Department of Medical Sciences, Clinical Epidemiology, University of Uppsala, Sweden.
Division of Cardiology, David Geffen School of Medicine at University of California Los Angeles (UCLA), UCLA, Los Angeles, California, USA.
Environ Health Perspect. 2021 Sep;129(9):95001. doi: 10.1289/EHP9321. Epub 2021 Sep 24.
The concept of chemical agents having properties that confer potential hazard called key characteristics (KCs) was first developed to identify carcinogenic hazards. Identification of KCs of cardiovascular (CV) toxicants could facilitate the systematic assessment of CV hazards and understanding of assay and data gaps associated with current approaches.
We sought to develop a consensus-based synthesis of scientific evidence on the KCs of chemical and nonchemical agents known to cause CV toxicity along with methods to measure them.
An expert working group was convened to discuss mechanisms associated with CV toxicity.
The group identified 12 KCs of CV toxicants, defined as exogenous agents that adversely interfere with function of the CV system. The KCs were organized into those primarily affecting cardiac tissue (numbers 1-4 below), the vascular system (5-7), or both (8-12), as follows: 1) impairs regulation of cardiac excitability, 2) impairs cardiac contractility and relaxation, 3) induces cardiomyocyte injury and death, 4) induces proliferation of valve stroma, 5) impacts endothelial and vascular function, 6) alters hemostasis, 7) causes dyslipidemia, 8) impairs mitochondrial function, 9) modifies autonomic nervous system activity, 10) induces oxidative stress, 11) causes inflammation, and 12) alters hormone signaling.
These 12 KCs can be used to help identify pharmaceuticals and environmental pollutants as CV toxicants, as well as to better understand the mechanistic underpinnings of their toxicity. For example, evidence exists that fine particulate matter [PM in aerodynamic diameter ()] air pollution, arsenic, anthracycline drugs, and other exogenous chemicals possess one or more of the described KCs. In conclusion, the KCs could be used to identify potential CV toxicants and to define a set of test methods to evaluate CV toxicity in a more comprehensive and standardized manner than current approaches. https://doi.org/10.1289/EHP9321.
最初开发化学物质的特性,即所谓的关键特性 (KCs),是为了识别致癌危害。识别心血管 (CV) 毒物的 KCs 可以促进 CV 危害的系统评估,并理解与当前方法相关的测定和数据差距。
我们旨在根据已知引起 CV 毒性的化学和非化学物质的科学证据,制定一个基于共识的综合报告,包括测量这些物质的方法。
召集了一个专家工作组来讨论与 CV 毒性相关的机制。
该工作组确定了 12 种 CV 毒物的 KCs,这些 KCs 被定义为会对心血管系统的功能产生不利影响的外源性物质。这些 KCs 分为主要影响心脏组织(下文 1-4 号)、血管系统(5-7 号)或两者兼有的物质(8-12 号),如下所示:1)损害心脏兴奋性的调节,2)损害心肌收缩和舒张功能,3)诱导心肌细胞损伤和死亡,4)诱导瓣膜基质增殖,5)影响内皮和血管功能,6)改变止血功能,7)导致血脂异常,8)损害线粒体功能,9)改变自主神经系统活动,10)诱导氧化应激,11)引起炎症,12)改变激素信号。
这 12 种 KCs 可用于帮助识别心血管毒物的药物和环境污染物,以及更好地理解它们毒性的机制基础。例如,有证据表明,细颗粒物(PM in aerodynamic diameter)空气污染、砷、蒽环类药物和其他外源性化学物质具有描述的 KCs 之一或多个。总之,这些 KCs 可用于识别潜在的 CV 毒物,并定义一组测试方法,以比当前方法更全面和标准化的方式评估 CV 毒性。