Universal DNA methylation age across mammalian tissues

Aging, often considered a result of random cellular damage, can be accurately estimated using DNA methylation profiles, the foundation of pan-tissue epigenetic clocks. Here, we demonstrate the development of universal pan-mammalian clocks, using 11,754 methylation arrays from our Mammalian Methylation Consortium, which encompass 59 tissue types across 185 mammalian species. These predictive models estimate mammalian tissue age with high accuracy (r > 0.96). Age deviations correlate with human mortality risk, mouse somatotropic axis mutations and caloric restriction. We identified specific cytosines with methylation levels that change with age across numerous species. These sites, highly enriched in polycomb repressive complex 2-binding locations, are near genes implicated in mammalian development, cancer, obesity and longevity. Our findings offer new evidence suggesting that aging is evolutionarily conserved and intertwined with developmental processes across all mammals.

SARS-CoV-2 Brain Regional Detection, Histopathology, Gene Expression, and Immunomodulatory Changes in Decedents with COVID-19

Brains of 42 COVID-19 decedents and 107 non-COVID-19 controls were studied. RT-PCR screening of 16 regions from 20 COVID-19 autopsies found SARS-CoV-2 E gene viral sequences in 7 regions (2.5% of 320 samples), concentrated in 4/20 subjects (20%). Additional screening of olfactory bulb (OB), amygdala (AMY) and entorhinal area for E, N1, N2, RNA-dependent RNA polymerase, and S gene sequences detected one or more of these in OB in 8/21 subjects (38%). It is uncertain whether these RNA sequences represent viable virus. Significant histopathology was limited to 2/42 cases (4.8%), one with a large acute cerebral infarct and one with hemorrhagic encephalitis. Case-control RNAseq in OB and AMY found more than 5000 and 700 differentially expressed genes, respectively, unrelated to RT-PCR results; these involved immune response, neuronal constituents, and olfactory/taste receptor genes. Olfactory marker protein-1 reduction indicated COVID-19-related loss of OB olfactory mucosa afferents. Iba-1-immunoreactive microglia had reduced area fractions in cerebellar cortex and AMY, and cytokine arrays showed generalized downregulation in AMY and upregulation in blood serum in COVID-19 cases. Although OB is a major brain portal for SARS-CoV-2, COVID-19 brain changes are more likely due to blood-borne immune mediators and trans-synaptic gene expression changes arising from OB deafferentation.

Factors contributing to racial differences in gait mechanics differ by sex

BACKGROUND

Racial differences in gait mechanics have been recently reported, but we don't know what factors may drive differences in gait and whether these factors are innate or modifiable. The answers to those questions will inform both basic research and clinical interventions and outcomes.

RESEARCH QUESTION

Do anthropometric, strength, and health status measures explain racial differences in gait between African Americans (AA) and white Americans (WA)?

METHODS

Venous blood samples, anthropometric measures, lower extremity strength, and an assessment of health status were collected from 92 participants (18-30 years old) as part of an Institutional Review Board-approved study. 3D motion capture and force plate data were recorded during 7 walking trials at set regular (1.35 m/s) and fast (1.6 m/s) speeds. Racial differences in gait were identified at both speeds. Correlations between anthropometric, strength, and health status independent variables and outcome measures were computed after stratifying data by sex. Stepwise linear regression models evaluated whether the inclusion of anthropometric, strength, and health status independent variables explained racial effects.

RESULTS

In males, no racial differences in gait were explained by independent variables. Q-angle and ankle dorsiflexion strength accounted for racial differences in self-selected walking speed in females. Racial differences in ankle plantarflexion angle were explained by ankle plantarflexion strength differences.

SIGNIFICANCE

Factors that explain racial differences in gait in females were both innate and modifiable. These data make clear that it is important to include racially diverse normative gait databases in research studies. These results also identify potential intervention targets aimed at reducing racial health disparities.

[Imaging of oligometastatic disease in selected urologic cancers]

BACKGROUND

Local treatment of the primary or metastatic sites in urologic malignancies is promising when compared to systemic therapy alone, leading to the definition of a potentially curative oligometastatic state.

OBJECTIVES

Comparison of imaging modalities regarding local and metastatic tumor sites in urologic cancers.

METHODS

Review of comparative trials addressing quality criteria of imaging modalities.

