Hydrolytic stability of selected pharmaceuticals and their transformation products

Transformation products of diclofenac: Formation, occurrence, and toxicity implication in the aquatic environment

Diclofenac (DCF) is the first drug on the EU Watch List of Priority Substances due to its extensive uses, incomplete removal in wastewater treatment plants (WWTPs), and toxic effects. Once in the environment, DCF undergoes processes that yield various transformation products (TPs) or metabolites, whichcan be more toxic than DCF. While these TPs or metabolites often dominate the majority of the drug load in municipal wastewater, they have been largely ignored. This review critically examines recent data on the formation, occurrence, fate, and toxicology of DCF TPs in the aquatic environment. This review reveals some important findings. First, DCF TPs may constitute >57 % of DCF in wastewater influent, ∼60 % in effluent, and ∼30 % in surface waters. Second, TPs persistently retain the core structure of DCF and may pose greater environmental risks than the parent drug. Third, some metabolites may revert back to the parent drug. Fourth, WWTPs serve as a consistent source that release DCF and its by-products into the environment. Fifth, mixtures of DCF and its metabolites, along with other contaminants, may pose elevated and synergistic environmental risks than individual compounds. These findings suggest that current risk assessment practices, which ignore the impacts of the metabolites and the chemical interactions/synergies, may seriously underestimate the overall toxicity of DCF and likely other pharmaceuticals. Further studies are needed to monitor the long-term fate and toxicity of the metabolites, as well as new analytical methods and standards to unveil the hidden metabolites and the associated environmental risks.

Effect of salinity on the toxicity of diclofenac, ibuprofen and naproxen toward cyanobacterium Synechocystis salina

Aquatic species are continuously exposed to pharmaceuticals and changeable water conditions simultaneously, which can induce changes in the toxicity of pollutants. Cyanobacterium are an organism for which less ecotoxicological tests have been performed compared to green algae. In this study, we decided to check how selected non-steroidal anti-inflammatory drugs (NSAID) affect the grow of Synechocystis salina, picocyanobacterium isolated from the Baltic Sea, with salinity as potential modulator of toxicity. S. salina was exposed to diclofenac (DCF), ibuprofen (IBF) and naproxen (NPX) (nominal 100 mg L-1) in BG11 medium and sea salt supplemented BG11 medium (38 PSU) over 96 h in continuous light at 23 °C. No acute toxicity was found in both tested salinity levels. The comparable grow rate in exposed culture compared to control culture over 4 days indicate lack of stress for several generations which need to be overcome with substantial energy consumption. S. salina was found to be halotolerant and can be species for ecotoxicology test where salinity in an additional stressor. Furthermore, resistant of S. salina to target NSAIDs provide a competitive advantage over other phytoplankton species.

Occurrence, environmental impact and fate of pharmaceuticals in groundwater and surface water: a critical review

In many nations and locations, groundwater serves as the population's primary drinking water supply. However, pharmaceuticals found in groundwater and surface waters may affect aquatic ecosystems and public health. As a result, their existence in natural raw waters are now more widely acknowledged as a concern. This review summarises the evidence of research on pharmaceuticals' occurrence, impact and fate, considering results from different water bodies. Also, various analytical techniques were reviewed to compare different pharmaceuticals' detection frequencies in water bodies. These include liquid chromatography-mass spectrometry (LC-MS), high-performance liquid chromatography (HPLC), ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), and gas chromatography-mass spectrometry (GC-MS). However, owing to LC-MS's high sensitivity and specification, it is the most reported instrument used for analysis. The PRISMA reviewing methodology was adopted based on relevant literature in order to focus on aim of the review. Among other pharmaceuticals reviewed, sulfamethoxazole was found to be the most frequently detected drug in wastewater (up to 100% detection frequency). The most reported pharmaceutical group in this review is antibiotics, with sulfamethoxazole having the highest concentration among the analysed pharmaceuticals in groundwater and freshwater (up to 5600 ng/L). Despite extensive study and analysis on the occurrence and fate of pharmaceuticals in the environment, appropriate wastewater management and disposal of pharmaceuticals in the water environment are not still monitored regularly. Therefore, there is a need for mainstream studies tailored to the surveillance of pharmaceuticals in water bodies to limit environmental risks to human and aquatic habitats in both mid and low-income nations.

