International STakeholder NETwork (ISTNET): creating a developmental neurotoxicity (DNT) testing road map for regulatory purposes

A major problem in developmental neurotoxicity (DNT) risk assessment is the lack of toxicological hazard information for most compounds. Therefore, new approaches are being considered to provide adequate experimental data that allow regulatory decisions. This process requires a matching of regulatory needs on the one hand and the opportunities provided by new test systems and methods on the other hand. Alignment of academically and industrially-driven assay development with regulatory needs in the field of DNT is a core mission of the International STakeholder NETwork (ISNET) in DNT testing. The first meeting of ISTNET was held in Zurich on 23-24 January 2014 in order to explore the concept of adverse outcome pathway (AOP) to practical DNT testing. AOPs were considered promising tools to promote test systems development according to regulatory needs. Moreover, the AOP concept was identified as an important guiding principle to assemble predictive integrated testing strategies (ITSs) for DNT. The recommendations on a roadmap towards AOP-based DNT testing is considered a stepwise approach, operating initially with incomplete AOPs for compound grouping, and focussing on key events of neurodevelopment. Next steps to be considered in follow-up activities are the use of case studies to further apply the AOP concept in regulatory DNT testing, making use of AOP intersections (common key events) for economic development of screening assays, and addressing the transition from qualitative descriptions to quantitative network modelling.JRC.I.5-Systems Toxicolog

International STakeholder NETwork (ISTNET): creating a developmental neurotoxicity (DNT) testing road map for regulatory purposes

A major problem in developmental neurotoxicity (DNT) risk assessment is the lack of toxicological hazard information for most compounds. Therefore, new approaches are being considered to provide adequate experimental data that allow regulatory decisions. This process requires a matching of regulatory needs on the one hand and the opportunities provided by new test systems and methods on the other hand. Alignment of academically and industrially driven assay development with regulatory needs in the field of DNT is a core mission of the International STakeholder NETwork (ISTNET) in DNT testing. The first meeting of ISTNET was held in Zurich on 23-24 January 2014 in order to explore the concept of adverse outcome pathway (AOP) to practical DNT testing. AOPs were considered promising tools to promote test systems development according to regulatory needs. Moreover, the AOP concept was identified as an important guiding principle to assemble predictive integrated testing strategies (ITSs) for DNT. The recommendations on a road map towards AOP-based DNT testing is considered a stepwise approach, operating initially with incomplete AOPs for compound grouping, and focussing on key events of neurodevelopment. Next steps to be considered in follow-up activities are the use of case studies to further apply the AOP concept in regulatory DNT testing, making use of AOP intersections (common key events) for economic development of screening assays, and addressing the transition from qualitative descriptions to quantitative network modelling

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally

Neue Ansätze zur Entwicklung von Alternativmethoden zur Prüfung auf chronische Nierentoxizität

