Assessment of safety/risk of chemicals: inception and evolution of the ADI and dose-response modeling procedures

A history of antimicrobial drugs in animals: Evolution and revolution

The evolutionary process of antimicrobial drug (AMD) uses in animals over a mere eight decades (1940-2020) has led to a revolutionary outcome, and both evolution and revolution are ongoing, with reports on a range of uses, misuses and abuses escalating logarithmically. As well as veterinary therapeutic perspectives (efficacy, safety, host toxicity, residues, selection of drug, determination of dose and measurement of outcome in treating animal diseases), there are also broader, nontherapeutic uses, some of which have been abandoned, whilst others hopefully will soon be discontinued, at least in more developed countries. Although AMD uses for treatment of animal diseases will continue, it must: (a) be sustainable within the One Health paradigm; and (b) devolve into more prudent, rationally based therapeutic uses. As this review on AMDs is published in a Journal of Pharmacology and Therapeutics, its scope has been made broader than most recent reviews in this field. Many reviews have focused on negative aspects of AMD actions and uses, especially on the question of antimicrobial resistance. This review recognizes these concerns but also emphasizes the many positive aspects deriving from the use of AMDs, including the major research-based advances underlying both the prudent and rational use of AMDs. It is structured in seven sections: (1) Introduction; (2) Sulfonamide history; (3) Nontherapeutic and empirical uses of AMDs (roles of agronomists and veterinarians); (4) Rational uses of AMDs (roles of pharmacologists, clinicians, industry and regulatory controls); (5) Prudent use (residue monitoring, antimicrobial resistance); (6) International and inter-disciplinary actions; and (7) Conclusions.

Host cell proteins in biotechnology-derived products: A risk assessment framework

To manufacture biotechnology products, mammalian or bacterial cells are engineered for the production of recombinant therapeutic human proteins including monoclonal antibodies. Host cells synthesize an entire repertoire of proteins which are essential for their own function and survival. Biotechnology manufacturing processes are designed to produce recombinant therapeutics with a very high degree of purity. While there is typically a low residual level of host cell protein in the final drug product, under some circumstances a host cell protein(s) may copurify with the therapeutic protein and, if it is not detected and removed, it may become an unintended component of the final product. The purpose of this article is to enumerate and discuss factors to be considered in an assessment of risk of residual host cell protein(s) detected and identified in the drug product. The consideration of these factors and their relative ranking will lead to an overall risk assessment that informs decision-making around how to control the levels of host cell proteins.

Toxicology comes of age

This paper contains recollections of some of the people and events that influenced the development of toxicology as an academic discipline. It also describes my experiences in pharmacology at the University of Chicago and the University of Kansas Medical Center and concludes with speculation concerning the future of toxicology. Moderation in all things/Ne quid nimis. --Terence in Andria

Addressing human variability in risk assessment--the robustness of the intraspecies uncertainty factor

Addressing human variability and sensitive subpopulations is one of the challenges of risk assessment and is an important aspect of the Food Quality Protection Act, the law passed in 1996 that regulates food use pesticides in the United States. The intraspecies uncertainty factor is intended to address differences in susceptibility within the human population. This paper examines the history and scientific basis for the intraspecies uncertainty factor. Our best source of knowledge about human variability in the response to chemicals comes from clinical trials of pharmaceuticals. This large body of data allows both qualitative and quantitative characterization of variability in pharmacokinetic and pharmacodynamic parameters in the general population and in subgroups such as children. The preponderance of evidence in the areas of pharmacodynamics and pharmacokinetics supports the routine use of an intraspecies uncertainty factor in the range of 1-10 as being protective of greater than 99% of the human population. The intraspecies uncertainty factor is highly protective of various subpopulations, including infants and children.

Health risk above the reference dose for multiple chemicals

Recent work indicates that the regression of toxicity data viewed as categories of pathological staging is useful for exploring the likely health risk at doses above a Reference Dose (RfD), which is an estimate (with uncertainty spanning perhaps an order of magnitude) of a daily exposure to the human population (including sensitive subgroups) that is likely to be without an appreciable risk of deleterious effects during a lifetime. Toxic effects, which may include both quantal and continuous data, are classified into ordered categories of total toxic severity (e.g., none, mild, adverse, severe). These severity categories are regressed on explanatory variables, such as dose or exposure duration, to estimate the probability of observing an adverse or severe effect. In this paper, categorical regression has been expanded to compare the likely risks across multiple chemicals when exposures are above their RfDs. Existing health risk data for diazinon, disulfoton, S-ethyl dipropylthiocarbamate, fenamiphos, and lindane were analyzed. As expected, the estimated risks of adverse effects above the RfD varied among the chemicals. For example, at 10-fold above the RfD these risks were modeled to be 0.002, 0.0001, 0.0007, 0.002, and 0.02, respectively. The results and impacts of this analysis indicate that categorical regression is a useful screening tool to analyze risks above the RfD for specific chemicals and suggest its application in evaluating comparative risks where multiple chemical exposures exist.

