Developing Integrated Approaches for Testing and Assessment (IATAs) in order to support nanomaterial safety.

Due to the unique characteristics of nanomaterials (NM) there has been an increase in their use in nanomedicines and innovative medical devices (MD). Although large numbers of NMs have now been developed, comprehensive safety investigations are still lacking. Current gaps in understanding the potential mechanisms of NM-induced toxicity can make it challenging to determine the safety testing necessary to support inclusion of NMs in MD applications. This article provides guidance for implementation of pre-clinical tailored safety assessment strategies with the aim to increase the translation of NMs from bench development to clinical use. Integrated Approaches to Testing and Assessment (IATAs) are a key tool in developing these strategies. IATAs follow an iterative approach to answer a defined question in a specific regulatory context to guide the gathering of relevant information for safety assessment, including existing experimental data, integrated with in silico model predictions where available and appropriate, and/or experimental procedures and protocols for generating new data to fill gaps. This allows NM developers to work toward current guidelines and regulations, while taking NM specific considerations into account. Here, an example IATA for NMs with potential for direct blood contact was developed for the assessment of haemocompatibility. This example IATA brings together the current guidelines for NM safety assessment within a framework that can be used to guide information and data gathering for the safety assessment of intravenously injected NMs. Additionally, the decision framework underpinning this IATA has the potential to be adapted to other testing needs and regulatory contexts.

Physiologically based mathematical models of nanomaterials for regulatory toxicology: A review.

The development of physiologically based (PB) models to support safety assessments in the field of nanotechnology has grown steadily during the last decade. This review reports on the availability of PB models for toxicokinetic (TK) and toxicodynamic (TD) processes, including in vitro and in vivo dosimetry models applied to manufactured nanomaterials (MNs). In addition to reporting on the state-of-the-art in the scientific literature concerning the availability of physiologically based kinetic (PBK) models, we evaluate their relevance for regulatory applications, mainly considering the EU REACH regulation. First, we performed a literature search to identify all available PBK models. Then, we systematically reported the content of the identified papers in a tailored template to build a consistent inventory, thereby supporting model comparison. We also described model availability for physiologically based dynamic (PBD) and in vitro and in vivo dosimetry models according to the same template. For completeness, a number of classical toxicokinetic (CTK) models were also included in the inventory. The review describes the PBK model landscape applied to MNs on the basis of the type of MNs covered by the models, their stated applicability domain, the type of (nano-specific) inputs required, and the type of outputs generated. We identify the main assumptions made during model development that may influence the uncertainty in the final assessment, and we assess the REACH relevance of the available models within each model category. Finally, we compare the state of PB model acceptance for chemicals and for MNs. In general, PB model acceptance is limited by the absence of standardised reporting formats, psychological factors such as the complexity of the models, and technical considerations such as lack of blood:tissue partitioning data for model calibration/validation.

Acute ecotoxicity of coated colloidal goethite nanoparticles on Daphnia magna: Evaluating the influence of exposure approaches.

Synthesized iron oxide nanoparticles have been proposed as an alternative to non-dispersed iron oxides for in situ environmental remediation. Their colloidal properties enable their injection into porous media, i.e. soils and aquifers, and offer a higher efficiency in removing contaminants. However, this dispersed state is also the cause of concerns over their environmental fate and toxicity, e.g., by increasing the exposure time to aquatic organisms in groundwater remediation activities. Therefore, the objective of in situ groundwater remediation is to establish local reactive barriers in the subsurface by injection by means of reactive colloids with a controllable mobility under in situ conditions and present as colloids as shortly as possible. In this work, we examined the toxicity of humic acid-coated colloidal goethite nanoparticles in Daphnia magna. The adaptation of the ecotoxicological standard tests for nanomaterials is intensely discussed to increase comparability and reliability of results. In the present study, the effect of different exposure conditions on goethite nanoparticles colloidal behaviour and acute Daphnia immobilization effects was investigated. For this purpose, iron concentration in the water column, aggregation state and acute effects were studied in: i) a standard test, ii) test design with exposure dispersions incubated for a week and iii) water accommodated fraction. Despite the different aggregation and settling of the particles found between the approaches tested, no differences in toxicity were observed. Coated nanoparticles were found clogging up the filtering apparatus, and/or adhered to the exoskeleton, hindering the swimming and molting, and causing the immobilization and death of the organisms at doses of ≥943mg/L (EC50). The data suggests that the toxic potential of these nanoparticles is mainly related to the physical interaction with the daphnids.

