Oberdörster Günter
Department of Environmental Medicine, University of Rochester, School of Medicine and Dentistry, 575 Elmwood Avenue, Box EHSC, Rochester, NY 14642, USA.
Inhal Toxicol. 2002 Jan;14(1):29-56. doi: 10.1080/089583701753338622.
Chronic inhalation of fibrous and nonfibrous particles by rats at high concentrations results in lung tumor formation if the particles are poorly soluble in the lung. Even rather benign nonfibrous particles such as TiO(2) produce this result. One significant change during a chronic inhalation exposure of poorly soluble particles of low cytotoxicity (PSP) is an impairment of normal clearance mechanisms in the alveolar region of the lung in rats, resulting in a continued buildup to high lung burdens accompanied by chronic alveolar inflammation, fibrosis, and mutational events. Since these are obviously high-dose effects, questions about their extrapolation to humans exposed to much lower concentrations have been raised. Results of key studies reported for chronic inhalation of PSP in rats indicate that mechanisms of PSP-induced lung tumors at high doses do not operate at low dose levels. Furthermore, the existence of two thresholds can be postulated: One is a dosimetric threshold for the endpoint alveolar macrophage-mediated clearance, which is related to lung particle overload. The other is a mechanistic threshold for the endpoint mutation, which is determined by the level of antioxidant defenses to counterbalance reactive oxidant species released by activated inflammatory cells. A no-observed-adverse-effect level (NOAEL) could therefore be based on avoiding alteration of the toxicokinetic of the particles such that the lung burdens stay below the dosimetric threshold. The suggestion that PSP-associated organic compounds (e.g., diesel particulate matter) contribute to the lung tumor responses in rats observed in chronic inhalation studies is not supported by experimental data from in vivo studies. It can be concluded that high-dose rat lung tumors due to PSP should not be used for low-dose extrapolations, and no significant contribution to human lung cancer risk can be predicted from levels of PSP below lung overload. With respect to the pulmonary toxicokinetics of inhaled fibrous particles, the biopersistence of long fibers (>20 microm) which cannot be phagocytized by alveolar macrophages is a key parameter related to long-term carcinogenic effects. Long fibers with a very low biopersistence should not be considered as carcinogenic. Since the clearance kinetics of fibers can generally be described by a biphasic or multiphasic pattern-fast initial and slow final phase-it is essential that the slow phase of the retention kinetics of fibers longer than 20 microm is considered in a biopersistence assay. Based on the results of such assay, fibers can be classified into one of two categories: a biopersistent fiber that cannot be dissolved in the lung within an acceptable time period; or a biosoluble fiber when even long nonphagocytizable fibers will be disappearing rapidly from the lung. However, in addition to biopersistence, it should be mandatory to evaluate fiber toxicity in an appropriate assay relative to a fiber whose long-term effects are well known. Moreover, for organic fibers it is likely that different rules may have to be established for characterization of their toxic and carcinogenic potential.
如果大鼠长期高浓度吸入肺中难溶性的纤维状和非纤维状颗粒,会导致肺部肿瘤形成。即使是相当良性的非纤维状颗粒,如二氧化钛,也会产生这种结果。在长期吸入低细胞毒性的难溶性颗粒(PSP)的过程中,一个显著变化是大鼠肺部肺泡区域的正常清除机制受损,导致肺部负担持续增加,同时伴有慢性肺泡炎症、纤维化和突变事件。由于这些显然是高剂量效应,因此有人提出了关于将其外推至暴露于低得多浓度环境中的人类的问题。关于大鼠长期吸入PSP的关键研究结果表明,高剂量时PSP诱导肺部肿瘤的机制在低剂量水平下不起作用。此外,可以假定存在两个阈值:一个是肺泡巨噬细胞介导的清除终点的剂量阈值,它与肺部颗粒过载有关。另一个是突变终点的机制阈值,它由抗氧化防御水平决定,以抵消活化炎症细胞释放的活性氧。因此,未观察到有害作用水平(NOAEL)可以基于避免颗粒毒代动力学的改变,使肺部负担保持在剂量阈值以下。慢性吸入研究中观察到的PSP相关有机化合物(如柴油颗粒物)导致大鼠肺部肿瘤反应的说法,并未得到体内研究实验数据的支持。可以得出结论,不应将PSP导致的高剂量大鼠肺部肿瘤用于低剂量外推,并且低于肺部过载水平的PSP对人类肺癌风险没有显著贡献。关于吸入纤维状颗粒的肺部毒代动力学,长纤维(>20微米)的生物持久性是与长期致癌作用相关的关键参数,长纤维不能被肺泡巨噬细胞吞噬。生物持久性非常低的长纤维不应被视为致癌物质。由于纤维的清除动力学通常可以用双相或多相模式来描述——快速的初始阶段和缓慢的最终阶段——在生物持久性测定中考虑长于20微米的纤维保留动力学的缓慢阶段至关重要。基于这种测定的结果,纤维可以分为两类之一:在可接受的时间段内不能在肺中溶解的生物持久性纤维;或者即使是长的不可吞噬纤维也会迅速从肺中消失的生物可溶纤维。然而,除了生物持久性之外,还应强制在适当的测定中相对于一种长期效应已知的纤维来评估纤维毒性。此外,对于有机纤维,可能需要建立不同的规则来表征其毒性和致癌潜力。