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Summary Molecular Toxicology

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This is a summary of molecular toxicology based on Boelsterli, U. A. (2007). Mechanistic Toxicology: The Molecular Basis of How Chemicals Disrupt Biological Targets. It covers the molecular mechanisms by which chemicals and drugs can cause toxicity in humans and animals. Topics include: Basic principles of toxicology: dose-dependence, exposure routes, toxicokinetics (absorption, distribution, metabolism, excretion) and toxicodynamics (interaction with cellular targets). Biological responses: cellular adaptation, stress responses, and toxic outcomes such as necrosis, apoptosis, genotoxicity, and carcinogenicity. Organ-selective toxicity: why specific organs like the liver, kidney, and brain are particularly vulnerable, with examples such as paracetamol-induced liver damage and drug-induced cholestasis. Role of metabolism: detoxification versus bioactivation, with cytochrome P450 enzymes, conjugation pathways (glucuronidation, sulfation, acetylation, glutathione conjugation), and formation of reactive metabolites. Oxidative stress: generation of reactive oxygen/nitrogen species, antioxidant defenses, and consequences for DNA, proteins, and lipids. Covalent binding of metabolites: protein and DNA adduct formation leading to toxicity and carcinogenesis. Mitochondrial toxicity: disruption of oxidative phosphorylation, ATP production, and ROS generation. Immune-mediated toxicity: xenobiotic-induced immunosuppression, hypersensitivity reactions, and idiosyncratic drug reactions (hapten theory, P-I hypothesis, altered peptide repertoire). Genetic and individual variability: polymorphisms in metabolic enzymes, inter- and intra-individual susceptibility, and species-specific differences. Nanosafety: risks related to nanoparticle exposure and immune responses.

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Voorbeeld van de inhoud

Molecular Toxicology
This book was obligatory for this course, and it was used to make this summary:

Boelsterli, U. A. (2007). Mechanistic Toxicology: The Molecular Basis of How Chemicals Disrupt
Biological Targets (2nd ed.). CRC Press. https://doi.org/10.1201/9780367806293

Introduction lecture Chapter 1 & 2
Molecular toxicology and mechanisms of toxicity are required to:

- Estimate risk of human toxicity after exposure to a potentially toxic compound
- Determine toxicity thresholds
- Develop antidotes against acute toxicity
- Development of safe pharmaceuticals
- Develop biomarkers for exposure or toxicity

What is needed for toxicity

- Too high exposure
- Interaction with essential target
- Lack of cell adaptation to the stimulus

Paracelsus’ philosophy: “all compounds are poisons, but it’s the dose that determines if
something is toxic” too much of anything is never good

Dose (+ intrinsic properties) of a compound determine toxicity

- LD50 -> lethal dose (after which an animal is diseased within 50% of exposed animals)
- Potency of a compound has to do with the target it interferes with, and the mechanism

Route of exposure determines toxicity

- Ricin, when administrerd orally, has a di]erent LD50 (need higher dose) then when
injected directly
- Has to do with first pass metabolism and absorption in the intestines

(Internal) exposure determines toxicity -> “all substances are poisons, it is the exposure (of the
target) that determines if a substance is toxic or not”

Toxicokinetic factors; what does the body do with the toxic compound? (ADME):

- Absorbtion
- Distribution
- Metabolism / (de)toxification
- Excretion
è Together this determines what the exposure of the target is to the ultimate toxicant (e.g.
metabolite)

,Metabolism can be seen as a detoxification pathway (metabolites are less toxic than parent
compound), but it can also be the other way around = bioactivation / toxification pathway (in
which the metabolites are more toxic

Threshold of toxicity
- mutagens do not have a threshold of toxicity (B could be mutagenic)

Toxicodynamic factors

- What is the target of this compound? (protein, phospholipid
membrane, mitochondria, DNA, cellular receptor?) & is this aspecific
or highly specific?

Specific: key-and-lock dynamics, antibody-antigens interactions
Aspecific: ROS

- What kind of interaction does the compound undergo with the
target? And what are downstream e]ects?
- ‘So what does the compound do to the body?’

Toxicokinetic factors and toxicodynamic factors (together) can explain:

- Species di]erences in toxicity
- Gender di]erences in toxicity (hormones)
- Organ-selective toxicity (tissue types, permeability, enzymes)
- Interindividual di]erences (genetics, illnesses, predisposition)
- Intraindividual di]erences (within the same person; age)



Brainstorm session

Toxicokinetics in Organ-selective toxicity have to do with the metabolic pathways in that organ
(e.g. presence of certain enzymes that bioactivate), and the function of the organ / tissues the
organ exists of (epithelial cells; perfusion).