RESULTS

Depending on primary tumor and metastatic site, conventional imaging modalities such as computer tomography (CT) and bone scintigraphy still represent the standard of care in Germany. Due to superior quality criteria, hybrid-imaging techniques were widely adopted for oncological staging and particular due to the new PSMA-ligand (PSMA-PET/CT) in prostate cancer imaging. The development of new radioisotopes as well as their clinical application remains a focus of current research.

CONCLUSIONS

High-quality diagnostic imaging modalities lay the groundwork for a precise definition of an oligometastatic state. By enabling treatment of the entire tumor burden, a delay of systemic therapy, longer progression-free survival, or even curative treatment may become achievable.

Increased Risk of Autopsy-Proven Pneumonia with Sex, Season and Neurodegenerative Disease

There has been a markedly renewed interest in factors associated with pneumonia, a leading cause of death worldwide, due to its frequent concurrence with pandemics of influenza and Covid-19 disease. Reported predisposing factors to both bacterial pneumonia and pandemic viral lower respiratory infections are wintertime occurrence, older age, obesity, pre-existing cardiopulmonary conditions and diabetes. Also implicated are age-related neurodegenerative diseases that cause parkinsonism and dementia. We investigated the prevalence of autopsy-proven pneumonia in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), a longitudinal clinicopathological study, between the years 2006 and 2019 and before the beginning of the Covid-19 pandemic. Of 691 subjects dying at advanced ages (mean 83.4), pneumonia was diagnosed postmortem in 343 (49.6%). There were 185 subjects without dementia or parkinsonism while clinicopathological diagnoses for the other subjects included 319 with Alzheimer's disease dementia, 127 with idiopathic Parkinson's disease, 72 with dementia with Lewy bodies, 49 with progressive supranuclear palsy and 78 with vascular dementia. Subjects with one or more of these neurodegenerative diseases all had higher pneumonia rates, ranging between 50 and 61%, as compared to those without dementia or parkinsonism (40%). In multivariable logistic regression models, male sex and a non-summer death both had independent contributions (ORs of 1.67 and 1.53) towards the presence of pneumonia at autopsy while the absence of parkinsonism or dementia was a significant negative predictor of pneumonia (OR 0.54). Male sex, dementia and parkinsonism may also be risk factors for Covid-19 pneumonia. The apolipoprotein E4 allele, as well as obesity, chronic obstructive pulmonary disease, diabetes, hypertension, congestive heart failure, cardiomegaly and cigarette smoking history, were not significantly associated with pneumonia, in contradistinction to what has been reported for Covid-19 disease.

Prognostic impact of gross tumor volume during radical radiochemotherapy of locally advanced non-small cell lung cancer-results from the NCT03055715 multicenter cohort study of the Young DEGRO Trial Group

BACKGROUND

In radical radiochemotherapy (RCT) of inoperable non-small-cell lung cancer (NSCLC) typical prognostic factors include T- and N-stage, while there are still conflicting data on the prognostic relevance of gross tumor volume (GTV) and particularly its changes during RCT. The NCT03055715 study of the Young DEGRO working group of the German Society of Radiation Oncology (DEGRO) evaluated the prognostic impact of GTV and its changes during RCT.

METHODS

A total of 21 university centers for radiation oncology from five different European countries (Germany, Switzerland, Spain, Belgium, and Austria) participated in the study which evaluated n = 347 patients with confirmed (biopsy) inoperable NSCLC in UICC stage III A/B who received radical curative-intent RCT between 2010 and 2013. Patient and disease data were collected anonymously via electronic case report forms and entered into the multi-institutional RadPlanBio platform for central data analysis. GTV before RCT (initial planning CT, GTV1) and at 40-50 Gy (re-planning CT for radiation boost, GTV2) was delineated. Absolute GTV before/during RCT and relative GTV changes were correlated with overall survival as the primary endpoint. Hazard ratios (HR) of survival analysis were estimated by means of adjusted Cox regression models.

RESULTS

GTV1 was found to have a mean of 154.4 ml (95%CI: 1.5-877) and GTV2 of 106.2 ml (95% CI: 0.5-589.5), resulting in an estimated reduction of 48.2 ml (p < 0.001). Median overall survival (OS) was 18.8 months with a median of 22.1, 20.9, and 12.6 months for patients with high, intermediate, and low GTV before RT. Considering all patients, in one survival model of overall mortality, GTV2 (2.75 (1.12-6.75, p = 0.03) was found to be a stronger survival predictor than GTV1 (1.34 (0.9-2, p > 0.05). In patients with available data on both GTV1 and GTV2, absolute GTV1 before RT was not significantly associated with survival (HR 0-69, 0.32-1.49, p > 0.05) but GTV2 significantly predicted OS in a model adjusted for age, T stage, and chemotherapy, with an HR of 3.7 (1.01-13.53, p = 0.04) per 300 ml. The absolute decrease from GTV1 to GTV2 was correlated to survival, where every decrease by 50 ml reduced the HR by 0.8 (CI 0.64-0.99, p = 0.04). There was no evidence for a survival effect of the relative change between GTV1 and GTV2.

