Some considerations concerning the theory of combined toxicity: A case study of subchronic experimental intoxication with cadmium and lead

Modeling mixtures interactions in environmental toxicology

In the environment, organisms are exposed to mixtures of different toxicants, which may interact in ways that are difficult to predict when only considering each component individually. Adapting and expanding tools from pharmacology, the toxicology field uses analytical, graphical, and computational methods to identify and quantify interactions in multi-component mixtures. The two general frameworks are concentration addition, where components have similar modes of action and their effects sum together, or independent action, where components have dissimilar modes of action and do not interact. Other interaction behaviors include synergism and antagonism, where the combined effects are more or less than the additive sum of individual effects. This review covers foundational theory, methods, an in-depth survey of original research from the past 20 years, current trends, and future directions. As humans and ecosystems are exposed to increasingly complex mixtures of environmental contaminants, analyzing mixtures interactions will continue to become a more critical aspect of toxicological research.

Dose Dependence of the Separate and Combined Impact of Copper-Oxide and Selenium-Oxide Nanoparticles on Oxygen Consumption by Cells In Vitro With or Without the Background Action of Some Modulators of the Mitochondrial Respiratory Function

We had previously demonstrated on various stable cell cultures exposed to chemically different nanoparticles when assessing their cytotoxicity by different outcomes, dose-response relationships may be either monotonic or non-monotonic falling within an extended understanding of the hormesis paradigm. Presently, on human fibroblasts exposed to the copper-oxide and/or selenium-oxide nanoparticles, we assessed their cytotoxic effect by the inhibition of oxygen uptake against modulating the respiratory function of mitochondria (oligomycin, followed by carbonyl cyanide-4-(trifluoromethoxy) phenylhydrazone, and, finally, rotenone with antimycin A). It is hypothesized that a given type of this relationship is closely associated with the mitochondrial respiratory function. However, in only one case, this hypothesis was confirmed by finding that the monotonic dose-response relationship transformed into a non-monotonic one of the hormesis type under exposure to SeO-NP with the mitochondrial respiratory function fully inhibited by the effect of rotenone + antimycin А. In all other variants of the experiment, the shape of this relationship did not depend on the addition of the above agents to the cell culture. Neither did the effect of these modulators change the pattern of combined action of CuO-NP and SeO-NP, which was additive in all cases.

Attention deficit among preschool and school-aged children living near former metal-processing plants in Romania

Industrial areas affected by high and long-term heavy metal pollution have a great impact on health of the resident population. Children represent a group at high-risk with an increased susceptibility to chronic heavy metal intoxication. Our work included the assessment of attention particularities through a case-control study in pre-school and school-aged children (4-6 years and 8-11 years) from two study areas, Copşa Mică and Zlatna, compared to a non-polluted locality with no history of heavy metal pollution. Copşa Mică and Zlatna are two of the most polluted heavy metals regions in Romania due to non-ferrous metallurgy for a long period of time. Recruitment of participants was made by a random selection of an entire class for each age within the schools and kindergartens from the study areas (Copşa Mică and Zlatna) and from the non-polluted region. Interpretation of data was performed using statistical analysis (ANOVA and Student's t-test). Preschool children (4-6 years) were tested using Wechsler Preschool and Primary Scale of Intelligence (WPPSI) tests, Animal House and labyrinth samples. The results of the attention tests applied to pre-school children were lower in the study areas compared to the control group, but no statistical differences were found. The results of the attention tests applied to children aged between 8 and 11 years (Toulouse-Pieron test and Traffic light test) indicate lower average scores within the study groups from polluted areas, compared to the control group. Differences with statistically significance were registered for the 8 years age group (p = 0.037). In these areas efficient strategies and precise intervention measures are needed in order to limit or remove the heavy metal exposure and protect the human health, especially the groups exposed to a high level of risk.

Experimental Testing of an Approach to Establishing Combined Toxicity of Ternary Nanoparticle Mixtures

Our studies of exposure to binary mixtures of nanoparticles (TiO₂ + SiO₂; TiO₂ + Al₂O₃ and SiO₂ + Al₂O₃) based on mathematical modelling show that their combined subchronic toxicity can either be of an additive type or deviate from it depending on the outcome, dose ratio, and levels of effect. To characterize the type of toxicity of ternary mixtures of nanoparticles, we successfully tested a previously developed approach for assessing the combined toxicity of metal ions. In this approach, the effects are classified by a null, positive, or negative change in the toxicity of binary nanoparticle mixtures when modeled against the toxicity of the third agent added.