Acute and Transgenerational Effects of Non-Steroidal Anti-Inflammatory Drugs on Daphnia magna

Pharmaceuticals pose a great threat to organisms inhabiting the aquatic environment. Non-steroidal anti-inflammatory drugs (NSAIDs) are major pharmaceutical pollutants with a significant presence in freshwater ecosystems. In this study, the impact of indomethacin and ibuprofen, two of the most commonly prescribed NSAIDs, was assessed on Daphnia magna. Toxicity was assessed as the immobilization of animals and used to determine non-lethal exposure concentrations. Feeding was assessed as a phenotypic endpoint and key enzymes were used as molecular endpoints of physiology. Feeding was decreased in mixture exposures for five-day-old daphnids and neonates. Furthermore, animals were exposed to NSAIDs and their mixture in chronic and transgenerational scenarios revealing changes in key enzyme activities. Alkaline and acid phosphatases, lipase, peptidase, β-galactosidase, and glutathione-S-transferase were shown to have significant changes in the first generation at the first and third week of exposure, and these were enhanced in the second generation. On the other hand, the third recovery generation did not exhibit these changes, and animals were able to recover from the induced changes and revert back to the control levels. Overall, our study points towards transgenerational exposures as more impactful laboratory studies to understand pharmaceutical stressors with a combination of molecular and phenotypic markers of physiology.

Bench-to-bedside: Feasibility of nano-engineered and drug-delivery biomaterials for bone-anchored implants and periodontal applications

Nanotechnology and drug-release biomaterials have been thoroughly explored in the last few years aiming to develop specialized clinical treatments. However, it is rare to find biomaterials associated with drug delivery properties in the current dental market for application in oral bone- and periodontal-related procedures. The gap between basic scientific evidence and translation to a commercial product remains wide. Several challenges have been reported regarding the clinical translation of biomaterials with drug-delivery systems (BDDS) and nanofeatures. Therefore, processes for BDDS development, application in preclinical models, drug delivery doses, sterilization processes, storage protocols and approval requirements were explored in this review, associated with tentative solutions for these issues. The diversity of techniques and compounds/molecules applied to develop BDDS demands a case-by-case approach to manufacturing and validating a commercial biomaterial. Promising outcomes such as accelerated tissue healing and higher antibacterial response have been shown through basic and preclinical studies using BDDS and nano-engineered biomaterials; however, the adequate process for sterilization, storage, cost-effectiveness and possible cytotoxic effects remains unclear for multifunctional biomaterials incorporated with different chemical compounds; then BDDSs are rarely translated into products. The future benefits of BDDS and nano-engineered biomaterials have been reported suggesting personalized clinical treatment and a promising reduction in the use of systemic antibiotics. Finally, the launch of these specialized biomaterials with solid data and controlled traceability onto the market will generate strong specificity for healthcare treatments.

Transformation products of pharmaceuticals in the environment: Their fate, (eco)toxicity and bioaccumulation potential

Nowadays, a huge scientific attention is being paid to the chemicals of emerging concern, which may pose a significant risk to the human and whole ecosystems. Among them, residues of pharmaceuticals are a widely investigated group of chemicals. In recent years it has been repeatedly demonstrated that pharmaceuticals are present in the environment and that some of them can be toxic to organisms as well as accumulate in their tissues. However, even though the knowledge of the presence, fate and possible threats posed by the parent forms of pharmaceuticals is quite extensive, their transformation products (TPs) have been disregarded for long time. Since last few years, this aspect has gained more scientific attention and recently published papers proved their common presence in the environment. Also the interest in terms of their toxicity, bioconcentration and stability in the environment has increased. Therefore, the aim of our paper was to revise and assess the current state of knowledge on the fate and effects resulting from the presence of the pharmaceuticals' transformation drugs in the environment. This review discusses the metabolites of compounds belonging to six major pharmaceutical groups: SSRIs, anticancer drugs, antibiotics, antihistamines, NSAIDs and opioids, additionally discussing other individual compounds for which literature data exist. The data presented in this paper prove that some TPs may be as harmful as their native forms, however for many groups of drugs this data is still insufficient to assess the risk posed by their presence in the environment.

