Activation of acetaminophen-reactive metabolite formation by methylxanthines and known cytochrome P-450 activators.

Previous in vitro studies suggested that caffeine enhanced acetaminophen (APAP) oxidation to N-acetyl-p-benzoquinone imine (NAPQI) by selectively activating the male-specific constitutive cytochrome P-450IIIA2. Monomethylxanthine and dimethylxanthine analogs of caffeine (also metabolites) were studied for their potential effect to accelerate NAPQI formation in various preparations of rat liver microsomes. In contrast to caffeine, none of the mono- and dimethylxanthines (2.5 mM) activated P-450. Rather, the analogs either inhibited NAPQI formation or had no effect; 1-methylxanthine (2.5 mM) was the only compound which consistently inhibited (25-70%) APAP oxidation in all microsomal preparations. Thus, all three methyl groups appear to be required for P-450 activation by methylxanthines. Because of the highly selective activation effect of caffeine, it was of particular interest to determine whether other known P-450 activators could enhance APAP oxidation. Both acetone (400 mM) and flavone (50 microM) accelerated NAPQI formation in all microsomal preparations, whereas metyrapone caused only inhibition. Flavone (50 microM) caused a pattern of activation similar to that observed with 5 mM caffeine (maximal activation of 125-300%), except that NAPQI formation was increased approximately 40% by flavone in microsomes prepared from adult females, whereas no activation was caused by caffeine. Acetone yielded a pattern of P450 activation very different from that of either caffeine or flavone; the maximal degree of activation (3 times control) was observed in microsomes prepared from adult females. In contrast to caffeine and flavone, the degree of activation by acetone in microsomes prepared from juvenile animals was considerably lower (50%) than that observed in adult microsomes.(ABSTRACT TRUNCATED AT 250 WORDS)