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A Review of Bioinformatics Tools to Understand Acetaminophen-Alcohol Interaction

Department of Biological Science, Seton Hall University, South Orange, NJ 07079, USA
The Institute of NeuroImmune Pharmacology (I-NIP), Seton Hall University, South Orange, NJ 07079, USA
Authors to whom correspondence should be addressed.
Medicines 2019, 6(3), 79;
Received: 14 June 2019 / Revised: 15 July 2019 / Accepted: 23 July 2019 / Published: 25 July 2019
PDF [4633 KB, uploaded 25 July 2019]


Background: Drug-ethanol interaction can result in hepatotoxicity. The liver is capable of metabolizing both acetaminophen and ethanol; however, severe acute or moderate chronic simultaneous exposure can cause cell and tissue damage. Therapeutic doses can become harmful if gene activity is altered via competition for metabolic pathways. Simultaneous intake of ethanol and acetaminophen results in overactive CYP2E1 and depletion of glutathione, leaving NAPQI to build up in the liver. NAPQI is a hepatotoxic substance typically neutralized by glutathione. Methods: Bioinformatics tools including PharmGKB, Chemical Annotation Retrieval Toolkit, Transcriptome Analysis Console 4.0 (TAC), wikipathways, STRING, and Ingenuity Pathway Analysis (IPA) were used to explore interactive metabolic pathways of ethanol-acetaminophen exposure as a proof of concept for assessing drug-drug or drug-alcohol interactions. Results: As the ethanol-acetaminophen comparison indicates, bioinformatics tools may be used to understand interactive pathways following exposure to ethanol and acetaminophen, with potential extrapolation to other drug-drug/drug-ethanol interactions. Conclusions: Direct interactive effects were not able to be confirmed through this bioinformatics study due to the lack of existing ethanol-acetaminophen simultaneous exposure data. This work suggests that a battery of software applications should be used to assess interactive effects. View Full-Text
Keywords: alcohol; drug-ethanol interaction; acetaminophen; bioinformatics; pathways alcohol; drug-ethanol interaction; acetaminophen; bioinformatics; pathways

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Hedgpeth, B.; Missall, R.; Bambaci, A.; Smolen, M.; Yavuz, S.; Cottrell, J.; Chu, T.; Chang, S.L. A Review of Bioinformatics Tools to Understand Acetaminophen-Alcohol Interaction. Medicines 2019, 6, 79.

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