Comparative and Combined In Vitro Vasotoxicity of Nanoparticles Containing Lead and Cadmium

In vitro toxicological experiments were performed on an endothelial cell line exposed to different doses of spherical nanoparticles of cadmium and/or of lead sulfides with mean diameter 37 ± 5 nm and 24 ± 4 nm, respectively. Toxic effects were estimated by Luminescent Cell Viability Assay, endothelin-1 concentration and cell size determination. Some dose-response relationships were typically monotonic (well approximated with hyperbolic function) while others were bi- or even 3-phasic and could be described within the expanded hormesis paradigm. The combined toxicity type variated depending on the effect it was assessed by.

Some data on the comparative and combined toxic activity of nanoparticles containing lead and cadmium with special attention to their vasotoxicity

Moderate subchronic intoxication was induced in rats by repeated intraperitoneal injections of PbO (49.6 ± 16.0 nm) and/or CdO (57.0 ± 13.0 nm) nanoparticles (NP) three times a week during 6 weeks. In particular, there was a reduction in arterial blood pressure and in blood concentrations of a number of factors controlling vasoconstriction and vasodilation, particularly of endothelin 1 (ET-1). This toxic effect was attenuated with a bioprotective complex administered in the background. The study confirmed as well that the combined binary action typology varies depending on which effect it is estimated by.

Some outcomes and a hypothetical mechanism of combined lead and benzo(a)pyrene intoxication, and its alleviation with a complex of bioprotectors

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Rats were injected repeatedly intraperitoneally with lead acetate and/or benzo(а)pyrene solutions in various dose ratios.

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Under combined exposure the organism load with benzo(а)pyrene was increased while that with its metabolites reduced.

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The genotoxic effect of the combined exposure was higher than that of benzo(a)pyrene alone.

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This effect was inhibited by a complex of antitoxic bioprotectors.

Rats were exposed 3 times a week during 6 weeks to repeated intraperitoneal injections of lead acetate solution in water (Pb) and/or benzo(а)pyrene solution in petrolatum oil (B(а)P) in various dose ratios. Towards the end of the period, the animals developed a moderate subchronic intoxication having some features characteristic of lead effects. The type of combined toxicity estimated with the help of isoboles constructed by the Response Surface Methodology was found to be varied depending on a particular effect, its level, and dose ratio. However, Pb and B(a)P in combination often displayed an additive or even superadditive action. In the group exposed to this combination compared with the group of rats exposed to B(a)P alone, its concentration in the organism was increased while the concentration of some B(a)P oxidative metabolism products was reduced. Such inhibition of B(a)P biotransformation, assumingly associated with impaired heme and, thus, cytochrome P450 synthesis induced by lead intoxication, can serve as an explanation for certain enhancement of the genotoxic effect of B(a)P. This effect was not present in the same combined intoxication if a complex of antitoxic bioprotectors was being administered in the background.

Force-velocity characteristics of isolated myocardium preparations from rats exposed to subchronic intoxication with lead and cadmium acting separately or in combination

This investigation continues our study of the effects of Pb-Cd poisoning on the heart, extending the enquiry from isometric to auxotonic contractions, thereby examining the effect on the ability of myocardial tissues to perform mechanical work. Different shifts were revealed in myocardial force-velocity relations following subchronic exposure of rats to lead acetate and cadmium chloride acting separately, in combination, or in combination with a bioprotective complex (BPC). The experiments were conducted on isolated preparations of trabecules and papillary muscles of the right ventricle in physiological loading conditions and on isolated heart muscle contractile proteins examined by the in vitro motility assay. The results of the latter correlate with the shifts in the ratio of cardiac myosin isoforms. The amount of work performed by the myocardium was calculated on the basis of the tension-shortening loop area and was found to be similar in the preparations from all experimental groups. This fact presumably reflects adaptive capacity of the myocardial function even when contractility is damaged due to the metallic intoxication of a moderate severity. Some characteristics of rat myocardium altered by the impact of lead-cadmium intoxication became fully or partly normalized if intoxication developed against background administration of a bioprotective complex (BPC). Together with previously reported results obtained in the isometric mode of contractility, all these results strengthen the scientific foundations of risk assessment and risk management projects in the occupational and environmental conditions characterized by human exposure to lead and/or cadmium.

An overview of experiments with lead-containing nanoparticles performed by the Ekaterinburg nanotoxicological research team

Over the past few years, the Ekaterinburg (Russia) interdisciplinary nanotoxicological research team has carried out a series of investigations using different in vivo and in vitro experimental models in order to elucidate the cytotoxicity and organ-systemic and organism-level toxicity of lead-containing nanoparticles (NP) acting separately or in combinations with some other metallic NPs. The authors claim that their many-sided experience in this field is unique and that some of their important results have been obtained for the first time. This paper is an overview of the team's previous publications in different journals. It is suggested to be used as a compact scientific base for assessing health risks associated not only with the production and usage of engineered lead-containing NPs but also with their inevitable by-production as toxic air pollutants in the metallurgy of lead, copper or their alloys and in soldering operations.

