Urinary bladder carcinogenesis induced by melamine in F344 male rats: correlation between carcinogenicity and urolith formation

Prevention of melamine-induced hepatorenal impairment by an ethanolic extract of Moringa oleifera: Changes in KIM-1, TIMP-1, oxidative stress, apoptosis, and inflammation-related genes

BACKGROUND/AIMS

Melamine (ML) is a common food adulterant and contaminant. Moringa oleifera is a well-known medicinal plant with many beneficial biological properties. This study investigated the possible prophylactic and therapeutic activity of an ethanolic extract of M. oleifera (MEE) against ML-induced hepatorenal damage.

METHOD

Fifty male Sprague Dawley rats were orally administered distilled water, MEE (800 mg/kg bw), ML (700 mg/kg bw), MEE/ML (prophylactically) or MEE+ML (therapeutically). Hepatic aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphate (ALP) in serum were measured. Serum total bilirubin, direct bilirubin, indirect bilirubin, protein, albumin, and globulin contents were also assayed, and urea and creatinine levels were determined. Moreover, antioxidant enzyme activity of glutathione peroxidase (GPx) and catalase (CAT) in serum levels were quantified. Complementary histological and histochemical evaluation of renal and hepatic tissues was conducted, and expression of oxidative stress (GPx and CAT) and apoptosis-related genes, p53 and Bcl-2, in hepatic tissue were assessed. In parallel, transcriptional expression of inflammation and renal injury-related genes, including kidney injury molecule 1 (KIM-1), metallopeptidase inhibitor 1 (TIMP1), and tumor necrosis factor alpha (TNF-α) in the kidney tissue were determined.

RESULTS

ML caused significant increases in serum levels of ALT, AST, ALP, total bilirubin, direct bilirubin, indirect bilirubin, urea, and creatinine. Further, ML treated rats showed significant reductions in serum levels of protein, albumin, globulin, GPx, and CAT. Distinct histopathological damage and disturbances in glycogen and DNA content in hepatic and renal tissues of ML treated rats were observed. KIM-1, TIMP-1, and TNF-α gene expression was significantly upregulated in kidney tissue. Also, GPx, CAT, and Bcl-2 genes were significantly downregulated, and p53 was significantly upregulated in liver tissue after ML treatment. MEE significantly counteracted the ML-induced hepatorenal damage primarily for co-exposed rats.

CONCLUSION

MEE could be an effective therapeutic supplement for treatment of ML-induced hepato-renal damage, probably via modulating oxidative stress, apoptosis, and inflammation.

Does melamine exposure during infancy cause rhabdomyolysis?

We investigated the possible toxic effects of melamine on muscle tissue in rats using biochemical, hematological and histopathological methods. We used three groups of female albino Wistar rats. The first group was given 0.1 ml saline. The second and third groups were given 50 and 75 mg/kg melamine dissolved in 0.1 ml saline, respectively, daily for 21 days. On day 45, all rats were sacrificed, and whole blood and plasma were analyzed for hematologic and biochemical characteristics. Muscle samples were stained with hematoxylin and eosin for histopathological investigation. Other sections were immunostained for matrix metalloproteinase-9 (MMP-9) and type IV collagen. We found a significant increase in the lymphocytosis-compliant leukocyte number in the 75 mg/kg melamine group compared to the other groups. We also found significant decreases in the hemoglobin levels and hematocrit values in the 75 mg/kg compared to the other groups. We found that the 75 mg/kg melamine group exhibited a significant increase in plasma aspartate aminotransferase (AST) activity compared to the other groups. Changes in plasma creatine kinase and lactate dehydrogenase activity were not statistically significant. Plasma AST activity and mean corpuscular hemoglobin levels were correlated with the lymphocyte:neutrophil ratio. We found mononuclear cell infiltration at the periphery of muscle bundles and in the connective tissue bundles in the melamine treated group. We found MMP-9 expression in muscle cell membranes and type IV collagen expression in degenerative connective tissue fibers. Whole blood, plasma and muscle tissue analysis indicated that the 75 mg/kg melamine group exhibited rhabdomyolysis that was associated with lymphocytosis and anemia. The underlying mechanisms by which melamine causes rhabdomyolytic effects remain unclear.

Kidney stones and the risk of renal cell carcinoma and upper tract urothelial carcinoma: the Netherlands Cohort Study

Background

We examined the association between kidney stones and renal cell carcinoma (RCC) and upper tract urothelial carcinoma (UTUC) risk in the Netherlands Cohort Study on diet and cancer.

Methods

In total, 120,852 participants aged 55–69 completed a self-administered questionnaire on diet, medical conditions and other risk factors for cancer at baseline (1986). After 20.3 years of cancer follow-up 4352 subcohort members, 544 RCC cases and 140 UTUC cases were eligible for case-cohort analysis. Hazard ratios (HR) and 95% confidence intervals (CIs) were estimated by multivariable-adjusted proportional hazards models.