CONCLUSION

Our results indicate that independently of T stage, the re-planning GTV during RCT is a significant and superior survival predictor compared to baseline GTV before RT. Patients with a high absolute (rather than relative) change in GTV during RT show a superior survival outcome after RCT.

P05.07 Effect of Tumor-Treating Fields plus Short-Course Radiation with or without Temozolomide in Elderly Patients with Glioblastoma (GERAS Trial)

BACKGROUND

Despite advances in the therapy of glioblastomas (GBM) in the last decades, the most common malignancy of glial origin is still associated with poor prognosis. At present, maximal safe resection followed by adjuvant chemoradiotherapy (CRT) with temozolomide (TMZ) is the standard of care. After completion of CRT, patients usually receive 6 maintenance cycles of TMZ that may be complemented by Tumor-Treating Fields (TTFields). Regardless of age and other prognostic factors, the recent EF-14 trial has shown that addition of TTFields to the maintenance therapy significantly increases overall survival in all patient subgroups. In the EF-14 trial, TTFields were used during maintenance therapy, however a potential benefit of concomitant TTFields therapy during CRT remains unclear. In elderly patients aged >65–70 years, depending on performance status, hypofractionated (chemo)radiotherapy with or without TMZ is the recommended treatment.The primary aim of the GERAS trials is to investigate the optimal time point to start TTFields therapy in elderly patients, as well as feasibility and safety of treatment with the TTFields device in elderly patients with newly diagnosed glioblastoma during hypofractionated (chemo)radiotherapy. Secondary endpoints include progression-free survival at 6 months, overall survival and quality of life during combined treatment.

MATERIAL AND METHODS

The GERAS trial is a single centre, randomized, two-arm, phase I/II trial that will recruit a total of 64 patients. Patients undergo stratified randomization into treatment arm A or control arm B.Patients in arm A start TTFields therapy at the beginning of hypofractionated radiotherapy with or without TMZ and continue treatment during maintenance chemotherapy. Patients in arm B receive hypofractionated radiotherapy with or without TMZ and begin TTFields therapy together with maintenance chemotherapy. Patients in both arms will be trained in using the TTFields device by certified device support specialists. Follow-up includes MRI imaging four weeks after (chemo)radiotherapy and then every 12 weeks as well as regular lab testing according to the current standard of care. Patients will be assessed for neurological status, neurocognitive function, compliance with TTFields therapy and adverse events during, four weeks after (C)RT and then every 12 weeks for up to 52 weeks.

RESULTS

Not applicable due to ongoing trial.

CONCLUSION

With TTFields, a new element in the maintenance therapy of glioblastomas has found its way into clinical routine. The GERAS trial aims to determine the optimal time point to start TTFields therapy as well as the safety and feasibility of concomitant TTFields- and hypofractionated (C)RT in elderly patients. This may lead the way for further phase II/III trials that evaluate survival benefits in this subpopulation of elderly patients treated with hypofractionated (C)RT.

Gender and limb differences in temporal gait parameters and gait variability in ankle osteoarthritis

BACKGROUND

The effects of ankle osteoarthritis on gait are noticeable in the clinic, but are difficult to quantify and score without detailed kinematic and kinetic analysis. Evaluationof temporal gait parameters and gait variability is a potential alternative.

RESEARCH QUESTION

This study aimed to determine associations between limb and gender with temporal gait parameters and gait variability in ankle OA patients to evaluate the utility of these parameters for gait assessment in a clinical setting.

METHODS

Following informed consent, 242 end-stage unilateral ankle OA patients walked at self-selected speed across force plates. Means and stride-to-stride standard deviations (SD) of stride, swing, stance, and double support times were determined for each patient. Limb x Gender ANCOVA models co-varying for walking speed were run for swing and stance times, while stride and double support times were only compared between genders. Statistical analysis was performed in SPSS (α = 0.05).