Some Peculiarities in the Dose Dependence of Separate and Combined In Vitro Cardiotoxicity Effects Induced by CdS and PbS Nanoparticles With Special Attention to Hormesis Manifestations

Spherical nanoparticles (NPs) of cadmium and lead sulfides (diameter 37 ± 5 and 24 ± 4 nm, respectively) have been found to be cytotoxic for HL-1 cardiomyocytes as evidenced by decrease in adenosine triphosphate-dependent luminescence. Cadmium sulfide (CdS)-NPs were discovered to produce a much greater cytotoxic impact than lead sulphide (PbS)-NP. Given the same dose range, CdS-NP reduced the number of calcium spikes. A similar effect was observed for small doses of PbS-NP. In addition to cell hypertrophy under the impact of certain doses of CdS-NP and PbS-NP, doses causing cardiomyocyte size reduction were identified. For these 3 outcomes, we obtained both monotonic "dose-response" functions (well approximated by the hyperbolic function) and different variants of non-monotonic ones for which we found adequate mathematical expressions by modifying certain models of hormesis available in the literature. Data analysis using a response surface linear model with a cross-term provided new support to the previously established postulate that a diversity of types of joint action characteristic of one and the same pair of damaging agents is one of the important assertions of the general theory of combined toxicity.

Manifestation of Systemic Toxicity in Rats after a Short-Time Inhalation of Lead Oxide Nanoparticles

Outbred female rats were exposed to inhalation of lead oxide nanoparticle aerosol produced right then and there at a concentration of 1.30 ± 0.10 mg/m³ during 5 days for 4 h a day in a nose-only setup. A control group of rats were sham-exposed in parallel under similar conditions. Even this short-time exposure of a relatively low level was associated with nanoparticles retention demonstrable by transmission electron microscopy in the lungs and the olfactory brain. Some impairments were found in the organism’s status in the exposed group, some of which might be considered lead-specific toxicological outcomes (in particular, increase in reticulocytes proportion, in δ-aminolevulinic acid (δ-ALA) urine excretion, and the arterial hypertension’s development).

Further verification of some postulates of the combined toxicity theory: New animal experimental data on separate and joint adverse effects of lead and cadmium

Outbred male rats were repeatedly injected intraperitoneally two-level sub-lethal doses of lead acetate and/or cadmium chloride solutions 3 times a week during 6 weeks. The animals developed explicit, even if moderate, subchronic intoxication characterized by a large number of indices, both common to both metals (including increased DNA fragmentation coefficient) and lead-specific. Special attention was paid to hemodynamic and electrocardiographic effects. The combined action of lead and cadmium was modeled with the help of the Response Surface Methodology to obtain additional support for the previously substantiated postulates of combined toxicity's typological ambiguity. This is dependent on which particular effect comes under consideration, on its level, and on the acting dose ratio. For one and the same toxic combination, the type of combined toxic action can vary from synergistic to contra-directional. In particular, the actions of lead and cadmium on blood pressure were found to be opposite in direction. Furthermore, it is shown once again that the systemic toxic effects of a metal combination, its in vivo genotoxicity included, can be more or less attenuated by background administration of a theoretically justified composition of biologically active agents.

Recent advances in the development of electrochemical aptasensors for detection of heavy metals in food

Heavy metal contamination in environment and food has attracted intensive attention from the public since it poses serious threats to ecological system and human health. Traditional detection methods for heavy metals such as atomic absorption spectrometry have a fairly low detection limit, but the methods have many limitations and disadvantages. Therefore, it is of significance to develop a rapid technology for real-time and online detection of heavy metals. The electrochemical aptasensor-based technology is promising in the detection of heavy metals with advantages of high sensitivity, specificity, and accuracy. Although its development is rapid, more researches should be carried out before this technology can be used for on-site detection. In this review, the origin, basic principles and development of electrochemical aptasensors are introduced. The applications of nanomaterials and electrochemical aptasensors for the detection of heavy metals (mainly mercury, lead, cadmium, and arsenic) are summarized. The research and application tendency of electrochemical aptasensors for detection of heavy metals are prospected.

