Paracetamol is one of the most popular and widely used
analgesic and
antipyretic agents, but an overdose can cause hepatotoxicity and lead to
acute liver failure.
Aliskiren directly inhibits
renin which downregulates the renin-angiotensin-aldosterone system (RAAS). Recent findings suggest that RAAS system takes part in the pathogenesis of
liver fibrosis. We aimed to reveal the relationship between hepatotoxicity and the RAAS by examining
paracetamol induced hepatotoxicity. Rats were separated into five groups as follows: control, 100 mg/kg
aliskiren (p.o.), 2 g/kg
paracetamol (per os (p.o.)), 2 g/kg paracetamol + 50mg/kg
aliskiren (p.o.), and 2 g/kg paracetamol + 100 mg/kg
aliskiren(p.o.). Samples were analyzed at the biochemical, molecular, and histopathological levels.
Paracetamol toxicity increased
alanine aminotransferases (ALT),
aspartate aminotransferases (AST),
renin, and
angiotensin II levels in the serum samples. In addition, the SOD activity and
glutathione (GSH) levels decreased while Lipid Peroxidation (MDA) levels increased in the livers of the rats treated with
paracetamol.
Paracetamol toxicity caused a significant increase in TNF-α and TGF-β. Both
aliskiren doses showed an improvement in ALT, AST, oxidative parameters,
angiotensin II, and inflammatory
cytokines. Only
renin levels increased in
aliskiren treatment groups due to its pharmacological effect. A histopathological examination of the liver showed that
aliskiren administration ameliorated the
paracetamol-induced liver damage. In immunohistochemical staining, the expression of TNF-α in the cytoplasm of the hepatocytes was increased in the
paracetamol group but not in other treatment groups when compared to the control group. In light of these observations, we suggest that the therapeutic administration of
aliskiren prevented oxidative stress and
cytokine changes and also protected liver tissues during
paracetamol toxicity by inhibiting the RAAS.