Environmental N-nitroso compounds: implications for public health

Association of Dietary Nitrate, Nitrite, and N-Nitroso Compounds Intake and Gastrointestinal Cancers: A Systematic Review and Meta-Analysis

N-nitroso compounds (NOCs) are a class of chemical carcinogens found in various environmental sources such as food, drinking water, cigarette smoke, the work environment, and the indoor air population. We conducted a systematic review and meta-analysis to investigate the links between nitrate, nitrite, and NOCs in food and water and the risk of gastrointestinal (GI) cancers, including esophageal cancer (EC), gastric cancer (GC), colorectal cancer (CRC), and pancreatic cancer (PC). A systematic search of the literature in Scopus, PubMed, Google Scholar, Web of Science, ScienceDirect, and Embase was performed for studies on the association between NOCs in drinking water and food sources and GI cancers. Forest plots of relative risk (RR) were constructed for all the cancer sites and the intake sources. The random-effects model was used to assess the heterogeneity between studies. Forty articles were included after removing duplicate and irrelevant articles. The meta-analysis indicated that the intake of high dose vs. low dose of these compounds was significantly associated with the overall GI cancer risk and nitrite (RR = 1.18, 95% CI = 1.07-1.29), and N-nitrosodimethylamine (NDMA) (RR = 1.32, 95% CI = 1.06-1.65). We found that dietary nitrite intake increased GC (RR = 1.33, 95% CI = 1.02-1.73), and EC (RR = 1.38, 95% CI = 1.01-1.89). Additionally, dietary NDMA intake increased the risk of CRC (RR = 1.36, 95% CI = 1.18-1.58). This meta-analysis provides some evidence that the intake of dietary and water nitrate, nitrite, and NOCs may be associated with GI cancers. In particular, dietary nitrite is linked to GC and EC risks and dietary NDMA intake is associated with CRC.

Drinking water nitrosamines in a large metropolitan region in Brazil

Nitrosamines are a concerning group of carcinogens, which have gained increasing attention over the last years, frequently found in drinking and recycled water systems. In this work, an analytical method was developed for the detection and quantification of seven nitrosamines (NDMA, NMEA, NPYR, NDEA, NPIP, NDPA, and NDBA) in drinking water. The method is based on gas chromatography coupled with a single quadrupole mass spectrometer (GC-MS) with electron ionization (EI) mode. Sample enrichment and matrix cleanup by solid-phase extraction (SPE) were performed using the US EPA Method 521 cartridge packed with coconut-based charcoal. The simple method allowed reliable identification and quantification of nitrosamines in the water at nanogram per liter levels. The optimized method was validated at three concentration levels (20, 100, and 200 ng L-1) in ultrapure and drinking water samples. Average recoveries were 63-87% for ultrapure water and 38-79% for drinking water with relative standard deviations (RSD) below 10% for both matrices. Method detection limits were 1.23-3.14 ng L-1. The described method was applied to eighteen drinking water samples collected from 13 cities of the Metropolitan Region of Campinas (São Paulo, Brazil). NDMA was the most frequent nitrosamine detected (89% of samples) and had the highest concentration level found (67 ng L-1). The levels of nitrosamines found in drinking water samples are of considerable relevance since the selected area is a major urban center that has amply expanded industrial and agricultural activities over the last few decades. To the best of our knowledge, this is the first evaluation of nitrosamines in drinking water conducted in Brazil to date.

