Physiological pharmacokinetics and cancer risk assessment

Development of a physiologically-based toxicokinetic model of acrylamide and glycidamide in rats and humans

Physiologically-based toxicokinetic ("pharmacokinetic") (PBPK or PBTK) modeling can be used as a tool to compare internal doses of acrylamide (AA) and its metabolite glycidamide (GA) in humans and rats. An earlier PBTK model for AA and GA in rats was refined and extended to humans based on new data. With adjustments to the previous parameters, excellent fits to a majority of the data for male Fisher 344 rats were obtained. Kinetic parameters for the human model were estimated based on fit to available human data for urinary metabolites of AA, and levels of hemoglobin adducts of AA and GA measured in studies in which human volunteers ingested known doses of AA. The simulations conducted with the rat and human models predicted that rats and humans ingesting comparable levels of AA (in mg/kg day) would have similar levels of GA in blood and tissues. This finding stands in contrast to the default approach that assumes a 3.2-fold increase in human risk due to pharmacokinetic differences between rats and humans. This model was used in a companion paper to estimate safe levels of ingested AA.

Physiologically-based pharmacokinetic and toxicokinetic models in cancer risk assessment

Physiologically-based pharmacokinetic (PBPK) and toxicokinetic models are increasingly being used for the conduct of high dose to low dose and interspecies extrapolations required in cancer risk assessment. These models, by simulating tissue dose of toxic chemicals, help address the uncertainty associated with the default approaches for interspecies and high dose to low dose extrapolations. The applicability of PBPK models in cancer risk assessment has been demonstrated with a number of chemicals (e.g., acrylonitrile, 2-butoxyethanol, chloroform, 1,4-dioxane, methyl chloroform, methylene chloride, styrene, trichloroethylene, tetrachloroethylene, vinyl chloride, vinyl acetate). Recent advances in PBPK modeling facilitate the consideration of population distribution of parameter values, age-dependent changes in physiology and metabolism, multi-route exposures as well as multichemical interactions for application in cancer risk assessment. Whereas the average values for various input parameters have been used to evaluate the age-dependency of tissue dose, the Markov Chain Monte Carlo technique can be applied to address variability and uncertainty in parameter estimates, thus facilitating a more accurate estimation of cancer risk in the population. The PBPK models also uniquely facilitate the simulation of tissue dose, and thereby cancer risks, associated with multi-route and multichemical exposure situations. Overall, the recent advances reviewed in this article point to the continued enhancement of the scientific basis and applicability of PBPK models in cancer risk assessment.

Route-of-entry and brain tissue partition coefficients for common superfund contaminants

Various organic solvents may be encountered in contaminated water supplies at U.S. Environmental Protection Agency-designated Superfund sites. Human exposure to these environmental contaminants may occur by oral, dermal, or inhalation routes. The estimation of human health risk associated with exposure to these solvents can be improved through the use of physiologically based pharmacokinetic (PBPK) models to describe the absorption, tissue distribution, metabolism, and elimination of the compounds following any route of exposure. However, development of these PBPK models requires information on the relative solubility, or partition coefficient, of each compound in blood and various tissues. A number of investigators have provided partition coefficient information on different tissues in various species; however, the data for route of entry organs (i.e., skin, lung, stomach) and brain tissue are not complete. Therefore, the objective of this work was to replicate partition coefficient studies for several commonly encountered environmental contaminants using an in vitro gas-phase vial equilibration technique and to include tissues to evaluate brain, lung, stomach, and skin. A comparison of the partition coefficient values determined here with values reported in the literature, where available, showed good agreement in nearly all cases. An additional study was conducted to compare the liver-to-air partition coefficient values for toluene, benzene, and o-xylene introduced as single chemicals to partition coefficient values determined with the chemicals introduced as a mixture of all three compounds. The similarities of the resulting values suggest that both labor and laboratory resources may be reduced when partition coefficients are determined as chemical mixtures.

