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Zhu BT. Biochemical mechanism underlying the pathogenesis of diabetic retinopathy and other diabetic complications in humans: the methanol-formaldehyde-formic acid hypothesis. Acta Biochim Biophys Sin (Shanghai) 2022; 54:415-451. [PMID: 35607958 PMCID: PMC9828688 DOI: 10.3724/abbs.2022012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022] Open
Abstract
Hyperglycemia in diabetic patients is associated with abnormally-elevated cellular glucose levels. It is hypothesized that increased cellular glucose will lead to increased formation of endogenous methanol and/or formaldehyde, both of which are then metabolically converted to formic acid. These one-carbon metabolites are known to be present naturally in humans, and their levels are increased under diabetic conditions. Mechanistically, while formaldehyde is a cross-linking agent capable of causing extensive cytotoxicity, formic acid is an inhibitor of mitochondrial cytochrome oxidase, capable of inducing histotoxic hypoxia, ATP deficiency and cytotoxicity. Chronic increase in the production and accumulation of these toxic one-carbon metabolites in diabetic patients can drive the pathogenesis of ocular as well as other diabetic complications. This hypothesis is supported by a large body of experimental and clinical observations scattered in the literature. For instance, methanol is known to have organ- and species-selective toxicities, including the characteristic ocular lesions commonly seen in humans and non-human primates, but not in rodents. Similarly, some of the diabetic complications (such as ocular lesions) also have a characteristic species-selective pattern, closely resembling methanol intoxication. Moreover, while alcohol consumption or combined use of folic acid plus vitamin B is beneficial for mitigating acute methanol toxicity in humans, their use also improves the outcomes of diabetic complications. In addition, there is also a large body of evidence from biochemical and cellular studies. Together, there is considerable experimental support for the proposed hypothesis that increased metabolic formation of toxic one-carbon metabolites in diabetic patients contributes importantly to the development of various clinical complications.
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Affiliation(s)
- Bao Ting Zhu
- Shenzhen Key Laboratory of Steroid Drug Discovery and DevelopmentSchool of MedicineThe Chinese University of Hong KongShenzhen518172China
- Department of PharmacologyToxicology and TherapeuticsSchool of MedicineUniversity of Kansas Medical CenterKansas CityKS66160USA
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Akhgari M, Panahianpour MH, Bazmi E, Etemadi-Aleagha A, Mahdavi A, Nazari SH. Fatal methanol poisoning. Toxicol Ind Health 2011. [DOI: https://doi.org/10.1177%2f0748233711427050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Methanol poisoning has become a considerable problem in Iran. Liver can show some features of poisoning after methanol ingestion. Therefore, our concern was to examine liver tissue histopathology in fatal methanol poisoning cases in Iranian population. In this study, 44 cases of fatal methanol poisoning were identified in a year. The histological changes of the liver were reviewed. The most striking features of liver damage by light microscopy were micro-vesicular steatosis, macro-vesicular steatosis, focal hepatocyte necrosis, mild intra-hepatocyte bile stasis, feathery degeneration and hydropic degeneration. Blood and vitreous humor methanol concentrations were examined to confirm the proposed history of methanol poisoning. The majority of cases were men (86.36%). In conclusion, methanol poisoning can cause histological changes in liver tissues. Most importantly in cases with mean blood and vitreous humor methanol levels greater than 127 ± 38.9 mg/dL more than one pathologic features were detected.
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Affiliation(s)
- Maryam Akhgari
- Department of Forensic Toxicology, Legal Medicine Research Center, Tehran, Iran
| | | | - Elham Bazmi
- Department of Forensic Toxicology, Legal Medicine Research Center, Tehran, Iran
| | - Afshar Etemadi-Aleagha
- Tehran University of Medical Sciences, Faculty of Medicine, Amir Alam Hospital, Tehran, Iran
| | - Amirhosein Mahdavi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Hashemi Nazari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Akhgari M, Panahianpour MH, Bazmi E, Etemadi-Aleagha A, Mahdavi A, Nazari SH. Fatal methanol poisoning: features of liver histopathology. Toxicol Ind Health 2011; 29:136-41. [PMID: 22082823 DOI: 10.1177/0748233711427050] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Methanol poisoning has become a considerable problem in Iran. Liver can show some features of poisoning after methanol ingestion. Therefore, our concern was to examine liver tissue histopathology in fatal methanol poisoning cases in Iranian population. In this study, 44 cases of fatal methanol poisoning were identified in a year. The histological changes of the liver were reviewed. The most striking features of liver damage by light microscopy were micro-vesicular steatosis, macro-vesicular steatosis, focal hepatocyte necrosis, mild intra-hepatocyte bile stasis, feathery degeneration and hydropic degeneration. Blood and vitreous humor methanol concentrations were examined to confirm the proposed history of methanol poisoning. The majority of cases were men (86.36%). In conclusion, methanol poisoning can cause histological changes in liver tissues. Most importantly in cases with mean blood and vitreous humor methanol levels greater than 127 ± 38.9 mg/dL more than one pathologic features were detected.
