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All are PLP-containing enzymes and include (1) the cytosolic enzymes kynureninase, GTK/KAT I, cytosolic aspartate aminotransferase (cytAspAT), glutamine transaminase L (GTL)/KAT III, alanine aminotransferase (AlaAT), and cytosolic branched-chain aminotransferase (BCAT c ) and (2) the mitochondrial enzymes mitochondrial aspartate aminotransferase (mitAspAT), mitochondrial branched-chain aminotransferase (BCAT m ), alanine-glyoxylate aminotransferase isozyme II (AGAT II), and GABA aminotransferase (reviewed by Cooper and Pinto, 2006, Cooper and Pinto, 2008, Cooper et al., 2011)
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As a result, hepatocellular supplies of glutathione become exhausted and NAPQI is free to react with cellular membrane molecules, resulting in widespread hepatocyte damage and death, leading to acute hepatic necrosis