RESULTS

Walking speed affected all measures of interest. After adjusting for walking speed, mean stride time, stride time SD, and stance time SD were 3.5%, 67% and 29% higher among women than men (p = 0.002, 0.035 and 0.02 respectively). Swing time was 12% higher and stance time was 6% lower on the affected side compared to the unaffected side (p < 0.001 for both).

SIGNIFICANCE

Women have longer stride times and higher variability, which may indicate higher fall risk. Both genders minimized loading on the affected limb by increasing swing time and reducing stance time on the affected side. Simple, easy to record temporal gait patterns can provide useful insight into gait abnormalities in patients with ankle OA.

Interoperability and HealthGRID

Objectives: GRID technology, with initiatives like the GGF, will have the potential to allow both competition and interoperability not only among applications and toolkits, but also among implementations of key services.

The pyramid of eHealth interoperability should be achieved from standards in communication and data security, storage and processing, to the policy initiatives, including organizational protocols, financing procedures, and legal framework.

The open challenges for GRID use in clinical fields illustrate the potential of the combination of grid technologies with medical routine into a wider inter-operable framework.

Methods: The Telemedicine Alliance is a consortium (ESA, WHO and ITU), initiated in 2002, in building a vision for the provision of eHealth to European citizens by 2010. After a survey with more that 50 interviews of experts, interoperability was identified as the main showstopper to eHealth implementation.

Results: There are already several groups and organizations contributing to standardization. TM-Alliance is supporting the “e-Health Standardization Coordination Group” (eHSCG).

Conclusions: It is now, in the design and development phase of GRID technology in Health, the right moment to act with the aim of achieving an interoperable and open framework. The Health area should benefit from the initiatives started at the GGF in terms of global architecture and services definitions, as well as from the security and other web services applications developed under the Internet umbrella. There is a risk that existing important results of the standardization efforts in this area are not taken up simply because they are not always known.

Which pre-hospital triage parameters indicate a need for immediate evaluation and treatment of severely injured patients in the resuscitation area?

PURPOSE

To find ways to reduce the rate of over-triage without drastically increasing the rate of under-triage, we applied a current guideline and identified relevant pre-hospital triage predictors that indicate the need for immediate evaluation and treatment of severely injured patients in the resuscitation area.

METHODS

Data for adult trauma patients admitted to our level-1 trauma centre in a one year period were collected. Outpatients were excluded. Correct triage for trauma team activation was identified for patients with an ISS or NISS ≥ 16 or the need for ICU treatment due to trauma sequelae. In this retrospective analysis, patients were assigned to trauma team activation according to the S3 guideline of the German Trauma Society. This assignment was compared to the actual need for activation as defined above. 13 potential predictors were retained. The relevance of the predictors was assessed and 14 models of interest were considered. The performance of these potential triage models to predict the need for trauma team activation was evaluated with leave-one-out cross-validated Brier and logarithmic scores.

RESULTS

A total of 1934 inpatients ≥ 16 years were admitted to our trauma department (mean age 48 ± 22 years, 38% female). Sixty-nine per cent (n = 1341) were allocated to the emergency department and 31% (n = 593) were treated in the resuscitation room. The median ISS was 4 (IQR 7) points and the median NISS 4 (IQR 6) points. The mortality rate was 3.5% (n = 67) corresponding to a standardized mortality ratio of 0.73. Under-triage occurred in 1.3% (26/1934) and over-triage in 18% (349/1934). A model with eight predictors was finally selected with under-triage rate of 3.3% (63/1934) and over-triage rate of 10.8% (204/1934).

CONCLUSION

The trauma team activation criteria could be reduced to eight predictors without losing its predictive performance. Non-relevant parameters such as EMS provider judgement, endotracheal intubation, suspected paralysis, the presence of burned body surface of > 20% and suspected fractures of two proximal long bones could be excluded for full trauma team activation. The fact that the emergency physicians did a better job in reducing under-triage compared to our final triage model suggests that other variables not present in the S3 guideline may be relevant for prediction.

Incidence and prevention of infective endocarditis and bacteraemia after transcatheter aortic valve implantation in a French university hospital: a retrospective study

Infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI) is a rare but severe complication. Among 326 patients who underwent TAVI at Grenoble Alpes University Hospital, six (1.8%) cases of IE and 11 (3.4%) cases of bacteraemia were identified. No cases of IE were linked to the intervention; one was due to Staphylococcus aureus despite a screening and targeted decolonization strategy. This underscores the need for randomized studies to evaluate the benefit and cost-effectiveness of this policy.