Die Niere ist eines der wichtigsten Zielorgane für Toxizität, allerdings stellt die frühzeitige Erkennung einer Nierenschädigung und/oder kanzerogenen Wirkung infolge einer wiederholten Exposition gegenüber toxischen Verbindungen ein großes Problem dar, da traditionelle Marker für Nierenfunktionsstörungen wenig empfindlich sind. Daher ist es notwendig, verbesserte Testmethoden (Alternativmethoden) zur Prüfung auf chronische Nierentoxizität zu entwickeln. Ziel dieser Arbeit war es daher, mögliche Alternativmethoden zur Prüfung auf Nephrotoxizität nach wiederholter Exposition zu untersuchen. Zum einen wurden dazu in einem in vivo-Modell für chronische Nierentoxizität neue Biomarker für Stress und Gewebeschädigung untersucht, deren erhöhte Genexpression in mehreren Modellen für akute Schädigung des Nierengewebes gezeigt wurde, einschließlich kidney injury molecule-1 (KIM-1), Lipocalin-2 (LCN2), Clusterin (CLU), Osteopontin (OPN), tissue inhibitor of metalloproteinases-1 (TIMP-1), Vimentin (VIM) und Hämoxygenase-1 (HO-1). Diese Marker wurden nachfolgend auch in einem zellkulturbasierten in vitro-Modell untersucht. Ein weiterer Teil der Arbeit befasste sich mit Veränderungen der Zellteilung als möglicher Marker für die Früherkennung kanzerogener Effekte. Das in vivo-Modell bestand in einer Studie in männlichen F344/N-Ratten, die 14, 28 oder 90 Tage oral mit 0, 21, 70 oder 210 µg/kg Körpergewicht (KG) Ochratoxin A (OTA) behandelt wurden. OTA ist ein Mykotoxin, das in Ratten bei wiederholter Gabe eine Nierenschädigung und Nierenkrebs verursacht. Die Analyse der mRNA-Expression der neuen Biomarker in Nierengewebe zeigte bei Tieren, die mit 70 oder 210 µg/kg KG behandelt wurden, eine frühzeitige, zeit- und dosisabhängige Induktion von KIM-1, LCN2, TIMP-1, OPN und CLU, die mit histopathologischen Veränderungen in Form von Zelldegeneration und Regeneration einherging und das Fortschreiten der Schädigung gut widerspiegelte. Auch die mRNA-Expression von HO 1 und VIM wurde durch OTA moduliert, allerdings war eine Erhöhung nicht zu allen Zeitpunkten zu messen bzw. trat nicht so früh auf wie bei den anderen Markern. Effekte auf traditionelle Marker für Nephrotoxizität (Serum-Kreatinin, N-Acetyl-&#946;-D-glucosaminidase und &#947;-Glutamyltransferase im Urin) wurden im Vergleich zu den neuen Markern zu einem späteren Zeitpunkt und zumeist nur in der Hochdosisgruppe festgestellt. Zusätzlich zu den Effekten auf die Genexpression konnte in den Zielzellen von OTA im proximalen Tubulusepithel eine erhöhte Proteinexpression von KIM-1, CLU, OPN und VIM gezeigt werden; nur für KIM-1 wurde allerdings auch im Urin eine erhöhte Konzentration nachgewiesen, die mit den Effekten auf die mRNA- und Proteinkonzentration im Gewebe korrelierte. Damit stellt KIM-1 in dieser Studie hinsichtlich Empfindlichkeit und Messbarkeit den empfindlichsten Biomarker für Nephrotoxizität dar. Die Untersuchung der Zellteilung nach wiederholter Gabe von OTA zeigte einen dramatischen, zeit- und dosisabhängigen Anstieg der Proliferation von proximalen Tubulusepithelzellen in Nieren von Tieren, die mit 70 oder 210 µg/kg KG behandelt wurden. Dagegen wurden nach wiederholter Exposition gegenüber 21 µg/kg KG über 90 Tage keine OTA-abhängigen Effekte auf die renale Zellproliferation festgestellt. Somit korrelieren die Veränderungen der Zellteilung in der Niere in der 90-Tages-Studie sehr gut mit dem Ergebnis der 2-Jahres-Kanzerogenitätsstudie mit OTA, in der Nierentumoren nur nach Behandlung mit 70 oder 210 µg/kg KG auftraten. Ausgehend von den verschiedenen Endpunkten für Toxizität, die in der Studie untersucht wurden, liegt der no-observed-adverse-effect-level (NOAEL) bei 21 µg/kg KG OTA. Dies entspricht dem NOAEL der 2-Jahres-Kanzerogenitätsstudie. In einem weiteren Teil der Arbeit wurden die neuen in vivo-Biomarker für Nephrotoxizität in NRK 52E-Zellen als in vitro-Modell ausgetestet. Allerdings konnte eine erhöhte mRNA-Expression von KIM-1, einem sensitiven Marker in vivo, nach 24 oder 48 Stunden Behandlung mit verschiedenen nephrotoxischen Modellverbindungen (OTA, Kaliumbromat (KBrO3), Cisplatin oder Cadmiumchlorid (CdCl2)) in den Zellen nicht nachgewiesen werden. Die mRNA-Expression anderer Marker (VIM, CLU, TIMP-1, LCN2, OPN) war dagegen in unbehandelten Zellen bereits so hoch, dass die Behandlung mit Nephrotoxinen zu keiner weiteren Induktion führte. Allein die Gen- und Proteinexpression von HO-1 wurde durch CdCl2, KBrO3 und OTA induziert und könnte daher einen potentiellen Marker für screening-Studien in vitro darstellen. Insgesamt war der Nachweis zytotoxischer Wirkungen jedoch der empfindlichste Endpunkt in der Zellkultur. Die Ergebnisse stützen somit die Verwendung der neuen in vivo-Biomarker als gewebespezifische Marker für Nephrotoxizität in vitro nicht.The kidney is a main target organ of toxicity, but early detection of kidney damage and/or carcinogenic effects following the repeated exposure to toxic substances presents a major problem, since traditional markers of renal malfunction suffer from lack of sensitivity. Therefore, nephrotoxic effects are often detected only in long-term experiments in animals. Ethical reasons as well as the immense time and costs required for these animal studies have prompted the search for alternative methods by which animal numbers and duration of studies can be reduced. A further, albeit challenging, attempt is to replace experiments in animals by studies in vitro. The aim of this work was to test possible alternative methods for the detection of nephrotoxicity after repeated exposure. One the one hand, the expression of new biomarkers of stress and tissue damage was studied in an in vivo-model of chronic nephrotoxicity; enhanced gene expression of these biomarkers, including kidney injury molecule-1 (KIM-1), lipocalin-2 (LCN2), clusterin (CLU), osteopontin (OPN), tissue inhibitor of metalloproteinases-1 (TIMP-1), vimentin (VIM), and heme oxygenase-1 (HO-1), had been demonstrated before in several models of acute kidney damage. In addition to the experiments in vivo, the markers were also studied in a cell culture-based in vitro-model to assess their use as sensitive endpoints of toxicity in vitro. A further part of this work included the determination of cell proliferation as potential early marker of toxin-induced carcinogenic effects. As an in vivo-model, a toxicity study in male F344/N rats was performed. Rats were treated 14, 28 or 90 days with 0, 21, 70 or 210 µg/kg body weight (bw) ochratoxin A (OTA) by oral administration. OTA is a mycotoxin that is known to cause kidney damage and renal tumors in rats after repeated exposure. Analysis of mRNA expression of the new biomarkers showed early, time- and dose-dependent induction of KIM-1, LCN2, TIMP-1, OPN and CLU in kidney tissue of animals treated with 70 or 210 µg/kg bw. The induction of these biomarkers accompanied histopathological changes like cell degeneration and regeneration and mirrored well the progression of tissue damage. mRNA expression of HO-1 and VIM was also modulated by OTA, but overexpression was not evident at all time points or occurred later than for the other markers. Compared with the new biomarkers, effects on traditional markers of nephrotoxicity (serum creatinine, urinary N-acetyl-&#946;-D-glucosaminidase and &#947;-glutamyltransferase) were restricted to later time points and the high dose group. In addition to the effects on gene expression, enhanced protein expression of KIM-1, CLU, OPN and VIM was observed in target cells of OTA in the proximal tubule epithelium; however, only for KIM-1, increased protein levels were also measured in urine, which correlated with the effects on the gene and protein expression in kidney tissue. Therefore, KIM-1 appeared to be the most sensitive biomarker of nephrotoxicity in this study. The study of the renal cell division after repeated administration of OTA demonstrated a dramatic, time- and dose-dependent increase in the proliferation of proximal tubule epithelial cells in kidneys of rats exposed to 70 or 210 µg/kg bw. In contrast, no OTA-dependent effects on renal cell proliferation were observed after repeated administration of 21 µg/kg bw. Thus, changes of renal cell proliferation in this 90-day-study correlate well with the results of the 2-year-carcinogenicity study with OTA, where renal tumors were only detected at 70 or 210 µg/kg bw. Based upon the different endpoints of toxicity determined in this study, the no-observed-adverse-effect-level (NOAEL) is 21 µg/kg KG OTA. This is consistent with the result of the 2-year-carcinogenicity study. In another part of this work, the new in vivo biomarkers of nephrotoxicity were studied in NRK-52E cells as in vitro-model. However, mRNA expression of KIM-1, one of the best biomarkers in vivo, was not detected in the cells after treatment for 24 or 48 hours with several nephrotoxic model substances (OTA, potassium bromate (KBrO3), cisplatin or cadmium chloride (CdCl2)). In contrast, high basal mRNA expression of other markers (VIM, CLU, TIMP-1, LCN2, OPN) was evident even in untreated cells and treatment with nephrotoxins did not further enhance marker gene expression. Only in the case of HO-1, both gene and protein expression were induced by CdCl2, KBrO3 and OTA, and could therefore represent potential markers in screening studies in vitro. In summary, measurement of cytotoxicity was still the most sensitive endpoint of toxicity in vitro. Thus, results from this study do not support the use of the new in vivo-biomarkers as tissue-specific markers of nephrotoxicity in vitro

