Preston R Julian
Environmental Carcinogenesis Division, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
Toxicol Appl Pharmacol. 2005 Sep 1;207(2 Suppl):550-6. doi: 10.1016/j.taap.2004.12.024.
There is an increased interest in utilizing mechanistic data in support of the cancer risk assessment process for ionizing radiation and environmental chemical exposures. In this regard, the use of biologically based dose-response models is particularly advocated. The aim is to provide an enhanced basis for describing the nature of the dose-response curve for induced tumors at low levels of exposure. Cellular responses that might influence the nature of the dose-response curve at low exposures are understandably receiving attention. These responses (bystander effects, genomic instability, and adaptive responses) have been studied most extensively for radiation exposures. The former two could result in an enhancement of the tumor response at low doses and the latter could lead to a reduced response compared to that predicted by a linear extrapolation from high dose responses. Bystander responses, whereby cells other than those directly traversed by radiation tracks are damaged, can alter the concept of target cell population per unit dose. Similarly, induced genomic instability can alter the concept of total response to an exposure. There appears to be a role for oxidative damage and cellular signaling in the etiology of these cellular responses. The adaptive response appears to be inducible at very low doses of radiation or of some chemicals and reduces the cellular response to a larger challenge dose. It is currently unclear how these cellular toxic responses might be involved in tumor formation, if indeed they are. In addition, it is not known how widespread they are as regards inducing agents. Thus, their impact on low dose cancer risk remains to be established.
利用机制数据来支持电离辐射和环境化学物暴露的癌症风险评估过程,这一做法越来越受到关注。在这方面,尤其提倡使用基于生物学的剂量反应模型。目的是为描述低暴露水平下诱发肿瘤的剂量反应曲线的性质提供一个更好的基础。在低暴露水平下可能影响剂量反应曲线性质的细胞反应理所当然地受到了关注。这些反应(旁观者效应、基因组不稳定性和适应性反应)在辐射暴露方面得到了最广泛的研究。前两者可能导致低剂量时肿瘤反应增强,而后者可能导致与从高剂量反应线性外推所预测的反应相比反应降低。旁观者反应是指除了直接被辐射径迹穿过的细胞之外的其他细胞受到损伤,这可以改变单位剂量下靶细胞群体的概念。同样,诱导的基因组不稳定性可以改变对暴露的总体反应概念。氧化损伤和细胞信号传导似乎在这些细胞反应的病因学中起作用。适应性反应似乎在极低剂量的辐射或某些化学物质作用下即可诱导产生,并能降低细胞对更大挑战剂量的反应。目前尚不清楚这些细胞毒性反应是否真的参与肿瘤形成,如果参与,又是如何参与的。此外,对于诱导剂而言,它们的普遍程度也不清楚。因此,它们对低剂量癌症风险的影响仍有待确定。