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Mycotoxins in agriculturally used plants can cause intoxication in animals and can lead to severe financial losses for farmers. The endophytic fungus Epichloë festucae var. lolii living symbiotically within the cool season grass species Lolium perenne can produce vertebrate and invertebrate toxic alkaloids. Hence, an exact quantitation of alkaloid concentrations is essential to determine intoxication risk for animals. Many studies use different methods to detect alkaloid concentrations, which complicates the comparability. In this study, we showed that alkaloid concentrations of individual plants exceeded toxicity thresholds on real world grasslands in Germany, but not on the population level. Alkaloid concentrations on five German grasslands with high alkaloid levels peaked in summer but were also below toxicity thresholds on population level. Furthermore, we showed that alkaloid concentrations follow the same seasonal trend, regardless of whether plant fresh or dry weight was used, in the field and in a common garden study. However, alkaloid concentrations were around three times higher when detected with dry weight. Finally, we showed that alkaloid concentrations can additionally be biased to different alkaloid detection methods. We highlight that toxicity risks should be analyzed using plant dry weight, but concentration trends of fresh weight are reliable.
Analysis of the Frequency of Kidney Toxicity in Preclinical Safety Studies using the eTOX Database
(2022)
This research aimed to obtain reliable data on the frequency of different
types of renal toxicity findings in 28-day oral gavage studies in Wistar rats, their
consistency across species and study duration, as well as the correlation between histopathological endpoints and routinely used clinical chemistry parameters indicative of kidney injury. Analysis of renal histopathological findings was
carried out through extraction of information from the IMI eTOX database.
Spontaneous renal histopathological findings in 28-day oral gavage studies in control Wistar rats and beagle dogs confirmed tubular basophilia and renal
dilation as the most frequent incidental findings in controls, whereas necrosis
and glomerulosclerosis were not identified at all or only rarely as a background
lesion.
Histopathological evidence of necrosis and glomerulosclerosis was associated with changes in clinical chemistry parameters in 28-day oral gavage
Wistar rat studies. Necrosis was frequently accompanied by a statistically significant rise in serum creatinine and serum urea, whereas serum albumin was
frequently found to decrease statistically significantly in treatment groups in
which necrosis was recorded. In contrast to necrosis, glomerulosclerosis was
not associated with statistically significant changes in serum creatinine and urea
in any of the 28-day oral gavage Wistar rat treatment groups, but appears to be
best reflected by a pattern of statistically significantly lowered serum albumin
and serum protein together with a statistically significant increase in serum cholesterol. As might have been expected based on the high background incidences
of tubular basophilia and dilation, no consistent changes in any of the clinical
chemistry parameters were evident in animals in which renal lesions were confined to renal tubular basophilia or dilation. In summary, the routinely provided
clinical chemistry parameters are rather insensitive - novel kidney biomarkers
such as Cystatin C, β-trace protein and Kidney injury molecule 1 should further
be evaluated and integrated into routine preclinical and clinical practice. However, evaluation of clinical chemistry data was limited by the lack of individual
animal data. Even though an extensive amount of preclinical studies is accessible
through the eTOX database, comparison of consistency across time was limited
by the limited number of shorter- and longer term studies conducted with the
compounds identified as causing renal histopathological changes within a 28-
day study in rats. A high consistency across time for both treatment-related tubular basophilia and treatment-related dilation cannot be confirmed for either of
the two effects as these two findings were both induced only rarely in studies
over a different treatment-duration other than 28 days after administration of the
compounds which provoked the respective effect in a 28-day study. For the
finding of necrosis consistency across time was low with the exception of
“AZ_GGA_200002321”, in which renal papillary necrosis was identified consistently throughout different treatment durations (2, 4, 26, 104 weeks). No shorter and longer-term studies were available for the compounds identified as causing
glomerulosclerosis within a 28-day study in rats.
