Liver hypertrophy: a review of adaptive (adverse and non-adverse) changes--conclusions from the 3rd International ESTP Expert Workshop.

Preclinical toxicity studies have demonstrated that exposure of laboratory animals to liver enzyme inducers during preclinical safety assessment results in a signature of toxicological changes characterized by an increase in liver weight, hepatocellular hypertrophy, cell proliferation, and, frequently in long-term (life-time) studies, hepatocarcinogenesis. Recent advances over the last decade have revealed that for many xenobiotics, these changes may be induced through a common mechanism of action involving activation of the nuclear hormone receptors CAR, PXR, or PPARα. The generation of genetically engineered mice that express altered versions of these nuclear hormone receptors, together with other avenues of investigation, have now demonstrated that sensitivity to many of these effects is rodent-specific. These data are consistent with the available epidemiological and empirical human evidence and lend support to the scientific opinion that these changes have little relevance to man. The ESTP therefore convened an international panel of experts to debate the evidence in order to more clearly define for toxicologic pathologists what is considered adverse in the context of hepatocellular hypertrophy. The results of this workshop concluded that hepatomegaly as a consequence of hepatocellular hypertrophy without histologic or clinical pathology alterations indicative of liver toxicity was considered an adaptive and a non-adverse reaction. This conclusion should normally be reached by an integrative weight of evidence approach.

The comparative toxicology of 4-chloro-2-methylphenoxyacetic acid and its plant metabolite 4-chloro-2-carboxyphenoxyacetic acid in rats.

4-Chloro-2-carboxyphenoxyacetic acid (CCPA) residues have occasionally been observed in crops treated with 4-chloro-2-methylphenoxyacetic acid (MCPA). The oral toxicity of MCPA and CCPA was compared in a 4-week rat study at a dietary concentration of 2000 ppm. CCPA was also given at 12,000 ppm (equivalent to 1g/kg bodyweight/day). MCPA at 2000 ppm caused reduced food consumption and body weight gain and increased water consumption in females only. Changes in clinical chemistry confirmed the liver as a target organ. Increased serum creatinine and urobilinogen, degenerated transitional epithelial cells in the urine showed that the kidney was also affected. Response to CCPA was confined to the 12,000 ppm dose. The target organs were liver and kidney as for MCPA. Microscopic examination revealed an increased severity of basophilic tubules and calcification at the outer/inner medulla transition in the kidneys. The results demonstrate that CCPA is less toxic than MCPA, that CCPA has no different toxicological end points when compared to MCPA, and that any risks associated with consumption of CCPA will not be underestimated if the CCPA residue is treated as if it were parent MCPA. Based on the MCPA-CCPA comparison, criteria for read across and minimal information requirements are proposed.

Chronic toxicity and oncogenicity of N-methylpyrrolidone (NMP) in rats and mice by dietary administration.

A two-year feeding study in rats and an 18-month feeding study in mice were conducted to evaluate the potential chronic toxicity and oncogenicity of NMP in Crl:CD (SD)BR rats and B6C3F1/CrlBR mice. Groups of 62 male and female rats were administered diets containing 0, 1600, 5000, or 15,000 ppm of NMP for approximately 2 years. Groups of 50 male and female mice were administered diets containing 0, 600, 1200, or 7200 ppm NMP for approximately 18 months. In vivo parameters were evaluated weekly during the first 3 months of the study, and every other week or monthly during the remainder of the study. For rats, an ophthalmoscopic examination was conducted prior to study start and near the end of the study. Periodically, blood samples were collected from rats and mice for determination of leukocyte differential counts, and from mice for red blood cell morphology. After approximately 2 years of dietary administration in rats and 18 months in mice, all surviving animals were sacrificed. Selected tissues were processed for morphological evaluation. Over the course of the two-year study in rats, test substance-related decrements in body weight and weight gain occurred in 15,000 ppm males and females, which correlated with decreased food consumption and food efficiency. A toxicologically significant, test substance-related increase in the incidence of severe chronic progressive nephropathy occurred in 15,000 ppm males. Several morphological changes noted grossly and/or microscopically were secondary to the increased severity of chronic progressive nephropathy. NMP was not oncogenic in male or female rats at dietary concentrations of 15,000 ppm and below. A test substance-related decrease in the percentage of 15,000 ppm males surviving to the end of the two-year study compared to the control group resulted from the higher incidence of severe chronic progressive nephropathy. However, a sufficient population of 15,000 ppm rats were at risk for potential oncogenicity, so the lower survival did not impair the ability to detect an oncogenic response in this study. There were no adverse, test substance-related effects on the incidences of clinical observations, ophthalmic observations, or differential leukocyte counts in males or females, or on survival of females at any dietary concentration. Male and female mice administered dietary concentrations of 7200 ppm had significantly increased liver weight, significantly increased incidence of hepatocellular adenoma, and significantly increased foci of cellular alteration in the liver. At 7200 ppm, male mice also had an increased incidence of hepatocellular carcinoma while the increased incidence of hepatocellular carcinoma in female mice fell within the historical control range. In addition, the incidence of hepatocellular hypertrophy was increased in 7200 ppm males. Liver weight and hepatocellular hypertrophy were also increased in 1200 ppm males. There were no adverse, test substance-related effects on the incidences of clinical observations, food consumption, body weight, differential leukocyte counts, red blood cell morphology, or survival in either males or females at any dietary concentration. Under the conditions of the study, the no-observed-effect level for NMP was 5000 ppm for male and female rats, 600 ppm for male mice, and 1200 ppm for female mice.

