Gaylor David W
Gaylor and Associates, LLC, Eureka Springs, AR 72631, USA.
Regul Toxicol Pharmacol. 2005 Mar;41(2):128-33. doi: 10.1016/j.yrtph.2004.11.001. Epub 2004 Dec 19.
Chronic bioassays for over 500 chemicals have been conducted under the auspices of the National Cancer Institute and/or the National Toxicology Program (NTP) to screen chemicals for carcinogenicity, providing a wealth of information about bioassays. Typically, chemicals are administered for two years to both sexes in each of one strain of rats and mice generally at the maximum tolerated dose (MTD), MTD/2, MTD/4 (in recent years), as well as unexposed control animals. In an attempt to ascertain the sensitivity of this bioassay to detect animal carcinogens tested at the MTD for the current experimental design, the false negative rate (failure to detect increased tumor rates) was investigated. This was accomplished by examining the tumor incidences from over 150 NTP bioassays and estimating the probability that a statistically significant (P0.01) dose-response trend would be obtained at one or more tissue sites in either sex of rats or mice if 200, rather than 50, animals were used per dose group. This provides an estimate of the proportion of chemicals that were not declared high-dose animal carcinogens due to the limited sample size of 50 animals per species-sex-dose group. In this series of chemicals tested, 97/156 (62%) were identified by the NTP to show some or clear evidence of carcinogenicity. With an increase of the number of animals per dose group from 50 to 200, it is estimated that 92% of these chemicals would show statistically significant (P0.01) dose-response trends at one or more tissue sites in either sex of rats or mice. Many of these chemicals are not genotoxic. Some chemicals had no structural alerts for carcinogenicity, but were tested because of potentially high human exposure. This analysis suggests that almost all of the chemicals selected would produce a statistically significant increase in tumor incidence at the MTD with larger sample sizes. Hence, this MTD bioassay screen is not distinguishing between true carcinogens and non-carcinogens. Rather, the screen is simply failing to detect the weaker carcinogens at the MTD. More than 30% of chemicals tested failed to detect statistically significant dose-response trends for tumors because of inadequate sample sizes of 50 animals per dose. Presumably, little or no action would have been taken to regulate exposures to these chemicals as potential carcinogens due to lack of a positive test result. This analysis does not suggest that most chemicals are carcinogenic at human exposure levels nor does it suggest that more than 50 animals should be tested per dose group. With an MTD that may produce a difference (up to 10%) in weight gain between treated and control animals, there quite possibly is cytotoxicity at the MTD. Increased carcinogenicity would be expected from increased opportunities for mutagenic activity during regenerative cell replication to compensate for cytotoxicity. Since it appears that almost all chemicals tested adequately at the MTD will demonstrate carcinogenicity, it is tempting to surmise that this is due in large part to one or more nearly universal modes of action, such as, regenerative cell replication at the MTD rather than due to some unique carcinogenic property of a chemical. That is, the current bioassay possibly is just primarily a screen for the more potent cytotoxins at the MTD, rather than a screen specifically for carcinogenicity. This issue should be examined and suggests that cytotoxicity and cell proliferation should be considered in setting the MTD, particularly for non-genotoxic (non-DNA reactive) chemicals. From a public health view, it is prudent to assume that most chemicals could demonstrate increased tumor incidence rates at the MTD in rodents. The current standard NTP bioassay provides sufficient data to estimate a benchmark dose associated with a specified low tumor incidence to be used as a point-of-departure for cancer risk assessments. The question that should be investigated by a bioassay is not whether a chemical is a carcinogen at the MTD, but what is the relationship between dose and cytotoxicity and/or other modes of action that could produce an excess of tumors?
在国家癌症研究所和/或国家毒理学计划(NTP)的支持下,已对500多种化学物质进行了慢性生物测定,以筛选化学物质的致癌性,从而提供了大量有关生物测定的信息。通常,将化学物质以最大耐受剂量(MTD)、MTD/2、MTD/4(近年来)给予一组大鼠和小鼠的雌雄两性,为期两年,同时设置未接触化学物质的对照动物。为了确定这种生物测定在当前实验设计中检测MTD下受试动物致癌物的敏感性,对假阴性率(未能检测到肿瘤发生率增加)进行了研究。这是通过检查150多项NTP生物测定的肿瘤发生率,并估计如果每个剂量组使用200只动物而非50只动物,在大鼠或小鼠的任一性别中一个或多个组织部位获得具有统计学显著性(P<0.01)剂量反应趋势的概率来完成的。这提供了一个估计值,即由于每个物种-性别-剂量组样本量有限为50只动物,导致未被判定为高剂量动物致癌物的化学物质所占比例。在这一系列受试化学物质中,NTP鉴定出97/156(62%)显示出某种或明确的致癌证据。随着每个剂量组动物数量从50只增加到200只,估计这些化学物质中有92%会在大鼠或小鼠的任一性别中一个或多个组织部位显示出具有统计学显著性(P<0.01)的剂量反应趋势。其中许多化学物质没有基因毒性。一些化学物质没有致癌性的结构警示,但由于潜在的高人类暴露而进行了测试。该分析表明,几乎所有选定的化学物质在样本量更大时,在MTD下肿瘤发生率会有统计学显著性增加。因此,这种MTD生物测定筛选并不能区分真正的致癌物和非致癌物。相反,该筛选只是未能在MTD下检测到较弱的致癌物。超过30%的受试化学物质由于每个剂量组样本量仅50只动物而未能检测到肿瘤的统计学显著性剂量反应趋势。据推测,由于缺乏阳性测试结果,可能几乎不会采取行动将这些化学物质的暴露作为潜在致癌物进行监管。该分析并不表明大多数化学物质在人类暴露水平下具有致癌性,也不表明每个剂量组应测试超过50只动物。由于MTD可能使受试动物与对照动物之间的体重增加产生差异(高达10%),在MTD下很可能存在细胞毒性。预计在再生细胞复制过程中,由于诱变活性机会增加以补偿细胞毒性,致癌性会增加。由于似乎几乎所有在MTD下充分测试的化学物质都会显示致癌性,很容易推测这在很大程度上是由于一种或多种几乎普遍的作用模式,例如在MTD下的再生细胞复制,而不是由于化学物质的某些独特致癌特性。也就是说,当前的生物测定可能主要只是对MTD下更强效的细胞毒素的筛选,而不是专门针对致癌性的筛选。这个问题应该进行研究,这表明在设定MTD时应考虑细胞毒性和细胞增殖,特别是对于非基因毒性(非DNA反应性)化学物质。从公共卫生角度来看,谨慎的做法是假设大多数化学物质在啮齿动物的MTD下可能会显示肿瘤发生率增加。当前标准的NTP生物测定提供了足够的数据来估计与特定低肿瘤发生率相关的基准剂量,以用作癌症风险评估的起点。生物测定应该研究的问题不是一种化学物质在MTD下是否是致癌物,而是剂量与细胞毒性和/或其他可能导致肿瘤过多的作用模式之间的关系是什么?