Results

Kidney stones were associated with an increased RCC risk (HR: 1.39, 95% CI 1.05–1.84), vs. no kidney stones. Kidney stones were associated with an increased risk of papillary RCC (HR: 3.08, 95% CI 1.55–6.11), but not clear-cell RCC (HR: 1.14, 95% CI 0.79–1.65). UTUC risk was increased for participants with kidney stones (HR: 1.66, 95% CI 1.03–2.68). No heterogeneity of associations was found for UTUC in the ureter and renal pelvis. An early kidney stone diagnosis (≤40 years) was associated with an increased RCC and UTUC risk, compared to later diagnosis.

Conclusion

Kidney stones were associated with increased papillary RCC risk, but not clear-cell RCC risk. No heterogeneity was found for UTUC subtypes.

Melamine causes testicular toxicity by destroying blood-testis barrier in piglets

Melamine (MA) exposure causes male reproductive toxicity, however, the mechanism remains unclear. In this study, we investigated the roles of the blood-testis barrier (BTB) in MA-induced reproductive toxicity in piglets. Male weaned piglets were exposed to MA concentrations of 0, 100, 300, and 1000 mg/kg in the diet for 10 weeks. They were euthanized on days 1, 7 and 14 after the final exposure. Body and organ weights, serum biochemistry and testosterone, gross and histopathological changes, and BTB ultrastructure and integrity were assessed. BTB junction protein expression levels and protein levels of the mitogen-activated protein kinase (MAPK) pathway in testes were measured. We found that MA dose-dependently decreased serum testosterone levels and caused gross and histopathological lesions in the testis and epididymis. Marked BTB damage was evidenced by abnormal changes in BTB ultrastructure and increased BTB permeability. Furthermore, MA decreased the protein levels of ZO-1, occludin, N-cadherin, and connexin-43, paralleled by increased the protein levels of p-Erk, p-JNK and p-p38 in testes, suggesting that MA disrupted BTB by downregulating the expressions of BTB junction proteins, with possible involvement of the MAPK signaling pathway. In conclusion, MA exposure gives rise to testicular toxicity in male piglets through destroying BTB integrity.

Palliative effects of Moringa olifera ethanolic extract on hemato-immunologic impacts of melamine in rats

Melamine (MEL) is a widespread food contaminant and adulterant. Moringa olifera is a widely known medicinal plant with various pharmacological properties. Herein, this study aimed to investigate, for the first time, the probable protective or therapeutic role of M. olifera ethanolic extract (MOE) against MEL induced hemato-immune toxic hazards. Fifty Sprague Dawely male rats were orally treated with distilled water, MOE (800 mg/kg bw), MEL (700 mg/kg bw), MOE/MEl or MOE + MEl. Erythrogram and leukogram profiling were evaluated to assess hematological status. Innate immune functions were evaluated via measuring lysozyme levels, nitric oxide concentration, and bactericidal activity of phagocytes. Serum immunoglobulin levels were estimated as indicators of humoral immunity. Histologic and immunohistochemical evaluations of splenic tissues were also performed. The results indicated that MEL caused a significant decline in RBC, Hb, PCV, total WBC, neutrophil, lymphocyte, phagocytes bactericidal activity, lysozyme activity, nitric oxide, total IgM and IgG levels. Also, MEL induced various pathologic lesions in the spleen with strong expression of CD4 and CD8 positive cells. MOE significantly counteracted the former anaemic, leucopenic, innate and humoral depressant effects of MEL particularly at co-exposure. In conclusion, these findings revealed that MOE could be candidate therapy against MEL hemato-immunotoxic impacts.

Environmental toxin-induced acute kidney injury

Human beings are exposed to various potentially toxic agents and conditions in their natural and occupational environments. The kidney, due to its concentrating ability and excretory function, is highly vulnerable to the effects of environmental toxins. Identifying the precise cause and mechanisms of environmentally induced renal injury remains a challenge for which various scientific disciplines need to be involved. Investigations in this field are confronted with the apparent infinite types of toxins, their mutual interaction, handling/metabolization by the body, ways of exposure, etc. Although interdisciplinary efforts and persistence are required to identify, mechanistically unravel and tackle environmental toxin-induced pathologies, research eventually pays off in ameliorated working/living conditions and development of preventive/therapeutic strategies. This review was compiled to particularly emphasize the need for a maintained awareness of environmental threats in general and those targeting the kidney. Different mechanisms of renal toxicity are illustrated and discussed, thereby focusing on three types of environmental toxins, namely aristolochic acid, melamine and heavy metals.