ABCB1 c.3435C > T and EPHX1 c.416A > G polymorphisms influence plasma carbamazepine concentration, metabolism, and pharmacoresistance in epileptic patients

The gene polymorphisms of ABCB1, EPHX1, and SCN1A were found to influence carbamazepine (CBZ) metabolism and resistance in epilepsy patients, but the relevance remains controversial. To reveal the relationships among the gene polymorphisms of ABCB1, EPHX1, SCN1A and the metabolism and resistance of CBZ, the databases of PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Science and Technique Journals, China Biology medicine disc and Wan Fang were retrieved for suitable studies up to April 2021. 18 studies containing 3293 epilepsy patients were included. The result revealed the gene polymorphism of ABCB1 c.3435C > T is significantly associated with altered concentration-dose ratios of CBZ (CDR_CBZ) (CC vs. CT, OR = 0.25 (95% CI: 0.08-0.42), P = 0.004), and EPHX c.416A > G gene polymorphism may also significantly adjusted the concentration-dose ratios of carbamazepine-10, 11-trans dihydrodiol (CDR_CBZD) (AA vs. GG, OR = 0.48 (95% CI: 0.01-0.96), P = 0.045; AG vs. GG, OR = 0.68 (95% CI: 0.16-1.20), P = 0.010, respectively) and the ratio of CBZD:carbamazepine-10,11-epoxide (CBZE) (CDR_CBZD:CDR_CBZE) (AG vs GG, OR = 0.83 (95% CI: 0.31-1.36), P = 0.002). Furthermore, ABCB1 c.3435C > T polymorphism was also observed to be significantly influenced CBZ resistance (CC vs TT, OR = 1.78 (95% CI: 1.17-2.72), P = 0.008; CT vs TT, OR = 1.60 (95% CI: 1.12-2.30), P = 0.01; CC + CT vs TT, OR = 1.61 (95% CI: 1.15-2.26), P = 0.006, respectively). Therefore, CBZ metabolism and resistance in patients with epilepsy may be adjusted by the gene polymorphisms of ABCB1 c.3435C > T and EPHX1 c.416A > G which provides the further scientific basis for clinical individualized therapy of epilepsy. However, larger sample size studies are still needed to provide further conclusive evidence.

Hydrolytic stability of anticancer drugs and one metabolite in the aquatic environment

Due to the genotoxic, carcinogenic and teratogenic mechanism of action, anticancer drugs are highly hazardous compounds. Their occurrence, fate, and effects in the environment have not been systematically studied as compared to other medicaments. Therefore, reliable data, including their stability and persistency, is required in order to assess it. Taking into account, that hydrolysis is one of the most important factors regarding stability of chemicals in water, the aim of our study was to investigate the hydrolytic stability of five commonly used anticancer drugs (ifosfamide, cyclophosphamide, 5-fluorouracil, imatinib, and methotrexate) and one metabolite (7-hydroxymethotrexate), as the systematized and coherent data available is limited. The hydrolysis studies have been prepared according to the OECD 111 procedure to obtain standardized and comparable results. The preliminary tests at pH 4, 7, and 9 and 50 °C show that only cyclophosphamide and ifosfamide are unstable, whereas the estimated t_1/2 at 25 °C is >1 year for other investigated compounds. Moreover, much more detailed experiments were performed and indicate that at environmentally relevant temperatures, cyclophosphamide, and ifosfamide would be quite persistent in the terms of hydrolytic stability. Moreover, the preliminary investigation on the hydrolysis products was performed.

