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From a mechanistic perspective, these outcomes are mediated by multi-system endocrine adaptations, including suppression of the HPG axis, alterations in insulin and glucose-regulating hormones, reduced triiodothyronine (T3), elevated cortisol, and disruptions in growth hormone (GH) and insulin-like growth factor 1 (IGF-1) signaling [92]

Livers from patients, who overdosed on acetaminophen, exhibit upregulation of ABCC1 and ABCC4 mRNAs and elevated protein levels of ABCB1, ABCG2, ABCC4 and ABCC5

These substances are electrophiles and form conjugates with GSH, either spontaneously or enzymatically, in reactions catalyzed by GSH- S -transferases (GST) [22]