The utility of PBPK in the safety assessment of chloroform and carbon tetrachloride

Occupational exposure limits (OELs) for individual substances are established on the basis of the available toxicological information at the time of their promulgation, expert interpretation of these data in light of industrial use, and the framework in which they sit. In the United Kingdom, the establishment of specific OELs includes the application of uncertainty factors to a defined starting point, usually the NOAEL from a suitable animal study. The magnitude of the uncertainty factors is generally determined through expert judgment including a knowledge of workplace conditions and management of exposure. PBPK modeling may help in this process by informing on issues relating to extrapolation between and within species. This study was therefore designed to consider how PBPK modeling could contribute to the establishment of OELs. PBPK models were developed for chloroform (mouse and human) and carbon tetrachloride (rat and human). These substances were chosen for examination because of the extent of their toxicological databases and availability of existing PBPK models. The models were exercised to predict the rate (chloroform) or extent (carbon tetrachloride) of metabolism of these substances, in both rodents and humans. Monte Carlo analysis was used to investigate the influence of variability within the human and animal model populations. The ratio of the rates/extent of metabolism predicted for humans compared to animals was compared to the uncertainty factors involved in setting the OES. Predictions obtained from the PBPK models indicated that average rat and mouse metabolism of carbon tetrachloride and chloroform, respectively, are much greater than that of the average human. Application of Monte Carlo analysis indicated that even those people who have the fastest rates or most extensive amounts of metabolism in the population are unlikely to generate the levels of metabolite of these substances necessary to produce overt toxicity in rodents. This study highlights the value that the use of PBPK modeling may add to help inform and improve toxicological aspects of a regulatory process.

19F-MRS studies of fluorinated drugs in humans

The use of 19F-NMR as a noninvasive probe to measure directly the pharmacokinetics of drugs at their target (effector) site(s) is illustrated in this article by human studies with 5-fluorouracil (5-FU). This drug, and several of its metabolites, have been measured in vivo in animals and in patients using standard clinical MRI systems. Using a pharmacokinetic imaging approach the parameter that can be measured most readily is the tumoral t(1/2) of 5-FU. Patients whose tumoral t(1/2) of 5-FU is equal to/greater than 20 min are designated as "trappers", and those whose tumoral t(1/2) of 5-FU is less are nontrappers. Trapping of 5-FU in tumors is a necessary, albeit not a sufficient condition, for response. Problems associated with the technical aspects of these measurements have been discussed, as well as how modulators and other agents will affect the tumoral t(1/2) of 5-FU. The rationale for the biological processes underlying the fate of 5-FU in humans has been illustrated with the use of a 12 compartment model, where several of the steps have been discussed and the consequences of their inhibition/stimulation related to the noninvasive studies that can be performed with modulators of the action of 5-FU. These 19F-NMR studies have now been extended to other fluoropyrimidines, some of which are prodrugs of 5-FU, and others where the fluorine atoms are on the ribose ring. These studies also reveal information that has both scientific and clinical significance. The studies presented here illustrate some of the potential and some of the usefulness of 19F-MRS in patient management and in drug development. It is a technique that has proven itself.

Uncertainty in biomonitoring and kinetic modeling

Uncertainty in exposure assessment and uncertainty in kinetic models of early effects after exposure to a toxin are addressed in this paper. Sources of uncertainty in the determination of exposure of workers in chemical industry exposed to dioxins are exhibited and a simple kinetic model for biomonitor measurements of the concentrations from occupational exposure is derived. Model uncertainty, and uncertainty in the model parameters of physiologically-based pharmacokinetic models (PBPK models) are addressed when these models are used to estimate the effective dose in risk assessment. Uncertainty in the model parameters originating from the use of different statistical analysis methods is exhibited for Hill type nonlinear kinetics of enzyme induction mediated by a toxin.

Metabolism of chemical carcinogens

The transformation of chemicals is important in carcinogenesis, both in bioactivation and detoxification. Major advances in the past 20 years include appreciation of the migration of reactive electrophiles, the ability of Phase II conjugating enzymes to activate chemicals, understanding of the human enzymes, the realization that DNA modification can result from endogenous chemicals, and the demonstration that cancers can result from the metabolism of chemicals to non-covalently bound products. Pathways of transformation in which major insight was gained during the past 20 years include nitropolycyclic hydrocarbons, polycyclic hydrocarbons and their diols, vinyl halides and dihaloalkanes. Advances in analytical methods and recombinant DNA technology contributed greatly to the study of metabolism of chemical carcinogens. Major advances have been made in the assignment of roles of individual enzymes in reactions. The knowledge developed in this field has contributed to growth in the areas of chemoprevention, molecular epidemiology and species comparisons of risk. Some of the areas in which future development relevant to carcinogen metabolism is expected involve pathways of transformation of certain chemicals, regulation of genes coding for many of the enzymes under consideration and genomics.