A combination of liver fluke infection and traditional northeastern Thai foods associated with cholangiocarcinoma development

Opisthorchis viverrini infection is one of the risk factors for cholangiocarcinoma (CCA) in northeast Thailand, a region with one of the highest reported incidence rates of CCA. The traditional practice of eating raw fish, repeated exposure to liver flukes, and consumption of nitrosamine-contaminated food are major risk factors for CCA. So far, there have been no reports about which northeastern traditional dishes may be involved in CCA development. The present study, thus, investigated the effects of traditional foods. It focused specifically on the consumption of fermented foods in combination with O. viverrini infection in hamsters. Syrian hamsters were divided into six groups: (i) normal hamsters, (ii) O. viverrini infection only and (iii)-(vi) O. viverrini infection plus fermented foods (pla som-fish fermented for 1 day), som wua-fermented beef, som phag-fermented vegetables, and pla ra-fish fermented for 6 months. Syrian hamster livers were used for analysis of histopathological changes through hematoxylin and eosin; Sirius Red; and immunohistostaining for cytokeratin-19, proliferating cell nuclear antigen, and CA19-9. Hamster sera were used for liver and kidney function tests. Results of all O. viverrini-infected groups and fermented food groups showed that histopathological changes consisted primarily of aggregations of inflammatory cells surrounding the hepatic bile duct, especially at the hilar region. However, there was a difference in virulence. Interestingly, aggregations of inflammatory cells, new bile duct formation, and fibrosis were observed in subcapsular hepatic tissue, which correlated to positive immunohistochemical staining and increased liver function test. The present study suggests that fermented food consumption can exacerbate cholangitis and cholangiofibrosis, which are risk factors for cholangiocarcinoma-associated opisthorchiasis.

Morpholine nitrosation to better understand potential solvent based CO₂ capture process reactions

The amine assisted CO₂ capture process from coal fired power plants strives for the determination of degradation components and its consequences. Among them, nitrosamine formation and their emissions are of particular concern due to their environmental and health effects. The experiments were conducted using morpholine as a representative secondary amine as a potential CO₂ capture solvent with 100 ppm standard NO₂ gas to better understand the nitrosamine reaction pathways under scrubber and stripper conditions. The role of nitrite in the nitrosation reaction was probed at elevated temperatures. The effects of different concentrations of nitrite on morpholine were evaluated. Formation rate, decomposition rates, activation energy, and the possible reaction pathways are elaborated. Thermal stability tests at 135 °C indicated the decomposition of nitrosamines at the rate of 1 μg/(g h) with activation energy of 131 kJ/mol. The activation energy for the reaction of morpholine with sodium nitrite was found as 101 kJ/mol. Different reaction pathways were noted for lower temperature reactions with NO₂ gas and higher temperature reactions with nitrite.

Acute effects of ethanol on the transfer of nicotine and two dietary carcinogens in human placental perfusion

Many mothers use, against instructions, alcohol during pregnancy. Simultaneously mothers are exposed to a wide range of other environmental chemicals. These chemicals may also harm the developing fetus, because almost all toxic compounds can go through human placenta. Toxicokinetic effects of ethanol on the transfer of other environmental compounds through human placenta have not been studied before. It is known that ethanol has lytic properties and increases the permeability and fluidity of cell membranes. We studied the effects of ethanol on the transfer of three different environmental toxins: nicotine, PhIP (2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine) and NDMA (N-nitrosodimethylamine) in placental perfusion. We tested in human breast cancer adenocarcinoma cell line MCF-7 whether ethanol affects ABCG2/BCRP, which is also the major transporter in human placenta. We found that the transfer of ethanol is comparable to that of antipyrine, which points to passive diffusion as the transfer mechanism. Unexpectedly, ethanol had no statistically significant effect on the transfer of the other studied compounds. Neither did ethanol inhibit the function of ABCG2/BCRP. These experiments represent only the effects of acute exposure to ethanol and chronic exposure remains to be studied.