No consistent findings of the selected histopathological endpoints were
identified in any of the corresponding 28-day oral gavage beagle dog studies
after treatment with the identical compounds, which caused the respective effect after 28-day treatment in rats. However, in the overwhelming majority of
cases, beagle dogs were administered lower doses in these studies in comparison to the corresponding 28-day Wistar rat studies.
Searching the eTOX database yielded no 28-day oral gavage studies in
Wistar and Wistar Han rats in which accumulation of hyaline droplets, tubular
atrophy or hyperplasia was recorded. Only one 28-day oral gavage Wistar rat
study was identified with the histopathological result of neutrophilic inflammation. Consequently, evaluation of these four renal findings in relation to clinical
chemistry parameters and consistency across time and species cannot be
made.
In summary, this work contributes knowledge through mining and evaluating the eTOX database on a variety of specific renal endpoints that frequently
occur after administration of trial substances in 28-day oral gavage studies in
Wistar rats in the field of preclinical toxicity with specific focus on their frequency relation to background findings, as well as consistency across time and species. Targeted statistical evaluation of in vivo data within joint research ventures
such as the eTOX project, presents an enormous opportunity for an innovative
future way of aiding preclinical research towards a more efficient research in the
preclinical stage of drug development. This could be achieved through the augmentation of methodological strategies and possibly novel software tools in order to predict in vivo toxicology of new molecular entities by means of information that is already available before early stages of the drug development
pipeline begin.
The exposure of humans to nano-and microplastic particles (NMPs) is an issue recognized as a potential health hazard by scientists, authorities, politics, non-governmental organizations and the general public. The concentration of NMPs in the environment is increasing concomitantly with global plastic production and the usage of plastic materials. NMPs are detectable in numerous aquatic organisms and also in human samples, therefore necessitating a risk assessment of NMPs for human health. So far, a comprehensive risk assessment of NMPs is hampered by limited availability of appropriate reference materials, analytical obstacles and a lack of definitions and standardized study designs. Most studies conducted so far used polystyrene (PS) spheres as a matter of availability, although this polymer type accounts for only about 7% of total plastic production. Differently sized particles, different concentration and incubation times, and various biological models have been used, yielding hardly comparable data sets. Crucial physico-chemical properties of NMPs such as surface (charge, polarity, chemical reactivity), supplemented additives and adsorbed chemicals have been widely excluded from studies, although in particular the surface of NMPs determines the interaction with cellular membranes. In this manuscript we give an overview about the critical parameters which should be considered when performing risk assessments of NMPs, including novel reference materials, taking into account surface modifications (e.g., reflecting weathering processes), and the possible role of NMPs as a substrate and/or carrier for (pathogenic) microbes. Moreover, we make suggestions for biological model systems to evaluate immediate toxicity, long-term effects and the potential of NMPs to cross biological barriers. We are convinced that standardized reference materials and experimental parameters along with technical innovations in (nano)-particle sampling and analytics are a prerequisite for the successful realization of conclusive human health risk assessments of NMPs.
