Drug distribution studies in tissue are crucial for understanding
the pharmacokinetics and potential toxicity of drugs. Recently, matrix-assisted
laser desorption ionization-mass spectrometry imaging (MALDI-MSI)
has gained attention for drug distribution studies due to its high
sensitivity, label-free nature, and ability to distinguish between
parent drugs, their metabolites, and endogenous molecules. Despite
these advantages, achieving high spatial resolution in drug imaging
is challenging. Importantly, many drugs and metabolites are rarely
detectable by conventional vacuum MALDI-MSI because of their poor
ionization efficiency. It has been reported that acetaminophen (APAP)
and one of its major metabolites, APAP-Cysteine (APAP-CYS), cannot
be detected by vacuum MALDI-MSI without derivatization. In this context,
we showed the distribution of both APAP and APAP-CYS in kidneys at
high spatial resolution (25 and 10 μm) by employing an atmospheric
pressure-MALDI imaging mass microscope without derivatization. APAP
was highly accumulated in the renal pelvis 1 h after drug administration,
while APAP-CYS exhibited characteristic distributions in the outer
medulla and renal pelvis at both 30 min and 1 h after administration.
Interestingly, cluster-like distributions of APAP and APAP-CYS were
observed in the renal pelvis at 10 μm spatial resolution. Additionally,
a novel APAP metabolite, tentatively coined as APAP-butyl sulfate
(APAP-BS), was identified in the kidney, brain, and liver by combining
MSI and tandem MSI. For the first time, our study revealed differential
distributions of APAP, APAP-CYS (in kidneys), and APAP-BS (in kidney,
brain, and liver) and is believed to enhance the understanding of
the pharmacokinetics and potential nephrotoxicity of this drug.