The mechanism underlying acetaminophen-induced hepatotoxicity in humans and mice involves mitochondrial damage and nuclear DNA fragmentation.

By Mitch McGill, M. Sharpe, David Williams, M. Taha, Steven C. Curry, H. Jaeschke, C. Williams. Journal of Clinical Investigation, 2012

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Mechanisms of acetaminophen-induced liver injury and its implications for therapeutic interventions (2018, background): “The p53 tumor suppressor protein plays a crucial role in modulation of cell cycle, apoptosis, senescence and metabolism in response to diverse stimuli such as cellular stress and DNA damage [65].”
Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update (2016, background): “The highest activity of GDH in plasma has been found in patients with markedly elevated ALT levels emanating from zone 3 of the liver, where GDH is most highly expressed and where APAP is known to case the greatest extent of liver injury.(12) Moreover, the time course of the release of GDH and mtDNA”