Comparison of noncancer risk assessment approaches for use in deriving drinking water criteria

The development and promulgation of drinking water regulations to protect exposed human populations from contaminants that may occur in public drinking water supplies has been a major regulatory concern and effort of the United States Environmental Protection Agency for decades. Risk assessment, as applied in the development of drinking water regulations, involves the quantification of the level below which adverse health effects are not expected to occur. Traditionally, the oral reference dose (RfD) has been the preferred approach for characterizing these noncancer health risks. The benchmark dose approach to derive RfDs has increasingly gained scientific and regulatory acceptance as a risk assessment methodology since its introduction in 1984. Similarly, the use of categorical regression techniques were introduced at about the same time. The objective of this paper is to present an evaluation of the strengths and weaknesses of each risk assessment method as related to the development of drinking water criteria for noncarcinogenic chemicals. The data base requirements, performance record, mathematical or statistical basis, and other parameters are described and compared.

Categorical regression of toxicity data: a case study using aldicarb

Categorical regression is a mathematical tool that can be adapted to estimate potential health risk from chemical exposures. By regressing ordered categories of toxic severity or pathological staging on exposure dose, this method can estimate the likelihood of observing any of the categories of severity at any dose level. Depending on the nature of the available data, these estimates can take the form of incidence rates for any of the categories in an exposed population or the probability of a new study conducted at a specified dose level being classified as one of the categories. Categorical regression is illustrated using toxicity data on aldicarb. For aldicarb, the data fall into three different groups: human clinical studies, dietary exposures in experimental animals, and accidental human exposure by contaminated crops. The U.S. EPA has assessed this literature and developed a reference dose (RfD) of 0.001 mg/kg-day. The results of applying categorical regression to data from human clinical studies suggests a maximum likelihood risk estimate of adverse effects of 0.008% at a 10-fold higher dose than the RfD when blood cholinesterase inhibition is not considered as an adverse effect. When blood cholinesterase inhibition of 20% or more is considered as an adverse effect, a maximum likelihood risk estimate of adverse effects is 0.1% at a dose 10-fold higher than the RfD.

Toluene diisocyanate: an assessment of carcinogenic risk following oral and inhalation exposure

Although respiratory sensitization and pulmonary irritation have been the subject of particular studies with toluene diisocyanate (TDI), in recent years the potential carcinogenicity of TDI has been a reason for concern and speculation. This has arisen from the expectation that following exposure to TDI the chemical would hydrolyze at aqueous tissue surfaces to give rise to toluene diamine (TDA), a mutagen and rodent carcinogen. The chemistry of TDI suggests that the reaction with biological NH2 groups such as those on proteins, and polymerization to oligoureas, will compete with the hydrolysis reaction. This has been shown with results of in vitro studies where conjugation to protein occurs without detectable formation of TDA when protein solutions in saline are exposed to TDI vapor. Lower pH levels leading to high protonation of biological NH2 groups facilitate hydrolysis of TDI to TDA and subsequent formation of polyureas. These observations are consistent with comparative toxicokinetic studies in rats, which demonstrate significant levels of TDA following oral dosing with TDI--due to the acidic environment in the stomach--but not after inhalation. These results provide an explanation for the tumors observed in rodents after oral dosing of TDI in corn oil, but not after inhalation. Inhalation is the relevant route of human exposure for TDI and the toxicokinetics of TDI exposure at occupational exposure limits have been studied. These data provide a means by which quantitative estimates of the risk of carcinogenicity possibly resulting from the intermediate formation of TDA during TDI exposure can be obtained. Several calculations have been made, all of which lead to the conclusion that TDI exposure by inhalation at the recommended occupational limits will not give rise to significant carcinogenic risk.

Regulating carcinogenic risks from foodstuffs: present Danish approaches

The aim of the present Danish regulatory toxicological efforts is to identify and eliminate human carcinogens introduced in the human food supply directly or indirectly through the activity of man. The efforts are directed towards food additives, contaminants and food itself, both individual food items and dietary habits. The overall goal is to bring down the incidence of cancer. The scientific rationale for achieving this goal is discussed based upon recent knowledge. It is suggested that more scientific efforts should be directed towards determining the qualitative and quantitative role of the natural food constituents in human cancer causation.