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重新审视化学致癌性 2:目前对致癌作用的认识表明,将某种物质归类为致癌物或非致癌物在科学上是不可信的。

Chemical carcinogenicity revisited 2: Current knowledge of carcinogenesis shows that categorization as a carcinogen or non-carcinogen is not scientifically credible.

机构信息

Parker Doe LLP, Carpenter Court, Maple Road, Bramhall, Stockport, Cheshire, SK7 2DH, UK.

Centre for Pharmacology & Therapeutics, Toxicology Unit, Department of Medicine, Hammersmith Campus, Imperial College London, London, W12 0NN, UK.

出版信息

Regul Toxicol Pharmacol. 2019 Apr;103:124-129. doi: 10.1016/j.yrtph.2019.01.024. Epub 2019 Jan 18.

Abstract

Developments in the understanding of the etiology of cancer have undermined the 1970s concept that chemicals are either "carcinogens" or "non-carcinogens". The capacity to induce cancer should not be classified in an inflexible binary manner as present (carcinogen) or absent (non-carcinogen). Chemicals may induce cancer by three categories of mode of action: direct interaction with DNA or DNA replication including DNA repair and epigenetics; receptor-mediated induction of cell division; and non-specific induction of cell division. The long-term rodent bioassay is neither appropriate nor efficient to evaluate carcinogenic potential for humans and to inform risk management decisions. It is of questionable predicitiveness, expensive, time consuming, and uses hundreds of animals. Although it has been embedded in practice for over 50 years, it has only been used to evaluate less than 5% of chemicals that are in use. Furthermore, it is not reproducible because of the probabilisitic nature of the process it is evaluating combined with dose limiting toxicity, dose selection, and study design. The modes of action that lead to the induction of tumors are already considered under other hazardous property categories in classification (Mutagenicity/Genotoxicity and Target Organ Toxicity); a separate category for Carcinogenicity is not required and provides no additional public health protection.

摘要

癌症病因学研究的进展破坏了 20 世纪 70 年代的概念,即化学物质不是“致癌物”就是“非致癌物”。诱导癌症的能力不应以死板的二元方式进行分类,要么存在(致癌物),要么不存在(非致癌物)。化学物质可能通过三种作用模式诱导癌症:直接与 DNA 或 DNA 复制相互作用,包括 DNA 修复和表观遗传学;受体介导的细胞分裂诱导;以及非特异性诱导细胞分裂。长期啮齿动物生物测定既不适合也不高效,无法评估对人类的致癌潜力并为风险管理决策提供信息。它的预测性值得怀疑,费用高、耗时且使用数百只动物。尽管它已经在实践中应用了 50 多年,但只用于评估不到 5%的正在使用的化学物质。此外,由于它正在评估的过程具有概率性质,加上剂量限制毒性、剂量选择和研究设计,因此它是不可复制的。导致肿瘤诱导的作用模式已经在分类中的其他危险特性类别(致突变性/遗传毒性和靶器官毒性)中考虑到了;不需要单独的致癌性类别,也不能为公共卫生保护提供额外的保障。

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