In vitro toxicity evaluation of melamine on mouse TM4 Sertoli cells

The male reproductive toxicity of melamine (MA) has been recognized in recent years excepted for its renal toxicity. Our previous in vivo studies revealed that the damages of Sertoli cell barrier played a critical role in MA-induced testicular toxicity in mice. Herein, we performed an in vitro study to comprehensively evaluate the toxicity of MA on Sertoli cell by examining the influences of MA on the viability, morphology, mortality and intercellular junctions of mouse TM4 Sertoli cells (TM4 cells). The results showed that MA suppressed cell viability, induced obvious ultrastructural changes and cell apoptosis in concentration-dependent manner. Moreover, MA down-regulated the expressions of junction-associated proteins including occludin, N-cadherin, and vimentin, suggesting that MA disrupted the integrity of Sertoli cell barrier. Thus, these results indicated that Sertoli cell might be an important cellular target for MA-induced male reproductive toxicity.

Evaluation of the in vivo mutagenicity of melamine by the RBC Pig-a assay and PIGRET assay

The Pig-a assay is a new in vivo genotoxicity test for detecting mutagens in the bodies of animals, using the endogenous Pig-a gene as the target. There are two types of Pig-a assays: the red blood cell (RBC) Pig-a assay, which uses RBCs, and the PIGRET assay, which uses reticulocytes. The Japanese Environmental Mutagen Society-Mammalian Mutagenicity Study Group collaborative study of the Pig-a assay was carried out to investigate the usefulness of the PIGRET assay. The mutagenicity of melamine was evaluated as part of this study. Eight-week-old male Crl:CD (SD) rats were administered a single gavage dose of melamine as a non-genotoxic bladder carcinogen. Blood samples were collected at the first, second and fourth weeks after administration, and the RBC Pig-a assay and PIGRET assays were conducted using these samples. Three dose levels were used in the study: the highest dose was 2000mg/kg, which is generally used as the maximum dose in in vivo genotoxicity testing, and 1000 and 500mg/kg were also used. As a positive control, a group of rats was administered a single dose of N-nitroso-N-ethylurea (ENU) by gavage at 40mg/kg. The Pig-a mutant frequencies (Pig-a MFs) did not increase in any of the melamine groups throughout the experimental period in either the RBC Pig-a assay or the PIGRET assay. Both the RBC Pig-a and PIGRET assays revealed significant increases in the Pig-a MFs in the ENU group, starting at day 7 after a single administration. Therefore, these two assays, when evaluated after a single administration, can be used to determine that melamine is non-mutagenic.

Melamine-associated urinary stone

The devastating contamination of milk formula with Melamine, which caused havoc in China, happened almost eight years ago. Although most patients with melamine-associated urinary stone were given conservative medical treatment, the impact was not completely eliminated. Extensive studies are needed to assess chronic effects in the affected population. In this review, we describe the pathogenesis, pathology, clinical manifestations, management and epidemiology; and the need for longer term follow-up of melamine-associated urinary stones.

Use of urinary renal biomarkers to evaluate the nephrotoxic effects of melamine or cyanuric acid in non-pregnant and pregnant rats

Although traditional assessments of renal damage detect loss of kidney function, urinary renal biomarkers are proposed to indicate early changes in renal integrity. The recent adulteration of infant formula and other milk-based foods with melamine revealed a link between melamine ingestion and nephropathy. Thus, the effects of melamine and related analogs (e.g., cyanuric acid) should be assessed in other potentially sensitive groups. We evaluated whether urinary Kim-1, clusterin, and osteopontin could detect the effects of high doses of melamine or cyanuric acid in pregnant and non-pregnant female rats gavaged with 1000 mg/kg bw/day for 10 days. We demonstrate that these biomarkers can differentiate the severity of effects induced by melamine or cyanuric acid. All melamine-treated animals experienced adverse effects; however, pregnant rats were most sensitive as indicated by increased SCr, BUN, and kidney weights, decreased body weight, and presence of renal crystals. These effects coincided with elevated urinary biomarker levels as early as day 2 of exposure. One cyanuric acid-treated rat displayed effects similar to melamine, including increased urinary biomarker levels. This work illustrates that these biomarkers can detect early effects of melamine or cyanuric acid crystal-induced nephropathy and further supports the use of urinary protein immunoassays as a powerful, non-invasive method to assess nephrotoxicity.

The risk of kidney cancer in patients with kidney stones: a systematic review and meta-analysis

BACKGROUND

The objective of this meta-analysis was to evaluate the association between a history of kidney stones and kidney cancer.

METHODS

A literature search was performed from inception until June 2014. Studies that reported odds ratios or hazard ratios comparing the risk of renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) of the upper urinary tract in patients with the history of kidney stones versus those without the history of kidney stones were included. Pooled risk ratios (RRs) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.

RESULT

Seven studies were included in our analysis to assess the association between a history of kidney stones and RCC. The pooled RR of RCC in patients with kidney stones was 1.76 (95% CI, 1.24-2.49). The subgroup analysis found that the history of kidney stones was associated with increased RCC risk only in males (RR, 1.41 [95% CI, 1.11-1.80]), but not in females (RR, 1.13 [95% CI, 0.86-1.49]). Five studies were selected to assess the association between a history of kidney stones and TCC. The pooled RR of TCC in patients with kidney stones was 2.14 (95% CI, 1.35-3.40).

