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利用实验和流行病学研究数据对“二噁英”对人类毒性评估的思考

Reflections on the assessment of the toxicity of "dioxins" for humans, using data from experimental and epidemiological studies.

作者信息

Neubert D

机构信息

Institute of Clinical Pharmacology and Toxicology, Department of Toxicology, Benjamin Franklin Medical Center, Free University Berlin, Germany.

出版信息

Teratog Carcinog Mutagen. 1997;17(4-5):157-215.

PMID:9508730
Abstract

"Dioxins" (polyhalogenated dibenzo-p-dioxins and dibenzofurans, PHDDs/PHDFs) have gained considerable scientific interest, and (unjustified or justified) also received tremendous political attention. The data pool available on sources, distribution in the environment, kinetics in animals and humans, and on biological and toxic actions in various species (including humans), is one of the largest among all environmental organic substances; but quality and predictive power of the data on possible effects in humans vary widely, from adequate to not acceptable. This fact is often ignorantly or perhaps even deliberately disregarded, and such divergent data are frequently given the same weight in attempted risk assessments. It must be stressed that the quality of the toxicological data on most "environmental compounds" in general is far below today's standards required for preclinical and clinical data on medicinal substances. The crucial question is whether humans constitute an especially vulnerable species for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) or the other PHDDs/PHDFs. Since ample data on body burdens and some results of clinical and epidemiological studies on TCDD have become available, answering this question may now be attempted on the basis of a comparison of animal and human data. Quality of the data and the predictive power of the methods used must be considered, dose-response relationships must be critically evaluated, and body burdens achieved in humans and experimental animals must be taken into account. Pitfalls in attempts to extrapolate data from animal studies to humans and limitations of conclusions to be drawn from epidemiological data on humans are discussed in this presentation.

摘要

“二噁英”(多卤代二苯并 - 对 - 二噁英和二苯并呋喃,PHDDs/PHDFs)已引起了科学界的广泛关注,并且(无论是否合理)也受到了极大的政治关注。关于其来源、在环境中的分布、在动物和人类体内的动力学以及在各种物种(包括人类)中的生物学和毒性作用的现有数据库,是所有环境有机物质中最大的数据库之一;但关于对人类可能产生的影响的数据质量和预测能力差异很大,从充分到不可接受不等。这一事实常常被忽视,甚至可能是故意被忽视,而且在进行风险评估时,这些差异很大的数据常常被赋予同等的权重。必须强调的是,一般来说,大多数“环境化合物”的毒理学数据质量远远低于当今药物临床前和临床数据所需的标准。关键问题在于,人类是否是对2,3,7,8 - 四氯二苯并 - 对 - 二噁英(TCDD)或其他PHDDs/PHDFs特别敏感的物种。由于现在已经有了关于人体负荷的大量数据以及一些关于TCDD的临床和流行病学研究结果,现在可以尝试通过比较动物和人类数据来回答这个问题。必须考虑数据质量和所使用方法的预测能力,必须严格评估剂量 - 反应关系,并且必须考虑人类和实验动物所达到的人体负荷。本报告将讨论从动物研究推断人类数据时的陷阱以及从人类流行病学数据得出结论的局限性。

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