Genotoxicity of heat-processed foods

Gene-environment interactions include exposure to genotoxic compounds from our diet and it is no doubt, that humans are regularly exposed to e.g. food toxicants, not least from cooked foods. This paper reviews briefly four classes of cooked food toxicants, e.g. acrylamide, heterocyclic amines, nitrosamines and polyaromatic hydrocarbons. Many of these compounds have been recognised for decades also as environmental pollutants. In addition cigarette smokers and some occupational workers are exposed to them. Their occurrence, formation, metabolic activation, genotoxicity and human cancer risk are briefly presented along with figures on estimated exposure. Several lines of evidence indicate that cooking conditions and dietary habits can contribute to human cancer risk through the ingestion of genotoxic compounds from heat-processed foods. Such compounds cause different types of DNA damage: nucleotide alterations and gross chromosomal aberrations. Most genotoxic compounds begin their action at the DNA level by forming carcinogen-DNA adducts, which result from the covalent binding of a carcinogen or part of a carcinogen to a nucleotide. The genotoxic and carcinogenic potential of these cooked food toxicants have been evaluated regularly by the International Agency for Research on Cancer (IARC), which has come to the conclusion that several of these food-borne toxicants present in cooked foods are possibly (2A) or probably (2B) carcinogenic to humans, based on both high-dose, long-term animal studies and in vitro and in vivo genotoxicity tests. Yet, there is insufficient scientific evidence that these genotoxic compounds really cause human cancer, and no limits have been set for their presence in cooked foods. However, the competent authorities in most Western countries recommend minimising their occurrence, therefore this aspect is also included in this review.

Food mutagens

Several lines of evidence indicate that diet and dietary behaviors can contribute to human cancer risk. One way that this occurs is through the ingestion of food mutagens. Sporadic cancers result from a gene-environment interactions where the environment includes endogenous and exogenous exposures. In this article, we define environment as dietary exposures in the context of gene-environment interactions. Food mutagens cause different types of DNA damage: nucleotide alterations and gross chromosomal aberrations. Most mutagens begin their action at the DNA level by forming carcinogen-DNA adducts, which result from the covalent binding of a carcinogen or part of a carcinogen to a nucleotide. However the effect of food mutagens in carcinogenesis can be modified by heritable traits, namely, low-penetrant genes that affect mutagen exposure of DNA through metabolic activation and detoxification or cellular responses to DNA damage through DNA repair mechanisms or cell death. There are some clearly identified (e.g., aflatoxin) and suspected (e.g., N-nitrosamines, polycyclic aromatic hydrocarbons or heterocyclic amines) food mutagens. The target organs for these agents are numerous, but there is target-organ specificity for each. Mutagenesis however is not the only pathway that links dietary exposures and cancers. There is growing evidence that epigenetic factors, including changes in the DNA methylation pattern, are causing cancer and can be modified by dietary components. Also DNA damage may be indirect by triggering oxidative DNA damage. When considering the human diet, it should be recognized that foods contain both mutagens and components that decrease cancer risk such as antioxidants. Thus nutritionally related cancers ultimately develop from an imbalance of carcinogenesis and anticarcinogenesis. The best way to assess nutritional risks is through biomarkers, but there is no single biomarker that has been sufficiently validated. Although panels of biomarkers would be the most appropriate, their use as a reflection of target-organ risk remains to be determined. Also even when new biomarkers are developed, their application in target organs is problematic because tissues are not readily available. For now most biomarkers are used in surrogate tissues (e.g., blood, urine, oral cavity cells) that presumably reflect biological effects in target organs. This article reviews the role of food mutagens in mutagenesis and carcinogenesis and how their effects are modified by heritable traits and discusses how to identify and evaluate the effects of food mutagens.