CONCLUSION

Our study demonstrates a significant increased risk of RCC and TCC in patients with prior kidney stones. However, the increased risk of RCC was noted only in male patients. This finding suggests that a history of kidney stones is associated with kidney cancer and may impact clinical management and cancer surveillance.

Acute testicular toxicity induced by melamine alone or a mixture of melamine and cyanuric acid in mice

Eight-week-old male Kunming mice were administered either melamine (MA, 30, 140, or 700 mg/kg/day), a melamine and cyanuric acid mixture (MC, each at 15, 70, or 350 mg/kg/day), or vehicle (control) for 3 consecutive days. Testicular toxicity was evaluated on days 1 and 5 after the final exposure. The testicular and epididymal weights and serum testosterone level were significantly decreased in the highest MC group (350 mg/kg/day). Histopathologically, both MA and MC caused obvious lesions in the testis and epididymis, with significant increases in sperm abnormalities. By TEM, the blood-testis barrier was damaged dose dependently. TUNEL staining showed that both MA and MC induced increases in germ cell apoptosis. The Sertoli cell vimentin was collapsed in the treated animals as detected by immunohistochemical staining and Western blotting. This study demonstrated that both MA and MC treatments could disrupt the blood-testis barrier and cause a clear testicular toxicity.

Mammalian toxicology and human exposures to the flame retardant 2,2',6,6'-tetrabromo-4,4'-isopropylidenediphenol (TBBPA): implications for risk assessment

The compound 2,2',6,6'-Tetrabromo-4,4'-isopropylidenediphenol (tetrabromobisphenol A, TBBPA) is used as a reactive and additive flame retardant. This review evaluates the mammalian toxicology of TBBPA and summarizes recent human exposure and risk assessments. TBBPA has a low potential for systemic or reproductive toxicity, and no-observed-adverse-effect-levels were greater than 1,000 mg/kg body weight (bw)/day in a 90-day oral toxicity study, a developmental toxicity study and a two-generation reproductive and developmental toxicity study. Some interactions of TBBPA with hormone-mediated pathways were noted in vitro; however, when studied in vivo, TBBPA did not produce adverse effects that might be considered to be related to disturbances in the endocrine system. Therefore, in accordance with internationally accepted definitions, TBBPA should not be considered an "endocrine disruptor." Furthermore, TBBPA is rapidly excreted in mammals and therefore does not have a potential for bioaccumulation. Measured concentrations of TBBPA in house dust, human diet and human serum samples are very low. Daily intakes of TBBPA in humans were estimated to not exceed a few ng/kg bw/day. Due to the low exposures and the low potential for toxicity, margins of exposures for TBBPA in the human population were between 6 × 10(4) (infants) to 6 × 10(7) (adults). Exposures of the general population are also well below the derived-no-effect-levels derived for endpoints of potential concern in REACH.

The true stone composition and abnormality of urinary metabolic lithogenic factors of rats fed diets containing melamine

To better understand the toxicity of melamine to humans, the stone composition and urinary metabolic lithogenic factors of rats fed diets containing melamine including the infant's melamine-induced stone composition were studied. Sixty 4-week-old male rats divided into three groups were, respectively, fed diets containing no melamine (control), 0.1% melamine, and 1% melamine for 4 weeks. At the end of experiment, the collected stones and 24-h urines from rats were, respectively, measured with compositions and metabolic lithogenic parameters. The stone from an infant who ingested melamine-adulterated formula was also included in compositional analysis. Across three groups, the stone was only detected in 1% melamine group, with composition of almost melamine different from the affected infant's stone composed of melamine and uric acid with a ratio of 1:2. Compared with control group, urine calcium and phosphate excretions were significantly increased in 1% melamine group. Urine uric acid excretion was significantly increased but citrate excretion was significantly decreased in 0.1% and 1% melamine groups. Urine oxalate excretion and pH were indicated without any significant difference. In addition based on urine physicochemical characters, melamine-uric acid stone seems difficult to be formed in the rats due to their characters of urine high-pH and low-uric acid. These results demonstrated that (1) the stone composition of rats fed melamine was not and could not be as that of infants fed melamine-adulterated formula, two species had a different mechanism of melamine-induced stone formation; (2) the exposure of melamine could result in abnormalities of urine metabolic lithogenic factors to rats, perhaps as well as human beings.

A population-based study on the association between urinary calculi and kidney cancer

BACKGROUND

Using a nationwide population-based dataset and case-control study design, we investigate the association between urinary calculi (UC) and kidney cancer (KC) in Taiwan.

METHODS

The data for this case-control study were sourced from the Taiwan National Health Insurance program. The cases included 1308 incident patients pathologically diagnosed with KC. This study also used 6540 randomly selected subjects as controls. Conditional logistic regression was used to examine the associations between KC and patients previously diagnosed with UC.

