The use of decision-theoretic approach in regulating toxicity

This paper presents a general decision model for quantitative risk analysis to help in solving the problem of setting the optimal exposure level of a potential carcinogen in regulatory decision-making. This model consists of a probability function and two loss functions. The probability function describes the dose-response relationship for a potential carcinogen at various exposure levels. The two loss functions include the cost of using a potential carcinogen, e.g., health loss, and the cost of not using the compound, e.g., economic loss. Using the principle of minimum expected loss, a fundamental formula for setting the optimal beneficial dose level is derived. The formula equates the probability function to a ratio of loss functions. The general form of loss functions is described in the paper. Under certain conditions, the current approach for quantitative risk assessment is a special situation of this general model.

Evidence that cholesteryl ester hydrolase and triglyceride lipase are different enzymes in rat liver

Studies on intracellular cholesteryl ester hydrolase (CEH) and triglyceride lipase (TGL) from rat adipose tissue and adrenal cortex have suggested that a single protein is responsible for both activities. To determine whether one hepatic protein catalyzes both reactions, we studied several properties of CEH and TGL in rat liver. During liver perfusion with heparin, perfusate peaks of TGL and CEH did not consistently coincide, and TGL activity was considerably higher and less heat-stable than that of CEH. Significant TGL, but not CEH, activity was released during incubation of isolated hepatocytes. Although microsomes isolated from hepatocytes contained both activities, the specific activities of CEH and TGL in cytosol from hepatocytes were 95% and 3%, respectively, of those found in cytosol from whole liver. Preincubation of liver cytosol with 5 mM Mg2+ decreased CEH, but not TGL, activity. Intracellular CEH and TGL activities were completely separated by prep-disc gel electrophoresis. Finally, both cytosolic and microsomal TGL, but not CEH, activities were inhibited by antiserum against rat hepatic TGL. We conclude that extracellular TGL does not have CEH activity and intracellular CEH differs from TGL.

Effect of large-dose progesterone on plasma levels of lipids, lipoproteins and apolipoproteins in males

Eleven men with sexual deviation syndrome were hospitalized for treatment with medroxyprogesterone acetate (Depo-provera). Plasma total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, apo A-I and LDL apo B were measured before and during Depo-provera treatment. Ten normolipidemic and one mildly hypertriglyceridemic patient with 117 +/- 17% ideal body weight were maintained on a regular hospital diet before and during the study. They received an average total dose of 1273 +/- 467 mg Depo-provera by im injections over a mean period of 17 +/- 6 days. In the whole group, Depo-provera significantly reduced the plasma total cholesterol by 12% (p less than 0.0005), triglycerides by 24% (p less than 0.005), LDL cholesterol by 13% (p less than 0.01), LDL apo B by 15% (p less than 0.05), and apo A-I by 7% (p less than 0.05). Total HDL cholesterol, HDL2 cholesterol and HDL3 cholesterol did not change significantly. Excluding from the data analysis a normolipidemic patient who had a significant weight loss during the study and the hypertriglyceridemic patient, the fall in apo A-I during Depo-provera treatment was no longer statistically significant. We conclude that short-term, pharmacological doses of progesterone significantly reduce plasma concentrations of cholesterol, triglycerides, LDL cholesterol, and LDL apo B in men.

Discordant hypothyroxinemia and hypertriiodothyroninemia in treated patients with hyperthyroid Graves' disease