Exposure to N-nitroso compounds in a population of high liver cancer regions in Thailand: volatile nitrosamine (VNA) levels in Thai food

The recent case-control studies in Thailand indicate that a high incidence of liver cancer in Thailand has not been associated with common risk factors such as hepatitis B infection, aflatoxin intake and alcohol consumption. While the infestation by the liver fluke Opisthorchis viverrini (OV) accounted for the high risk in north-east Thailand, there was no such exposure in the other regions of the country where the incidence of liver cancer is also high. Case-control studies suggest that exposure to exogenous and possibly endogenous nitrosamines in food or tobacco in betel nut and cigarettes may play a role in the development of hepatocellular carcinoma (HCC), while OV infestation and chemical interaction of nitrosamines may also be aetiological factors in the development of cholangiocarcinoma (CCA). Over 1800 samples of fresh and preserved food were systematically collected and tested between 1988 and 1996. All the food items identified by anthropological studies to be consumed frequently in four major regions of Thailand were analysed for volatile nitrosamines using gas chromatography combined with a thermal energy analyser. Relatively high levels of N-nitrosodimethylamine (NDMA), N-nitrosopiperidine (NPIP) and N-nitrosopyrrolidine (NPYR) were detected in fermented fish ("Plasalid"). NDMA was also detected at levels ranging from trace amounts to 66.5 microg/kg in several salted and dried fish ("Larb-pla" and "Pla-siu"). NDMA and NPYR were frequently detected in several vegetables, particularly fermented beans ("Tau-chiau") at levels ranging between 1 and 95.1 microg/kg and 0-146 microg/kg, respectively. The possible role of nitrosamines in Thai food in the aetiology of liver cancer (HCC, CCA) is discussed.

Colorectal carcinogenesis

It is generally accepted that genetic and environmental factors combine in the aetiology of bowel cancer. Epidemiological studies have shown that the environmental factors effects are shown more clearly in the left colon, and that they are related to living in western societies whose diets contain high levels of protein, fat and energy. There has been recent awareness that consumption of alcoholic beverages, particularly beer, may be causally related to cancers of the left colon and rectum. This review attempts to relate the general epidemiological data to more specific mechanisms of colorectal carcinogenesis. Dimethylhydrazine (DMH) and N-nitroso chemicals are potent colorectal carcinogens in animals. They have not been thought very relevant to humans because their existence in appropriate forms in the environment has been debatable and analytical methods for the specific detection of non-volatile nitrosamines and nitrosamides have not been available. Recently, however, relevant alkylating activity has been detected in foods incubated in quasi-gastric conditions, and several epidemiological studies have shown a protective effect for Vitamin C, which may inhibit the development of rectal cancer through beer consumption. As Vitamin C prevents nitrosation and as precursors of nitrosamides are present in prepared foods, further dietary studies with hypotheses based on N-nitroso carcinogenesis are required. Unfortunately, these studies will probably not show clear dose-response relationships. Many of the complex reasons for this are discussed; however, one of the most important could be related to an interplay between inherited and environmental factors. The inherited factors demonstrated by chromosomal analysis in cancer and polyposis syndromes are a reminder that other genetic (oncogenetic) changes may occur in sporadic colorectal cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of pretreatment with pyrazole and inducers of mixed function oxidases on DNA repair elicited by dimethylnitrosamine in rat hepatocytes in vivo and in vitro

Experiments were performed to investigate the relationship between the rate of oxidative metabolism of dimethylnitrosamine (DMN) by rat liver microsomes (i.e., DMN demethylase activity, DMNd) and its genotoxicity in liver, as assessed by the in vitro and in vivo/in vitro rat hepatocyte primary culture/DNA repair (HPC/DR) assays. Pretreatment of rats with pyrazole (PYR) resulted in a 4-fold increase in DMNd and a 3-fold greater DNA repair response to in vivo administration of 5 mg DMN/kg body weight. Pretreatment with phenobarbital (PB), dichlorodiphenyltrichloroethane (DDT), 3-methylcholanthrene (3-MC), beta-naphthoflavone (beta-NF) or Aroclor 1254 (ARO) produced a variable degree of inhibition of DMNd and had no significant effects on the response to DMN in the in vivo/in vitro HPC/DR assay. DNA repair elicited by DMN in vitro was decreased in hepatocytes from rats pretreated with 3-MC, while PB, DDT, beta-NF and ARO pretreatments had little effect on the response. In contrast, PYR pretreatment produced a 4.5-6.7-fold increase in the in vitro DNA repair response to DMN, and extended detection of positive responses to lower concentrations. Most of the inducers had no effect on DNA repair elicited by the direct acting alkylator, methyl methanesulfonate (MMS). Thus, the pretreatment-related changes in DMN-induced DNA repair were probably due to alterations in DMNd rather than to effects on the DNA repair capacity of the hepatocytes.