[Long term results of a series of cementless total hip prostheses on patients of less than 50 years old]

Since 1974, we have more than 20 years experience with cementless rehabitable total hip arthroplasty.The purpose of this work is a long term study of development of this type of fixation about a personal series of 83 hips which benefitted from this type of arthroplasty before 50 years old between 1974 and 1980.

MATERIAL AND METHODS

The implants used are among the oldest. On the acetabular side, we used the BG spiked acetabular component (Fig. 1), containing 4 teeth for primary fixation, 3 equatorial armatures and a surface treatment. This metal back in two sizes 50 and 54 mm, initially permitted the insertion of a polyethylen insert of an interior diameter of 32 mm with a peripheric thickness of 5.5 mm; since 1979, the insert had a 22.2 mm diameter, assuring 10 mm minimal thickness of. The femoral implant (Fig. 2) for 62 hips was the Huchet prothesis, then in 16 cases, the minimadreporic prothesis composed of a morse cone and a head of 22.2, the Huchet prothesis was one-piece femoral implant.The dominant etiology was coxarthrosis (56 cases) of which 50 % had major dysplasis. The average age at the time of the intervention was 41 years old (18-50 years), the follow-up of this series is 17 years, and 8 months (15-21 years). Resumption of former activities was the rule.Results of the rehabitable pro thesis up to 12.31.1995: Of the 83 cases, the outcome of 55 of them (66.3%) is known : 49 (59%) were examined for this study; the evolution has been documented; 28 (33.7%) were uncontactable, 6 patients (7.3%) were deceased between 8 and 9 years following the operation, without having had the hip revised.Among the 49 protheses which were evaluated, 22 (44.9%) have not been revised to date. Clinically, the function is normal and there are no radiological signs of attrition of the insert or mobilisation of implants. There are 10 Huchet Protheses and 12 minimadreporic protheses in this group. The average age at the time of the intervention was 42 years old (30-50 years old), the follow-up was 16 years and 7 months (15-19 years) (Fig. 3a-d).27 hips (51%) needed to be revised, but the causes of reoperationn include different reasons tied to the failure of biological fixation but particularly to errors in the initial concept of the Huchet prothesis.Reoperation linked to the failure of the biological fixation: Out of 7 acetabular implant reoperations, one was carried out systematically on a cup which was perfectly bone-integrated during the changing of a femoral component, 3 were necessary due to perforation (attrition of the insert). Only 3 acetabular implants (6.1%) required reoperation for symptomatic loosening.Four femoral implants (8.6%) have been taken out because of failure of biological fixation between 2 and 11 years follow-up. Finally, for one patient the persistance of the incapacitating crural pain which lasted for more than one year led to the removal of the femoral stem, nevertheless perfectly integrated.Reoperation linked to the concept of the Huchet prothesis: These were undertaken in two sets of circumstances.Changing only the polyethylene insert was only called for in the Huchet prosthesis and concerned 18 hips (36.7%); the delay to reoperation varied from 11 to 18 years with an average of 14 years delay. Changing of the insert had a simple short post-operative outcome and functional recuperation was between 6 and 8 weeks (Fig. 4a-c).Removal for perforative attrition of polyethylene insert causing metal-to-metal wear between head and metal back. Five Huchet prostheses are included in this group, with an average delay to reoperation of 16 years and 3 months (14-19 years).

COMMENTS

This retrospective study with a 66.3 % rate of re-examination permits three types of comments.The principal cause of revision (23 cases), is linked to polyethylene attrition and is only found in the group with Huchet prosthesis. More than the quality of the polyethylene used at this time, it is its thickness in contact with a 32 mm head which led to the complete removal of the prosthesis in 10.2% of the cases.The second comment argues for the modularisation of the femoral implant. The presence of a stem with a cone and a removable head would have avoided the removal of 5 perfectly bone-integrated femoral implants. Certainly, the literature demonstrates the risk of corrosion generated by the morse cone but it is up to the manufacturers to improve their procedures.Finally, the third comment concerns the current state of the long term of the biological fixation by rehabilitation with surface treatment. With 17 years 8 months follow-up (15-21 years), 81.6% of components are still fixed, the real failure of the bony ingrowth of 10.2% is comparable to the rate of failure in long term follow-up of totally cemented prothesis found in young subjects.