The effect of music in the postanesthesia care unit on pain levels in women who have had abdominal hysterectomies.

Management of pain in the immediate postoperative period is a major concern of postanesthesia nurses. Music is a nursing intervention with the potential to decrease patient perception of pain in the PACU. The purpose of this study was to examine the effect of the use of music on the level of patient pain in the immediate postoperative period. A quasi-experimental study design was used with three study groups. All patients scheduled for elective abdominal hysterectomies using a general anesthesia technique were eligible for participation in the study. The setting is a PACU in a community hospital in a suburban area. Subjects were asked to rate their pain level every 15 minutes while in the PACU using two valid and reliable measures, a verbal pain rating scale and a graphic numeric pain intensity scale. Repeated measures of analysis of variance showed no differences in level of pain between groups or over time.

Long-term inhalation toxicity of N-vinylpyrrolidone-2 vapours. Studies in rats.

In previous subchronic studies inhaled N-vinylpyrrolidone-2 (NVP) was haemotoxic, hepatotoxic and irritant to the nose. In the first of two long-term studies, study A, Sprague-Dawley rats were exposed by inhalation to 0, 5, 10 or 20 ppm NVP (6 hr/day, 5 days/wk) for 24 months. Satellite groups were killed after 3, 12 or 24 months. In study B, female Sprague-Dawley rats were exposed to 0 or 45 ppm NVP for 3 months and killed at 3 or 12 and 24 months post-exposure. In study A, survival was unaffected, but reduced body weight gain, haemotoxicity, effects on clinical chemistry parameters indicative of hepatotoxicity, increased liver weight, hepatocellular carcinomas, necrosis, reparative hyperplasia, adenomas and adenocarcinomas of the nasal cavity, and squamous cell carcinomas of the larynx were seen. Increased tumour incidence was seen only in the liver and upper respiratory tract. In study B, the effect of NVP on body weight evident at 3 months disappeared before 1 yr, but effects on liver pathology persisted throughout the subsequent 21-month exposure-free period, and a few liver tumours were seen at 2 yr. As NVP gave negative results in a battery of in vitro and in vivo genotoxicity tests, it appears that the tumours that arose were manifestations of a non-genotoxic mechanism.

Subchronic inhalation and oral toxicity of N-vinylpyrrolidone-2. Studies in rodents.