Cell uptake and oral absorption of titanium dioxide nanoparticles.

Large efforts are invested on the development of in vitro tests to evaluate nanomaterial (NM) toxicity. In order to assess the relevance of the adverse effects identified in in vitro toxicity tests a thorough understanding of the biokinetics of NMs is critical. We used different in vitro and in vivo test methods to evaluate cell uptake and oral absorption of titanium dioxide nanoparticles (TiO2 NPs). These NPs were readily uptaken by A549 cells (carcinomic human alveolar basal epithelial cells) in vitro. Such rapid uptake contrasted with a very low oral absorption in a differentiated Caco-2 monolayer system (human epithelial colorectal adenocarcinoma cells) and after oral gavage administration to rats. In this oral study, no significant increase in the levels of titanium was recorded by ICP-MS in any of the tissues evaluated (including among other: small intestine, Peyer's patches, mesenteric lymph nodes, liver, and spleen). No NPs were observed by TEM in sections of the small intestine, except for several particles in the cytoplasm of a cell from a Peyer's Patch area. The observation of NPs in Peyer's Patch suggests that the Caco-2 monolayer system is likely to underestimate the potential for oral absorption of NPs and that the model could be improved by including M-cells in co-culture.

The intestinal anti-inflammatory effect of dersalazine sodium is related to a down-regulation in IL-17 production in experimental models of rodent colitis.

BACKGROUND AND PURPOSE: Dersalazine sodium (DS) is a new chemical entity formed by combining, through an azo bond, a potent platelet activating factor (PAF) antagonist (UR-12715) with 5-aminosalicylic acid (5-ASA). DS has been demonstrated to have anti-inflammatory effects on trinitrobenzene sulphonic acid (TNBS)-induced colitis in rats and recently in UC patients in phase II PoC. There is Increasing evidence that Th17 cells have an important role in the pathogenesis of inflammatory bowel disease (IBD). The aim of this study was to further characterize the anti-inflammatory effects of DS. EXPERIMENTAL APPROACH: Effect of DS (10 or 30 mg·kg(-1) b.i.d.) on TNBS-induced colitis in rats was studied after 2 and 7 days with special focus on inflammatory mediators. Additionally, its anti-inflammatory properties were analysed in two different models of dextran sodium sulphate (DSS)-induced colitis, BALB/c and C57BL/6 mice, the latter being dependent on IL-17. KEY RESULTS: DS, when administered for 7 days, showed intestinal anti-inflammatory effects in TNBS-induced colitis; these effects were observed both macroscopically and through the profile of inflammatory mediators (TNF, IL-1ß, IL-6 and IL-17). Although the 2 day treatment with DS did not induce intestinal anti-inflammatory effects, it was sufficient to reduce the enhanced IL-17 expression. DS showed beneficial effects on DSS-induced colitis in C57BL/6 mice and reduced colonic pro-inflammatory cytokines IL-1ß, IL-6 and IL-17. In contrast, it did not exert intestinal anti-inflammatory effects on DSS-induced colitis in BALB/c mice. CONCLUSIONS AND IMPLICATIONS: DS exerts intestinal anti-inflammatory activity in different rodent models of colitis through down-regulation of IL-17 expression.

Use of the rat postimplantation embryo culture to assess the embryotoxic potency within a chemical category and to identify toxic metabolites.

The implementation of in vitro alternatives in the safety evaluation of chemicals in the animal intensive area of reproductive toxicity testing is highly desirable, but has been limited by issues around predictivity and applicability domains. The validation of alternatives may gain from a category approach, in which, rather than validating a test for the universe of chemicals, its predictive value is assessed for each class of chemicals for which the test represents relevant end point(s). We studied the embryotoxicity in rodent postimplantation whole embryo culture (WEC) of a series of phthalates and their metabolites. Phthalate diesters are widely applied industrial chemicals, their monoester derivatives being considered as their embryotoxic metabolites. The relative in vitro potency of three out of four monophthalates was found to mimick that of corresponding diphthalates tested in vivo. The phthalate that deviated from this ranking, monoethylhexylphthalate (MEHP), showed a relatively high in vitro toxicity as compared to in vivo data. This deviation could be explained through kinetic differences among phthalates, as shown between MEHP and monobutylphthalate. In addition, in vitro testing of specific secondary MEHP metabolites showed that they were all less potent than MEHP. This finding confirmed that MEHP in vitro embryotoxicity is most likely the best correlate to DEHP in vivo embryotoxicity. This study shows that a category approach in the assessment of the validation of in vitro alternatives is feasible, and can be improved when kinetic considerations are taken into account.