Further analysis of rat myocardium contractility changes associated with a subchronic lead intoxication

A moderate subchronic lead intoxication was observed in male rats after repeated intraperitoneal injections of lead acetate. Right ventricular trabeculae and papillary muscles were isolated for in vitro studying of the contraction-relaxation cycle under isotonic and physiological loading. The contractile function of the myocardium was also assessed by measuring the velocity of thin filament movement over myosin. Lead intoxication led in papillary muscles to a decrease in the maximal rate of isotonic shortening for all afterloads and a decrease in the thin filament sliding velocity. Papillary muscles from lead-exposed rats displayed marked changes in most of the main characteristics of afterload contraction-relaxation cycles, but in trabeculae these changes were less pronounced. The reported changes were attenuated to some extent in rats treated with a Ca-containing bioprotector. The amount of work produced by both types of heart muscle preparations was not changed by lead. Only in papillary muscles the load-dependent relaxation index was significantly increased in the lead-treated groups. Thus subchronic lead intoxication affects the peak rate of force development and relaxation properties of cardiac muscle contracting in isotonic/physiological regimes rather than the total amount of mechanical work, which may reflect adaptive changes in the myocardial function under decreased contractility.

Using Various Nonlinear Response Surfaces for Mathematical Description of the Type of Combined Toxicity

The article considers the problem of characterizing the type of combined action produced by a mixture of toxic substances with the help of nonlinear response functions. Most attention is given to second-order models: the linear model with a cross-term and the quadratic model. General propositions are formulated based on the data on combined toxicity patterns previously obtained by the Ekaterinburg nanotoxicology team in animal experiments and analyzed with the help of the linear model with a cross-term. It is shown now that the quadratic model features these general characteristics in full measure, but interpretation of combined toxicity types based on isobolograms obtained by the quadratic model is more difficult. This suggests that where both models ensure a comparable quality of combined toxicity type identification, it would be enough to use the linear model with a cross-term.

Effects of subchronic lead intoxication of rats on the myocardium contractility

Outbred male rats were repeatedly injected IP with sub-lethal doses of lead acetate 3 times a week during 5 weeks. They developed an explicit, even if moderate, lead intoxication characterized by typical hematological and some other features. The next day after the last injection the heart of each animal was excised, and the trabecules and papillary muscles from the right ventricle were used for modeling in vitro isometric (with varying starting length of the preparation) regimes of the contraction-relaxation cycle with different preloads. Several well-established parameters of this model were found changed compared with the preparations taken from the hearts of healthy control rats. Background in vivo calcium treatment attenuated both systemic and cardiotoxic effects of lead to an extent. We show for the first time that subchronic intoxication with lead caused myocardial preparations in a wide range of lengths to respond by a decrease in the time and speed parameters of the isometric contraction while maintaining its amplitude and by a decrease in the passive stiffness of trabecules. The responses of the various heart structures are outlined, and the isomyosin ratio is shown to have shifted towards the slow isoform. Mechanistic and toxicological inferences from the results are discussed.

Combined Subchronic Toxicity of Aluminum (III), Titanium (IV) and Silicon (IV) Oxide Nanoparticles and Its Alleviation with a Complex of Bioprotectors

Stable suspensions of metal/metalloid oxide nanoparticles (MeO-NPs) obtained by laser ablation of 99.99% pure elemental aluminum, titanium or silicon under a layer of deionized water were used separately, or in three binary combinations, or in a ternary combination to induce subchronic intoxications in rats. To this end, the MeO-NPs were repeatedly injected intraperitoneally (i.p.) 18 times during 6 weeks before measuring a large number of functional, biochemical, morphological and cytological indices for the organism’s status. In many respects, the Al₂O₃-NP was found to be the most toxic species alone and the most dangerous component of the combinations studied. Mathematical modeling with the help of the Response Surface Methodology showed that, as well as in the case of any other binary toxic combinations previously investigated by us, the organism’s response to a simultaneous exposure to any two of the MeO-NP species under study was characterized by a complex interaction between all possible types of combined toxicity (additivity, subadditivity or superadditivity of unidirectional action and different variants of opposite effects) depending on which outcome this type was estimated for and on effect and dose levels. With any third MeO-NP species acting in the background, the type of combined toxicity displayed by the other two remained virtually the same or changed significantly, becoming either more or less unfavorable. Various harmful effects produced by the (Al₂O₃-NP + TiO₂-NP + SiO₂-NP)-combination, including its genotoxicity, were substantially attenuated by giving the rats per os during the entire exposure period a complex of innocuous bioactive substances expected to increase the organism’s antitoxic resistance.