An introduction to the use of physiologically based pharmacokinetic models in risk assessment

Many extrapolation issues surface in quantitative risk assessments. The extrapolation from high-dose animal studies to low-dose human exposures is of particular concern. Physiologically based pharmacokinetic (PBPK) models are often proposed as tools to mitigate the problems of extrapolation. These models provide a representation of the disposition, metabolism, and excretion of xenobiotics that are believed to possess the potential of inducing adverse human health responses. Given a model of xenobiotic disposition that is applicable for multiple species and appropriate for nonlinearity of the xenobiotic biotransformation process, better extrapolation may be possible. Unfortunately, the true structure of these models (e.g. number of compartments, type of metabolism, etc.) is seldom known, and attributes of these models (tissue volumes, partition coefficients, etc.) are often experimentally determined and often only central measures of these quantities are reported. We describe the use of PBPK models in risk assessment, the structural and parameter uncertainty in these models, and provide a simple illustration of how these characteristics can be incorporated in a statistical analysis of PBPK models. Additional complexity in the analysis of variability in the models is also outlined. This discussion is illustrated using data from methylene chloride.

Biokinetics and biokinetic models in risk assessment

Risk assessment of xenobiotics using animal data involves extrapolation from high doses to low ones, and from animal species to humans. In some cases it also involves extrapolation from one route of exposure to another. To assess the risk of exposure to xenobiotics, information on both biokinetics and biodynamics are needed. The contribution of biokinetics to risk assessment is the subject of this review. The review includes the general aspects of biokinetics of chemicals, the models available to describe the biokinetic behaviour of a chemical and a discussion of the class of biokinetic models that is considered most suited for application to risk assessment: the physiologically-based biokinetic (PBBK) models. The power of PBBK models is illustrated with a few examples.

Toxicokinetic models for volatile industrial chemicals and reactive metabolites

Two approaches of compartmental toxicokinetic modeling of gaseous compounds are presented which are suitable for kinetic analysis of concentration-time data measured in the air of closed exposure systems. The first approach is based on a two-compartment model with physiological gas uptake, the second on a physiologically-based toxicokinetic model. Both models can be used for the description of inhalation, accumulation, exhalation and metabolism of gaseous compounds together with the toxicokinetics of metabolites. Interspecies extrapolation is based on physicochemical, physiological and biochemical parameters. The advantage of the two-compartment model is its limited number of variables and its experimentally easy applicability. Its disadvantage is the impossibility to predict tissue specific concentrations. The advantage of the physiologically-based model is its usability for predictions and for the description of tissue specific concentrations. However, it entails great effort, since a series of parameters has to be determined before meaningful model calculations can be carried out.

The future of mechanistic research in risk assessment: where are we going and can we get there from here?

Quantitative estimates of human health risk are often based on mathematical models fit to experimental or epidemiological data. Recent years have witnessed a trend towards the use of mechanistic models in risk assessment applications. Such models afford a more biologically based interpretation of the data and a firmer scientific basis for extrapolation beyond the conditions under which the original data were obtained. In this article, we review some recent advances in the development of biologically based models for mutagenesis, carcinogenesis and developmental toxicity. Pharmacokinetic and receptor-binding models and their roles in mechanistic risk assessment are also discussed. The future of mechanistic research in risk assessment is contemplated, including the need for more elaborate experiments to obtain the data necessary for mechanistic modeling.

Development of physiologically based pharmacokinetic and physiologically based pharmacodynamic models for applications in toxicology and risk assessment

Pharmacokinetics (PK) involves the study of the rates of absorption, distribution, excretion, and biotransformation of chemicals and their metabolites. PK models can be used to reconstruct extensive time-course data sets based on a small number of kinetic parameters. These models can be used to predict the results of new experiments and integrate studies on kinetics, disposition and metabolism in various animal species [1]. The 2 main approaches that have been pursued in developing PK models are: (1) data-based compartmental modeling; and (2) physiologically based compartmental modeling. Data-based models rely on the collection of time-course concentration data and fitting these data with mathematical models. Compartments in these models do not necessarily reflect the anatomy and physiology of the animal, and the kinetic constants derived from these models do not have obvious physiological or biochemical counterparts. In physiologically based pharmacokinetic (PBPK) models, compartments correspond more closely to actual anatomical structures, defined with respect to their volumes, blood flows, chemical binding (partitioning) characteristics, and ability to metabolize or excrete the compounds of interest. Because the kinetic parameters of these models reflect tissue blood flows, partitioning, and biochemical constants, these models are more readily scaled from one animal species to another [2]. PBPK models have been used to understand the disposition of chemicals in the body for almost 70 years. Their more widespread application in toxicology dates back only 15 years or so to models developed for polychlorinated biphenyls and other persistent lipophilic compounds. Quantitative applications of PBPK models in risk assessment date to the development of a number of PBPK models for methylene chloride in the mid 1980s. The burgeoning use of PBPK models in toxicology research and chemical risk assessment today is primarily related to their ability to make more accurate predictions of target tissue dose for different exposure situations in different animal species, including humans. This overview includes a discussion of the development of these PBPK models in toxicology and speculates about future applications of PBPK and physiologically based pharmacodynamic (PBPD) models in chemical risk assessment.