Endocrine disruptors in marine organisms: approaches and perspectives.

Organic pollutants exhibiting endocrine disrupting activity (Endocrine Disruptors--EDs) are prevalent over a wide range in the aquatic ecosystems; most EDs are resistant to environmental degradation and are considered ubiquitous contaminants. The actual potency of EDs is low compared to that of natural hormones, but environmental concentrations may still be sufficiently high to produce detrimental biological effects. Most information on the biological effects and mechanisms of action of EDs has been focused on vertebrates. Here we summarize recent progress in studies on selected aspects of endocrine disruption in marine organisms that are still poorly understood and that certainly deserve further research in the near future. This review, divided in four sections, focuses mainly on invertebrates (effects of EDs and mechanisms of action) and presents data on top predators (large pelagic fish and cetaceans), a group of vertebrates that are particularly at risk due to their position in the food chain. The first section deals with basic pathways of steroid biosynthesis and metabolism as a target for endocrine disruption in invertebrates. In the second section, data on the effects and alternative mechanisms of action of estrogenic compounds in mussel immunocytes are presented, addressing to the importance of investigating full range responses to estrogenic chemicals in ecologically relevant invertebrate species. In the third section we review the potential use of vitellogenin (Vtg)-like proteins as a biomarker of endocrine disruption in marine bivalve molluscs, used worldwide as sentinels in marine biomonitoring programmes. Finally, we summarize the results of a recent survey on ED accumulation and effects on marine fish and mammals, utilizing both classical biomarkers of endocrine disruption in vertebrates and non-lethal techniques, such as non-destructive biomarkers, indicating the toxicological risk for top predator species in the Mediterranean. Overall, the reviewed data underline the potential to identify specific types of responses to specific groups of chemicals such as EDs in order to develop suitable biomarkers that could be useful as diagnostic tools for endocrine disruption in marine invertebrates and vertebrates.

The effect of organotin compounds on gender specific androstenedione metabolism in the freshwater ramshorn snail Marisa cornuarietis.

In a recent study, we demonstrated that androstenedione was mainly converted to testosterone (T) and 5alpha-dihydrotestosterone (DHT) by digestive gland/gonad complex microsomal fractions isolated from male Marisa cornuarietis, whereas it was primarily metabolized to 5alpha-dihydroandrostenedione (DHA) by females. In the present work, the sexual dimorphic metabolism of androstenedione was further investigated, and attributed to a higher 17beta-hydroxysteroid dehydrogenase activity in males than in females. Thereafter, the hypothesis was tested that the metabolism of androstenedione might be affected by exposure to tributyltin (TBT) and triphenyltin (TPT), which are known to induce the development of imposex in several gastropod species. The in vitro metabolism of androstenedione, particularly the formation of DHA and DHT, was inhibited by both compounds. However, in vivo experiments showed no significant alteration in the metabolism of androstenedione in males, but a marginal (TBT) and a significant (TPT) inhibition of the formation of DHA in females exposed for 150 days to concentrations that had significantly induced the development of imposex. The ratio DHT+T/DHA, a possible indicator of metabolic androgenization, tended to increase (0.43 versus 0.35, p=0.06) in TPT exposed females. However, this ratio never reached values comparable to those found in males (11+/-1).

A comparative study on androgen metabolism in three invertebrate species.

A comparative approach was taken in this study to evaluate androgen (androstenedione and testosterone) metabolism in three invertebrate species: the gastropod Marisa cornuarietis, the amphipod Hyalella azteca, and the echinoderm Paracentrotus lividus. The existence of 17beta/3beta-hydroxysteroid dehydrogenase (HSD) and 5alpha-reductase catalyzed reactions was demonstrated in all three species. Androstenedione was primarily converted to 5alpha-androstanedione in M. cornuarietis, while it was primarily metabolized to testosterone in P. lividus and H. azteca. In addition, and consistent with vertebrate findings, tissue specific pathways and sexual dimorphism in androgen metabolism were observed. Namely, testosterone was metabolized to dihydrotestosterone in P. lividus gonads (via 5alpha-reductase), and metabolized to 4-androstene-3beta,17beta-diol in the digestive tube (via 3beta-hydroxysteroid dehydrogenase). Furthermore, the synthesis of 17beta-reduced metabolites of androstenedione (testosterone and dihydrotestosterone) was 3- to 4-fold higher in males of M. cornuarietis than in females. Organotin compounds, which have been shown to interfere with some aspects of androgen metabolism, had no major effect on testosterone metabolism in any of the three species. Fenarimol enhanced 5alpha-reductase-mediated catalysis in gonads of P. lividus. Overall, results demonstrate the ubiquity of some androgen biotransformation processes in invertebrates and reveals interphyla differences in androgen metabolic pathways, and different sensitivity of these pathways to some xenobiotics.