trans-1,1,1,3-Tetrafluoropropene (HFO-1234ze) and 2,3,3,3-tetrafluoropropene (HFO-1234yf) are non-ozone-depleting fluorocarbon replacements with low global warming potentials and short atmospheric lifetimes. They are developed as foam blowing agent and refrigerant, respectively. Investigations on biotransformation in different test species and in vitro systems are required to assess possible health risks of human exposure and needed for commercial development. The biotransformation of HFO-1234ze and HFO-1234yf was therefore investigated after inhalation exposure. Male Sprague-Dawley rats were exposed to air containing 2 000; 10,000; or 50,000 ppm (n=5/concentration) HFO-1234ze or HFO-1234yf. Male B6C3F1 mice were only exposed to 50,000 ppm HFO-1234ze or HFO-1234yf. Due to lethality observed in a developmental study with rabbits after exposure to high concentrations of HFO-1234yf, the metabolic fate of the compound was tested by whole body inhalation exposure of female New Zealand White rabbits to air containing 2 000; 10,000; or 50,000 ppm (n=3/concentration) HFO-1234yf. All inhalation exposures were conducted for 6 h in a dynamic exposure chamber. After the end of the exposures, animals were individually housed in metabolic cages and urines were collected at 6 or 12 h intervals for 48 h (rats and mice) or 60 h (rabbits). For metabolite identification, urine samples were analyzed by 1H-coupled and 1H-decoupled 19F-NMR and by LC/MS-MS or GC/MS. Metabolites were identified by 19F-NMR chemical shifts, signal multiplicity, 1H-19F coupling constants and by comparison with synthetic reference compounds. Biotransformation of HFO-1234ze in rats exposed to 50,000 ppm yielded S-(3,3,3-trifluoro-trans-propenyl)mercaptolactic acid as the predominant metabolite which accounted for 66% of all integrated 19F-NMR signals in urines. No 19F-NMR signals were found in spectra of rat urine samples collected after inhalation exposure to 2 000 or 10,000 ppm HFO-1234ze likely due to insufficient sensitivity. S-(3,3,3-Trifluoro-trans-propenyl)-L-cysteine, N-acetyl-S-(3,3,3-trifluoro-trans-propenyl)-L-cysteine, 3,3,3-trifluoropropionic acid and 3,3,3-trifluorolactic acid were also present as metabolites in urine samples of rats and mice at the 50,000 ppm level. A presumed amino acid conjugate of 3,3,3-trifluoropropionic acid was the major metabolite of HFO-1234ze in urine samples of mice exposed to 50,000 ppm and related to 18% of total integrated 19F-NMR signals. Quantitation of three metabolites in urines of rats and mice was performed, using LC/MS-MS or GC/MS. The quantified amounts of the metabolites excreted with urine in both mice and rats, suggest only a low extent (<<1% of dose received) of biotransformation of HFO-1234ze and 95% of all metabolites were excreted within 18 h after the end of the exposures (t1/2 approx. 6 h). Due to its low boiling point of −22 °C, most of the inhaled HFO-1234ze is expected to be readily exhaled. Moreover, steric and electronic factors may decrease the reactivity of the parent compound with soft nucleophiles such as glutathione. The obtained results suggest that HFO-1234ze is subjected to an addition-elimination reaction with glutathione and to a cytochrome P450-mediated epoxidation at low rates. The extent of a direct addition reaction of HFO-1234ze with glutathione is negligible, compared to that of the observed addition-elimination reaction. The results of in vivo testing of HFO-1234ze could not be supported by in vitro investigations, since HFO-1234ze was not metabolized in incubations with either liver microsomes or subcellular fractions from rat and human. Regarding the structures delineated in the biotransformation scheme of HFO-1234ze, 1,1,1,3-tetrafluoroepoxypropane and 3,3,3-trifluoropropionic acid are toxic intermediates which, however, are not supposed to display toxicity in the species after exposure to HFO-1234ze, due to the low extent of formation and an efficient detoxification of the epoxide by hydrolysis and glutathione conjugation. The findings of biotransformation of HFO-1234ze in rats and mice correlate with the absence of adverse effects in the toxicity testings and indicate their innocuousness to a human exposure. Biotransformation of HFO-1234yf yielded N-acetyl-S-(3,3,3-trifluoro-2-hydroxypropanyl)-L-cysteine as predominat metabolite which accounted for approx. 44, 90 and 32% (50,000 ppm) of total 19F-NMR signal intensities in urine samples from rabbits, rats and mice, respectively. S-(3,3,3-Trifluoro-2-hydroxypropanyl)mercaptolactic acid and the sulfoxides of mercapturic acid and mercaptolactic acid S-conjugate were identified as minor metabolites of HFO-1234yf in urine samples from rabbits, rats and mice, whereas trifluoroacetic acid, 3,3,3-trifluorolactic acid and 3,3,3-trifluoro-1-hydroxyacetone were present as minor metabolites only in urine samples from rats and mice. The absence of these metabolites in rabbit urine samples...