RESULTS

Of the sampled patients, 1262 (16.1 %) had previously been diagnosed with UC; 415 (31.7 % of the patients with KC) and 847 controls (13.0 % of patients without KC). After adjusting for monthly income, geographic location, urbanization level, hypertension, diabetes, renal disease, obesity, cystic kidney disease, tobacco use disorder, and alcohol abuse, we found that patients with KC were likely to have been previously diagnosed with UC than controls (odds ratio [OR] 3.18, 95% confidence interval [CI] 2.75-3.68, p < 0.001). In addition, the magnitude of the observed associations were stronger among females (females OR 3.59; 95% CI 2.87-4.48 vs. males OR 2.93, 95% CI 2.42-3.55) and transitional cell carcinoma patients (transitional cell carcinoma, OR 3.96; 95% CI 3.23-4.86 vs. renal cell carcinoma OR 2.76, 95% CI 2.31-3.29).

CONCLUSIONS

We conclude that there is an association between KC and prior UC, especially in females and patients with transitional cell carcinoma.

Outcome of children with melamine-induced urolithiasis: results of a two-year follow-up

OBJECTIVE

Our purpose is to describe the characteristics and the outcome of melamine-induced renal and urinary tract injury in young children who consumed melamine-contaminated infant formula.

METHODS

This is a descriptive longitudinal study over 2 years in 240 children with melamine-induced urolithiasis screened in our hospital from September 15 to October 31, 2008. Ultrasonography and serum creatinine (SCr), urea, β2-microglobulin (MG), cystatin C (Cys C), urinary Cr (UCr), microalbumin (mALB), α1-MG, β2-MG, n-acetyl-β-d-glucosaminidase (NAG) and retinol-binding protein (RBP) measurements were performed.

RESULTS

The children ranged in age from 1 to 82 months, and 145 were males. The largest calculus was 33 mm in diameter. X-ray diffraction pattern of the calculi displayed two diffraction peaks at 10.9° and 27.7° (2θ). Surgical management was performed in 14 patients. In 226 patients without surgical management, the calculi were passed in 59.63% patients within 1 month, in 85.40% within 6 and in 91.15% within 24 months. Increased SCr and urea levels were noted in three and six patients, respectively, at the time of diagnosis. The SCr, serum β2-MG, and Cys C levels at the time of diagnosis were higher than those at 3 and 6 months after diagnosis (P < 0.05, respectively). The levels of mALB/UCr, NAG/UCr, and RBP/UCr at the time of diagnosis were higher than those at 3, 6, 12, and 24 months after diagnosis (P < 0.05, respectively). α1-MG/UCr and β2-MG/UCr levels at the time of diagnosis were similar to those at 3 months after diagnosis, and significantly higher than those in the follow-up period (P < 0.05, respectively).

CONCLUSION

Melamine might injure both the renal glomerulus and the tubule, and that the predominant lesion is urolithiasis. The compositions of melamine-induced urolithiasis are melamine and cyanuric acid crystals. The urolithiasis might persist for over 2 years and cause irreversible damage. Therefore, a long-term follow-up for all patients is required.

Toxicity of melamine, an adulterant in fish feeds: experimental assessment of its effects on tilapia

Unscrupulous inclusion of melamine in fish feeds can be harmful to fish and may be hazardous to human health. An eight-week feeding trial examined the effects of melamine (inclusion levels; 5-30 g kg⁻¹ feed) on the growth performance, feed efficiency, histopathological changes and melamine residues in sex-reversed red tilapia, Oreochromis niloticus (L.) × O.mossambicus (Peters). Fish which received melamine-containing feeds grew less, utilized feeds less efficiently and performed poorly, besides exhibiting defects such as fin erosion, anorexia, sluggish swimming behaviour, paling/darkening of skin and low survival. Melamine concentration in the fish reflected its inclusion level in the feeds, and the content was higher in the viscera than in the fish fillet or whole fish. Histopathological alterations were evident in the kidney, liver and gills of fish subjected to melamine treatment - the severity of lesions corresponded to its dosage. Enlargement of renal tubules was observed in the kidney of fish fed with ≥10 g melamine kg⁻¹ feed, although, crystals were not deposited. Fish subjected to melamine insult had more prominent lesions in liver than in kidney. Toxic effects on the gills manifested as epithelial hyperplasia of the primary and secondary lamellae. The anomalies were severe at higher intake levels of melamine.