Hypothyroxinemia and hypertriiodothyroninemia may occur in the course of antithyroid drug or 131I treatment for hyperthyroid Graves' disease. To determine the frequency of combined high serum T3 and low serum T4 concentrations during such treatment and to assess the clinical significance of its recognition, we reviewed 60 patients treated for hyperthyroid Graves' disease with antithyroid drugs (n = 43) or radioactive iodine (n = 17). Six of these patients (10%) were found to have high serum T3 and low serum T4 concentrations during therapy. Four were receiving antithyroid drugs, and 2 had received radioactive iodine. At the time this abnormality occurred, 4 patients were euthyroid, 1 was hypothyroid, and 1 was hyperthyroid. The serum TSH concentration was increased in 2, at the upper limit of normal in 1, and undetectable in 3 patients. In 2 clinically euthyroid patients, these biochemical findings resolved spontaneously. After discontinuation or reduction in the dose of antithyroid drug, clinical and chemical euthyroidism was restored in 2 additional patients with previously elevated TSH levels. In 2 patients, both of whom previously had undetectable serum TSH levels, clinical hyperthyroidism persisted or recurred, and additional therapy was required. No patient developed permanent hypothyroidism during the period of follow-up (1-22 months). An additional 19 of the 60 patients (32%) had an elevated serum T3 level with a normal serum T4 concentration during the course of follow-up. Among these 19 patients, the magnitude of serum T3 elevation was not different between clinically euthyroid (n = 13) and hyperthyroid (n = 6) patients. We conclude that discordance of serum T4 and T3 concentrations is frequently encountered in patients with hyperthyroid Graves' disease during or after therapy. In such patients, the low serum T4 level does not predict hypothyroidism, nor does a high serum T3 level predict hyperthyroidism. Furthermore, the serum T3 concentration in these patients correlates poorly with their clinical thyroid status.

Developmental toxicology of trimethyltin in the rat

Pregnant rats were treated on either gestational day (GD) 7, 12, or 17 with single doses of trimethyltin chloride (TMT) ip at either 0, 5, 7, or 9 mg/kg. A significant effect of dose was manifest as decreased maternal weight at term, which persisted during lactation until postnatal day (PND) 15 in some groups. For all treatments combined, term weights of dams exposed on GDs 7 and 12 were greater than those treated on GD 17. Litter sizes were decreased for groups treated on GD 17 with 9 mg/kg TMT. Pups treated in utero and exhibiting treatment-induced decreases in weight at or near birth remained smaller than untreated animals into adulthood (PND 280). By PND 20, weights of pups treated on GD 7 greater than GD 12 greater than GD 17. Neuropathology of pups sacrificed on PND 1 was minimal in all animals with lesions only identified in animals treated on GDs 12 or 17 which consisted of subtle degenerative changes in the CA3 and CA4 regions of Ammon's horn of the hippocampus. Muscarinic cholinergic receptor binding in whole brains from pups on PND 1 did not show any significant changes compared to controls for any dose or day of exposure. These data indicate that prenatal TMT exposure results in postnatal toxicity in treated pups but only in the presence of maternal toxicity.

Relationships between the DNA adducts and the mutations and sister-chromatid exchanges produced in Chinese hamster ovary cells by N-hydroxy-2-aminofluorene, N-hydroxy-N'-acetylbenzidine and 1-nitrosopyrene

Chinese hamster ovary cells were exposed to N-hydroxy-2-aminofluorene, N-hydroxy-N'-acetylbenzidine and 1-nitrosopyrene, and the resulting DNA adducts, sister-chromatid exchanges (SCEs) and mutations at the hypoxanthine-guanine phosphoribosyl transferase locus were quantified. Each agent produced a major DNA adduct substituted through the C8 of deoxyguanosine. When the data from all three agents were combined, both mutation and SCE induction correlated strongly with the concentration of DNA adducts. However, significant differences were found in the relationships between adduct formation and the biological responses produced by the individual agents. While N-hydroxy-N'-acetylbenzidine induced the most mutations per adduct, N-hydroxy-2-aminofluorene caused the greatest number of SCEs per adduct. The data support the involvement of C8-deoxyguanosine adducts in mutation and SCE induction, and indicate that the structure of the group adducted to DNA may be an important factor in determining the magnitude of these biological responses. These findings also suggest that SCE and mutation induction are independent expressions of DNA damage.