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Affiliation(s)
- Maryam Akhgari
- Department of Forensic Toxicology, Legal Medicine Research Center, Tehran, Iran.
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Kumarathasan P, Vincent R, Tardif R, Potvin M, Bjarnason S, Poon R, Moir D, Chu I. Experimental Atmosphere Monitoring in Gasoline Vapor Inhalation Studies. ACTA ACUST UNITED AC 2008. [DOI: 10.3109/15376519609068454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cooper RG. Renal function in male Sprague-Dawley rats concurrently exposed to long-term nicotine (3-{1-methyl-2-pyrrolidinyl}pyridine) and methylated spirits (methyl alcohol). Ren Fail 2008; 30:107-14. [PMID: 18197551 DOI: 10.1080/08860220701742179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Abuse of nicotine and methylated spirits is a global problem. The current study determined the concurrent influence of nicotine and methylated spirits on renal hemodynamics. Two series of experimental protocols were designed: conscious and anesthetized vehicle loading. Conscious animals received nicotine (0.1 mg x kg(-1) bwt, 0.26-0.30 mL), methylated spirits (1.0 g x kg (-1) bwt, 0.26-0.30 mL), combined nicotine and methylated spirits, and control animals (water, 0.26-0.30 mL). Anesthetized animals were challenged with a continuous jugular infusion of 0.077M NaCl. Plasma nicotine concentration was significantly elevated in combined conscious treatments by comparison with animals infused nicotine alone. Plasma arginine vasopressin was significantly attenuated in combined conscious groups, and those infused methylated spirits alone. Aldosterone was elevated in all conscious groups. Both plasma ethanol and methanol concentrations were elevated in rats concurrently administered nicotine and methylated spirits compared with those given methylated spirits alone. Urinary Na(+) levels were significantly elevated in all anesthetized groups associated with attenuated aldosterone concentrations. Plasma nicotine concentrations were increased in combined treatments. Plasma ethanol levels were significantly reduced and elevated in rats concurrently exposed to nicotine and methylated spirits, respectively. The present study suggests that chronic exposure to methylated spirits alone and in combination with nicotine increases urinary Na(+) loss. The renal toxicity is manifested hypothetically via elevations in plasma nicotine and methanol concentrations. This implies that people who concurrently consume methylated spirits and smoke cigarettes have an increased risk of renal failure by being predisposed to fluid and electrolyte disturbances.
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Affiliation(s)
- R G Cooper
- Department of Physiology, Faculty of Medicine, College of Health Sciences, University of Zimbabwe, Mount Pleasant, Harare, Zimbabwe.
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Chu I, Poon R, Valli V, Yagminas A, Bowers WJ, Seegal R, Vincent R. Effects of an ethanol-gasoline mixture: results of a 4-week inhalation study in rats. J Appl Toxicol 2005; 25:193-9. [PMID: 15856534 DOI: 10.1002/jat.1051] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The inhalation toxicity of an ethanol-gasoline mixture was investigated in rats. Groups of 15 male and 15 female rats were exposed by inhalation to 6130 ppm ethanol, 500 ppm gasoline or a mixture of 85% ethanol and 15% gasoline (by volume, 6130 ppm ethanol and 500 ppm gasoline), 6 h a day, 5 days per week for 4 weeks. Control rats of both genders received HEPA/charcoal-filtered room air. Ten males and ten females from each group were killed after 4 weeks of treatment and the remaining rats were exposed to filtered room air for an additional 4 weeks to determine the reversibility of toxic injuries. Female rats treated with the mixture showed growth suppression, which was reversed after 4 weeks of recovery. Increased kidney weight and elevated liver microsomal ethoxyresorufin-O-deethylase (EROD) activity, urinary ascorbic acid, hippuric acid and blood lymphocytes were observed and most of the effects were associated with gasoline exposure. Combined exposure to ethanol and gasoline appeared to exert an additive effect on growth suppression. Inflammation of the upper respiratory tract was observed only in the ethanol-gasoline mixture groups, and exposure to either ethanol and gasoline had no effect on the organ, suggesting that an irritating effect was produced when the two liquids were mixed. Morphology in the adrenal gland was characterized by vacuolation of the cortical area. Although histological changes were generally mild in male and female rats and were reversed after 4 weeks, the changes tended to be more severe in male rats. Brain biogenic amine levels were altered in ethanol- and gasoline-treated groups; their levels varied with respect to gender and brain region. Although no general interactions were observed in the brain neurotransmitters, gasoline appeared to suppress dopamine concentrations in the nucleus accumbens region co-exposed to ethanol. It was concluded that treatment with ethanol and gasoline, at the levels studied, produced mild, reversible biochemical hematological and histological effects, with some indications of interactions when they were co-administered.