Melamine activates NFκB/COX-2/PGE2 pathway and increases NADPH oxidase-dependent ROS production in macrophages and human embryonic kidney cells

Melamine is a wildly used compound in manufactures of plastics and resins. A variety of toxic effects from melamine, including nephrolithiasis, chronic kidney inflammation, and bladder carcinoma, have been mentioned. Oxidative stress is considered to be an important pathogenic mechanism of kidney disease which may develop from an increasing free radical production through inflammation. The aim of this study is to investigate melamine-induced oxidative stress and inflammation in macrophage-like cell line RAW 264.7 and human embryonic kidney cell line HEK293. Results indicated melamine activated nuclear factor (NF)-κB through increasing IκB-α degradation and NF-κB p65/p50 DNA-binding activity. In addition, melamine significantly increased COX-2 expression and prostaglandin E2 (PGE2) production. Moreover, melamine activated NADPH oxidase (NOX), including NOX1, NOX2 and NOX4, accompanied with an increase in reactive oxygen species (ROS) production. Furthermore, melamine-induced ROS production could be attenuated by apocynin, a NOX inhibitor. In conclusion, our findings suggest melamine increased inflammation and oxidative stress via activation of NF-κB/COX-2 and NOX/ROS pathway, and first revealed the critical role of NOX in melamine-induced ROS production, suggesting the potential of NOX inhibitor against melamine toxicity.

Crosstalk among dietary polyunsaturated fatty acids, urolithiasis, chronic inflammation, and urinary tract tumor risk

Based on a consistent bulk of experimental and epidemiologic works, we proposed that abnormal metabolism and/or dietary deprivation of essential polyunsaturated fatty acids by inducing a chronic and subclinical essential fatty acid deficiency (EFAD) in urothelial cell membranes may enhance the risk for urinary tract tumor (UTT) development. This threat may be enhanced by the unusual fact that the fatty-acid profile of the normal urothelium is similar to that reported in EFAD. The risk for UTT may be worsened when coexisting with a low-grade chronic inflammation (LGCI) state induced by urolithiasis or disbalance management of peroxides, free radical molecules, and their quenchers. There is cumulative evidence linking the LGCI of the urinary tract mucosa, calculi, and UTT, due to the long-standing release of promitotic, promutagen, and pro-inflammatory antiapoptotic cytokines in these conditions. The dual role played by pro- and anti-inflammatory eicosanoids and bioactive lipids, cytokines, and the disbalance of lipid peroxidation is discussed, concluding that the moderate, long-standing consumption or dietary supplementation of ω-3 PUFAs may improve the chances of avoiding UTT development.

Clinical observation of childhood urinary stones induced by melamine-tainted infant formula in Anhui province, China

INTRODUCTION

The current report detailed an investigation of melamine-linked urinary stones in children exposed to contaminated formula.

MATERIAL AND METHODS

A total of 1062 children fed with melamine-contaminated infant formula were screened for urinary stones. Sixty healthy children without melamine exposure were recruited as a control group. Ultrasonography of the urinary tract system was performed. Urinalysis, renal function, liver status, and serum electrolytes were determined.

RESULTS

We encountered 49 affected children from the 1062 screened ones, at a rate of 4.6% per ultrasound performed. Thirty-two were male, and 17 were female. The affected children ranged in age from 1 month to 96 months, with a mean of 25 months. Duration of exposure was from 1.3 months to 84 months, with a mean of 19.5 months. The melamine contents in serum were between 12 mg/kg and 2563 mg/kg, with mean concentration of 1295.3 mg/kg. Most affected children were asymptomatic with no urinary findings. Patients with urinary stones exhibited lower urine pH and serum HCO3 (-) than those in the healthy children, whereas for serum uric acid, alanine aminotransferase, aspartate aminotransferase, and anion gap the opposite trends were observed. The stone diameter ranged from 2 mm to 18 mm with a median of 6.5 mm. Multiple stones were noted in all patients. After 1 week of conservative management, stone diameters of 38 cases (77.6%) were significantly decreased. Among them, urinary stones were discharged completely in 21 affected children (42.9%).

CONCLUSIONS

The short-term outcome of melamine-linked urinary stones is satisfactory.

Toxicity of melamine: the public health concern

Melamine contamination in food has resulted in sickness and deaths of human infants, pets, and farm animals in the past decade. The majority of the victims suffered from acute kidney injury, nephrolithiasis, and urolithiasis. Since then, animal studies have revealed the possible target organs of the melamine toxicity and the extent of the adverse effects of the contaminant. State-of-the-art analytical methods have been developed to achieve the "zero tolerance" aim for such economically motivated adulteration. These studies provide in-depth understanding of the melamine toxicity and promising analytical methods, which can help us safeguard our dairy food source.

