UT Researcher discovers potential target for Tylenol overdose

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Researchers at UT have found a new method to help combat Tylenol overdoses.

Tylenol, also known as an over-the-counter acetaminophen product, is found in many over-the-counter drugs as well as prescriptions, pharmacy professor Sharon Demorrow said.

“(It’s) insidious in that because there’s a lot of medications like cough medicine … that, if you read it, has acetaminophen in their ingredients,” said DeMorrow, a co-investigator on the study. “(People) will take cough medicine and then also take Tylenol, not realizing that they’ve just doubled up the dose.”

Tylenol overdoses can lead to acute liver failure, said Matthew McMillin, an assistant professor in Dell Medical School’s Department of Internal Medicine.

Individuals with preexisting liver damage are more susceptible to overdosing on Tylenol, McMillin said.

“They’re more sensitive to Tylenol to where they’re more able to easily overdose,” said McMillin, the lead researcher on the study. “It becomes toxic versus therapeutic.”

Currently, methods of treating Tylenol overdoses are only effective within an immediate window of about 6–8 hours. 

 

“You can take things that will purge your stomach, like activated charcoal, that will clear your gut and absorb the toxic (substances),” pharmacy graduate student Christine Shin said.

McMillin said his research explores treatment beyond the initial window to mitigate liver injury.

McMillin has connected thrombospondin 1 (THBS1), a protein found in the body, to liver tissue regeneration.  

“We used a mouse that did not have THBS1 … and we found that it made the injury worse,” McMillin said. “If you could increase (THBS1) levels, that could be a therapeutic strategy to reduce cell death as well as stimulate aspects of (liver) regeneration.”

Currently, McMillin’s team is exploring the pathways involved with the protein to see if they can manipulate the amount present in a person’s body to help treat liver damage
after an overdose.

The next phase of the study involves moving to clinical trials and testing on human patients, McMillin said.

“The goal is to … get to a point where we can do clinical trials,” McMillin said. “Now, we’ve just got to find a way to get a (receptor binding substance) and find specifically where to target.”

McMillin said patients need to be educated about the risks of Tylenol.

“There probably needs to be a little bit more education in patients when they’re taking medications that contain acetaminophen,” McMillin said. “I think there’s a lack of knowledge (in patients) or communication between doctors and patients …  on how acetaminophen is toxic to the liver.”