N-Vinylpyrrolidone-2 (NVP) is a monomeric compound used as an industrial intermediate. Nine of 11 studies previously reported involved exposure of rats (two different strains), mice or hamsters to NVP by the inhalation route at concentrations of up to 120 ppm (6 hr/day, 5 days/wk) over a period of 1 wk to 12 months. The remaining two studies involved exposure of rats to NVP through the drinking water or by gavage at dose levels of up to 100 mg/kg body weight/day. Reduced body weight gain was seen in rats exposed by inhalation to 5 ppm or more for 3 months and in mice and hamsters exposed to 45 ppm for only 1 day. Effects were seen on haematological (reduced haemoglobin, erythrocyte count, haematocrit) and clinical chemistry parameters (specially raised gamma-glutamyltransferase activity and decreases in plasma protein), liver weight increase and liver lesions (centrilobular single-cell necrosis and foci of hepatocellular alteration) in rats and mice but not hamsters. Rats exposed to 40 mg/kg body weight/day NVP or more for 3 months by gavage developed similar liver changes. Atrophy of olfactory epithelium and hyperplasia of nasal respiratory epithelium was seen in rats exposed by inhalation to 5 ppm NVP for 7 wk but not in response to 1 ppm for 13 wk (no observed-adverse-effect level, NOAEL). These studies indicated that the upper respiratory tract and the liver are the main targets for NVP toxicity.

Subchronic toxicity studies of 3-methyl-1-butanol and 2-methyl-1-propanol in rats.

1. 90-day subchronic toxicity studies with 3-methyl-1-butanol (MEB) and 2-methyl-1-propanol (MEP) were performed on rats to evaluate the toxicological profile of the compounds under conditions of drinking water studies, to identify the potential target organs, and to determine no-observable-adverse-effect-levels (NOAELs) respective of the substances. The test substances were administered to groups of 10 male and 10 female Wistar rats in drinking water at concentrations of 0, 1000 p.p.m. (about 80 mg/kg/d), 4000 p.p.m. (about 340 mg/kg/d) and 16,000 p.p.m. (about 1250 and 1450 mg/kg/d of MEB and MEP respectively). 2. 16,000 p.p.m. was found to be the maximal concentration for both alcohols applicable to rats in drinking water. Higher concentrations had an influence on palatability and could thus not be tested in drinking water studies. 3. At 16,000 p.p.m. MEB a marginal increase in the red blood cell count as well as a slight decrease in the mean corpuscular volume and the mean corpuscular hemoglobin content was observed in males only. These changes are considered to be treatment-related, although the toxicological significance of these findings is unclear. No other substance-related effects were found on body weight (b.w.), mortality, various parameters of clinical chemistry, organ weights, gross pathology and histopathology. 4000 p.p.m. MEB did not cause any substance-induced changes. Therefore, the NOAEL of MEB was defined as 4000 p.p.m. for male and 16,000 p.p.m. for female rats under conditions of oral application via drinking water. 4. MEP concentrations up to and including 16,000 p.p.m. did not induce any signs of toxicity and were therefore defined as the NOAEL respective of this substance for rats under conditions of drinking water application.

Characteristics of an attenuated Anaplasma marginale of deer origin as an anaplasmosis vaccine.

A fully virulent field Anaplasma marginale isolate, passaged to a splenectomised white tailed deer, lost virulence for cattle after 18 months in the non-bovine host. This attenuated A. marginale produced a mild response in four 18-month-old Holstein steers characterised by an average 2.4% parasitaemia, a 13% drop in PCV and a positive serological response. All vaccinated steers were immune to challenge with a fully virulent, heterologous A. marginale when compared with non-vaccinated controls.

The pathogenicity and immunologic relationship of a virulent and a tissue-culture-adapted Babesia bovis.

Babesia bovis grown in tissue culture was used to inoculate 12, 2-year-old Holstein steers. All 12 developed serological evidence of infection but only six had a febrile response of greater than or equal to 40 degrees C, and only one had a demonstrable B. bovis parasitemia. An average modest drop of 19% was observed in packed cell volume (PCV) during the period of reaction. All 12 steers were subsequently challenged with virulent B. bovis: seven on day 78 post inoculation (p.i.), two on day 106 p.i., and three on day 251 p.i. No demonstrable clinical response was observed in any of the 12 steers previously exposed to the tissue-culture organism, whereas severe signs of babesiosis occurred in seven 2-year-old, non-vaccinated control steers given a comparably virulent B. bovis challenge. All seven controls showed a febrile response, B. bovis parasitemias, with an average drop of 55% in PCV and a 28% mortality.

Prevalence of anaplasmosis and babesiosis in N'Dama cattle of the Gambia.

