Experimental Testing of an Approach to Establishing Combined Toxicity of Ternary Nanoparticle Mixtures.

Our studies of exposure to binary mixtures of nanoparticles (TiO2 + SiO2; TiO2 + Al2O3 and SiO2 + Al2O3) based on mathematical modelling show that their combined subchronic toxicity can either be of an additive type or deviate from it depending on the outcome, dose ratio, and levels of effect. To characterize the type of toxicity of ternary mixtures of nanoparticles, we successfully tested a previously developed approach for assessing the combined toxicity of metal ions. In this approach, the effects are classified by a null, positive, or negative change in the toxicity of binary nanoparticle mixtures when modeled against the toxicity of the third agent added.

Changes in the Cardiotoxic Effects of Lead Intoxication in Rats Induced by Muscular Exercise.

Exposure to lead is associated with an increased risk of cardiovascular diseases. Outbred white male rats were injected with lead acetate intraperitoneally three times a week and/or were forced to run at a speed of 25 m/min for 10 min 5 days a week. We performed noninvasive recording of arterial pressure, electrocardiogram and breathing parameters, and assessed some biochemical characteristics. Electrophoresis in polyacrylamide gel was used to determine the ratio of myosin heavy chains. An in vitro motility assay was employed to measure the sliding velocity of regulated thin filaments on myosin. Isolated multicellular preparations of the right ventricle myocardium were used to study contractility in isometric and physiological modes of contraction. Exercise under lead intoxication normalized the level of calcium and activity of the angiotensin-converting enzyme in the blood serum, normalized the isoelectric line voltage and T-wave amplitude on the electrocardiogram, increased the level of creatine kinase-MB and reduced the inspiratory rate. Additionally, the maximum sliding velocity and the myosin heavy chain ratio were partly normalized. The effect of exercise under lead intoxication on myocardial contractility was found to be variable. In toto, muscular loading was found to attenuate the effects of lead intoxication, as judged by the indicators of the cardiovascular system.

Cardioinotropic Effects in Subchronic Intoxication of Rats with Lead and/or Cadmium Oxide Nanoparticles.

Subchronic intoxication was induced in outbred male rats by repeated intraperitoneal injections with lead oxide (PbO) and/or cadmium oxide (CdO) nanoparticles (NPs) 3 times a week during 6 weeks for the purpose of examining its effects on the contractile characteristics of isolated right ventricle trabeculae and papillary muscles in isometric and afterload contractions. Isolated and combined intoxication with these NPs was observed to reduce the mechanical work produced by both types of myocardial preparation. Using the in vitro motility assay, we showed that the sliding velocity of regulated thin filaments drops under both isolated and combined intoxication with CdO-NP and PbO-NP. These results correlate with a shift in the expression of myosin heavy chain (MHC) isoforms towards slowly cycling ß-MHC. The type of CdO-NP + PbO-NP combined cardiotoxicity depends on the effect of the toxic impact, the extent of this effect, the ratio of toxicant doses, and the degree of stretching of cardiomyocytes and muscle type studied. Some indices of combined Pb-NP and CdO-NP cardiotoxicity and general toxicity (genotoxicity included) became fully or partly normalized if intoxication developed against background administration of a bioprotective complex.

Comparative and Combined In Vitro Vasotoxicity of Nanoparticles Containing Lead and Cadmium.

In vitro toxicological experiments were performed on an endothelial cell line exposed to different doses of spherical nanoparticles of cadmium and/or of lead sulfides with mean diameter 37 ± 5 nm and 24 ± 4 nm, respectively. Toxic effects were estimated by Luminescent Cell Viability Assay, endothelin-1 concentration and cell size determination. Some dose-response relationships were typically monotonic (well approximated with hyperbolic function) while others were bi- or even 3-phasic and could be described within the expanded hormesis paradigm. The combined toxicity type variated depending on the effect it was assessed by.

Looking for the LOAEL or NOAEL Concentration of Nickel-Oxide Nanoparticles in a Long-Term Inhalation Exposure of Rats.

Rats were exposed to nickel oxide nano-aerosol at a concentration of 2.4 ± 0.4 µg/m3 in a "nose only" inhalation setup for 4 h at a time, 5 times a week, during an overall period of 2 weeks to 6 months. Based on the majority of the effects assessed, this kind of exposure may be considered as close to LOAEL (lowest observed adverse effect level), or even to NOAEL (no observed adverse effect level). At the same time, the experiment revealed genotoxic and allergic effects as early as in the first weeks of exposure, suggesting that these effects may have no threshold at all.