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Affiliation(s)
- I Chu
- Safe Environments Directorate, Health Canada, Ottawa, Canada.
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Shelby M, Portier C, Goldman L, Moore J, Iannucci A, Jahnke G, Donkin S. NTP-CERHR Expert Panel report on the reproductive and developmental toxicity of methanol. Reprod Toxicol 2004; 18:303-90. [PMID: 15082073 DOI: 10.1016/j.reprotox.2003.10.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The National Toxicology Program (NTP) and the National Institute of Environmental Health Sciences (NIEHS) established the NTP Center for the Evaluation of Risks to Human Reproduction (CERHR) in June 1998. The purpose of the Center is to provide timely, unbiased, scientifically sound evaluations of human and experimental evidence for adverse effects on reproduction, including development, caused by agents to which humans may be exposed. Methanol was selected for evaluation by the CERHR based on high production volume, extent of human exposure, and published evidence of reproductive or developmental toxicity. Methanol is used in chemical syntheses and as an industrial solvent. It is a natural component of the human diet and is found in consumer products such as paints, antifreeze, cleaning solutions, and adhesives. It is used in race car fuels and there is potential for expanded use as an automobile fuel. This evaluation is the result of a 10-month effort by a 12-member panel of government and non-government scientists that culminated in a public Expert Panel meeting. This report has been reviewed by CERHR staff scientists, and by members of the Methanol Expert Panel. Copies have been provided to the CERHR Core Committee, which is made up of representatives of NTP-participating agencies. This report is a product of the Expert Panel and is intended to (1). interpret the strength of scientific evidence that a given exposure or exposure circumstance may pose a hazard to reproduction and the health and welfare of children; (2). provide objective and scientifically thorough assessments of the scientific evidence that adverse reproductive/development health effects are associated with exposure to specific chemicals or classes of chemicals, including descriptions of any uncertainties that would diminish confidence in assessment of risks; and (3). identify knowledge gaps to help establish research and testing priorities. The expert panel report becomes a central part of the subsequent NTP-CERHR Monograph. Each monograph includes the NTP Brief on the chemical under evaluation, the expert panel report, and all public comments on the expert panel report. The NTP Brief contains the NTP's conclusions on the potential for exposure to result in adverse effects on human development and reproduction. It is based on the expert panel report, public comments on the report, and relevant data published after the expert panel report was completed. NTP-CERHR Monographs are publicly available and are transmitted to appropriate health and regulatory agencies.
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Poon R, Yagminas A, Singh A, Valli VE, Chu I. Short-term oral toxicity of gasohol in female rats. J Appl Toxicol 2001; 21:461-7. [PMID: 11746192 DOI: 10.1002/jat.781] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The systemic toxicity of gasohol (10% ethanol in gasoline by volume) in female rats following 4-week oral administration was studied. Female Sprague-Dawley rats (198+/-14 g) were divided into four groups of ten animals each. The low- and medium-dose groups received by gavage corn oil containing gasoline/ethanol at 16/1.8 and 160/18 (mg kg(-1) body weight), respectively, for 28 consecutive days. The high-dose animals were administered gasoline/ethanol at 1600/180 mg kg(-1) on the first day and the dose was reduced to 800/90 mg kg(-1) for the rest of the study period. Control animals received corn oil only. Urine was obtained from all rats after weeks 1, 2 and 4 for biochemical analysis. At termination of the study, kidneys of four rats from each group were examined by electron microscopy. Body weight gains, organ weights, tissue and organ histopathology, serum biochemistry, hematology, liver enzymes and biochemistry were determined in the remaining six animals of each group. No treatment-related changes were observed in the following endpoints: body weight gain or relative weights of the brain, lungs, liver, kidneys, spleen and thymus. A significant increase in pentoxyresorufin O-deethylase (PROD) and benzoylresorufin O-dealkylase (BROD) activities was detected in the high-dose animals, whereas ethoxyresorufin O-deethylase (EROD) activity was unchanged. Treatment with gasohol did not produce any significant changes in hematology and serum clinical chemistry parameters. Biomarkers of oxidative stress such as serum and liver thiobarbituric acid reactive substances (TBARS) and liver glutathione also were unaffected by treatments. Urinary ascorbic acid was elevated markedly in the medium- and high-dose groups following the first, second and fourth weeks of treatment. Urine hippuric acid was increased significantly in the high-dose groups. A dose-related increase in urinary aldehydes also was observed in animals after the first, second and fourth week of treatment. Interestingly, a separate 1-week dosing study revealed that the increase in urinary aldehydes was associated with gasoline and not with ethanol treatment. In the high-dose animals slight increases in urinary protein and N-acetylglucosaminidase activity were observed after week 1 but not after week 2 or week 4. No histopathological changes were detected in the liver, kidneys, stomach, brain, lungs or other tissues examined. Electron microscopic examination of the kidneys also did not reveal any abnormalities. It was concluded that short-term oral administration of gasoline/ethanol at 800/90 mg kg(-1) produced a biochemical response in the liver but no adverse effects in the kidneys and lungs. The biological significance of elevated urinary aldehydes at gasoline/ethanol concentrations of 160/18 mg kg(-1) and higher remains to be studied.
