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Toxicological findings from 1587 civil aviation accident pilot fatalities, 1999-2003.

INTRODUCTION: The prevalence of drug and ethanol use in aviation is monitored by the Federal Aviation Administration (FAA). Under such monitoring, toxicological studies for the 1989-1993 and 1994-1998 periods indicated lower percentages of the presence of controlled substances (illegal drugs) than that of prescription and nonprescription (over-the-counter) drugs in aviation accident pilot fatalities. In continuation, a toxicological assessment was made for an additional period of 5 yr. METHODS: Biosamples from aviation accident pilot fatalities submitted to the FAA Civil Aerospace Medical Institute (CAMI) are analyzed, and those findings are stored in a database. This database was examined for the 1999-2003 period for the presence of controlled substances (Schedules I-V), prescription/nonprescription drugs, and ethanol in the fatalities. RESULTS: Out of 1629 fatal aviation accidents from which CAMI received biosamples, pilots were fatally injured in 1587 accidents. Drugs and/or ethanol were found in 830 (52%) of the 1587 fatalities. Controlled substances from Schedules I-II (SI-II) and Schedules III-V (SIII-V) were detected in 113 and 42 pilots, respectively. Prescription drugs were present in 315 pilots, nonprescription drugs in 259, and ethanol in 101. SI-II substances were detected in 5 of 122 first-class medical certificate-holding airline transport pilots. In addition to the controlled substances, many of the prescription/nonprescription drugs found in the fatalities have the potential for impairing performance. CONCLUSIONS: Findings from this study were consistent with those of two previous toxicological studies and support the FAA's programs aimed at reducing the usage of performance-impairing substances.

Accidents, Aviation↗

NTP technical report on the toxicology and carcinogenesis studies of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (CAS No. 1746-01-6) in female Harlan Sprague-Dawley rats (Gavage Studies).