Toxicity of nitrite and dimethylamine in rats

Weanling male Wistar strain rats were administered, through the drinking water, nitrite (0.2%) and dimethylamine (DMA) (0.2%), either singly or in combination for 9 months. Some animals also received 0.5% butylated hydroxytoluene (BHT) in the diet. Nitrite, as well as DMA, caused higher in vitro lipoperoxidation, free lysosomal enzyme activities and cytosolic superoxide dismutase activity in liver. Some of these increases viz., the enzyme activities in liver, were counteracted to a significant extent in the rats receiving a dietary supplement of BHT. The results indicate that nitrite and DMA may induce toxicity through some free radical reactions and that BHT can provide some protection.

High concentrations of dimethylamine and methylamine in squid and octopus and their implications in tumour aetiology

The levels of the common secondary amines in various squid, in octopus and in 17 other seafoods were determined by HPLC. Ammonia and dimethylamine were found in all of the seafoods tested and some of them also contained methylamine and/or ethylamine. Particularly high levels of dimethylamine (946-2043 ppm) and methylamine (38-255 ppm) were detected in various species of squid and in the octopus. Reaction of nitrite in acidic medium with aqueous extract of squid yielded appreciable amounts of N-nitrosodimethylamine. The optimum pH for this reaction was around 2.4. Dimethylamine in dried squid tissues was readily extracted with water or 1% sodium carbonate solution. Heat treatment of dried squid at 200 degrees C was found to increase its amine content dramatically. It appeared that pyrolytic decarboxylation of some amino acids might cause this increase. Squid is a popular seafood in Japan and other oriental countries. The high incidence of stomach cancer in Japan and China is thought by epidemiologists to be associated with traditional Japanese and Chinese diets. Our present finding that squid and other seafoods contain unusually high levels of dimethylamine and other amines adds to the evidence that dietary factors may have an important role in the aetiology of stomach cancer and other gastro-intestinal tumours.

The fate of N-nitrosodiethanolamine after oral and topical administration to rats

14C-labelled N-nitrosodiethanolamine ([14C]NDELA) was given to Osborne-Mendel rats at two dose levels, 0.5 or 50 mg/kg, by oral or topical administration. The excreta and tissues were analysed at various times from 4 hr to 1 wk after administration to determine the distribution of radioactivity. After oral administration, [14C]NDELA was rapidly absorbed from the gastro-intestinal tract, distributed throughout all organs and tissues, and then excreted, mainly via the kidneys. The tissue concentration reached a peak at 8 hr, but some activity remained after 1 wk. After topical application NDELA was slowly absorbed percutaneously, but once absorbed was distributed as in the orally dosed rats. Metabolic profiles of urine and bile samples from both the orally and topically dosed rats were identical, although the quantities varied. In addition to unchanged NDELA, one metabolite was present. The dose level had little effect on the quantities of unchanged NDELA or the metabolite present.