On an extended understanding of the term "hormesis" for denoting alternating directions of the organism's response to increasing adverse exposures.

The authors propose to consider as hormesis phenomenon not only a realization of the Arndt-Schulze rule but any non-monotonic dose-response relationship for a certain outcome that is characterized by changing direction of a response between adjacent ranges of doses of an initiator of this response, the number of such ranges being two or more. This approach is illustrated with results of several in vitro experiments on different established cell lines exposed to CdS or PbS nanoparticles.

Some data on the comparative and combined toxic activity of nanoparticles containing lead and cadmium with special attention to their vasotoxicity.

Moderate subchronic intoxication was induced in rats by repeated intraperitoneal injections of PbO (49.6 ± 16.0 nm) and/or CdO (57.0 ± 13.0 nm) nanoparticles (NP) three times a week during 6 weeks. In particular, there was a reduction in arterial blood pressure and in blood concentrations of a number of factors controlling vasoconstriction and vasodilation, particularly of endothelin 1 (ET-1). This toxic effect was attenuated with a bioprotective complex administered in the background. The study confirmed as well that the combined binary action typology varies depending on which effect it is estimated by.

Some outcomes and a hypothetical mechanism of combined lead and benzo(a)pyrene intoxication, and its alleviation with a complex of bioprotectors.

Rats were exposed 3 times a week during 6 weeks to repeated intraperitoneal injections of lead acetate solution in water (Pb) and/or benzo(а)pyrene solution in petrolatum oil (B(а)P) in various dose ratios. Towards the end of the period, the animals developed a moderate subchronic intoxication having some features characteristic of lead effects. The type of combined toxicity estimated with the help of isoboles constructed by the Response Surface Methodology was found to be varied depending on a particular effect, its level, and dose ratio. However, Pb and B(a)P in combination often displayed an additive or even superadditive action. In the group exposed to this combination compared with the group of rats exposed to B(a)P alone, its concentration in the organism was increased while the concentration of some B(a)P oxidative metabolism products was reduced. Such inhibition of B(a)P biotransformation, assumingly associated with impaired heme and, thus, cytochrome P450 synthesis induced by lead intoxication, can serve as an explanation for certain enhancement of the genotoxic effect of B(a)P. This effect was not present in the same combined intoxication if a complex of antitoxic bioprotectors was being administered in the background.

Force-velocity characteristics of isolated myocardium preparations from rats exposed to subchronic intoxication with lead and cadmium acting separately or in combination.

This investigation continues our study of the effects of Pb-Cd poisoning on the heart, extending the enquiry from isometric to auxotonic contractions, thereby examining the effect on the ability of myocardial tissues to perform mechanical work. Different shifts were revealed in myocardial force-velocity relations following subchronic exposure of rats to lead acetate and cadmium chloride acting separately, in combination, or in combination with a bioprotective complex (BPC). The experiments were conducted on isolated preparations of trabecules and papillary muscles of the right ventricle in physiological loading conditions and on isolated heart muscle contractile proteins examined by the in vitro motility assay. The results of the latter correlate with the shifts in the ratio of cardiac myosin isoforms. The amount of work performed by the myocardium was calculated on the basis of the tension-shortening loop area and was found to be similar in the preparations from all experimental groups. This fact presumably reflects adaptive capacity of the myocardial function even when contractility is damaged due to the metallic intoxication of a moderate severity. Some characteristics of rat myocardium altered by the impact of lead-cadmium intoxication became fully or partly normalized if intoxication developed against background administration of a bioprotective complex (BPC). Together with previously reported results obtained in the isometric mode of contractility, all these results strengthen the scientific foundations of risk assessment and risk management projects in the occupational and environmental conditions characterized by human exposure to lead and/or cadmium.

An overview of experiments with lead-containing nanoparticles performed by the Ekaterinburg nanotoxicological research team.

Over the past few years, the Ekaterinburg (Russia) interdisciplinary nanotoxicological research team has carried out a series of investigations using different in vivo and in vitro experimental models in order to elucidate the cytotoxicity and organ-systemic and organism-level toxicity of lead-containing nanoparticles (NP) acting separately or in combinations with some other metallic NPs. The authors claim that their many-sided experience in this field is unique and that some of their important results have been obtained for the first time. This paper is an overview of the team's previous publications in different journals. It is suggested to be used as a compact scientific base for assessing health risks associated not only with the production and usage of engineered lead-containing NPs but also with their inevitable by-production as toxic air pollutants in the metallurgy of lead, copper or their alloys and in soldering operations.