DIOXIN TOXIC EQUIVALENCY FACTOR EVALUATION OVERVIEW: Polyhalogenated aromatic hydrocarbons such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) have the ability to bind to and activate the ligand-activated transcription factor, the aryl hydrocarbon receptor (AhR). Structurally related compounds that bind to the AhR and exhibit biological actions similar to TCDD are commonly referred to as "dioxin-like compounds" (DLCs). Ambient human exposure to DLCs occurs through the ingestion of foods containing residues of DLCs that bioconcentrate through the food chain. Due to their lipophilicity and persistence, once internalized, they accumulate in body tissue, mainly adipose, resulting in chronic lifetime human exposure. Since human exposure to DLCs always involves a complex mixture, the toxic equivalency factor (TEF) methodology has been developed as a mathematical tool to assess the health risk posed by complex mixtures of these compounds. The TEF methodology is a relative potency scheme that ranks the dioxin-like activity of a compound relative to TCDD, which is the most potent congener. This allows for the estimation of the potential dioxin-like activity of a mixture of chemicals based on a common mechanism of action involving an initial binding of DLCs to the AhR. The toxic equivalency of DLCs was nominated for evaluation because of the widespread human exposure to DLCs and the lack of data on the adequacy of the TEF methodology for predicting relative potency for cancer risk. To address this, the National Toxicology Program conducted a series of 2-year bioassays in female Harlan Sprague-Dawley rats to evaluate the chronic toxicity and carcinogenicity of DLCs and structurally related polychlorinated biphenyls (PCBs) and mixtures of these compounds. TCDD is not manufactured commercially other than for scientific research purposes. The main sources of TCDD releases into the environment are from combustion and incineration; metal smelting, refining, and processing; chemical manufacturing and processing; biological and photochemical processes; and existing reservoir sources that reflect past releases. TCDD (dioxin) was selected for study by the National Toxicology Program as a part of the dioxin TEF evaluation to assess the cancer risk posed by complex mixtures of polychlorinated dibenzodioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and PCBs. The dioxin TEF evaluation includes conducting multiple 2-year rat bioassays to evaluate the relative chronic toxicity and carcinogenicity of DLCs, structurally related PCBs, and mixtures of these compounds. While one of the aims of the dioxin TEF evaluation was a comparative analysis across studies, in this Technical Report, only the TCDD results are presented and discussed. TCDD was included because it is the reference compound for the dioxin TEF methodology. Female Harlan Sprague-Dawley rats were administered TCDD (at least 98% pure) in corn oil:acetone (99:1) by gavage for 14, 31, or 53 weeks or 2 years. Genetic toxicology studies were conducted in Salmonella typhimurium, L5178Y mouse lymphoma cells, cultured Chinese hamster ovary cells, Drosophila melanogaster, and mouse bone marrow cells. 2-YEAR STUDY: Groups of 81 or 82 female rats were administered 3, 10, 22, 46, or 100 ng TCDD/kg body weight in corn oil:acetone (99:1) by gavage, 5 days per week, for up to 105 weeks; a group of 81 vehicle control female rats received the corn oil/acetone vehicle alone. Up to 10 rats per group were evaluated at 14, 31, or 53 weeks. A stop-exposure group of 50 female rats was administered 100 ng/kg TCDD in corn oil:acetone (99:1) by gavage for 30 weeks and then just the vehicle for the remainder of the study. Survival of dosed groups was similar to that of the vehicle control group. Mean body weights of 100 ng/kg core study and stop-exposure groups were less than those of the vehicle control group after week 13 of the study. Mean body weights of 46 ng/kg rats were less than those of the vehicle controls during year 2 of the study, and those of 22 ng/kg rats were less than those of the vehicle controls the last 10 weeks of the study. THYROID HORMONE CONCENTRATIONS: Alterations in serum thyroid hormone levels were evaluated at the 14-, 31- and 53-week interim evaluations. At 14 weeks, there were significant decreases in serum total and free thyroxine (T4) levels and increases in serum total triiodothyronine (T3) and thyroid stimulating hormone (TSH). At 31 weeks, there were significant decreases in serum total and free T4 levels and increases in serum total T3 but no significant effect on TSH. At 53 weeks, there were significant decreases in serum total T4 levels and increases in serum total T3. There were no significant effects on total T4 or TSH levels. HEPATIC CELL PROLIFERATION DATA: To evaluate hepatocyte replication, analysis of labeling of replicating hepatocytes with 5-bromo-2'-deoxyuridine was conducted at the 14-, 31-, and 53-week interim evaluations. The hepatocellular labeling index was significantly higher in the 22 ng/kg group compared to vehicle controls at 14 weeks. At the 31-week interim evaluation, the labeling indices in hepatocytes were significantly higher in all dosed groups than in the vehicle controls. At 53 weeks, labeling indices were significantly higher in the 46 and 100 ng/kg groups than in the vehicle controls. CYTOCHROME P450 ENZYME ACTIVITIES: To evaluate the expression of known dioxin-responsive genes, CYP1A1-associated 7-ethoxyresorufin-O-deethylase (EROD) activity and CYP1A2-associated acetanilide-4-hydroxylase (A4H) activity were evaluated at 14, 31, and 53 weeks. In addition, pentoxyresorufin-O-deethylase (PROD) activity was analyzed. Hepatic EROD, PROD, and A4H activities were significantly higher in all dosed groups relative to vehicle controls at the 14-, 31-, and 53-week interim evaluations. Pulmonary EROD was also significantly higher in all dosed groups compared to vehicle controls at 14, 31, and 53 weeks. DETERMINATIONS OF TCDD CONCENTRATIONS IN TISSUES: The tissue disposition of TCDD was analyzed in the liver, lung, fat, and blood of all animals in each group at the 14-, 31-, and 53-week interim evaluations and in 10 animals per group at the end of the 2-year study (105 weeks). The highest concentrations of TCDD were observed in the liver, followed by fat tissue. Liver and fat tissue concentrations of TCDD increased with increasing doses of TCDD. No measurable concentrations of TCDD were observed in blood from vehicle control or treated rats at any of the interim evaluations. Mean levels of TCDD in the liver and fat in the 100 ng/kg group at the end of the 2-year study were 9.3 and 3.2 ng/g, respectively. In liver tissue from the stop-exposure group, TCDD concentrations were slightly higher than those observed in the 3 ng/kg group. In the stop-exposure group, TCDD concentrations in fat were below the limits of quantitation. PATHOLOGY AND STATISTICAL ANALYSES: Absolute and/or relative liver weights were increased at 14, 31, and 53 weeks, with more severe effects occurring in the higher dosed groups. Increased liver weights correlated with increased incidences of hepatocyte hypertrophy at 14, 31, and 53 weeks. Exposure led to a treatment-related increase in hepatic toxicity with a broad spectrum of lesions. Incidences and severities of lesions increased at higher doses and longer durations of exposure. The earliest effects were increased incidences and severities of hepatocyte hypertrophy at 14 weeks. At 2 years, there was a significant increase in toxic hepatopathy characterized by increased incidences of numerous nonneoplastic liver lesions including hepatocyte hypertrophy, multinucleated hepatocytes, altered hepatocellular foci, inflammation, pigmentation, diffuse fatty change, necrosis, portal fibrosis, oval cell hyperplasia, bile duct hyperplasia, bile duct cysts, cholangiofibrosis, and nodular hyperplasia At 2 years, the incidence of hepatocellular adenoma was significantly increased in the 100 ng/kg core study group. Dose-related increased incidences of cholangiocarcinoma were seen in core study rats administered 22 ng/kg or greater. The highest incidence of cholangiocarcinoma was seen in the 100 ng/kg core study group and included a significant number of animals with multiple cholangiocarcinomas. Two cholangiocarcinomas and two hepatocellular adenomas were seen in the 100 ng/kg stop-exposure group. Two hepatocholangiomas were seen in the 100 ng/kg core study group, and one cholangioma was seen in the 100 ng/kg stop-exposure group. In the lung, the incidence of cystic keratinizing epithelioma of the lung was significantly increased at 2 years in the 100 ng/kg core study group. Nonneoplastic effects in the lung included increased incidences of bronchiolar metaplasia. The incidence of gingival squamous cell carcinoma of the oral mucosa was significantly increased in the 100 ng/kg core study group at 2 years and was accompanied by an increased incidence of gingival squamous hyperplasia. At 2 years, the incidence of squamous cell carcinoma of the uterus in the 46 ng/kg group was significantly increased, and there were two squamous cell carcinomas in the 100 ng/kg stop-exposure group. At 2 years, one acinar adenoma and two acinar cell carcinomas of the pancreas were seen in the 100 ng/kg core study group; one acinar carcinoma was seen in the 100 ng/kg stop-exposure group. The incidences of acinar cell adenoma or carcinoma (combined) exceeded the historical vehicle control range. Nonneoplastic effects in the lung included acinar cytoplasmic vacuolization, chronic active inflammation, acinar atrophy, and arterial chronic active inflammation. (ABSTRACT TRUNCATED)

