Basketter David A, Gerberick G Frank, Kimber Ian
St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
Cutan Ocul Toxicol. 2007;26(4):293-301. doi: 10.1080/15569520701556647.
The local lymph node assay (LLNA) is being used increasingly in the identification of skin sensitizing chemicals for regulatory purposes. In the context of new chemicals legislation (REACH) in Europe, it is the preferred assay. The rationale for this is that the LLNA quantitative and objective approach to skin sensitization testing allied with the important animal welfare benefits that the method offers. However, as with certain guinea pig sensitization tests before it, this increasing use also brings experience with an increasingly wide range of industrial and other chemicals where the outcome of the assay does not always necessarily meet with the expectations of those conducting it. Sometimes, the result appears to be a false negative, but rather more commonly, the complaint is that the chemical represents a false positive. Against this background we have here reviewed a number of instances where false positive and false negative results have been described and have sought to reconcile science with expectation. Based on these analyses, it is our conclusion that false positives and false negatives do occur in the LLNA, as they do with any other skin sensitization assay (and indeed with all tests used for hazard identification), and that this occurs for a number of reasons. We further conclude, however, that false positive results in the LLNA, as with the guinea pig maximization test, arise most commonly via failure to distinguish what is scientifically correct from that which is unpalatable. The consequences of this confusion are discussed in the article, particularly in relation to the need to integrate both potency measurement and risk assessments into classification and labelling schemes that aim to manage potential risks to human health.
局部淋巴结试验(LLNA)越来越多地用于监管目的下皮肤致敏化学物质的鉴定。在欧洲新的化学品法规(REACH)背景下,它是首选试验。其理由是LLNA对皮肤致敏测试采用定量和客观的方法,同时该方法具有重要的动物福利优势。然而,与之前某些豚鼠致敏试验一样,这种使用的增加也带来了对越来越多工业化学品和其他化学品的经验,而该试验的结果并不总是必然符合进行试验者的预期。有时,结果似乎是假阴性,但更常见的情况是,有人抱怨该化学物质呈现假阳性。在此背景下,我们回顾了一些描述假阳性和假阴性结果的实例,并试图使科学与预期相协调。基于这些分析,我们的结论是,LLNA中确实会出现假阳性和假阴性,就像其他任何皮肤致敏试验(实际上与所有用于危害识别的测试一样),且出现这种情况有多种原因。然而,我们进一步得出结论,LLNA中的假阳性结果,与豚鼠最大化试验一样,最常见的原因是未能区分科学上正确的内容与令人不快的内容。本文讨论了这种混淆的后果,特别是关于将效力测量和风险评估纳入旨在管理对人类健康潜在风险的分类和标签方案的必要性。