Further verification of some postulates of the combined toxicity theory: New animal experimental data on separate and joint adverse effects of lead and cadmium.

Outbred male rats were repeatedly injected intraperitoneally two-level sub-lethal doses of lead acetate and/or cadmium chloride solutions 3 times a week during 6 weeks. The animals developed explicit, even if moderate, subchronic intoxication characterized by a large number of indices, both common to both metals (including increased DNA fragmentation coefficient) and lead-specific. Special attention was paid to hemodynamic and electrocardiographic effects. The combined action of lead and cadmium was modeled with the help of the Response Surface Methodology to obtain additional support for the previously substantiated postulates of combined toxicity's typological ambiguity. This is dependent on which particular effect comes under consideration, on its level, and on the acting dose ratio. For one and the same toxic combination, the type of combined toxic action can vary from synergistic to contra-directional. In particular, the actions of lead and cadmium on blood pressure were found to be opposite in direction. Furthermore, it is shown once again that the systemic toxic effects of a metal combination, its in vivo genotoxicity included, can be more or less attenuated by background administration of a theoretically justified composition of biologically active agents.

Using Various Nonlinear Response Surfaces for Mathematical Description of the Type of Combined Toxicity.

The article considers the problem of characterizing the type of combined action produced by a mixture of toxic substances with the help of nonlinear response functions. Most attention is given to second-order models: the linear model with a cross-term and the quadratic model. General propositions are formulated based on the data on combined toxicity patterns previously obtained by the Ekaterinburg nanotoxicology team in animal experiments and analyzed with the help of the linear model with a cross-term. It is shown now that the quadratic model features these general characteristics in full measure, but interpretation of combined toxicity types based on isobolograms obtained by the quadratic model is more difficult. This suggests that where both models ensure a comparable quality of combined toxicity type identification, it would be enough to use the linear model with a cross-term.

The most important inferences from the Ekaterinburg nanotoxicology team's animal experiments assessing adverse health effects of metallic and metal oxide nanoparticles.

During 2009-2017 we have studied nanoparticles of elemental silver or gold and of iron, copper, nickel, manganese, lead, zinc, aluminium and titanium oxides (Me-NPs) using, in most cases, a single low-dose intratracheal instillation 24 h before the bronchoalveolar lavage to obtain a fluid for cytological and biochemical assessment and, in all cases, repeated intraperitoneal injections in non-lethal doses to induce subchronic intoxications assessed by a lot of toxicodynamic and toxicokinetic features. We have also studied the same effects for a number of relevant combinations of these Me-NPs and have revealed some important patterns of their combined toxicity. Besides, we have carried out long-term inhalation experiments with Fe2O3, NiO and amorphous SiO2 nano-aerosols. We have demonstrated that Me-NPs are much more noxious as compared with their fine micrometric counterparts although the physiological mechanisms of their elimination from the lungs proved to be highly active. Even if water-insoluble, Me-NPs are significantly solubilized in some biological milieus in vitro and in vivo, which may explain some important peculiarities of their toxicity. At the same time, the in situ cytotoxicity, organ-systemic toxicity and in vivo genotoxicity of Me-NPs strongly depends on specific mechanisms characteristic of a particular metal. For some of the Me-NPs studied, we have proposed standards of presumably safe concentrations in workplace air. Along with this, we have proved that the adverse effects of Me-NPs could be significantly alleviated by background or preliminary administration of adequately composed combinations of some bioprotectors.

Combined Subchronic Toxicity of Aluminum (III), Titanium (IV) and Silicon (IV) Oxide Nanoparticles and Its Alleviation with a Complex of Bioprotectors.

