Report of the BTS/UKEMS Working Group on Dose Setting in In-Vivo Mutagenicity Assays

The BTS/UKEMS Working Group was established to consider dose selection for in-vivo mutagenicity assays, and the feasibility of establishing criteria for identifying maximum dose levels that did not involve relating these to a high fraction (50-80%) of the estimated LD50 value.

In view of the importance attached by regulatory authorities to negative results from in-vivo tests, namely reassurance that mutagenic potential seen in vitro could not be expressed in the whole animal, the need for the use of some form of MTD was accepted. The crucial question facing the group was whether the use of 'evident toxicity' rather than some index of lethality would result in any meaningful loss of sensitivity of the assays.

The group endorsed the concept of a limit dose for relatively non-toxic compounds and supported the use of a value of 2 g kg-1 for single oral dosing and 1 g kg-1 for repeated dosing, in line with the general values used by the OECD and EEC.

In order to assess the question of sensitivity of the assays the group considered the available data from the published literature, and from 'in-house' studies, on dose-response for mutagenicity and for toxicity, using the same dosing regime. It rapidly became apparent that few data were available, and that these were limited essentially to the micronucleus test; there were inadequate data to consider any other methods. In addition, there was the added complication that most of the available data related to protocols which were less rigorous than those currently recommended. The group thus concentrated on the micronucleus test because of its relatively wide use and since it had given rise to specific concerns due to a recent recommendation from the relevant EPA Gen-Tox group namely that the top dose should be 50-80% of the estimated LD50 value. It was noted that the EPA appear to be considering this approach as one alternative when dose setting, with the possibility of the use of a dose producing overt toxicity as another. Available data indicate that around 90% of tested mutagens would have been identified using an MTD based on non-lethal criteria. Moreover the percentage would be expected to be higher if all tests had been carried out to current protocol standards. However, the possibility of missing compounds could not be completely eliminated.

Furthermore, it was important to put the bone marrow study in context. In the UK, Regulatory Authorities would not accept negative data from one tissue as providing adequate reassurance regarding the absence of in-vivo activity. Data from at least one other assay using a different tissue would be needed. It would not therefore be necessary to use 'heroic' and unrealistically high doses in the bone marrow assay in a misguided attempt to obtain absolute assurance from the one study. It is believed that Regulatory Authorities in most other countries would seek data from more than one in-vivo assay before discounting positive data from in-vitro studies.

The group also considered in quantitative terms, the actual difference in MTD in the mouse if based on 'evident toxicity' or on lethality (an estimate of a dose equivalent to 50-80% the LD50 value). There was relatively little difference between the two levels, due to the steep dose response for toxicity seen in the mouse with most compounds.

Incorporating potency into EU classification for carcinogenicity and reproductive toxicity

Although risk assessment, assessing the potential harm of each particular exposure of a substance, is desirable, it is not feasible in many situations. Risk assessment uses a process of hazard identification, hazard characterisation, and exposure assessment as its components. In the absence of risk assessment, the purpose of classification is to give broad guidance (through the label) on the suitability of a chemical in a range of use situations. Hazard classification in the EU is a process involving identification of the hazards of a substance, followed by comparison of those hazards (including degree of hazard) with defined criteria. Classification should therefore give guidance on degree of hazard as well as hazard identification. Potency is the most important indicator of degree of hazard and should therefore be included in classification. This is done for acute lethality and general toxicity by classifying on dose required to cause the effect. The classification in the EU for carcinogenicity and reproductive toxicity does not discriminate across the wide range of potencies seen (6 orders of magnitude) for carcinogenicity and for developmental toxicity and fertility. Therefore potency should be included in the classification process. The methodology in the EU guidelines for classification for deriving specific concentration limits is a rigorous process for assigning substances which cause tumours or developmental toxicity and infertility in experimental animals to high, medium or low degree of hazard categories by incorporating potency. Methods are suggested on how the degree of hazard so derived could be used in the EU classification process to improve hazard communication and in downstream risk management.

Hazard characterisation of chemicals in food and diet. dose response, mechanisms and extrapolation issues

Hazard characterisation of low molecular weight chemicals in food and diet generally use a no-observed-adverse-effect level (NOAEL) or a benchmark dose as the starting point. For hazards that are considered not to have thresholds for their mode of action, low-dose extrapolation and other modelling approaches may be applied. The default position is that rodents are good models for humans. However, some chemicals cause species-specific toxicity syndromes. Information on quantitative species differences is used to modify the default uncertainty factors applied to extrapolate from experimental animals to humans. A central theme for extrapolation is unravelling the mode of action for the critical effects observed. Food can be considered as an extremely complex and variable chemical mixture. Interactions among low molecular weight chemicals are expected to be rare given that the exposure levels generally are far below their NOAELs. Hazard characterisation of micronutrients must consider that adverse effects may arise from intakes that are too low (deficiency) as well as too high (toxicity). Interactions between different nutrients may complicate such hazard characterisations. The principle of substantial equivalence can be applied to guide the hazard identification and hazard characterisation of macronutrients and whole foods. Macronutrients and whole foods must be evaluated on a case-by-case basis and cannot follow a routine assessment protocol.