Background: There is a lack of predictive models to identify patients at risk of high neoadjuvant chemoradiotherapy (CRT)-related acute toxicity in rectal cancer. Patient and Methods: The CAO/ARO/AIO-04 trial was divided into a development (n = 831) and a validation (n = 405) cohort. Using a best subset selection approach, predictive models for grade 3–4 acute toxicity were calculated including clinicopathologic characteristics, pretreatment blood parameters, and baseline results of quality-of-life questionnaires and evaluated using the area under the ROC curve. The final model was internally and externally validated. Results: In the development cohort, 155 patients developed grade 3–4 toxicities due to CRT. In the final evaluation, 15 parameters were included in the logistic regression models using best-subset selection. BMI, gender, and emotional functioning remained significant for predicting toxicity, with a discrimination ability adjusted for overfitting of AUC 0.687. The odds of experiencing high-grade toxicity were 3.8 times higher in the intermediate and 6.4 times higher in the high-risk group (p < 0.001). Rates of toxicity (p = 0.001) and low treatment adherence (p = 0.007) remained significantly different in the validation cohort, whereas discrimination ability was not significantly worse (DeLong test 0.09). Conclusion: We developed and validated a predictive model for toxicity using gender, BMI, and emotional functioning. Such a model could help identify patients at risk for treatment-related high-grade toxicity to assist in treatment guidance and patient participation in shared decision making.
Axicabtagene ciloleucel (axi-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved for relapsed or refractory large B-cell lymphoma (R/R LBCL). To reduce axi-cel–related toxicity, several exploratory safety management cohorts were added to ZUMA-1 (NCT02348216), the pivotal phase 1/2 study of axi-cel in refractory LBCL. Cohort 4 evaluated the rates and severity of cytokine release syndrome (CRS) and neurologic events (NEs) with earlier corticosteroid and tocilizumab use. Primary endpoints were incidence and severity of CRS and NEs. Patients received 2 × 106 anti-CD19 CAR T cells/kg after conditioning chemotherapy. Forty-one patients received axi-cel. Incidences of any-grade CRS and NEs were 93% and 61%, respectively (grade ≥ 3, 2% and 17%). There was no grade 4 or 5 CRS or NE. Despite earlier dosing, the cumulative cortisone-equivalent corticosteroid dose in patients requiring corticosteroid therapy was lower than that reported in the pivotal ZUMA-1 cohorts. With a median follow-up of 14·8 months, objective and complete response rates were 73% and 51%, respectively, and 51% of treated patients were in ongoing response. Earlier and measured use of corticosteroids and/or tocilizumab has the potential to reduce the incidence of grade ≥ 3 CRS and NEs in patients with R/R LBCL receiving axi-cel.
Fungal endophytes of the genus Epichloë live symbiotically in cool season grass species and can produce alkaloids toxic to insects and vertebrates, yet reports of intoxication of grazing animals have been rare in Europe in contrast to overseas. However, due to the beneficial resistance traits observed in Epichloë infected grasses, the inclusion of Epichloë in seed mixtures might become increasingly advantageous. Despite the toxicity of fungal alkaloids, European seed mixtures are rarely tested for Epichloë infection and their infection status is unknown for consumers. In this study, we tested 24 commercially available seed mixtures for their infection rates with Epichloë endophytes and measured the concentrations of the alkaloids ergovaline, lolitrem B, paxilline, and peramine. We detected Epichloë infections in six seed mixtures, and four contained vertebrate and insect toxic alkaloids typical for Epichloë festucae var. lolii infecting Lolium perenne. As Epichloë infected seed mixtures can harm livestock, when infected grasses become dominant in the seeded grasslands, we recommend seed producers to test and communicate Epichloë infection status or avoiding Epichloë infected seed mixtures.
