Asthma And Acetaminophen

It came to my attention in a Dec. 19, 2011, New York Times article that there is a circumstantial link between asthma and increased used of acetaminophen. An interesting issue that the article raised seems to be depletion of glutathione. Based on work that my group at Allergan and our collaborators conducted some years ago (Exp. Eye Res. 1997,64, 767; Chem. Res. Toxicol.,DOI: 10.1021/tx9700735) as well as earlier work with amodiaquine, an antimalarial agent, and urushiol, an agent isolated from poison ivy that induces allergies, this is actually an expected observation.

We demonstrated that hydroquinone-like structures including p-aminoclonidine undergo a facile oxidation to a quinonelike structure and then add glutathione, thus depleting that compound. That is the same mechanism of induction of allergy found for both amodiaquine and urushiol—similar hydroquinone-like structures. Acetaminophen, a hydroquinone-like structure, probably undergoes a similar oxidation and is then rendered reactive to nucleophiles, including glutathione. This line of work is worth pursuing.

By Stephen A. Munk
CEO and president Ash Stevens Inc.