Health risk of low-dose pesticides mixtures: a review of the 1985-1998 literature on combination toxicology and health risk assessment

A literature review covering the last 14 yr has been performed in the field of combination toxicology and human risk assessment from exposure to chemical mixtures, with special emphasis on mixtures of pesticides at low doses, that is, at levels likely to occur in human diet and environment. Despite a large body of knowledge in the field of risk assessment methodologies for exposure to chemical and pesticide mixtures, there is no single methodological approach in "combination toxicology" and health risk assessment of chemical mixtures, and therefore professional judgment is still required. Generally, the dose or response additivity approach that may be applied to evaluate potential risk for chemical mixtures in human toxicology overestimates the risk of a combination of chemicals. The recent endocrine disrupter issue demonstrated the difficulty of reproducibility of data when testing environmental toxicants at very low levels, and the need for more basic work in this field. The use of integrated methodological approaches may provide more reliable predictive data in the risk assessment of chemical mixtures in future. Yet data have demonstrated that exposure to a combination of compounds does not cause effects stronger than the ones of their most active component, provided components are present at low concentration levels, like acceptable daily intake (ADI) or reference dose (RfD) levels, well below their respective no-observed-adverse-effect levels (NOAELs). Although it has been demonstrated that a combination of compounds with the same target organ and the same or very similar mechanisms of action may cause additive or synergistic effects, the chance of such effects will most likely diminish with decreasing exposure levels to such combinations. Synergism and antagonism may both occur at the same time at different organs or targets in the same organism. However, and despite some exceptions, it has been demonstrated that interaction between components is not a common event at low levels of human exposure such as those that may occur through pesticides residues in food or drinking water. The introduction of a special safety factor as a standard for mixtures in addition to those normally used for deriving ADIs, RfDs, or minimal risk levels is not supported by data. It can be concluded from our review that, as a general rule, exposure to mixtures of pesticides at low doses of the individual constituents does not represent a potential source of concern to human health.

Respiratory hypersensitivity to diphenylmethane-4,4'-diisocyanate in guinea pigs: comparison with trimellitic anhydride

Published evidence demonstrates successful induction and elicitation of respiratory hypersensitivity in guinea pigs by the known human respiratory allergens trimellitic anhydride (TMA) and diphenylmethane-4,4'-diisocyanate (MDI). From these data it is apparent that TMA-related respiratory hyperresponsiveness can be elicited readily in guinea pigs upon inhalation challenge with the free chemical. Despite the interlaboratory variability in methodological procedures used for the sensitization as well as elicitation of response and the wide range of concentrations of TMA employed for challenge exposures (6-57 mg/m(3) air), TMA had been unequivocally identified as a benchmark respiratory sensitizer by measurements of the respiratory rate during challenge. The protocols were duplicated to examine the respiratory sensitizer MDI. In intradermally sensitized guinea pigs, changes in immediate-onset-like respiratory response were observed when MDI challenge concentrations exceeded approximately 30 mg MDI/m(3) air. Collective experimental evidence suggests that the respiratory responses observed upon challenge with TMA were markedly more pronounced and easier to identify than those recorded following challenge with MDI or MDI conjugate. In contrast to TMA, irritant concentrations of MDI had to be used to elicit any respiratory response and the differentiation of irritant and allergic responsiveness became increasingly difficult. Despite the absence of unequivocal changes in breathing patterns upon MDI challenge, MDI-sensitized animals displayed elevated anti-MDI immunoglobulin G1 (IgG1) antibodies, and a significant influx of eosinophilic granulocytes in the bronchial wall and lung-associated lymph nodes. Therefore, it is believed that the robustness of this animal model to identify low-molecular-weight agents as respiratory sensitizer is increased when several endpoints are considered. These are (1) positive respiratory response upon challenge with the hapten, and if negative, also challenge with the conjugate of the hapten; (2) an influx of eosinophilic granulocytes; and (3) increased specific IgG1 response. Furthermore, it appears that particles in the range of approximately 2-6 microm evoke more consistent respiratory response upon challenge exposure than particles in the 1-2 microm range.

Alleviation of severe emotional symptoms by carbidopa-levodopa, MSD, in a Parkinson's patient: a personal report

This is a personal account of the rapid disappearance of long-term severe emotional symptomatology following the diagnosis of parkinsonism and the beginning of Sinemet medication. It raises two questions. First, can mental health practitioners be sensitized to earlier detection and diagnosis of parkinsonism by reviewing the specific patterns of emotional disturbances in older patients? Second, is there a presymptomatic psychiatric syndrome in parkinsonism that is more akin to a global emotional instability than to a depressive state?

Response of human foetal thymocytes to phytohaemagglutinin (PHA)

Human foetal thymocytes first respond to phytohaemagglutinin at about 14 weeks gestation. This corresponds to the completion of thymic differentiation and is perhaps the earliest, but still indirect, evidence of immune competence in the foetus.