Levels of pollutants and their metabolites: exposures to organic substances

The measurement of levels of organic pollutants and/or their metabolites in body tissues or fluids are specific markers of internal dose and, provided that the pharmacokinetic properties of the compounds in question are known, these levels may also be used as predictors of effects. Although historical data still remain to be very useful in environmental studies, more reliable exposure measures than combination of environmental levels and such estimators as residential history, job titles, life-style habits, individual perceptions, etc., are highly desirable. This has been clearly demonstrated in studies with 2,3,7,8-tetrachlorndibenzo-p-dioxin (TCDD), where more recent measurements of serum concentrations in persons earlier classified as belonging to exposed groups have indicated that severe misclassifications may have occurred in previously epidemiological studies. This also demonstrates that, in retrospective studies, levels of persistent organic compounds are useful as markers of exposure, as their tissue levels mainly reflect previous exposures. However, most organic compounds are readily metabolized and excreted from the human body, and in many instances it will not be possible with current methodology and instrumentation to detect transient organic pollutants at low levels in the blood. In most cases, the use of urine samples offers a better opportunity to provide samples containing detectable levels. Therefore, the measurement of non-persistent organic substances and/or their metabolites may find potential use in prospective environmental health studies, but the predictive value highly depends on proper timing and frequency of sampling according to their toxicokinetic behaviour. A few examples on the use of organic compounds and/or metabolites as biomarkers are given, e.g., polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs), polychlorinated biphenyls (PCBs), polybrominated biphenyls (PBBs), ochratoxin A, polycyclic aromatic hydrocarbons (PAHs) and cooked food mutagens.

Perspectives in pharmacokinetics. Physiologically based pharmacokinetic modeling as a tool for drug development

Since the pioneering work of Haggard and Teorell in the first half of the 20th century, and of Bischoff and Dedrick in the late 1960s, physiologically based pharmacokinetic (PBPK) modeling has gone through cycles of general acceptance, and of healthy skepticism. Recently, however, the trend in the pharmaceuticals industry has been away from PBPK models. This is understandable when one considers the time and effort necessary to develop, test, and implement a typical PBPK model, and the fact that in the present-day environment for drug development, efficacy and safety must be demonstrated and drugs brought to market more rapidly. Although there are many modeling tools available to the pharmacokineticist today, many of which are preferable to PBPK modeling in most circumstances, there are several situations in which PBPK modeling provides distinct benefits that outweigh the drawbacks of increased time and effort for implementation. In this Commentary, we draw on our experience with this modeling technique in an industry setting to provide guidelines on when PBPK modeling techniques could be applied in an industrial setting to satisfy the needs of regulatory customers. We hope these guidelines will assist researchers in deciding when to apply PBPK modeling techniques. It is our contention that PBPK modeling should be viewed as one of many modeling tools for drug development.

Expression of exposure in negative carcinogenicity studies: dose/body weight, dose/body surface area, or plasma concentrations?

Evaluation of positive findings in a rodent carcinogenicity study and the subsequent extrapolation to humans is based on chemical structure, mutagenicity, pharmacology, hormone changes, chronic toxicity, and the nature of the tumors induced. For negative studies, adequacy of exposure may become an issue. The use of plasma concentrations as a metric for exposure assumes that each species responds in a similar manner to a given concentration; data are now available that demonstrate that this is not generally true for carcinogenicity. The use of the body surface area metric (i.e., mg/m2) is a special case of interspecies allometric scaling (i.e., W0.67). For a chemical to be amenable to such scaling in toxicology, it must satisfy 3 criteria: (a) the concentration-time profile of the putative toxicant at the site of action must be governed by a scalable pharmacokinetic process (e.g., glomerular filtration); (b) the mechanism of action and the susceptibility of each species to a given systemic exposure must be the same and, for example, be independent of lifespan, cellular repair mechanism/rate, and so forth; and (c) the biological response must depend only on size (e.g., not on race, strain, gender, age, or parity). Carcinogens rarely, if ever, meet these criteria. An empirical analysis of carcinogenic potency data in rodents and in humans shows that, in general, exposure is best expressed in terms of mg/kg body weight.