Sulfatase activity in the oyster Crassostrea virginica: its potential interference with sulfotransferase determination.

Two sulfatase isoforms, a soluble one with an optimum pH of 5.0, and a microsomal one with an optimum pH of 7.6, were observed in digestive gland, gonads, mantle and gills of the oyster C. virginica. The highest sulfatase activity was recorded in the digestive gland cytosol and is likely to interfere with the in vitro determination of sulfotransferase activity. Indeed, the sulfatase inhibitor Na(2)SO(3) led to an increase of measured sulfotransferase activity (31+/-9%), suggesting that those sulfatases might be partially responsible for the low sulfotransferase activities found in C. virginica.

Androgen metabolism in invertebrates and its modulation by xenoandrogens: a comparative study.

Marisa cornuarietis (Mollusc), Hyalella azteca (Crustacean), and Paracentrotus lividus (Echinoderm) demonstrated the ability to metabolize androgens through different pathways catalyzed by 5alpha-reductases (5alpha-R), hydroxysteroid dehydrogenases (HSD), hydroxylases, sulfotransferases (SULT), and fatty-acid acyl-CoA acyltransferases (ATAT). Interspecies differences and tissue-specific distribution of those enzymatic activities were observed. Xenobiotics, such as triphenyltin, tributyltin, and fenarimol, interfered with some of the pathways studied, namely, testosterone sulfation, testosterone esterification, and 5alpha-R activity. The work evidenced different sensitivity of those pathways to androgenic compounds, together with interphyla differences in androgen metabolism.

Testosterone conjugating activities in invertebrates: are they targets for endocrine disruptors?

Testosterone conjugation activities, microsomal acyltransferases and cytosolic sulfotransferases, were investigated in three invertebrate species, the gastropod Marisa cornuarietis, the amphipod Hyalella azteca, and the echinoderm Paracentrotus lividus. The goals of the study were to characterize steroid conjugation pathways in different invertebrate phyla and to assess the susceptibility of those processes to disruption by environmental chemicals. All three species exhibited palmitoyl-CoA: testosterone acyltransferase activity (ATAT) in the range of 100-510 pmol/min/mg protein. Despite similarities in specific activities, kinetic studies indicated that ATAT had a higher affinity for testosterone but a lower V(max) in M. cornuarietis than in P. lividus, and intermediate values were found for H. azteca. In contrast, the activity of testosterone sulfotransferase (SULT) was rather low (0.05-0.18 pmol/min/mg protein) in M. cornuarietis and H. azteca. The low activity precluded kinetic analyses and inhibition studies with these species. P. lividus digestive tube displayed high SULT activity (50-170 pmol/min/mg protein) at moderate testosterone concentrations, but was inhibited at high testosterone concentrations. The interference of model pollutants (triphenyltin (TPT), tributyltin (TBT), and fenarimol) with these conjugation pathways was investigated in vitro. Both TPT and TBT (100 microM) inhibited ATAT in P. lividus (68 and 42% inhibition, respectively), and appeared to act as non-competitive inhibitors. ATAT activity in M. cornuarietis was less affected by organotins, and a significant inhibition (20% inhibition) was detected only with TBT. Fenarimol (100 microM) did not affect ATAT in any of the species tested. Sulfation of testosterone was suppressed by the organotins as well as fenarimol when using cytosolic preparations from P. lividus. These results demonstrated the existence of interphyla differences in testosterone conjugation, and revealed that these processes can serve as targets for endocrine disrupting chemicals.

[Employees attitudes to workplace health promotion programs for cancer prevention]. / Actitudes de los trabajadores frente a los programas de promoción de la salud para la prevención del cáncer en el lugar del trabajo.