The most important inferences from the Ekaterinburg nanotoxicology team's animal experiments assessing adverse health effects of metallic and metal oxide nanoparticles

During 2009-2017 we have studied nanoparticles of elemental silver or gold and of iron, copper, nickel, manganese, lead, zinc, aluminium and titanium oxides (Me-NPs) using, in most cases, a single low-dose intratracheal instillation 24 h before the bronchoalveolar lavage to obtain a fluid for cytological and biochemical assessment and, in all cases, repeated intraperitoneal injections in non-lethal doses to induce subchronic intoxications assessed by a lot of toxicodynamic and toxicokinetic features. We have also studied the same effects for a number of relevant combinations of these Me-NPs and have revealed some important patterns of their combined toxicity. Besides, we have carried out long-term inhalation experiments with Fe2O3, NiO and amorphous SiO2 nano-aerosols. We have demonstrated that Me-NPs are much more noxious as compared with their fine micrometric counterparts although the physiological mechanisms of their elimination from the lungs proved to be highly active. Even if water-insoluble, Me-NPs are significantly solubilized in some biological milieus in vitro and in vivo, which may explain some important peculiarities of their toxicity. At the same time, the in situ cytotoxicity, organ-systemic toxicity and in vivo genotoxicity of Me-NPs strongly depends on specific mechanisms characteristic of a particular metal. For some of the Me-NPs studied, we have proposed standards of presumably safe concentrations in workplace air. Along with this, we have proved that the adverse effects of Me-NPs could be significantly alleviated by background or preliminary administration of adequately composed combinations of some bioprotectors.

Are in vivo and in vitro assessments of comparative and combined toxicity of the same metallic nanoparticles compatible, or contradictory, or both? A juxtaposition of data obtained in respective experiments with NiO and Mn3O4 nanoparticles

Comparative and combined damaging effects of NiO and Mn₃O₄ nanoparticles were estimated on cultures of several established human cell lines. The cytotoxicity indices used were: (a) reduction in cellular dehydrogenase activity, (b) decrease in the ATP-content, (c) for SH-SY5Y cells also decrease in the tyrosine hydroxylase content. The combined cytotoxicity was modeled using the Response Surface Methodology. When assessing the stability of metal oxide nanoparticles (MeO-NPs) in cultural media used by us, we found that the addition of the fetal bovine serum (FBS) to them renders NiO-NPs and, to even greater extent, Mn₃O₄-NPs exponentially slow soluble while without FBS their dissolution was virtually undetectable. At the same time, sedimentation of these MeO-NPs noticeably slowed down in the presence of the same FBS. We have found dependence of cell damage on concentrations of MeO-NPs and higher cytotoxicity of Mn₃O₄-NP compared with NiO-NP. Thus, comparative assessment of the NPs unspecific toxicity obtained in our animal experiments was reproduced by the "in vitro" tests. However, with respect to manganese-specific brain damage "in vivo" discovered previously, present experiments on neurons "in vitro" showed only a certain enhancing effect of Mn₃O₄-NP on the action of NiO-NP, but the role of NiO-NP in the combination prevailed.

The chemical disruption of human metabolism

BACKGROUND

Recent evidence highlights the reality of unprecedented human exposure to toxic chemical agents found throughout our environment - in our food and water supply, in the air we breathe, in the products we apply to our skin, in the medical and dental materials placed into our bodies, and even within the confines of the womb. With biomonitoring confirming the widespread bioaccumulation of myriad toxicants among population groups, expanding research continues to explore the pathobiological impact of these agents on human metabolism.

METHODS

This review was prepared by assessing available medical and scientific literature from Medline as well as by reviewing several books, toxicology journals, government publications, and conference proceedings. The format of a traditional integrated review was chosen.

RESULTS

Toxicant exposure and accrual has been linked to numerous biochemical and pathophysiological mechanisms of harm. Some toxicants effect metabolic disruption via multiple mechanisms.

CONCLUSIONS

As a primary causative determinant of chronic disease, toxicant exposures induce metabolic disruption in myriad ways, which consequently result in varied clinical manifestations, which are then categorized by health providers into innumerable diagnoses. Chemical disruption of human metabolism has become an etiological determinant of much illness throughout the lifecycle, from neurodevelopmental abnormalities in-utero to dementia in the elderly.

Experimental study and mathematical modeling of toxic metals combined action as a scientific foundation for occupational and environmental health risk assessment. A summary of results obtained by the Ekaterinburg research team (Russia)

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Cumulative health risks assessment should be based on toxicology of mixtures.

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Some principal discrepancies between these domains are discussed by the authors.

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While simplification of the theory is inevitable, its vulgarization should be avoided.

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Our contribution to this theory and its practical applications is summarized here.

Assessment of cumulative health risks associated with the widely observed combined effects of two or more metals and their compounds on the organism has the toxicology of mixtures as its scientific basis although there is no full match between such assessment and this basis while some of the contradictions between them are of a fundamental nature. This state of things may be explained not only by simplifications characteristic of the generally recognized methodology of risk assessment but also by extreme complexity of the theory of combined toxicity, the most essential issues of which are considered by authors on the basis of literary and, mostly, their own previously published data.