Sera from 184 N'Dama cattle randomly selected and averaging 2-7 years of age were tested for the presence of specific antibodies to Anaplasma marginale, Babesia bovis and B. bigemina, using one or more serological tests including complement fixation, rapid card agglutination and indirect fluorescent antibody (IFA). Tests for A. marginale and B. bovis were essentially negative. Utilising the IFA test 65% of the sera tested were positive for B. bigemina. Three randomly selected two-year-old N'Dama bulls were splenectomised. All three showed an acute recurrence of a B. bigemina parasitaemia. Two died following typical signs of acute babesiosis and a third recovered following diminazene therapy. No evidence of either B. bovis or A. marginale recrudescence was observed in the single surviving bull. Babesia bigemina appears endemic in the N'Dama cattle of The Gambia but no confirmed serological or clinical evidence of B. bovis or A. marginale was observed.

Serologic response of Babesia equi-infected horses as measured by complement-fixation and indirect fluorescent antibody tests.

Both the complement-fixation test (CFT) and the indirect fluorescent antibody test (IFAT) were conducted on weekly serum samples from nine Arab geldings for 28 days before and 256 days after their exposure to Babesia equi of European origin. On an average the IFAT became positive 8 days before the CFT and showed higher relative serum titer increases. Both test procedures successfully detected infection and neither showed an appreciable drop in titer during this time frame, with the exception of the CFT, which showed a transient drop immediately following treatment with imidocarb. A test conducted 540 days after infection showed four of the eight surviving, and presumably infected, horses to be negative on CFT, where as all eight were still positive on IFAT. Comparisons made with the IFAT, on horse sera from B. equi infection of both European and North American origin, utilizing homologous and heterologous antigens, showed significantly higher titers with homologous antigens.

Imidocarb and parvaquone in the treatment of piroplasmosis (Babesia equi) in equids.

The therapeutic efficacies of imidocarb and parvaquone were tested against Babesia equi of European origin in carrier horses and for induced acute infections in splenectomized ponies. Imidocarb, at a dosage of 4 mg/kg of body weight, given IM at 72-hour intervals 4 times, was ineffective in eliminating B equi-carrier infection in 9 mature geldings. A single IM administration of 4 mg/kg was not therapeutic in acutely infected splenectomized ponies. When given at 3 different dosages and treatment schedules, parvaquone was ineffective in clearing carrier infection. Parvaquone given IM once at a dosage of 20 mg/kg was effective for acute B equi infections in splenectomized ponies; parasitemia began to decrease within 24 hours after treatment. Infections were not eliminated however, and within 4 weeks, secondary parasitemia and anemia developed. Of 4 ponies, 3 died of acute piroplasmosis.

Attenuation of Babesia bovis by in vitro cultivation.

A virulent strain of Babesia bovis was adapted to grow in erythrocyte culture in the presence of equine serum and in lieu of bovine serum. Four splenectomized calves inoculated with the adapted strain, 429, developed hematologic signs of infection and a low grade fever, but remained free of central nervous system (CNS) signs and recovered. All of six control animals inoculated with a virulent strain reacted severely and five showed CNS signs and died. The calves injected with the attenuated strain were solidly immune when challenged with the virulent strain at 44 or 78 days after vaccination.

Experimental infections of Babesia bigemina in American bison.

Babesia bigemina was experimentally transmitted from cattle to bison and back to cattle. One spleen-intact and two splenectomized American bison (Bison bison) inoculated with a B. bigemina stabilate exhibited clinical and hematological signs of babesiosis within 10 days of exposure. Blood from the infected bison produced disease in a splenectomized bovine steer.

Evaluation of a cloned Babesia bovis organism as a live immunogen.

A Babesia bovis isolate was cloned by in vitro cultivation and compared to the original cultured isolate for pathogenicity by animal inoculation. Four yearling heifers were inoculated with cloned material and 4 with the original culture. The four animals which received the cloned Babesia showed comparatively minor hematologic changes and no clinical signs. One animal died in the group that received uncloned Babesia and the mean temperature increase and mean reduction in packed cell volume (PCV) was greater in that group. The four animals receiving the cloned material were challenged 100 days following initial inoculation. All of the animals were totally immune with no significant change in temperature or decrease in PCV, whereas control (previously non-inoculated) animals developed significant (P less than 0.001) increases in temperature and severe anemia. The cloned organism appears to be a candidate live immunogen for use in endemic areas to induce protection against bovine babesiosis.

