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In both rats and humans administered APAP, the endogenous quantities of p -cresol sulfate in the urine were correlated with liver effects (rat)37 and the APAP-sulfate/APAP-glucuronide ratio (humans),38 directly leading to the concept of pharmacometabonomics.37,38 Similarly, urinary concentrations of p -cresol and p -cresol sulfate have been found to be elevated in children with autism39 and when the urinary APAP-sulfate/APAP-glucuronide ratio was determined for 20 low functioning autistic children receiving the drug it was found to be significantly lower than for the controls.40 The prediction of acute APAP-induced liver injury in humans, and consequent treatment needs or patient outcomes during hepatotoxicity remains difficult

Proc Natl Acad Sci USA 104:1441814423 Ramirez-Barbieri G, Moskowitzova K, Shin B, Blitzer D, Orfany A, Guariento A, Iken K, Friehs I, Zurakowski D, Del Nido PJ et al (2019) Alloreactivity and allorecognition of syngeneic and allogeneic mitochondria

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