Slob Wout, Bakker Martine I, Bokkers Bas G H, Chen Guangchao, Chiu Weihsueh A, Mennes Wim, Nicolaie M Alina, Setzer R Woodrow, White Paul A
Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Centre for Safety of Substances and Products, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Crit Rev Toxicol. 2025;55(4):437-461. doi: 10.1080/10408444.2025.2464067. Epub 2025 Apr 9.
The benchmark dose (BMD) approach employs dose-response modeling to determine the dose associated with a small change in response relative to the background response. Here, we introduce a conceptual framework for modeling continuous data that is based on key risk assessment principles and requirements. Based on this framework, we define a class of dose-response models sharing the same four biologically interpretable model parameters, while exhibiting five common properties that are essential from a risk assessment perspective: such models are denoted as "canonical" models. The first two canonical properties are straightforward: property 1. The models should predict positive values only (as measurements of continuous endpoints are typically positive) and property 2. the outcomes should not depend on the measurement unit. Canonical property 3 reflects the observation that toxicological dose-response data related to different subgroups (e.g. species, sexes, and exposure durations) are typically (at least approximately) parallel on a log-dose scale, which is at the same time an implicit assumption in defining fundamental toxicological concepts, such as extrapolation factors, relative potency factors (RPFs), and relative sensitivity factors (RSFs). Property 4 is needed to enable comparisons of the sensitivity of endpoints differing in maximum response. A fifth canonical property reflects our view that choices regarding the dose-response model expression, the assumed distribution for the within-group variation, and the benchmark response (BMR) that is being used should be internally consistent. The canonical models that we discuss are suitable to fit parallel dose-response curves to combined datasets related to different subgroups (e.g. species, sexes, and exposure durations). Doing so provides a tool to check canonical property 3 of the particular data analyzed. We provide a review of empirical evidence indicating that this property has general validity, which is highly fortunate, as this legitimizes the use of extrapolation factors and RPFs in risk assessment. We then evaluate to what extent the approaches in current BMD guidance by European Food Safety Authority (EFSA) or U.S. Environmental Protection Agency (US-EPA) comply with the principles of canonical dose-response modeling, concluding that this is only partly the case. The latter can have unfavorable and sometimes far-reaching consequences. For instance, some of the recommended non-canonical models result in different BMDs when changing the measurement unit (e.g. µg to mg). As another example, the BMD tool recently developed by EFSA implements covariate analysis in such a way that canonical property 3 cannot possibly be represented by any of the models. As another disadvantage, non-canonical models preclude the effective development and use of prior distributions in a Bayesian approach. Finally, we argue that a concomitant but important advantage of only using canonical models is that BMD methodology will be more transparent, so that risk assessors will be better able to understand it, and BMDs with high societal impact can be more easily defended. The present paper may be a helpful tool for toxicologists and risk assessors to critically follow the developments in BMD methodology at the conceptual level.
基准剂量(BMD)方法采用剂量反应建模来确定与相对于背景反应的微小反应变化相关的剂量。在此,我们引入一个基于关键风险评估原则和要求的连续数据建模概念框架。基于此框架,我们定义了一类剂量反应模型,它们共享相同的四个具有生物学可解释性的模型参数,同时展现出从风险评估角度来看至关重要的五个共同特性:此类模型被称为“规范”模型。前两个规范特性很直接:特性1. 模型应仅预测正值(因为连续终点的测量通常为正值);特性2. 结果不应依赖于测量单位。规范特性3反映了这样一种观察结果,即在对数剂量尺度上,与不同亚组(如物种、性别和暴露持续时间)相关的毒理学剂量反应数据通常(至少大致)是平行的,这同时也是定义基本毒理学概念(如外推因子、相对效力因子(RPF)和相对敏感性因子(RSF))时的一个隐含假设。特性4用于能够比较最大反应不同的终点的敏感性。第五个规范特性反映了我们的观点,即关于剂量反应模型表达式、组内变异的假定分布以及所使用的基准反应(BMR)的选择应该在内部是一致的。我们讨论的规范模型适用于将平行剂量反应曲线拟合到与不同亚组(如物种、性别和暴露持续时间)相关的组合数据集。这样做提供了一种工具来检查所分析的特定数据的规范特性3。我们综述了经验证据,表明该特性具有普遍有效性,这非常幸运,因为这使外推因子和RPF在风险评估中的使用合法化。然后,我们评估欧洲食品安全局(EFSA)或美国环境保护局(US-EPA)当前BMD指南中的方法在多大程度上符合规范剂量反应建模的原则,得出结论是只是部分符合。后者可能会产生不利且有时影响深远的后果。例如,一些推荐的非规范模型在改变测量单位(如从μg到mg)时会导致不同的BMD。再举一个例子,EFSA最近开发的BMD工具实施协变量分析的方式使得任何模型都不可能体现规范特性3。另一个缺点是,非规范模型排除了在贝叶斯方法中有效开发和使用先验分布的可能性。最后,我们认为仅使用规范模型的一个伴随但重要的优点是BMD方法将更加透明,这样风险评估者将能够更好地理解它,并且具有高社会影响的BMD将更容易得到辩护。本文可能是毒理学家和风险评估者在概念层面批判性地跟踪BMD方法发展的一个有用工具。