Stable suspensions of metal/metalloid oxide nanoparticles (MeO-NPs) obtained by laser ablation of 99.99% pure elemental aluminum, titanium or silicon under a layer of deionized water were used separately, or in three binary combinations, or in a ternary combination to induce subchronic intoxications in rats. To this end, the MeO-NPs were repeatedly injected intraperitoneally (i.p.) 18 times during 6 weeks before measuring a large number of functional, biochemical, morphological and cytological indices for the organism's status. In many respects, the Al2O3-NP was found to be the most toxic species alone and the most dangerous component of the combinations studied. Mathematical modeling with the help of the Response Surface Methodology showed that, as well as in the case of any other binary toxic combinations previously investigated by us, the organism's response to a simultaneous exposure to any two of the MeO-NP species under study was characterized by a complex interaction between all possible types of combined toxicity (additivity, subadditivity or superadditivity of unidirectional action and different variants of opposite effects) depending on which outcome this type was estimated for and on effect and dose levels. With any third MeO-NP species acting in the background, the type of combined toxicity displayed by the other two remained virtually the same or changed significantly, becoming either more or less unfavorable. Various harmful effects produced by the (Al2O3-NP + TiO2-NP + SiO2-NP)-combination, including its genotoxicity, were substantially attenuated by giving the rats per os during the entire exposure period a complex of innocuous bioactive substances expected to increase the organism's antitoxic resistance.

Experimental study and mathematical modeling of toxic metals combined action as a scientific foundation for occupational and environmental health risk assessment. A summary of results obtained by the Ekaterinburg research team (Russia).

Assessment of cumulative health risks associated with the widely observed combined effects of two or more metals and their compounds on the organism has the toxicology of mixtures as its scientific basis although there is no full match between such assessment and this basis while some of the contradictions between them are of a fundamental nature. This state of things may be explained not only by simplifications characteristic of the generally recognized methodology of risk assessment but also by extreme complexity of the theory of combined toxicity, the most essential issues of which are considered by authors on the basis of literary and, mostly, their own previously published data.

In vivo toxicity of copper oxide, lead oxide and zinc oxide nanoparticles acting in different combinations and its attenuation with a complex of innocuous bio-protectors.

Stable suspensions of metal oxide nanoparticles (Me-NPs) obtained by laser ablation of 99.99% pure copper, zinc or lead under a layer of deionized water were used separately, in three binary combinations and a triple combination in two independent experiments on rats. In one of the experiments the rats were instilled with Me-NPs intratracheally (i.t.) (for performing a broncho-alveolar lavage in 24h to estimate the cytological and biochemical indices of the response of the lower airways), while in the other, Me-NPs were repeatedly injected intraperitoneally (i.p.) 18 times during 6 weeks (for estimating the accumulation of corresponding metals in the blood and their excretion with urine and feces and for assessing subchronic intoxication by a large number of functional and morphological indices). Mathematical description of the results from both experiments with the help of the Response Surface Methodology has shown that, as well as in the case of any other binary toxic combinations previously investigated by us, the response of the organism to a simultaneous exposure to any two of the Me-NPs under study is characterized by complex interactions between all possible types of combined toxicity (additivity, subadditivity or superadditivity of unidirectional action and different variants of opposite effects) depending on which effect it is estimated for as well as on the levels of the effect and dose. With any third Me-NP species acting in the background, the type of combined toxicity displayed by the other two may change significantly (as in the earlier described case of a triple combination of soluble metal salts). It is shown that various harmful effects produced by CuO-NP+ZnO-NP+PbO-NP combination may be substantially attenuated by giving rats per os a complex of innocuous bioactive substances theoretically expected to provide a protective integral and/or metal-specific effect during one month before i.t. instillation or during the entire period of i.p. injections.

The pulmonary phagocytosis response to separate and combined impacts of manganese (IV) and chromium (VI) containing particulates.

We investigated by the optical microscopy some cytological characteristics of the bronchoalveolar lavage fluid cell population 24h after intratracheal instillation of microscale MnO2 and BaCrO4 particles (separately or together at two different doses) into the lungs of Wistar rats. Besides, the cytotoxicity of both particulates for rat peritoneal macrophages in vitro was assessed by the trypan blue exclusion test and proved significant. They were found to evoke a typical dose-dependent pulmonary phagocytosis response usually observed under inhalation or intratracheal impacts of low-soluble mineral and metal particles. A significant shift in the above mentioned cell population toward the prevalence of neutrophllic leukocytes (NL) over alveolar macrophages (AM) proved once more to be the most characteristic feature of this response. Although the particle load of a unit AM was always higher than that of a unit NL, the collective contribution of the recruited NLs to the total particles internalization by both AMs and NLs together was quite significant. This fact confirms that NL recruitment is an important auxiliary mechanism of the cytotoxic particle elimination from lungs compensating for the macrophage damage caused by them. Well adjusted functioning of this compensatory mechanism was additionally demonstrated by isobolographic analysis based on the Response Surface Methodology. On the other hand, this analysis confirmed that the type of combined toxicity depends on a particular effect this type is assessed for and on the effect's dose-dependent level.