Environmental metal contamination and health impact assessment in two industrial regions of Romania

We investigated two Romanian industrial regions- Copşa Mică and Zlatna, to assess the current situation of soil pollution and bioaccumulation of Pb, Cd, Cu and Zn in different vegetable species and possible risks to consumers. Both total and mobile forms of the metals were determined in soil samples, and metal content in the edible parts of root vegetable samples was also assessed. The concentrations of Pb and Zn in soil were higher in Copşa Mică than in Zlatna (566mg/kg vs 271mg/kg for Pb and 1143mg/kg vs 368mg/kg for Zn)·The metal mobility in soil from Copsa Mica decreases in the order Zn>Cu>Cd>Pb (1.88mg/kg, 0.40mg/kg, 0.22mg/kg, 0.16mg/kg, respectively), while in Zlatna, the order was Cu>Zn>Pb>Cd (0.88mg/kg, 0.29mg/kg, 0.04mg/kg, 0.01mg/kg, respectively), apparently depending on metal and soil conditions. In Copsa Mica, the amount of Pb and Cd in vegetable samples exceeded the maximum permissible limits in carrots (median concentration 0.32mg/kg for Pb and Cd) and in yellow onions (median concentration 0.24mg/kg for Cd). In Zlatna region, the content of Cd exceeded the maximum limits in yellow onions (median concentration 0.11mg/kg). The amount of Pb was higher than the maximum acceptable level in carrots from the Zlatna region (median concentration 0.12mg/kg). Cu and Zn levels were within the normal range in all vegetable samples. In the Zlatna region, the transfer factors for Pb and Cd were higher in carrots (median values of 9.9 for Pb and 21.0 for Cd) compared to carrots harvested in Copsa Mica (median values of 4.0 for Pb and 2.0 for Cd). Daily intake rates of metals through local vegetable consumption exceeded the limit values established by the European Food Safety Authority for Pb (1.2 to 2.4 times) and Cd (5.5 to 9.1 times) in both regions, with potential adverse health effects for the local population. The results highlight the need for total soil remediation action before fruit and vegetables produced in these polluted areas can be safely consumed.

In vivo toxicity of copper oxide, lead oxide and zinc oxide nanoparticles acting in different combinations and its attenuation with a complex of innocuous bio-protectors

Stable suspensions of metal oxide nanoparticles (Me-NPs) obtained by laser ablation of 99.99% pure copper, zinc or lead under a layer of deionized water were used separately, in three binary combinations and a triple combination in two independent experiments on rats. In one of the experiments the rats were instilled with Me-NPs intratracheally (i.t.) (for performing a broncho-alveolar lavage in 24h to estimate the cytological and biochemical indices of the response of the lower airways), while in the other, Me-NPs were repeatedly injected intraperitoneally (i.p.) 18 times during 6 weeks (for estimating the accumulation of corresponding metals in the blood and their excretion with urine and feces and for assessing subchronic intoxication by a large number of functional and morphological indices). Mathematical description of the results from both experiments with the help of the Response Surface Methodology has shown that, as well as in the case of any other binary toxic combinations previously investigated by us, the response of the organism to a simultaneous exposure to any two of the Me-NPs under study is characterized by complex interactions between all possible types of combined toxicity (additivity, subadditivity or superadditivity of unidirectional action and different variants of opposite effects) depending on which effect it is estimated for as well as on the levels of the effect and dose. With any third Me-NP species acting in the background, the type of combined toxicity displayed by the other two may change significantly (as in the earlier described case of a triple combination of soluble metal salts). It is shown that various harmful effects produced by CuO-NP+ZnO-NP+PbO-NP combination may be substantially attenuated by giving rats per os a complex of innocuous bioactive substances theoretically expected to provide a protective integral and/or metal-specific effect during one month before i.t. instillation or during the entire period of i.p. injections.

Changes in the Dose-Response Relationship of One Toxicant Under Simultaneous Exposure to Another Toxicant

We considered, in general form for a 22 full factorial experiment, linear approximations of the organism's dose-response relationship for some factors operating alone and modification of this relationship by another factor operating in the background. A typological classification of such modifications is suggested. An analysis of the outcomes obtained in a number of subchronic animal experiments on rats in which this response was assessed by changes in a large number of biomedical indices revealed that all theoretically possible variants (types) of the modification under consideration are actually observed depending on a specific index and specific harmful exposure. Statistical significance estimation procedures are formulated for each of them.

