Paracetamol in the crossfire: New research project discovers fatal liver damage!

Paracetamol in the crossfire: New research project discovers fatal liver damage!

In a significant honor for pharmacological research, Rebekka Lambrecht, a biologist at the University of Konstanz, was honored with the Rudolf Buchheim Prize on March 27, 2025. This prize is awarded for outstanding achievements by young scientists in experimental pharmacological and toxicological research and is endowed with 2,000 euros. Lambrecht's work examines the cell biological basis of liver damage caused by paracetamol, a painkiller that is widely used worldwide.

If overdosed, paracetamol can cause severe liver damage and, in the worst case, lead to death. The research carried out by Lambrecht is part of the Collaborative Research Center/Transregio “Regulation of cell death decisions” (SFB/TRR 353), funded by the German Research Foundation. She researched how cell death mechanisms interact in liver damage caused by paracetamol overdose.

Mechanisms of liver injury

In her study, Lambrecht particularly examined the conditions under which liver cells switch from apoptosis, a programmed cell death, to necrotic cell death mechanisms. These changes are critical because they can lead to acute liver failure. Oxidative stress was identified in their results as a key factor promoting this switch. A central protein in this process is BIM (Bcl-2-like protein 11), which plays a crucial role in cellular energy metabolism and promotes the transition to necrotic programs.

The dangers of acetaminophen are not new; It is known that an overdose causes liver damage by destroying the tight junctions between liver cells. More recent findings, such as those from a team led by Wesam Gamal and Dr. Philipp Treskes at the University of Edinburgh, show that this is not only typical of diseases such as hepatitis, cirrhosis and cancer, but should also be linked to paracetamol toxicity. This damage has been detected even at low concentrations of the drug and results in serious impairment of liver structure and function.

Current challenges and possible solutions

Paracetamol, a popular painkiller worldwide, is well tolerated in small doses. However, toxic effects can occur if the therapeutic dosage is exceeded, which is why intentional or accidental overdoses are the main cause of acute liver failure in the Western world. To reduce the risk of unintentional intoxication, the maximum pack size of the 500 mg tablets was limited to 20 pieces.

Acetylcysteine ​​is used as an antidote, but its effectiveness is limited. The new findings on the mechanism of liver damage caused by paracetamol, published in the specialist journal Scientific Reports, could offer crucial starting points for the development of new antidotes. Lambrecht's studies not only provide valuable insights for toxicological research, but could also be important for clinical practice in dealing with paracetamol toxicity.