Hepatic injury can have many causes, from drugs and toxins to infection, inflammation, and neoplasia. Any derangement in liver function can result in physiologic and metabolic alterations as well as clinical disease. The pathophysiology of liver insult often involves oxidative and nitrosative stress, which result in part from decreased production of agents that perform antioxidant functions in a healthy liver. For example, glutathione has potent antioxidant activity. It is also critical in the liver's detoxification functions. Glutathione produced by hepatocytes can be used by the liver or can act systemically. A major complication of liver injury is decreased glutathione production. Hepatic glutathione concentrations have been shown to be reduced in dogs and cats with impaired hepatobiliary function; inadequate hepatic glutathione levels can then make the liver more vulnerable to oxidative injury and other cellular damage.
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