Experimental Babesia equi infection in mature horses.

Nine 4-year-old Arabian geldings were experimentally infected with Babesia equi of European origin. All horses developed detectable parasitemia an average of 30 days after they were inoculated, which was accompanied by a decrease in PCV. The infections were generally mild with no animal deaths. All horses became serologically positive by the indirect fluorescent antibody test within an average of 23 days after they were inoculated and by the complement-fixation test 30 days after they were inoculated.

Chemoprophylactic activity of imidocarb, diminazene and oxytetracycline against Babesia bovis and B. bigemina.

Splenectomized calves treated with imidocarb, diminazene, and oxytetracycline were exposed to Babesia bigemina and B. bovis stabilates at various time intervals following treatment to evaluate prophylactic efficacy. Diminazene showed no residual activity against a B. bigemina challenge given 54 days after treatment. Oxytetracycline appeared responsible for an increased incubation time when given 2 days prior to B. bigemina exposure. Imidocarb showed marked prophylactic efficacy against both B. bigemina and B. bovis. Treatment with 1 or 2 mg kg-1 imidocarb, followed by Babesia exposure on the day of treatment, 7 days after treatment, then every 14 days for 91 days, delayed patent B. bigemina infections for 49 days and patent B. bovis infections for 42 days. Imidocarb at 4 or 5 mg kg-1, followed by similar Babesia exposures, delayed patent B. bovis infections for 68 days, and delayed B. bigemina for 81-103 days, and in some instances prevented infections. The delayed onset of infection due to either B. bigemina or B. bovis, following imidocarb treatment was accompanied by a significantly milder clinical response. Calves not responding to the primary challenge were fully susceptible to stabilate challenge 196 days after treatment. Calves experiencing a mild clinical response to B. bovis following imidocarb treatment and exposure failed to show any signs of response to a 196-day challenge exposure. Calves experiencing a mild clinical response to B. bigemina following imidocarb treatment and exposure did, in some instances, show a second mild response when challenged 196 days after initial treatment.

Detection of an Anaplasma marginale common surface protein present in all stages of infection.

The establishment and maintenance of anaplasmosis-free cattle herds is impaired due to the lack of a rapid, sensitive, and specific serologic test to detect persistently infected cattle which serve as carriers for the organism. To develop an improved diagnostic test for anaplasmosis we screened Anaplasma marginale initial body proteins to identify a protein common to antigenically different isolates that is recognized by the host immune system at all stages of infection. Seronegative cattle were infected with either the Florida, Virginia, or North Texas isolate of A. marginale and monitored for infection by daily examination of Wright-stained blood smears for parasitized erythrocytes. Sera from cattle at different stages of infection, from acute through persistent, were used to immunoprecipitate A. marginale proteins that were metabolically radiolabeled with [35S]methionine or surface radiolabeled with 125I. Multiple A. marginale proteins were recognized by using sera either undiluted or at 1:10; however, only four or five proteins were sufficiently antigenic to elicit antibody reactive with a 1:1,000 serum dilution. A single protein with an apparent molecular mass of 86 kilodaltons was consistently recognized at all stages of infection regardless of the isolate used to infect the cattle. This protein was demonstrated to be on the surface of the A. marginale initial body and to be water soluble. We propose use of this 86-kilodalton protein to develop an improved serologic test for diagnosis of bovine anaplasmosis.

Dynamics of Anaplasma marginale in splenectomised calves treated with either imidocarb or oxytetracycline.

Neither imidocarb dipropionate (at 5 mg/kg body weight intramuscularly once or twice at a seven-day interval) nor oxytetracycline hydrochloride (at 20 mg/kg body weight intramuscularly once or twice at a seven-day interval) given to animals in the prepatent period of anaplasmosis, prevented the eventual onset of infection. Both compounds delayed the onset of detectable parasitaemia but this action was more noticeable with oxytetracycline. Oxytetracycline given twice significantly reduced the severity of the primary infection but the secondary infection was more severe. Neither compound showed prophylactic properties even though both are effective in extending the prepatent period and, in the case of oxytetracycline, reducing the severity of infection.