Identification of combined action types in experiments with two toxicants: a response surface linear model with a cross term.

Within the framework of the response surface linear model with a cross term, i.e. a model of the type Y(x1, x2) = b0 + b1x1 + b2x2 + b12x1x2 (hyperbolic paraboloid), a complete solution of identification of combined action types of two toxicants x1 and x2 is presented. It is shown that the type of combined effect in this model is determined by two factors: the direction in which the toxicants act (unidirectional or oppositely directed), and the position of the saddle point S of a hyperbolic paraboloid. For unidirectional actions of toxicants, already-known ways to identify the type of combined effect (including a shape of the isobole: concave-up or concave-down) provided identical and unambiguous answers regarding the type of combined effect (antagonism or synergism). For oppositely directed actions of toxicants, the shape of the isobole (concave-up or concave-down) did not allow us to determine the type of combined action type unambiguously. We show that in both cases (unidirectional or oppositely directed actions of toxicants) the signs of the model coefficients b1, b2 and b12, in conjunction with the coordinates of the saddle point S help unambiguously identify the type of combined action by comparing the observed effect with the zero interaction response surface. An atlas of all possibly combined action types for two toxicants for the hyperbolic paraboloid model was created. Applications of the developed formalism to experimental data are provided.

Some patterns of metallic nanoparticles' combined subchronic toxicity as exemplified by a combination of nickel and manganese oxide nanoparticles.

Stable suspensions of NiO and/or Mn3O4 nanoparticles with a mean diameter of 16.7 ± 8.2 nm and 18.4 ± 5.4 nm, respectively, prepared by laser ablation of 99.99% pure metals in de-ionized water were repeatedly injected IP to rats at a dose of 0.50 mg or 0.25 mg 3 times a week up to 18 injections, either separately or in different combinations. Many functional indices as well as histological features of the liver, spleen, kidneys and brain were evaluated for signs of toxicity. The accumulation of Ni and Mn in these organs was measured with the help of AES and EPR methods. Both metallic nanoparticles proved adversely bio-active, but those of Mn3O4 were found to be more noxious in most of the non-specific toxicity manifestations. Moreover, they induced a more marked damaging effect in the neurons of the caudate nucleus and hippocampus which may be considered an experimental correlate of manganese-induced parkinsonism. Mathematical analysis based on the Response Surface Methodology (RSM) revealed a diversity of combined toxicity types depending not only on particular effects these types are assessed for but on their level as well. The prognostic power of the RSM model proved satisfactory.

Attenuation of Combined Nickel(II) Oxide and Manganese(II, III) Oxide Nanoparticles' Adverse Effects with a Complex of Bioprotectors.

Stable suspensions of NiO and Mn3O4 nanoparticles (NPs) with a mean (±s.d.) diameter of 16.7±8.2 and 18.4±5.4 nm, respectively, purposefully prepared by laser ablation of 99.99% pure nickel or manganese in de-ionized water, were repeatedly injected intraperitoneally (IP) to rats at a dose of 2.5 mg/kg 3 times a week up to 18 injections, either alone or in combination. A group of rats was injected with this combination with the background oral administration of a "bio-protective complex" (BPC) comprising pectin, vitamins A, C, E, glutamate, glycine, N-acetylcysteine, selenium, iodide and omega-3 PUFA, this composition having been chosen based on mechanistic considerations and previous experience. After the termination of injections, many functional and biochemical indices and histopathological features (with morphometric assessment) of the liver, spleen, kidneys and brain were evaluated for signs of toxicity. The Ni and Mn content of these organs was measured with the help of the atomic emission and electron paramagnetic resonance spectroscopies. We obtained blood leukocytes for performing the RAPD (Random Amplified Polymorphic DNA) test. Although both metallic NPs proved adversely bio-active in many respects considered in this study, Mn3O4-NPs were somewhat more noxious than NiO-NPs as concerns most of the non-specific toxicity manifestations and they induced more marked damage to neurons in the striatum and the hippocampus, which may be considered an experimental correlate of the manganese-induced Parkinsonism. The comparative solubility of the Mn3O4-NPs and NiO-NPs in a biological medium is discussed as one of the factors underlying the difference in their toxicokinetics and toxicities. The BPC has attenuated both the organ-systemic toxicity and the genotoxicity of Mn3O4-NPs in combination with NiO-NPs.