Frequency of various congenital heart diseases in Chinese adults: analysis of 926 consecutive patients over 13 years of age

A retrospective analysis was performed in 926 consecutive Chinese persons, aged 14 to 68 years, in whom congenital heart disease had been diagnosed and catheterization had been performed over the past 24 years. The incidence of various congenital cardiac malformations was compared with that in other series reported world-wide. About 60% of the 926 patients underwent surgery, and anatomic details of the malformations were examined. Congenital aortic valvular stenosis and coarctation of the aorta were uncommon (2.4% and 1.2%, respectively) among the Chinese adults, and the ethnic differences with Western countries in the incidence of these 2 defects were apparent and real. In contrast, aneurysm of the sinus of Valsalva, either ruptured or nonruptured, was more common (4.3%) and the incidence of outlet muscular type (or type 1) of ventricular septal defect was 4 to 9 times as common as has been reported in the West. Genetic differences rather than environmental factors or dietary habits may explain these special features.

Concurrent psychiatric illness in non-Hispanic outpatients diagnosed as having posttraumatic stress disorder

Twenty-five consecutive admissions to an outpatient group therapy program for combat veterans meeting DSM-III criteria for posttraumatic stress disorder were systematically screened using operational diagnostic criteria for other coexisting psychiatric conditions, past or present. Eighty-four percent had coexisting conditions which, with one exception, were not significantly different in prevalence from those of an inpatient sample of combat veterans previously reported by the authors. The exception was a lower frequency of drug dependence in the outpatients compared with the inpatients. The authors conclude that a high proportion of conditions and symptoms--particularly alcoholism, antisocial personality, drug abuse, depression, and anxiety--can be routinely expected to coexist with posttraumatic stress disorder when it is diagnosed in Vietnam combat veterans.

The effects of N-ethylmaleimide on the phosphorylation and aggregation of insulin receptors in the isolated plasma membranes of 3T3-F442A adipocytes

We have examined the insulin-dependent phosphorylation of the insulin receptor in the isolated plasma membranes of 3T3-F442A adipocytes. Phosphorylation of the insulin receptor is detected readily in the plasma membrane of these cells by two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis. In the presence of sodium dodecyl sulfate and under nonreducing conditions, the predominant species of phosphorylated insulin receptor has an apparent molecular mass of 350,000 daltons with the beta-subunit (92,000 daltons) being phosphorylated. The phosphorylation of the insulin receptor in the isolated plasma membrane is absolutely dependent on insulin; tyrosine residues and, to a lesser extent, serine residues of the receptor are phosphorylated. Treatment of the plasma membrane with N-ethylmaleimide (NEM) has two effects; 1) NEM prevents the formation of a larger form (greater than 350,000 daltons) of the phosphorylated insulin receptor. The formation of this larger form of the receptor involves sulfhydryl oxidation which occurs at 37 degrees C under nondenaturing conditions, but does not occur at 0 degrees C or at room temperature even in the presence of sodium dodecyl sulfate. These results indicate that the larger form of the phosphorylated receptor can occur under physiological conditions and suggest that this process may be relevant to aggregation of the receptor-ligand complex. 2) Prior to treatment with insulin, NEM enhances the phosphorylation of the insulin receptor. Phosphopeptide analysis indicates that the site(s) of phosphorylation of the receptor is identical in the presence or absence of NEM.

Progesterone has no effect on serum thyroxine-binding globulin concentration in men

To examine the possible effect of progesterone on circulating T4-binding globulin (TBG) in men, RIA measurements of plasma TBG and T4 levels were made before and after weekly administration of 500 mg medroxyprogesterone acetate, im, to men being treated for paraphilia (sexual deviation syndromes). No change in the mean pretreatment plasma TBG concentration was found after 7-29 days [21.5 +/- 1.2 (+/- SEM) to 22.0 +/- 0.9 microgram/ml; n = 14) or 381-415 days (23.0 +/- 2.5 to 23.1 +/- 2.5 micrograms/ml; n = 5) of medroxyprogesterone treatment. Similarly, the mean pretreatment plasma T4 concentration was unaltered by acute (9.7 +/- 0.6 to 9.7 +/- 0.4 microgram/dl; n = 14) or chronic (11.1 +/- 1.2 to 11.4 +/- 1.0 microgram/dl; n = 5) medroxyprogesterone therapy. We conclude that progestational agents alone do not modify circulating TBG or total T4 concentrations in men.