Re-induction with immune checkpoint blockade (ICB) needs to be considered in many patients with uveal melanoma (UM) due to limited systemic treatment options. Here, we provide hitherto the first analysis of ICB re-induction in UM. A total of 177 patients with metastatic UM treated with ICB were included from German skin cancer centers and the German national skin cancer registry (ADOReg). To investigate the impact of ICB re-induction, two cohorts were compared: patients who received at least one ICB re-induction (cohort A, n = 52) versus those who received only one treatment line of ICB (cohort B, n = 125). In cohort A, a transient benefit of overall survival (OS) was observed at 6 and 12 months after the treatment start of ICB. There was no significant difference in OS between both groups (p = 0.1) with a median OS of 16.2 months (cohort A, 95% CI: 11.1–23.8) versus 9.4 months (cohort B, 95% CI: 6.1–14.9). Patients receiving re-induction of ICB (cohort A) had similar response rates compared to those receiving ICB once. Re-induction of ICB may yield a clinical benefit for a small subgroup of patients even after resistance or development of toxicities.
The topical application of tranexamic acid (TXA) helps to prevent post-operative blood loss in total joint replacements. Despite these findings, the effects on articular and periarticular tissues remain unclear. Therefore, this in vitro study examined the effects of varying exposure times and concentrations of TXA on proliferation rates, gene expression and differentiation capacity of chondrocytes and human mesenchymal stromal cells (hMSCs), which underwent osteogenic differentiation. Chondrocytes and hMSCs were isolated and multiplied in monolayer cell cultures. Osteogenic differentiation of hMSCs was induced for 21 days using a differentiation medium containing specific growth factors. Cell proliferation was analyzed using ATP assays. Effects of TXA on cell morphology were examined via light microscopy and histological staining, while expression levels of tissue-specific genes were measured using semiquantitative RT-PCR. After treatment with 50 mg/mL of TXA, a decrease in cell proliferation rates was observed. Furthermore, treatment with concentrations of 20 mg/mL of TXA for at least 48 h led to a visible detachment of chondrocytes. TXA treatment with 50 mg/mL for at least 24 h led to a decrease in the expression of specific marker genes in chondrocytes and osteogenically differentiated hMSCs. No significant effects were observed for concentrations beyond 20 mg/mL of TXA combined with exposure times of less than 24 h. This might therefore represent a safe limit for topical application in vivo. Further research regarding in vivo conditions and effects on hMSC functionality are necessary to fully determine the effects of TXA on articular and periarticular tissues.
Zinc oxide nanoparticles (ZnO-NPs) are widely utilized, for example in manufacturing paints and in the cosmetic industry. In addition, there is raising interest in the application of NPs in stem cell research. However, cytotoxic, genotoxic and pro-inflammatory effects were shown for NPs. The aim of this study was to evaluate the impact of ZnO-NPs on cytokine secretion and differentiation properties of human adipose tissue-derived stromal cells (ASCs). Human ASCs were exposed to the subtoxic concentration of 0.2 mu g/mL ZnO-NPs for 24 h. After four weeks of cultivation, adipogenic and osteogenic differentiation procedures were performed. The multi-differentiation potential was confirmed histologically and using polymerase chain reaction (PCR). In addition, the gene expression of IL-6, IL-8, vascular endothelial growth factor (VEGF) and caspase 3 was analyzed. Over the course of four weeks after ZnO-NPs exposure, no significant differences were detected in the gene expression of IL-6, IL-8, VEGF and caspase 3 compared to non-exposed cells. The differentiation was also not affected by the ZnO-NPs. These findings underline the fact, that functionality of ASCs is likely to be unaffected by ZnO-NPs, despite a long-term disposition of NPs in the cells, supposing that the starting concentration was safely in the non-toxic range. This might provide important information for single-use nanomedical applications of ZnO-NPs.