Differential effects of nitrofurans on the production/release of steroid hormones by porcine adrenocortical cells in vitro

Impact of Chemical Endocrine Disruptors and Hormone Modulators on the Endocrine System

There is growing concern regarding the health and safety issues of endocrine-disrupting chemicals (EDCs). Long-term exposure to EDCs has alarming adverse health effects through both hormone-direct and hormone-indirect pathways. Non-chemical agents, including physical agents such as artificial light, radiation, temperature, and stress exposure, are currently poorly investigated, even though they can seriously affect the endocrine system, by modulation of hormonal action. Several mechanisms have been suggested to explain the interference of EDCs with hormonal activity. However, difficulty in quantifying the exposure, low standardization of studies, and the presence of confounding factors do not allow the establishment of a causal relationship between endocrine disorders and exposure to specific toxic agents. In this review, we focus on recent findings on the effects of EDCs and hormone system modulators on the endocrine system, including the thyroid, parathyroid glands, adrenal steroidogenesis, beta-cell function, and male and female reproductive function.

Occurrence and levels of nitrofuran metabolites in sea cucumber from Dalian, China

The occurrence and levels of nitrofuran metabolites (NFMs) in sea cucumber (SC) from Dalian, China, are reported. Four metabolites including 3-amino-5-morpholinomethyl-2-oxazolidinone (AMOZ), 3-amino-2-oxazolidinone (AOZ), semicarbazide (SEM) and 1-aminohydantoin (AHD) in different SC products (fresh, instant and dry salted SCs) were measured. The frequency of occurrence for NFMs in all SC samples was 42.7%. The total NFM concentrations ranged from non-detectable to 64.6 ng g^-1, with a mean of 3.59 ng g^-1. AOZ and SEM were the dominant congeners, accounting for 40.1% and 59.1% of the total NFMs, respectively. The concentrations and patterns varied among different regions. Higher levels of NFMs were found in the fresh SC products, and the order for the average concentration of ∑₄NFM was fresh > dry salted > instant.

Trimethoprim-sulfamethoxazole and risk of sudden death among patients taking spironolactone

BACKGROUND

Trimethoprim-sulfamethoxazole increases the risk of hyperkalemia when used with spironolactone. We examined whether this drug combination is associated with an increased risk of sudden death, a consequence of severe hyperkalemia.

METHODS

We conducted a population-based nested case-control study involving Ontario residents aged 66 years or older who received spironolactone between Apr. 1, 1994, and Dec. 31, 2011. Within this group, we identified cases as patients who died of sudden death within 14 days after receiving a prescription for trimethoprim-sulfamethoxazole or one of the other study antibiotics (amoxicillin, ciprofloxacin, norfloxacin or nitrofurantoin). For each case, we identified up to 4 controls matched by age and sex. We determined the odds ratio (OR) for the association between sudden death and exposure to each antibiotic relative to amoxicillin, adjusted for predictors of sudden death using a disease risk index.

RESULTS

Of the 11,968 patients who died of sudden death while receiving spironolactone, we identified 328 whose death occurred within 14 days after antibiotic exposure. Compared with amoxicillin, trimethoprim-sulfamethoxazole was associated with a more than twofold increase in the risk of sudden death (adjusted OR 2.46, 95% confidence interval [CI] 1.55-3.90). Ciprofloxacin (adjusted OR 1.55, 95% CI 1.02-2.38) and nitrofurantoin (adjusted OR 1.70, 95% CI 1.03-2.79) were also associated with an increased risk of sudden death, although the risk with nitrofurantoin was not apparent in a sensitivity analysis.

INTERPRETATION

The antibiotic trimethoprim-sulfamethoxazole was associated with an increased risk of sudden death among older patients taking spironolactone. When clinically appropriate, alternative antibiotics should be considered in these patients.

Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study

OBJECTIVES

To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone.

DESIGN

Population based nested case-control study.

SETTING

Ontario, Canada, from 1 April 1992 to 1 March 2010.

PARTICIPANTS

Cases were residents of Ontario aged 66 years or above receiving chronic treatment with spironolactone and admitted to hospital with hyperkalaemia within 14 days of receiving a prescription for either trimethoprim-sulfamethoxazole, amoxicillin, norfloxacin, or nitrofurantoin. Up to four controls for each case were identified from the same cohort, matched on age, sex, and presence or absence of chronic kidney disease and diabetes, and required to have received one of the study antibiotics within 14 days before the case's index date.

MAIN OUTCOME MEASURES

Odds ratio for association between admission to hospital with hyperkalaemia and receipt of a study antibiotic in the preceding 14 days, adjusted for conditions and drugs that may influence risk of hyperkalaemia.

RESULTS

During the 18 year study period, 6903 admissions for hyperkalaemia were identified, 306 of which occurred within 14 days of antibiotic use. Of these, 248 (81%) cases were matched to 783 controls. 10.8% (17,859/165,754) of spironolactone users received at least one prescription for trimethoprim-sulfamethoxazole. Compared with amoxicillin, prescription of trimethoprim-sulfamethoxazole was associated with a marked increase in the risk of admission to hospital for hyperkalaemia (adjusted odds ratio 12.4, 95% confidence interval 7.1 to 21.6). The population attributable fraction was 59.7%, suggesting that approximately 60% of all cases of hyperkalaemia in older patients taking spironolactone and treated with an antibiotic for a urinary tract infection could be avoided if trimethoprim-sulfamethoxazole was not prescribed. Treatment with nitrofurantoin was also associated with an increase in the risk of hyperkalaemia (adjusted odds ratio 2.4, 1.3 to 4.6), but no such risk was found with norfloxacin (adjusted odds ratio 1.6, 0.8 to 3.4)

CONCLUSIONS

Among older patients receiving spironolactone, treatment with trimethoprim-sulfamethoxazole was associated with a major increase in the risk of admission to hospital for hyperkalaemia. This drug combination should be avoided when possible.