Nucleic acids and protein in brains and cerebella of rats transplacentally exposed to ethylnitrosourea

Female rats were injected (IP) with either 15, 60, 100, or 150 mg/kg N-ethyl-N-nitrosourea (ENU) on gestation day 18. The neurochemical development of the whole brain and the cerebellum was studied in 21- and 60-day old offspring; pups from mothers subjected to 150 mg/kg were examined only at 21 days. Brain weights were significantly reduced in all ENU-exposed groups at 21 days, and the 60 mg/kg group at 60 days. Whole brain DNA and protein concentrations of most ENU groups were elevated at 21 days and RNA content and RNA/DNA ratios were subnormal. Deficits in whole brain DNA content were observed in all ENU groups on day 60. Cerebellar weight was reduced in the 60 and 150 mg/kg groups on day 21 and in the 100 mg/Kg group on day 60. At 21 days, reductions in cerebellar DNA and RNA concentrations and contents were often recorded in several ENU groups. Cerebellar DNA concentration and content of the 60 and 100 mg/kg groups remained subnormal at 60 days of age. In general, a dose-response effect was evident in the number and magnitude of neurochemical alterations produced by ENU. These data suggest that transplacental exposure to ENU, a potent neurotropic carcinogen, affects the biochemical maturation of the brain.

Some toxic compounds produced in food by cooking and processing

Both cooking and processing of food can produce toxic compounds in food, if the appropriate precursors are present. N-Nitrosamines, polycyclic aromatic hydrocarbons and phenolic compounds, lipid polymerisation products resulting from deep-fat frying, lipid oxidation products, Maillard-browning products and other products of protein reactions are discussed as well as their formation, concentration and control. The conclusion points out that contamination of human food is almost impossible to avoid and must be considered together with the beneficial effects of food processing on food safety, flavour, shelf-life and convenience.

Effects of induction of cytochrome P-450 enzymes on the concentration of foreign compounds and their metabolites and on the toxicological effects of these compounds

Most foreign compounds, including nonnutrients in foods and vapors in air, undergo extensive metabolism before they are eliminated from the body. Included in this paper are discussions of the urinary clearance of various kinds of foreign compounds, the nonspecific enzymes that catalyze the formation of many metabolites of foreign compounds, the mechanisms by which the activities of these enzymes are altered, and the pharmacokinetics of the accumulation and elimination of the metabolites after single dose administration and during constant exposure of animals to foreign compounds. The formation of toxic reactive metabolites of foreign compounds and their role in toxic reactions are discussed.

Oxidative metabolism of dimethylnitrosamine: correlation with toxicity

The relationship between oxidative metabolism and acute toxicity of dimethylnitrosamine (DMN) was examined in neonatal and adult rats to take advantage of developmental changes in activity of the metabolizing enzymes. The objective was to determine the extent to which CO2 production from DMN is correlated with toxicity. Neonatal rat liver and kidney demonstrated the ability to metabolize DMN. This ability progressed to a maximum activity in liver between the 5th and 21st d of age and in kidney between the 15th and 21st d of age. After weaning, the activity of DMN oxidation decreased with age in both tissues. Evidence is also presented to suggest that more than one enzyme may be responsible for the oxidation of DMN to CO2 and that the predominance of individual enzymes varies as the neonate develops. Estimates of LD50 values, used to quantitate the acute toxicity of DMN at various ages, suggest that the rat is most sensitive to DMN toxicity at 5 d of age; however, conversion of DMN to CO2, both in vitro and in vivo, was not well correlated with acute toxicity.

Kinetic studies on the formation of nitrosamines I. Formation of dimethylnitrosamine in aqeous solution of perchloric acid

The kinetics of nitrosation of dimethylamine (DMA) in aqueous perchloric acid solution have been studied using a differential spectrophotometric technique. The rate law is Initial rate = e[DMA]0 [nitrite]2 0 [H+]/(f + [H+])2 where [DMA]0 and [nitrite]0 represent initial stoichiometric concentrations. At 310.0 K and mu = 2.0 M, e = (2.2 +/- 0.2) X 10(-5) M-1 s-1 and f = (1.28 +/- 0.02) X 10(-3) M. The associated activation energy is 56 +/- 3 kJ mol-1. A clear inhibition of the nitrosation rate by ionic strength has been observed in which only the kinetic parameter (f) has an effective change. It is concluded that under the experimental conditions of this work only the dinitrogen trioxid is the effective carrier for the nitrosation.