Occurrence of tumors among litters of BALB/c female mice

In the application of statistical techniques to tumor incidence data it is generally assumed that animals respond independently with regard to tumor occurrence, with littermates being no more alike than are animals from different litters. Data for nine different types of tumors from the large ED01 study conducted at the National Center for Toxicological Research were used to compare tumor prevalence rates among litters with the tumor rates expected under the assumption of homogeneity of tumor rates among litters. These data did not provide sufficient evidence to reject the assumption of homogeneity of tumor prevalence rates among litters of inbred female BALB/c mice for either spontaneously occurring tumors or bladder tumors produced by exposure to 2-acetylaminofluorene (CAS: 53-96-3). However, there does appear to be a difference in liver tumor prevalence rates among litters at 24 months of age. Thus litter effects are a factor that should be considered in the assignment of animals to treatment groups in carcinogenesis studies.

The antilipemic effectiveness of pentaerythritol tetranicotinate on hyperlipidemic patients with or without diabetes mellitus--a double-blind, randomized and two-period change-over experiment

Pentaerythritol tetranicotinate (Perycit), at an oral dosage of 750 mg daily, was given to 12 patients with idiopathic hyperlipidemia and to 12 patients with hyperlipidemia superimposed with diabetes mellitus (DM). With 2 months off-drug period as the baseline, each patient then received 3 months of placebo and 3 months of Perycit. The sequence of treatment was randomized and balanced in frequency. Blood glycosylated hemoglobin (Hb A1) and fasting plasma glucose (FPG) were used as indices of diabetic control. Serum triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and TC/HDL-C ratio were measured and calculated in order to compare the antilipemic effectiveness of Perycit with that of placebo. The non-parametric Wilcoxon test was used for the statistical analysis. The results showed that in the idiopathic group, Perycit significantly lowered the serum level of TG and the ratio of TC/HDL-C, and elevated the serum level of HDL-C. In the diabetic group, although there was a similar improvement in diabetic control in both periods of placebo and Perycit treatments, there was no change in the serum levels of TG and HDL-C. There was a slight increase of the serum levels of TC in the periods of Perycit treatment, whereas a small increase of HDL-C resulted in a mild decrease of the TC/HDL-C ratio. There was mild and transient facial flushing during the Perycit treatment in 6 out of 12 diabetic patients. Otherwise, there was no side effects in either group. Pooling the two groups' data together, Perycit increased the serum levels of HDL-C and decreased the TC/HDL-C ratio. It is concluded that Perycit has antilipemic effects in patients with idiopathic hyperlipidemia, and may be helpful in reducing the atherogenic risks in these patients. In patients with hyperlipidemia superimposed with DM, although the serum lipids composition was not significantly changed after Perycit, the atherogenic risks might also be reduced as demonstrated by the decrease of the TC/HDL-C ratio.

Growth-related expression of a double-stranded RNA-dependent protein kinase in 3T3 cells

Cultured mouse 3T3-F442A and 3T3-C2 fibroblasts exhibit a transient double-stranded RNA (dsRNA)-dependent phosphorylation of a 67,000-dalton protein (67K) without prior treatment with interferon (IFN). This phosphoprotein is similar but not identical to the dsRNA-dependent eukaryotic initiation factor-2 (eIF-2) alpha protein kinase (dsI), which regulates protein synthesis in rabbit reticulocytes. We have studied the relationship between cell growth and phosphorylation of the 67K protein (designated 3T3-dsRNA-dependent eIF-2 alpha kinase). A low level of dsRNA-dependent phosphorylation of 3T3-dsI was detectable in extracts prepared from cells not treated with IFN and grown at a low cell density. The phosphorylation of dsI and the phosphorylation of a 38K protein identified as the alpha-subunit (38K) of 3T3-eIF-2 (eIF-2 alpha) occurred concomitantly; the levels of these phosphorylations confluent and thereafter decreased markedly. Treatment of cells with IFN at all stages of growth resulted in an increase in phosphorylation of dsI. 3T3-F442A and 3T3-C2 fibroblasts were found to produce and secrete IFN at levels sufficient to induce an elevated dsI activity.