The pulmonary phagocytosis response to separate and combined impacts of manganese (IV) and chromium (VI) containing particulates

We investigated by the optical microscopy some cytological characteristics of the bronchoalveolar lavage fluid cell population 24h after intratracheal instillation of microscale MnO₂ and BaCrO₄ particles (separately or together at two different doses) into the lungs of Wistar rats. Besides, the cytotoxicity of both particulates for rat peritoneal macrophages in vitro was assessed by the trypan blue exclusion test and proved significant. They were found to evoke a typical dose-dependent pulmonary phagocytosis response usually observed under inhalation or intratracheal impacts of low-soluble mineral and metal particles. A significant shift in the above mentioned cell population toward the prevalence of neutrophllic leukocytes (NL) over alveolar macrophages (AM) proved once more to be the most characteristic feature of this response. Although the particle load of a unit AM was always higher than that of a unit NL, the collective contribution of the recruited NLs to the total particles internalization by both AMs and NLs together was quite significant. This fact confirms that NL recruitment is an important auxiliary mechanism of the cytotoxic particle elimination from lungs compensating for the macrophage damage caused by them. Well adjusted functioning of this compensatory mechanism was additionally demonstrated by isobolographic analysis based on the Response Surface Methodology. On the other hand, this analysis confirmed that the type of combined toxicity depends on a particular effect this type is assessed for and on the effect's dose-dependent level.

Prediction and assessment of ecogenotoxicity of antineoplastic drugs in binary mixtures

The combined genotoxic effects of four anticancer drugs (5-fluorouracil [5-FU], cisplatin [CDDP], etoposide [ET], and imatinib mesylate [IM]) were studied testing their binary mixtures in two crustaceans that are part of the freshwater food chain, namely Daphnia magna and Ceriodaphnia dubia. Genotoxicity was assessed using the in vivo comet assay. Assessment was based on two distinct effect sizes determined from dose-response experiments. Doses for single and combined exposures expected to result in these effect sizes were computed based on Bliss independence as reference model. Statistical comparison by analysis of variance of single and combined toxicities allowed accepting or rejecting the independency hypothesis. The results obtained for D. magna showed independent action for all mixtures except for IM+5-FU that showed an antagonistic interaction. In C. dubia, most mixtures had antagonist interactions except IM+5-FU and IM+CDDP that showed Bliss independence. Despite the antagonistic interactions, our results demonstrated that combinations of anticancer drugs could be of environmental concern because effects occur at very low concentrations that are in the range of concentrations encountered in aquatic systems.

Identification of combined action types in experiments with two toxicants: a response surface linear model with a cross term

Within the framework of the response surface linear model with a cross term, i.e. a model of the type Y(x1, x2) = b0 + b1x1 + b2x2 + b12x1x2 (hyperbolic paraboloid), a complete solution of identification of combined action types of two toxicants x1 and x2 is presented. It is shown that the type of combined effect in this model is determined by two factors: the direction in which the toxicants act (unidirectional or oppositely directed), and the position of the saddle point S of a hyperbolic paraboloid. For unidirectional actions of toxicants, already-known ways to identify the type of combined effect (including a shape of the isobole: concave-up or concave-down) provided identical and unambiguous answers regarding the type of combined effect (antagonism or synergism). For oppositely directed actions of toxicants, the shape of the isobole (concave-up or concave-down) did not allow us to determine the type of combined action type unambiguously. We show that in both cases (unidirectional or oppositely directed actions of toxicants) the signs of the model coefficients b1, b2 and b12, in conjunction with the coordinates of the saddle point S help unambiguously identify the type of combined action by comparing the observed effect with the zero interaction response surface. An atlas of all possibly combined action types for two toxicants for the hyperbolic paraboloid model was created. Applications of the developed formalism to experimental data are provided.

Some patterns of metallic nanoparticles' combined subchronic toxicity as exemplified by a combination of nickel and manganese oxide nanoparticles

Stable suspensions of NiO and/or Mn3O4 nanoparticles with a mean diameter of 16.7 ± 8.2 nm and 18.4 ± 5.4 nm, respectively, prepared by laser ablation of 99.99% pure metals in de-ionized water were repeatedly injected IP to rats at a dose of 0.50 mg or 0.25 mg 3 times a week up to 18 injections, either separately or in different combinations. Many functional indices as well as histological features of the liver, spleen, kidneys and brain were evaluated for signs of toxicity. The accumulation of Ni and Mn in these organs was measured with the help of AES and EPR methods. Both metallic nanoparticles proved adversely bio-active, but those of Mn3O4 were found to be more noxious in most of the non-specific toxicity manifestations. Moreover, they induced a more marked damaging effect in the neurons of the caudate nucleus and hippocampus which may be considered an experimental correlate of manganese-induced parkinsonism. Mathematical analysis based on the Response Surface Methodology (RSM) revealed a diversity of combined toxicity types depending not only on particular effects these types are assessed for but on their level as well. The prognostic power of the RSM model proved satisfactory.