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Affiliation(s)
- R Poon
- Safe Environments Directorate, Health Canada, Ottawa, Canada, K1A 0L2.
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Poon R, Park G, Viau C, Chu I, Potvin M, Vincent R, Valli V. Inhalation toxicity of methanol/gasoline in rats: effects of 13-week exposure. Toxicol Ind Health 1998; 14:501-20. [PMID: 9664642 DOI: 10.1177/074823379801400402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The subchronic inhalation toxicity of a methanol/gasoline blend (85% methanol, 15% gasoline, v/v) was studied in rats. Sprague Dawley rats (10 animals per group) of both sexes were exposed to vapours of methanol/gasoline at 50/3, 500/30 and 5000/300ppm for 6 hours per day, 5 days per week, for 13 weeks. Control animals inhaled filtered room air only. Control recovery and high dose recovery groups were also included which inhaled room air for an extra 4 weeks following the treatment period. No clinical signs of toxicity were observed in the treatment group and their growth curves were not significantly different from the control. Except for decreased forelimb grip strength in high dose females, no treatment-related neurobehavioural effects (4-6 hours post inhalation) were observed using screening tests which included cage-side observations, righting reflex, open field activities, and forelimb and hindlimb grip strength. At necropsy, the organ to body weight ratios for the liver, spleen, testes, thymus and lungs were not significantly different from the control group. There were no treatment-related effects in the hematological endpoints and no elevation in serum formate levels. Minimal serum biochemical changes were observed with the only treatment-related change being the decreased creatinine in the females. A dose-related increase in urinary ascorbic acid was detected in males after 2, 4 and 8 weeks of exposure, but not after the 12th week, and in females only at week-2. Increased urinary albumin was observed in treated males starting at the lowest dose and at all exposure periods, but not in females. A treatment-related increase in urinary beta 2-microglobulin was detected in males at week-2 only. Except for mild to moderate mucous cell metaplasia in nasal septum B, which occurred more often and with a slightly higher degree of severity in the low dose groups of both sexes, and presence of a minimal degree of interstitial lymphocyte infiltration in the prostate glands in the high dose males. No other significant microscopic changes were observed in the tissues of treated animals. Based on the marked increase in urinary ascorbic acid and albumin in the high dose males and the decreased forelimb grip strength in the high dose females, we concluded that the no-observed adverse effect level (NOAEL) of methanol/gasoline vapour is 500/30 ppm.
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Affiliation(s)
- R Poon
- Environmental Health Directorate, Health Protection Branch, Ottawa, Canada.
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Caprino L, Togna GI. Potential health effects of gasoline and its constituents: A review of current literature (1990-1997) on toxicological data. ENVIRONMENTAL HEALTH PERSPECTIVES 1998; 106:115-25. [PMID: 9452413 PMCID: PMC1533055 DOI: 10.1289/ehp.98106115] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
We reviewed toxicological studies, both experimental and epidemiological, that appeared in international literature in the period 1990-1997 and included both leaded and unleaded gasolines as well as their components and additives. The aim of this overview was to select, arrange, and present references of scientific papers published during the period under consideration and to summarize the data in order to give a comprehensive picture of the results of toxicological studies performed in laboratory animals (including carcinogenic, teratogenic, or embryotoxic activity), mutagenicity and genotoxic aspects in mammalian and bacterial systems, and epidemiological results obtained in humans in relation to gasoline exposure. This paper draws attention to the inherent difficulties in assessing with precision any potential adverse effects on health, that is, the risk of possible damage to man and his environment from gasoline. The difficulty of risk assessment still exists despite the fact that the studies examined are definitely more technically valid than those of earlier years. The uncertainty in overall risk determination from gasoline exposure also derives from the conflicting results of different studies, from the lack of a correct scientific approach in some studies, from the variable characteristics of the different gasoline mixtures, and from the difficulties of correctly handling potentially confounding variables related to lifestyle (e.g., cigarette smoking, drug use) or to preexisting pathological conditions. In this respect, this paper highlights the need for accurately assessing the conclusive explanations reported in scientific papers so as to avoid the spread of inaccurate or misleading information on gasoline toxicity in nonscientific papers and in mass-media messages.
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Affiliation(s)
- L Caprino
- Institute of Medical Pharmacology, University of Rome "La Sapienza," Rome, Italy
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