We appreciate Dr. Fujita's valuable input regarding an animal model of chronic endotoxemia and the role of regulatory T cells (Tregs) in liver disease. Cani and colleagues recently reported that a high-fat diet increases plasma lipopolysaccharide (LPS) level. 1 Chronic infusion of LPS in mice fed a normal diet causes a metabolic response similar to high-fat feeding, including obesity, insulin resistance, and increased liver triglyceride content. In this sense, the high-fat diet mouse model that we use represents a model of chronic endotoxemia. Our acute exogenous LPS experiments merely reflect an exacerbated inflammatory status that helped us to determine the role of Tregs in modulation of hepatic inflammation under a fatty liver condition. 2 Tregs express several members of Toll-like receptors (TLR
AASLD Public Policy Statement Should Be Evidence-BasedTo the Editor:The October 2007 issue of HEPATOLOGY contained the American Association for the Study of Liver Diseases (AASLD) Public Policy statement regarding acetaminophen safety. 1 As the manufacturer of the Tylenol brand of consumer products, McNeil continually strives to collect and evaluate all available data that pertain to acetaminophen safety. However, we have been unable to locate data that would substantiate the following 3 statements made in this position paper:(1) The AASLD position paper states as "fact" on p. 969 that 10% of acute liver failure cases result from therapeutic doses of acetaminophen, which contradicts the statement on p. 967 that the percent is "uncertain" but that it "probably represents 10%". We are unaware of data that support this position statement.(2) The AASLD position paper states that warfarin causes "severe or even fatal liver injury" when combined with acetaminophen. We are unaware of data that support this position statement.(3) The AASLD position paper states that "most hepatologists might dispute" that acetaminophen is the safest over-the-counter analgesic choice. We are unaware of data that support this position statement.We fully understand that editorial articles in scientific journals often do not cite references for all statements and that it is acceptable in editorials to propose opinions and theories that may not necessarily be based on data. The aforementioned article, however, is presented not as an opinion piece, but as the official policy position of the AASLD. We therefore assume that the AASLD possesses the data necessary to support the 3 statements noted above and would be willing to share these data.We therefore respectfully request that the AASLD share the published or unpublished data that support these 3 statements.