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历史错误:毒理学如何在剂量反应关系上只说对了一半。

Historical blunders: how toxicology got the dose-response relationship half right.

作者信息

Calabrese E J

机构信息

Environmental Health Sciences Program, School of Public Health, University of Massachusetts, Amherst, 01003, USA.

出版信息

Cell Mol Biol (Noisy-le-grand). 2005 Dec 14;51(7):643-54.

Abstract

Substantial evidence indicates that reliable examples of hormetic dose responses in the toxicological literature are common and generalizable across biological model, endpoint measured and chemical class. Further evaluation revealed that the hormetic dose response model is more common than the threshold dose response model in objective, head-to-head comparisons. Nonetheless, the field of toxicology made a profound error by rejecting the use of the hormetic dose response model in its teaching, research, risk assessment and regulatory activities over nearly the past century. This paper argues that the hormetic dose response model (formerly called the Arndt-Schulz Law) was rejected principally because of its close historical association with the medical practice of homeopathy as a result of the prolonged and bitter feud between traditional medicine and homeopathy. Opponents of the concept of hormesis, making use of strong appeals to authority, were successful in their misrepresentation of the scientific foundations of hormesis and in their unfair association of it with segments of the homeopathic movement with extreme and discreditable views. These misrepresentations became established and integrated within the pharmacology and toxicology communities as a result of their origins in and continuities with traditional medicine and subsequently profoundly impacted a broad range of governmental risk assessment activities further consolidating the rejection of hormesis. This error of judgment was reinforced by toxicological hazard assessment methods using only high and few doses that were unable to assess hormetic responses, statistical modeling processes that were constrained to deny the possibility of hormetic dose response relationships and by the modest nature of the hormetic stimulatory response itself, which required more rigorous study designs to evaluate possible hormetic responses.

摘要

大量证据表明,毒理学文献中可靠的 hormetic 剂量反应实例很常见,并且在生物模型、测量终点和化学类别之间具有普遍性。进一步评估发现,在客观的、直接的比较中,hormetic 剂量反应模型比阈值剂量反应模型更为常见。尽管如此,毒理学领域在近一个世纪的教学、研究、风险评估和监管活动中拒绝使用 hormetic 剂量反应模型,这是一个严重的错误。本文认为,hormetic 剂量反应模型(以前称为阿恩特 - 舒尔茨定律)被拒绝主要是因为它与顺势疗法医学实践有着密切的历史联系,这是传统医学与顺势疗法之间长期激烈争斗的结果。hormesis 概念的反对者利用对权威的强烈呼吁,成功地歪曲了 hormesis 的科学基础,并将其与顺势疗法运动中持有极端和可耻观点的部分不公平地联系在一起。这些错误表述由于其源于传统医学并与之延续,从而在药理学和毒理学界得以确立并融入其中,随后深刻影响了广泛的政府风险评估活动,进一步巩固了对 hormesis 的拒绝。毒理学危害评估方法仅使用高剂量和少量剂量,无法评估 hormetic 反应;统计建模过程受到限制,否认 hormetic 剂量反应关系的可能性;以及 hormetic 刺激反应本身的适度性质,需要更严格的研究设计来评估可能的 hormetic 反应,这些都强化了这种错误的判断。

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