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In vitro to in vivo extrapolation represents a critical challenge intoxicology. In this paper we explore extrapolation strategies for acetaminophen(APAP) based on mechanistic models, comparing classical homogeneous compartmentpharmaco-dynamic (PD) models and a multiscale digital twin model resolvingliver microarchitecture at cellular resolution. The models integrate consensusdetoxification reactions in each individual hepatocyte. We study theconsequences of the two model types on the extrapolation and show in whichcases these models perform better than the classical extrapolation strategythat is based either on the maximal drug concentration (Cmax) or the area underthe pharmaco-kinetic curve (AUC) of the drug blood concentration.

In-vitro to in-vivo acetaminophen hepatotoxicity extrapolation using  classical schemes, pharmaco-dynamic models and a multiscale spatial-temporal  liver twin