The effects of the nitrofuran furaltadone on Ulva lactuca

The use of pharmaceuticals in the food production industry as prophylatic and therapeutic agents is necessary to promote animal health, but may entail significant consequences to natural ecosystems, especially in the cases of overdosing and use of banned pharmaceuticals. The vast effects that antibiotics released into the environment have on non-target organisms are already under the scope of researchers but little attention has been given to primary producers such as macroalgae. The present study assessed furaltadone's, an antibacterial agent illegally used for veterinary purposes, uptake capacity by Ulva lactuca and its effect in the growth of this cosmopolitan macroalgae. Differences in macroalgal growth were shown when submitted to prophylactic and therapeutic concentrations of furaltadone in the water (16 and 32 μg mL⁻¹, respectively). The therapeutic concentration caused higher growth impairment than the prophylactic treatment did, with 87.5% and 58% reductions respectively. Furthermore, together with data collected from the accumulation assays, with values of internal concentrations as high as 18.84 μg g⁻¹ WW, suggest that the macroalgae U. lactuca should be included in field surveys as a biomonitor for the detection of nitrofurans.

Potential role of cysteine and methionine in the protection against hormonal imbalance and mutagenicity induced by furazolidone in female rats

The use of nitrofurans as veterinary drugs has been banned in the EU since 1993 due to doubts on the safety of the protein-bound residues of these drugs in edible products. Furazolidone (FUZ) is a nitrofuran drug, which has been used for many years as an antibacterial drug in veterinary practice. The aim of the current study is to investigate the role of L-cysteine and L-methionine in the protection against hormonal imbalance and the genotoxicity induced by FUZ using the micronucleus (MN) assay and random amplified polymorphism DNA (RAPD-PCR) analysis in female rats. Forty female Sprague-Dawley rats were divided into four groups included the untreated control group; a group treated with FUZ (300 mg/kg b.w.); a group treated with a mixture of L-cysteine (300 mg/kg b.w.) and L-methionine (42.8 mg/kg b.w.) and a group treated with FUZ plus the mixture of L-cysteine and L-methionine for 10 days. The results indicated that FUZ induced hormonal disturbances involving thyroid, ovarian and adrenal hormones. Moreover, FUZ increased the micronucleus formation and induced changes in polymorphic band patterns. The combined treatment with FUZ and the mixture of L-cysteine and L-methionine succeeded to prevent or diminish the endocrine disturbance and the clastogenic effects of FUZ. The current study is casting new light on the complex mechanisms underlying the ameliorating action of dietary L-cysteine and L-methionine against FUZ toxicity in experimental animals.

Effects of endocrine-disrupting chemicals on adrenal function

Considering the wide range of chemicals known to disrupt adrenal function and the physiological importance of the adrenal cortex, it is surprising that endocrine disruption of the adrenal gland has not been more widely researched. The chemical nature of adrenal disruptors is highly varied, and there are features of the adrenal structure and function, which render it particularly vulnerable to toxic attack. However, the homeostatic mechanisms inherent in the hypothalamo-pituitary-adrenal axis mean that only the most catastrophic effects are recognized as adrenal disruption, such as in the case of etomidate. In order to detect potentially significant but milder forms of toxic disruption of adrenal function a new approach is needed; this requires the use of more sophisticated approaches than simply measuring one hormone at one time point. New methodologies are also needed, such as the use of human adrenal cell lines for the screening of toxins and for mechanistic investigation of adrenal disruptors. This review focuses on mechanisms of adrenal toxicity and on the challenges facing researchers in this important field.

Gonadal histology and serum vitellogenin levels of bigeye tuna Thunnus obesus from the Northern Pacific Ocean--absence of endocrine disruption bio-indicators

Endocrine disrupting chemicals such as organochlorines have been detected in a large number of marine fish. Histological observation of the gonads, measurement of serum vitellogenin (VTG) level and of liver polychlorinated biphenyl (PCB) content were performed to evaluate the reproductive health and the contamination with endocrine disruptors in bigeye tuna Thunnus obesus, collected in the northern Pacific Ocean in 1999 and 2000. Abnormalities commonly found in species affected by endocrine disruptors such as the presence of oocytes in the testis or elevated serum VTG levels were not found in any of males examined. Both males and females had only small amounts of liver PCB content. The results suggest that currently there is little if any risk of organochlorine contamination or endocrine disruption of gonadal function in bigeye tuna from the northern Pacific Ocean. However, further studies are necessary to evaluate the health status of the open sea fishery resources.

Pharmacological, therapeutic and toxicological properties of furazolidone: some recent research

Some of the recent publications on the pharmacological, therapeutic and toxicological properties of the antimicrobial agent furazolidone (FZ) are briefly reviewed. In animals, most of the recently published papers focus on (1) the methodology of measuring the residues of the drug and its metabolites in edible tissues; (2) the carcinogenicity and genotoxicity of FZ; (3) the cellular and molecular basis of FZ-induced cardiomyopthy, and the action of different cardioprotectant drugs thereon; and (4) hormonal effects. In humans, the use of FZ as an anti-ulcer drug and in controlling infectious diseases, especially opportunistic infections in AIDS patients, is described.