Ochratoxin A: 13-week oral toxicity and cell proliferation in male F344/N rats

Ochratoxin A (OTA) is nephrotoxic and a potent renal carcinogen. Male rats are most susceptible to OTA toxicity, and chronic administration of OTA (70 and 210 mu g/kg bw) for 2 years has been shown to induce high incidences of adenomas and carcinomas arising from the straight segment of the proximal tubule epithelium. In contrast, treatment with a lower dose of 21 mu g/kg bw did not result in increased tumor rates, suggesting a nonlinear dose response for renal tumor formation by OTA. Since the mechanism of OTA carcinogenicity is still largely unknown, this study was conducted to investigate early functional and pathological effects of OTA and to determine if sustained stimulation of renal cell proliferation plays a role. Male F344/N rats were treated with OTA for up to 13 weeks under conditions of the National Toxicology Program (NTP) bioassay. Cell proliferation in the renal cortex and outer stripe of the outer medulla (OSOM) was determined using bromodeoxyuridine incorporation and immunohistochemistry. Histopathological examination showed renal alterations in mid- and high-dose-treated animals involving single-cell death and prominent nuclear enlargement within the straight proximal tubules. Treatment with OTA at doses of 70 and 210 mu g/kg bw led to a marked dose- and time-dependent increase in renal cell proliferation, extending from the medullary rays into the OSOM. No effects were evident in kidneys of low-dose-treated animals or in the liver, which is not a target for OTA carcinogenicity. A no observed effect level in this study was established at 21 mu g/kg bw, correlating with the dose in the NTP 2-year bioassay that did not produce renal tumors. The apparent correlation between enhanced cell turnover and tumor formation induced by OTA indicates that stimulation of cell proliferation may play an important role in OTA carcinogenicity and provides further evidence for an epigenetic, thresholded mechanism