Interindividual di]erences in toxicodynamics -> genetic di]erences; Di]erent blood types ->
reactions with antigens; microbiome; Age and disease -> altered metabolic or excretion
capabilities

Intraindividual di]erences (di]erent reactions within the same person, e.g. at a di]erent hour /
moment) -> e.g. pregnant women / di]erential receptor expression across ageing, diet, stress



Biological response: how does the body/cell react to a toxic insult?

- Adaptation (via stress response)
- Toxic response (leading to irreversible cell damage or cell death)
- Similar reactions can be provoked by di]erent types of stress (ischemia, hyperthermia,
oxidative stress, electrophile stress)

,Toxic response or adaptation?

- Is dependent on exposure (concentration and duration) of the toxicant
- Some toxicants reduce ability to respond to stress

Adaptation = ‘harm-induced capability of the organism for increased tolerance of
the harm itself’, by:

- Decreased delivery to the target
- Decreased size/concentration/susceptibility of the target
- Increased capacity for repair (e.g. DNA repair / increased proliferation of cells to replace
damaged cells)
- Compensation of dysfunction

Stress response -> adaptation is often accomplished by stress response reactions, for example:

- Electrophile stress response (nrf-2)
- Heat-shock protein response
- ER-stress response

All result in changes in gene expression
A stress response can also lead to autophagy and apoptosis

Hormesis = sign of adaptation caused by mild forms of stress -> leads to improved
performance e.g. by aquisition of tolerance -> the system now also works better

- E.g. increased DNA repair, anti-oxidant response through more Nrf-2 activity

In case of no adaptation toxic responses can occur, which can be:

- Cell death: necrosis, apoptosis (organ failure)
- Pharmacological / physiological e]ects
- Genotoxicity / mutagenicity
- Carcinogenicity
- Reproduction toxicity, incl. teratogenicity
- Neurotoxicity
- Immunotoxicity, sensitisation
- Irritation (skin, eye)
- Remodelling (fibrosis)

Toxicity vs. adverse drug reactions

Adverse drug reactions (ADR) are toxicity but at pharmaceutical dose levels (bijwerkingen)
(This is toxicity of drugs at normal doses, overdoses lead to intoxications)

- Type A: exaggerated pharmacological e]ect (ON target toxicity)

e.g. if you take two drugs, and the one interveres with the other / polymorphisms (e.g.
expression of CYP enzymes)

- Type B: not related to pharmacological e]ect, not predictable, specific to (some)
individuals (idiosyncreatic drug reactions)

, Some individuals have immune reactions to certain drugs; is very patient specific

- Type C: not related to pharmacological e]ect, often toxic metabolite, predictable (OFF
target toxicity)

e.g. the medicine against morning sickness in pregnancy -> lead to dysmorphia in babies;
probably an interaction with a receptor that is not the target

Adverse outcome pathway = describes etiology of adverse e]ect, from molecular initial event
(MIE) to organism / population response; this assumes a temporal sequence of events
From molecular events on the target to organ e]ects eventually




e.g. drug induced cholestasis = accumulation of bile salts in the liver as they can no longer
enter the bile bladder (look at slides)

- BSEP transports biles salts from the cells into the bile

- if BSEP is inhibited, this leads to bile accumulation in the liver -> inflammation -> apoptosis /
necrosis -> increased enzymes in liver -> cholastasis

Paracetamol is metabolised (bioactivated) by Cytochrome
p450 -> paracetamol now has a delta+ (in its NAPQI form,
electrophili) that can readily bind to cellular macromolecules,
leading to cell damage and cell death, primarily in the liver

BUT this NAPQI group can be detoxified by GSH (glutathione)
- GSH has a thiol (-SH) group on cysteine, wich is nucleophilic
- This -SH group reacts with the electrophilic NAPQI

Paracetamol can also be metabolized in two di]erent
manners in di]erent organs, which do not produce the ‘toxic’
NAPQI group, and can be excreted through urine
- glucuronidation & sulfation

Because there are su]icient detoxification pathways, paracetamol is safe to use (which means
that under its threshold use, it does not lead to toxicity)

Acrylamide -> it’s metabolite binds to DNA -> leading to liver carcinogenesis in rodents

In humans, the detoxification is more e]icient -> no direct danger
for human health at low concentrations

- glycidamine = toxic metabolite
- can be detoxified by GSH

Summary:
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