CONCLUSION

With more than 20 years follow-up for the older cases, the concept of the biological fixation of an implant by bony ingrowth using surface treatment seems to be very reliable.The experience of this long term study argues for the thickness of polyethylene to be at least 10 mm for all metal back acetabular component and the future of this kind of implant seems to lie in modularisation made possible by the morse cone which would allow the replacement of the bearing surfaces.

Padrões de deslocamento de bovinos em pastos de capim-quicuiu sob lotação intermitente

RESUMO O objetivo deste trabalho foi avaliar o padrão de deslocamento de bovinos em pastos de capim-quicuiu submetidos a diferentes alturas de entrada (10, 15, 20 e 25cm) e mesma proporção de rebaixamento (redução em 50% da altura inicial). O padrão de exploração das estações alimentares foi avaliado com base na observação direta de dois animais (1/observador) por unidade experimental, com concomitante registro de códigos em gravadores de voz dos passos, bocados e outras atividades. As avaliações foram realizadas duas vezes por dia (10 e 15h) durante uma hora, no primeiro e no último dia do período de ocupação dos piquetes. Adicionalmente, foram realizadas avaliações em pré e pós-pastejo da massa de forragem, massa de lâminas foliares e altura do perfilho e da bainha estendida. O experimento foi conduzido de acordo com um delineamento em blocos completos ao acaso, com quatro tratamento e três repetições. Durante a fase inicial de rebaixamento, as variáveis passos por minuto, número de bocados por estação alimentar e taxa de bocados foram maiores nos pastos mais baixos, reduzindo com o aumento da altura em pré-pastejo, sem diferenças significativas durante a fase final de rebaixamento. Ocorrem variações no padrão de deslocamento dos animais em pastos de capim-quicuiu durante a fase inicial de rebaixamento, quando alturas entre 20-25cm apresentam melhores condições para o processo de forrageamento. O rebaixamento em 50% da altura inicial interfere negativamente no padrão de deslocamento dos animais, independentemente das metas de altura em pré-pastejo utilizadas.

Assessment of the Systemic Effects, Primary Dermal Irritation, and Ocular Irritation of Chlorhexidine Acetate Solutions

The biologic effects of various chlorhexidine acetate (ClAc) solutions containing isopropyl alcohol, Synperonic NP8, and carmoisin were evaluated (1) following intraperitoneal (IP) administration in rats for 5 consecutive days followed by a 5-day recovery period, (2) by measuring the primary irritation of the skin by a patch-test technique on intact and abraded skin of rabbits, and (3) following instillation into the eyes or rabbits followed by washing 50% of the treated eyes with lukewarm water in order to evaluate ocular irritation. Physiologic saline solution served as the control article throughout the studies. There was a high incidence of deaths (i.e., 28/32 and 11/16 for ClAc solutions with and without Synperonic NP8, respectively) among rats receiving IP treatment at a dosage of 40 ml/kg per day for 5 consecutive days. No toxicologically significant treatment-related changes were observed in rats treated IP with either surfactant or isopropyl alcohol with Synperonic NP8. Toxicity of ClAc solution appears to be due to a chemically induced peritonitis with no evidence of systemic toxicity. ClAc solution or the respective surfactants elicited either no reaction or a mild dermal irritation in the rabbit. Likewise, ClAc solution with or without Synperonic NP8 and the three respective surfactants did not cause any significant ocular irritation changes that are considered of toxicologic significance. It is concluded that (1) the multiple IP administration of ClAc solution elicited a toxic response in rats, and thus, caution must be exercised when the solution is used for the purposes of peritoneal lavage, and (2) ClAc solution is a mild dermal and ocular irritant in the rabbit.

Toxicological Evaluation of β-Caryophyllene Oil: Subchronic Toxicity in Rats

In a subchronic toxicity study, administration of β-caryophyllene (BCP) oil by oral gavage to Wistar rats at dosages of 0, 150, 450, or 700 mg/kg/d for 90 days, including a 21-day recovery period, did not produce any significant toxicologic manifestations. The study design also included a 28-day interim sacrifice in the control and high-dose groups. The BCP oil test article was well tolerated as evidenced by the absence of major treatment-related changes in the general condition and appearance of the rats, neurobehavioral end points, growth, feed and water intake, ophthalmoscopic examinations, routine hematology and clinical chemistry parameters, urinalysis, and necropsy findings. The no observed adverse effect level was the highest dosage level administered of 700 mg/kg body weight/d for both male and female rats. The study was conducted as part of an investigation to examine the safety of BCP oil for its proposed use in medical food products.