Although the complex processes which accompany oxidative stress result in damage to many cell components, peroxidative decomposition of membrane lipids and the associated changes in bulk membrane properties have frequently been considered as the basis of cell injury.This idea was put forth in early studies of carbon tetrachloride (CCL)-and ethanol-associated hepatotoxicity (1, 2) and has persisted because lipid peroxidation provides a logical link between free radical-initiated processes and associated cellular membrane dysfunction and because lipid peroxidation occurs in the progression of cellular injury from many diverse hepatotoxins. Yet, while the chemistry of lipid peroxidation is well known with regard to the potential mechanisms for radical formation (3, 4), the sequences of reactions involved in the formation of endproducts (5, 6) and the cellular defenses against such injury (3, 7, 81, controversy remains as to the significance of lipid peroxidation in oxidative cell injury and death (5, 6, 9, 10).Much of this controversy can be attributed to methodological difficulties in defining the critical irreversible steps in oxidative injury and in accurately quantitating the species and rates of reactions involved in intact tissues. While considerable evidence exists to show that lipid peroxidation increases in the oxidatively stressed cell (lo), it is not known whether the associated changes in cellular properties are necessary for or of a sufficient magnitude to cause cell injury. Lipid peroxidation which occurs after cell death is not easily distinguished from that which may be causally related to cell injury. Moreover, the radical processes which initiate lipid peroxidation also cause direct damage to other macromolecules, including damage to proteins, nucleic acids and carbohydrates, and these processes may be more important in cell injury than the peroxidation of lipids (11).In this review, we consider some of the methodological difficulties which limit the ability to discern a causal role for lipid peroxidation in toxic cell injury. With these in mind, we suggest that lipid peroxidation may be more important in modulating the extent of free radical-induced injury than in directly causing injury. This possibility is discussed in terms of a variety of toxins which are thought to cause hepatocellular injury by oxidative mechanisms.
DETECTION OF LIPID PEROXIDATIONSDelineation of the oxidative processes in cells that lead to lipid peroxidation and cell injury is complicated because multiple, short-lived reactive species are involved (organic radicals and reactive oxygen species) (3, 12), cells have powerful antioxidant systems (7,8) and assays are indirect and nonspecific (10). Considerable data are available on radical formation and the initiation of lipid peroxidation in pure chemical systems and in uitm systems with purified enzymes and isolated organelles (13). The short half-lives of reactive species, such as the hydroxyl radical, can preclude their detection in more complex systems such as cells, perfu...