OBJECTIVE: [corrected] We describe a method for feasibility assessment of workplace health promotion (WHP) programs as a necessary prerequisite of any WHP program. METHODS: A total of 167 employees from five workplace communities participated in the study. A questionnaire on the basic components of feasibility (risk factors, attitudes to workplace health promotion interventions, and social-occupational context) was administered. RESULTS: Risk behaviours were common among the employees interviewed. Health promotion in the workplace was favorably viewed by 79% of subjects but reported participation would be lower. Interventions on diet and physical activity received the highest acceptance. Participation would be greatest among local administration employees. CONCLUSIONS: The method demonstrated its utility in obtaining useful data for designing workplace health promotion interventions.

Actitudes de los trabajadores frente a los programas de promoción de la salud para la prevención del cáncer en el lugar del trabajo / Employees attitudes to workplace health promotion programs for cancer prevention

Objetivo: Presentamos un método para evaluar la factibilidad de los programas de promoción de la salud en el trabajo como paso previo a su diseño. Métodos: Un total de 167 trabajadores de cinco ramas de actividad económica participaron en el estudio. Se administró un cuestionario con preguntas sobre los componentes básicos de la factibilidad (factores de riesgo de cáncer, actitudes hacia los programas de promoción de la salud y entorno sociolaboral). Resultados: Las conductas de riesgo para el cáncer son frecuentes entre los trabajadores entrevistados. Un 79 por ciento demostró interés por los programas de promoción de la salud, pero la participación sería inferior. Dieta y ejercicio físico serían los factores de riesgo más susceptibles a la intervención. La participación más alta se hallaría entre los trabajadores de la administración local. Conclusiones: La información obtenida parece válida y útil para orientar el objeto y la planificación de un programa promoción de la salud en el trabajo (AU)

Objetive: We describe a method for feasibility assessment of workplace health promotion (WHP) programs as a necessary prerequisite of any WHP program. Methods: A total of 167 employees from five workplace communities participated in the study. A questionnaire on the basic components of feasibility (risk factors, attitudes to workplace health promotion interventions, and social-occupational context) was administered. Results: Risk behaviours were common among the employees interviewed. Health promotion in the workplace was favorably viewed by 79% of subjects but reported participation would be lower. Interventions on diet and physical activity received the highest acceptance. Participation would be greatest among local administration employees. Conclusions: The method demonstrated its utility in obtaining useful data for designing workplace health promotion interventions (AU)

Less painful alternatives for local anesthesia.

BACKGROUND: Infiltration of commonly used local anesthetics is painful. It has been speculated that the pain on infiltration is a direct consequence of the acidity of the anesthetic solution. OBJECTIVE: To compare the degree of pain of intradermal infiltration and the duration of anesthesia for 1% lidocaine with epinephrine 1:100,000, 1% lidocaine with epinephrine 1:100,000 with 80 meq/L sodium bicarbonate, bacteriostatic saline solution with 1% lidocaine with epinephrine 1:300,000, and bacteriostatic saline solution with 1% lidocaine with epinephrine 1:100,000. METHODS: The study was performed in three phases: 1) double-blind comparison study, 2 and 3) open clinical trials. RESULTS: Bacteriostatic saline solution with epinephrine 1:300,000 is significantly less painful on intradermal infiltration than lidocaine with epinephrine 1:100,000 with sodium bicarbonate 80 meq/mL. The saline preparation is an effective anesthetic alternative for superficial surgical procedures such as shave and scissors excision, light curettage and electrodesiccation, and superficial CO2 laser vaporization. CONCLUSION: The pH values of bacteriostatic saline solution with epinephrine 1:300,000 and lidocaine with epinephrine diluted with bacteriostatic saline solution are 5.3 and 4.2, respectively. Both were found to be less painful than 1% lidocaine with epinephrine with sodium bicarbonate 84 meq/mL, which had a pH of 7.4. It is unlikely that the pain of infiltration is a simple function of the pH of the anesthetic solution.

Prevalence and clinical spectrum of skin diseases in kidney transplant recipients.

Cutaneous lesions can be a significant problem in kidney transplant recipients. Factors such as climate and skin types have been implicated as modifiers of these clinical manifestations. With the purpose of determining the prevalence and clinical spectrum of skin diseases in a group of Hispanic kidney transplant recipients in a tropical climate, 82 serial unselected patients were examined. Seventy-eight were found to have some type of skin disease. Infections of the skin were the most common, followed by drug-induced changes and malignant or premalignant cutaneous tumors. Except for the preponderance of superficial mycotic infections, the overall results in our population are in agreement with other series.