been reported to regulate multiple pathways important for tissue regeneration, including TNFα signaling (
Gassmann and Werner, 2000;
Lopez-Rivera et al., 2005;
Canbay et al., 2007). Although TNFα was rapidly up-regulated in Cav-1
−/− mice after acetaminophen administration, hepatocyte proliferation, assessed by PCNA expression, was delayed when compared to wild type mice, suggesting that alternative signaling molecules control hepatocyte proliferation in Cav-1
−/− mice. Of note is our observation that PCNA expression was significantly greater in Cav-1
−/− mice relative to wild type mice 24 hr post acetaminophen. This may contribute to the hepatoprotective effects of loss of Cav-1. Interestingly, macrophages located within the sinusoids in the midzonal and portal regions and necrotic areas of the liver were found to express PCNA, indicating that these cells rapidly proliferate in response to acetaminophen-induced injury. Macrophage proliferation in the liver has been described after partial body irradiation, carbon tetrachloride intoxication, or depletion by liposome-encapsulated dichloromethylene diphosphate, suggesting that this may be a generic response to tissue injury (
Bouwens et al., 1986;
Yamamoto et al., 1996;
Orfila et al., 1999). The finding that there are greater numbers of proliferating macrophages in acetaminophen-treated wild type mice may be indicative of more severe injury in the liver when compared to Cav-1
−/− mice. The phenotype of the proliferating macrophages in the liver is unknown and is likely to influence the ultimate pathogenic response to acetaminophen (
Laskin, 2009). Thus, whereas M1 macrophages contribute to tissue injury, M2 cells are involved in repair. It may be that early proliferation of M1 macrophages in wild type mice plays a role in tissue injury, while delayed proliferation of M2 macrophages initiates repair and is important in hepatoprotection in Cav-1
−/− mice. Delayed proliferation of mitogen producing M2 macrophages in Cav-1
−/− mice is consistent with the delay in the initiation of hepatocyte proliferation observed after acetaminophen, as well as the decreased need for tissue repair.
Survivin is a member of the family of inhibitor of apoptosis proteins and functions as a regulator of mitosis and apoptosis (
Mita et al., 2008). Expression of survivin is associated with inhibition of cell death and is required for cell division (
Altieri, 2008). Survivin has recently been reported to be important in liver regeneration following partial hepatectomy (
Baba et al., 2009). Within 3 h of acetaminophen administration to wild type mice, we found that survivin protein expression was up-regulated in hepatocyte nuclei located adjacent to portal veins and spreading to necrotic zones in the livers by 24 h. Evidence suggests that expression of survivin is controlled by Cav-1 via the β-catenin-Tcf/Lef-dependent signaling pathway and it has been suggested that the anti-proliferative and pro-apoptotic properties of Cav-1 are due to reduced survivin expression (
Torres et al., 2006). Our observation that acetaminophen-induced expression of survivin in livers of Cav-1
−/− mice was attenuated, relative to wild type mice, and hepatocyte proliferation increased 24 h post acetaminophen are consistent with this idea.
In summary, the present studies demonstrate that protection of Cav-1
−/− mice from acetaminophen-induced liver injury is associated with increased expression of cytokines implicated in down-regulation of inflammation and initiation of tissue repair including IL-10, MCP-1 and TNFα. This is correlated with reduced expression of COX-2, an enzyme important in the generation of proinflammatory eicosaniods. Taken together, these data suggest that Cav-1 plays a role in promoting acetaminophen-induced hepatotoxicity. This is surprising since Cav-1 has been shown to play an important role in regulating signaling molecules involved in cell replication, a key step in tissue repair in other models of tissue injury (
Quest et al., 2008). Further studies are necessary to determine if the pro-inflammatory activity of Cav-1 is unique to the pathogenesis of hepatotoxicity induced by acetaminophen.