An NMR-based metabonomic investigation of the subacute effects of melamine in rats

The subacute toxic effects of 28 days of exposure to three dosages (250, 500, 1000 mg/kg/day) of melamine on Wistar rats were investigated using nuclear magnetic resonance spectra, histopathological examination, and biochemical analysis. Rats treated with melamine developed adverse health effects compared to the controls, including decrease in body weight and kidney damage. Blood biochemical analysis showed that the blood urea nitrogen and creatinine increased distinctly compared to the control group. Urinary metabonomic analysis indicated that melamine caused an increase in succinate and citrate. Serum metabonomic analysis showed that the lowest dose led to an increase in dimethylglycine, N-acetylglycoprotein (NAC), accompanied by a decrease in taurine and glucose. Rats treated with the highest dose developed high levels of serum choline and 3-hydroxybutyrate (3-HB) together with low lactate levels. Metabonomic analysis of liver tissue indicated that melamine caused an increase in NAC, choline, and creatine, accompanied by a decrease in lactate, trimethylamine-N-oxide, glutamate, and glucose. All three dosages resulted in an increase in glutamate, lactate, choline, glucose, and animo acids and a decrease in 3-HB and pyruvate in aqueous kidney extract. These results indicate that melamine not only caused renal disfunction but also disturbed the liver's glucose, protein, and nitrogen metabolism.

Melamine-induced urolithiasis in a Drosophila model

Melamine-tainted food can induce renal stones in both humans and animals. We have previously reported a novel Drosophila model for the study of renal stone disease. In addition to hyperoxaluria-causing agents, we also tested herein the effect of melamine on crystal formation in Drosophila . The results indicate that administration of melamine alone caused crystal formation in a dose-dependent manner. The crystals also appeared after ingestion of melamine for 3 weeks in the Malpighian tubules of Drosophila when viewed with polarized light. Administration of potassium citrate (K citrate) was found to significantly ameliorate the melamine-induced reduction of lifespan. However, administration of K citrate failed to reduce the quantity of crystals. Because calcium oxalate is not the major crystal induced by melamine, the predominant components of melamine-induced crystals and the potential crystal inhibitors warrant further investigation.

Veterinary Pesticides

Veterinary pesticides are used to treat a range of parasitic conditions in companion and farm animals. These products are based on a number of different compounds with different modes of action and different spectra of toxicity. The older agents include the synthetic pyrethroids and organophosphorus compounds, while the newer examples include, for example, representatives of the insect growth promoters, the neonicotinoids, and the oxadiazones. For many of these compounds, toxicity is associated with their pharmacological activity or mode of action. Thus the synthetic pyrethroids and the organophosphorus compounds exert neurotoxic effects. For others, toxicity may be associated with mechanisms that are independent of their mode of action. When used according to the manufacturer's instructions, these products are generally safe and efficacious. However, accidental contamination and misuse can lead to toxicity in operators and treated animals. These compounds are important in the treatment of parasitic disease in animals and their regulation and uses are based on favourable risk-benefit outcomes.

Nutritional chemoprevention of urinary tract tumors (UTT) induced by lithogenic agents: risk for UTT in children exposed to melamine-contaminated milk formulas

Urinary tract tumors are tenth in frequency, and many environmental carcinogens are excreted by urine. Interplay between chronic inflammatory urolithiasis and urothelial carcinogenesis is not well understood. Experimental evidences show that dietary melamine induce these events even at low concentrations. This is important because thousands of children were exposed to melamine through intentionally contaminated milk formula worldwide. We propose that an increased risk for urinary tumors in adult life may occur and screenings for early urinary signs may be necessary. Therefore, urothelial biology, melamine carcinogenic potential, and related epidemiology are discussed, recommending a preventive dietary polyunsaturated fatty acid-based supplementation, since they modulate such interplay in rodents.

Fast quantitative determination of melamine and its derivatives by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry

A simple, sensitive and fast method for the determination of melamine and its derivatives in milk powder using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) was developed. Neither time-consuming sample preparation, nor special target plates, or other extra equipment are necessary. The common matrix sinapinic acid (SA) was used with a dried-droplet preparation. Detection limits (signal-to-noise (S/N) ratio = 3) for standard solutions of melamine, ammeline and cyanuric acid were 10, 25 and 10 µg/L, respectively. The limit of quantification (LOQ) for melamine was 25 µg/L and excellent linearity (R(2): 0.9990) was maintained over the range of 10-2000 µg/L. Ammeline and cyanuric acid were analyzed with an LOQ of 50 µg/L and also excellent linearity (R(2): 0.9997 and R(2): 0.9998). Good accuracy and precision were obtained for all concentrations within the range of the standard curve. The developed method was successfully used for the determination of melamine, ammeline and cyanuric acid in milk powder samples with a simple sample preparation. The LOQ of melamine was 0.5 µg/g. Ammeline and cyanuric acid were detectable at 0.5 and 5 µg/g. This method showed excellent accuracy, precision and linearity and significantly reduces the needed analysis time, as only approximately 10 s/sample measuring time is required. To the authors' knowledge, this is the first published method to quantify melamine and derivatives by MALDI-TOF-MS.