Further development of the theory and mathematical description of combined toxicity: An approach to classifying types of action of three-factorial combinations (a case study of manganese-chromium-nickel subchronic intoxication)

For characterizing the three-factorial toxicity, we proposed a new health risk-oriented approach, the gist of which is a classification of effects depending on whether a binary combined toxicity's type remains virtually the same or appears to be either more or less adverse when modeled against the background of a third toxic. To explore possibilities of this approach, we used results of an experiment in which rats had been injected ip 3 times a week (up to 20 injections) with a water solution of either one of the toxics (Mn, Ni or Cr-VI salts) in a dose equivalent to 0.05 LD50, or any two of them, or all the three in the same doses, the controls receiving injections of the same volume of distilled water (4mL per rat). Judging by more than 30 indices for the organism's status, all exposures caused subchronic intoxication of mild to moderate strength. For each two-factorial exposure, we found by mathematical modeling based on the isobolograms that the binary combined subchronic toxicity either was of additive type or departed from it (predominantly toward subadditivity) depending on the effect assessed, dose, and effect level. For the three-factorial combination, different classes of effects were observed rather consistently: class A - those regarding which the third toxic's addition made the binary toxicity type more unfavorable for the organism, class B - those regarding which the result was opposite, and class C - those regarding which the type of binary combined toxicity on the background of a third toxic virtually remained the same as in its absence. We found a complicated reciprocal influence of combined metals on their retention in kidneys, liver, spleen and brain which might presumably be one of the possible mechanisms of combined toxicity, but the lack of an explicit correspondence between the above influence and the influence on toxicity effects suggests that this mechanism is not always the most important one. The relevance of the proposed classification to health risk analysis and management is briefly discussed.

Disability adjusted life year (DALY): a useful tool for quantitative assessment of environmental pollution

Disability adjusted life year (DALY) has been widely used since 1990s for evaluating global and/or regional burden of diseases. As many environmental pollutants are hazardous to human health, DALY is also recognized as an indicator to quantify the health impact of environmental pollution related to disease burden. Based on literature reviews, this article aims to give an overview of the applicable methodologies and research directions for using DALY as a tool for quantitative assessment of environmental pollution. With an introduction of the methodological framework of DALY, the requirements on data collection and manipulation for quantifying disease burdens are summarized. Regarding environmental pollutants hazardous to human beings, health effect/risk evaluation is indispensable for transforming pollution data into disease data through exposure and dose-response analyses which need careful selection of models and determination of parameters. Following the methodological discussions, real cases are analyzed with attention paid to chemical pollutants and pathogens usually encountered in environmental pollution. It can be seen from existing studies that DALY is advantageous over conventional environmental impact assessment for quantification and comparison of the risks resulted from environmental pollution. However, further studies are still required to standardize the methods of health effect evaluation regarding varied pollutants under varied circumstances before DALY calculation.

Further development of mathematical description for combined toxicity: A case study of lead-fluoride combination

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Rats were exposed during 6 weeks to repeated i.p. injections of lead acetate, sodium fluoride or both in doses 0.05 LD₅₀.

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The development of intoxication was estimated quantitatively with 54 functional, biochemical and morphometric indices.

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For mathematical description of effects a response surface regression model containing linear and cross terms was used.

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10 types of combined action were found thus confirming the result of the similar study on Pb and Cd.

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Special attention is given to indices on which combined toxics produce opposite effects.

In this article, we check and develop further some postulates of the theory and mathematical modeling of combined toxic effect that we proposed earlier [1]. To this end, we have analyzed the results of an experiment on rats exposed during 6 weeks to repeated intraperitoneal injections of lead acetate, sodium fluoride or both. The development of intoxication was estimated quantitatively with 54 functional, biochemical and morphometric indices. For mathematical description of the effect that lead and fluorine doses produced alone or in combination, we used a response surface regression model containing linear and cross terms (hyperbolic paraboloid). It is shown that the combination of lead and fluoride features the same 10 types of combined effect that we found previously for the lead and cadmium combination. Special attention is given to indices on which lead and fluorine produce an opposite effect.

Toxicodynamic and toxicokinetic descriptors of combined chromium (VI) and nickel toxicity

After repeated intraperitoneal injections of nickel and chromium (VI) salts to rats, we found, and confirmed by mathematical modeling, that their combined subchronic toxicity can either be of additive type or depart from it (predominantly toward subadditivity) depending on the effect assessed. Against the background of moderate systemic toxicity, the combination under study proved to possess a marked additive genotoxicity assessed by means of the random amplification of polymorphic DNA test. We also demonstrated that chromium and nickel reciprocally influenced the retention of these metals in some organs (especially in the spleen) but not their urinary excretion in this study.