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In addition, hepatocytes have the ability to induce innate and adaptive immune defenses to dampen the inflammatory response during necrosis.11 It has been suggested that perhaps the role of the innate immune system, as mediated by the natural killer (NK) and natural killer T cells (NKT) which are abundant in hepatocytes, is to cause the release of pro-inflammatory cytokines and chemokines that enhance hepatocellular cytotoxicity.15 Damage-associated molecular pattern (DAMP) species released into the circulation, such as nuclear fragments and mitochondrial DNA (mtDNA), appear to recruit inflammatory cells via the innate immune system as the livers attempt to remove necrotic cell debris and promote the livers recovery phase.12,16 APAP-induced cell death of hepatocytes takes on the characteristic changes of necrosis