Dissecting the molecular pathophysiology of drug-induced liver injury

Figure 2 The Fenton reaction in liver disease. Oxidative stress produces large amounts of reactive compounds and cytotoxic free radicals (H₂O₂, O₂^•- and OH^•). The Fenton reaction generates hydroxyl radicals (OH^•) from hydrogen peroxide (H₂O₂) and superoxide (O₂^•-) catalyzed by iron. This reaction occurs in cells and free radicals can attack the double bonds of non-saturated phospholipids in cell membranes which eventually degrade the structural integrity of cell membranes, impair enzymatic function and cause cross-linking of proteins or strand breaks in DNA. Cells also have an antioxidant enzyme system (catalase, GSH or SOD) is meant to neutralize free radicals and prevent damage.