Exposure of Mytilus trossulus to diclofenac and 4'-hydroxydiclofenac: Uptake, bioconcentration and mass balance for the evaluation of their environmental fate

Diclofenac (DIC) is one of the most widely consumed drugs in the world, and its presence in the environment as well as potential effects on organisms are the subject of numerous recent scientific works. However, it is becoming clear that the risk posed by pharmaceuticals in the environment needs to be viewed more broadly and their numerous derivatives should also be considered. In fact, already published results confirm that the transformation products of NSAIDs including DIC may cause a variety of potentially negative effects on marine organisms, sometimes showing increased biological activity. To date, however, little is known about bioconcentration of DIC and DIC metabolites and the role of sex in this process. Therefore, the present study for the first time evaluates sex-related differences in DIC bioconcentration and estimates bioconcentration potential of DIC metabolite, 4-OH DIC, in the Mytilus trossulus tissues. In the experiment lasting 7 days, mussels were exposed to DIC and 4-OH DIC at concentrations 68.22 and 20.85 μg/L, respectively. Our study confirms that DIC can be taken up by organisms not only in its native form, but also as a metabolite, and metabolised further. Furthermore, in the present work, mass balance was performed and the stability of both studied compounds under experimental conditions was analysed. Obtained results suggest that DIC is more stable than its derivative under the tested conditions, but further analyses of the environmental fate of these compounds are necessary.

Interaction of pharmaceutical metabolites with blood proteins and membrane lipids in the view of bioconcentration: A preliminary study based on in vitro assessment

Pharmaceuticals pose a real threat to the environment, which has been proven in many studies to date. However, still little is known about the transformation products (TPs) of these compounds, which can also interact with organisms, causing adverse effects like noticeable toxicity or bioconcentration. Many recent works confirm that metabolites of pharmaceuticals are present in the environment, and preliminary studies suggest that they may be equally dangerous to or even more so than their parent compounds. Additionally, it has been proven that some of them have high hydrolytic stability, thus they may be persistent in the environment. This property also increases the likelihood that these compounds will be uptaken and accumulated in the tissues of organisms. Therefore, the aim of the present study was to preliminarily estimate the affinity of the transformation products of selected drugs for blood proteins and cell membrane-forming lipids, considered as important sorption phases during distribution in a living organism. In this study, it was shown that although the examined metabolites do not have a strong affinity for membrane lipids, they exhibit relatively strong binding to proteins, which may considerably affect the distribution of TPs in an organism and may indicate a non-classical process of bioconcentration. The results obtained confirm that the TPs of pharmaceuticals should be given much more attention and their potential for bioconcentration should be further determined.

Toxic effects of NSAIDs in non-target species: A review from the perspective of the aquatic environment

The presence of pharmaceuticals in the aquatic environment, both in marine and freshwater reservoirs, is a major concern of global environmental protection. Among the drugs that are most commonly used, NSAIDs tend to dominate. Currently, being aware of the problem caused by drug contamination, it is extremely important to evaluate the scale and the full spectrum of its consequences, from short-term to long-term effects. The influence on non-target aquatic animals can take place at many levels, and the effects can be seen both in behaviour and physiology, but also in genetic alterations or reproduction disorders, affecting the development of entire populations. This review summarises all the advances made to estimate the impact of NSAIDs on aquatic animals. Multicellular animals from all trophic levels, inhabiting both inland waters, seas and oceans, have been considered. Particular attention has been paid to chronic studies, conducted at low, environmentally-relevant concentrations, to estimate the real effects of the present pollution. The number of such studies has indeed increased in recent years, allowing for a better insight into the possible consequences of pharmaceutical pollution. It should be stressed, however, that our knowledge is still limited to a few model species, while there are many groups of organisms completely unexplored regarding the effects of drugs. Therefore, the main aim of this paper was to summarise the current state of knowledge on the toxicity of NSAIDs in aquatic animals, also identifying important gaps and major issues requiring further analysis.