Toxicity of cyanuric acid to broilers on hepatic and renal health with and without melamine

The purpose of this study was to evaluate the toxicity potential of cyanuric acid (CYA) and a combination of melamine (MEL) and CYA in broilers. A total of 1200 male COBB 500 broilers were randomly allocated into 1 of 10 treatment groups by a 5 × 2 factorial design in a 42-d experiment. The dietary treatments were as follows: T1 to T5: basal diets with 0, 10, 20, 33.3, and 50 mg CYA per kg diet; T6 to T10: basal diet with CYA regimens similar to T1 to T5 but with 100 mg MEL per kg diet. There were 6 replication pens with 20 chicks per pen. No differences were observed in alanine transaminase (ALT) and aspartate aminotransferase (AST) activities. But on d 22, uric acid (UA) and creatinine (Crea) concentrations were significantly greater when birds were fed CYA at 33.3 mg/kg with MEL 100 mg/kg, and Crea concentration was also higher when birds were fed CYA at 50 mg/kg. No crystals were found in kidneys but dilated renal tubules and small blood vessel expansion were found in kidneys of birds fed CYA at 50 mg/kg and CYA at 33.3 mg/kg with MEL 100 mg/kg. The apoptosis rate (AR) of kidneys of all birds fed CYA and MEL contaminated diets were higher than the control group. These results indicated that the dietary addition of CYA and MEL could induce kidney damage, and the effects were harmful when the ratio of CYA/MEL was 1:3.

The Role of the Toxicologic Pathologist in the Biopharmaceutical Industry

Toxicologic pathologists contribute significantly to the development of new biopharmaceuticals, yet there is often a lack of awareness of this specialized role. As the members of multidisciplinary teams, toxicologic pathologists participate in all aspects of the drug development process. This review is part of an initiative by the Society of Toxicologic Pathology to educate scientists about toxicologic pathology and to attract junior scientists, veterinary students, and veterinarians into the field. We describe the role of toxicologic pathologists in identifying candidate agents, elucidating bioactive pathways, and evaluating efficacy and toxicity in preclinical animal models. Educational and specialized training requirements and the challenges of working in a global environment are discussed. The biopharmaceutical industry provides diverse, challenging, and rewarding career opportunities in toxicologic pathology. We hope that this review promotes understanding of the important role the toxicologic pathologist plays in drug development and encourages exploration of an important career option.

Follow-up results of children with melamine induced urolithiasis: a prospective observational cohort study

BACKGROUND

Melamine-contaminated milk powder was the cause of the 2008 outbreak of urolithiasis in young children and infants in China, but the prognosis of these children remains unknown. We hypothesized that urolithiasis induced by melamine-contaminated milk powder may be associated with secondary renal injury.

METHODS

A total of 8335 children (≤6 years old) with a history of consuming melamine-contaminated milk powder were screened. Urine analysis and urinary system ultrasonography were performed. For children with urolithiasis, the basic information and the results of examination were recorded, and effective therapy was given. They were followed up for 6 months after the original diagnosis, and urinary microprotein profiles were measured.

RESULTS

Of the 8335 children, 105 (1.26%) were diagnosed with melamine-contaminated milk powder-associated urolithiasis. The size of the stone was correlated with the duration of exposure to melamine. Six months later, 69.8% (67) of the children with urolithiasis passed stones (follow-up rate: 91.4%). Of the 67 children, 28 passed stones within 2 months. The higher possibility of passing a stone was correlated with the smaller diameter of the stone (P<0.001). The detection rate of abnormal urinary microprotein excretion (microalbumin, immunoglobulin G, and N-acetyl-β-D-glucosidase) was 52.4% in children with persistent stones and 38.2% in those who passed their stones. The detection rate was lower in children who passed stones within 2 months (31.8%) than in those who passed stones in 2 to 6 months (50.0%). The levels of microalbumin/creatinine and immunoglobulin G/creatinine were significantly higher in children with persistent stones than in those who passed their stones.

CONCLUSIONS

Early passage of a stone may reduce the renal injury induced by melamine-contaminated milk powder-associated urolithiasis.

Toxicological risk of melamine and cyanuric acid in food and feed

From the toxicological point of view, in the last two years melamine and cyanuric acid have become matters of great interest. These substances, especially melamine, have been abused during food and feed adulteration by increasing the content of nitrogen compounds in these products. Melamine and cyanuric acid as individual substances do not pose any serious risk in terms of toxicology. From the point of view of toxicology, it is especially the complex of melamine with cyanuric acid that is important. This complex, also known as the melamine-cyanurate complex, is a cause of human and animal health problems. In this work we present two examples of the incidence of melamine and cyanuric acid in two feed products originating from China. They were rice and the pea concentrates intended for animal nutrition. Protein concentrates can be the main risk factor for food chain contamination with melamine and cyanuric acid, especially those of unknown origin. Feed with a high content of nitrogen compounds and low content of aminoacids can be regarded as particularly suspicious. A comparison of results for determining nitrogen compounds and amines can be used as proof of adulteration of protein feeds. These feeds must be subjected to further analysis to determine melamine and cyanuric acid.