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Upon entering liver hepatocytes, much of the acetaminophen is conjugated to sulfate by SULTs or to glycogen-derived sugars by UDP-glucuronyltransferase and exported by multidrug resistance (MDR) or ATP-binding cassette (ABC) organic ion transporters, thereby removing oxidized sulfur and depleting energetic resources (glycogen) (56)

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These mechanisms involve the gut flora, dysregulation of calcium signaling, mitochondrial dysfunction and oxidative stress, and pathological alterations in Tau proteins (Fesharaki-Zadeh and Datta, 2024)