Animals↗

[Use of primary cultured hepatocytes for toxicology].

Toxicological studies using primary cultured hepatocytes were reviewed. Primary cultures of mature hepatocytes retain many liver functions and various hormonal responses for long term. Therefore, this system overcomes various limitations of another in vitro system using liver. Toxicological studies using primary cultured hepatocytes showed high correlation to in vivo studies, for example, in vitro screening of inducible chemicals of hepatitis, and unscheduled DNA synthesis activity, etc. But there still remain some shortcomings, for example, rapid loss of cytochrome P450 and other drug metabolizing enzymes. A number of attempts to modify culture conditions resulted in long term maintenance of these enzymes. Recently Guzelian and colleagues established that using matrigel coated dishes, primary cultured hepatocytes expressed highly and maintained cytochrome P450 and other specific genes for long periods like in vivo. In the future study using cultured hepatocytes, if it can culture more long term or subculture as maintenance liver functions, not only rodent hepatocytes but also human hepatocytes are more useful for toxicological assessments and screening of drugs for liver diseases.

Animal Testing Alternatives↗

Drugs involved in self-poisoning: verification by toxicological analysis.

During a two-month prospective survey in a metropolitan teaching hospital's accident and emergency department, 239 consecutive drug-related attendances (excluding admissions to hospital that were primarily alcohol related) were identified. This represented 2.6% of total attendances. Of the 199 patients who presented to hospital with self-poisoning, a biological specimen was obtained from 158 (79%) for toxicological analysis, thus providing reliable data on the drugs that were involved in the overdoses. The most common drug groups that were identified were barbiturate (51% of cases) and benzodiazepine (49%) agents, alcohol with other drugs (44%), cannabinoids (32%) and opiate analgesic drugs (25%). Quinalbarbitone and amylobarbitone (Tuinal) and oxazepam were the most common "single" preparations. The use of cannabis and alcohol and the use of several drugs concurrently were more common than in previously reported surveys of self-poisoning. Discrepancies between the purported drug consumption and the toxicological results were frequent; complete agreement occurred in only 35% of the cases. The TOXI-LAB system was an adequate method for toxicological analysis. However, for epidemiological studies an additional back-up method is recommended to verify the presence of some drugs such as barbiturate and benzodiazepine agents.

Alcohol Drinking↗

Changes in the pattern of drugs detected in a toxicology screen in an Upstate New York Hospital.

We analyzed the results from our clinical toxicology service over two consecutive 24-month periods from 1980 to 1983. The frequencies of drug or drugs detected, tabulated by patient and type of specimen submitted to the laboratory were studied. A toxicology screen or the identification of one drug was requested on 3328 patients in the 48 months of the study. Alcohol was the most frequently requested test--1221 requests in 1980 to 1981, and 627 in 1982 to 1983. Seventy-five percent of these requests were positive. Ethanol, in fact, accounted for 53 percent of all drugs detected in all specimens received. There were 989 requests for a drug screen (530 in 1980 to 1981, and 459 in 1982 to 1983) for which 1734 serum, urine, or gastric specimens were received. Serum or serum and urine were the most frequently submitted specimens. Gastric contents with or without a urine sample were sent least often. After alcohol, the most frequently detected drug classification was analgesic/antipyretic. The most dramatic change in prevalence was seen in over-the-counter stimulants which accounted for almost 11 percent of all drugs in 1982 to 1983, an increase from only 4 percent in 1980 to 1981. More than one drug per patient was found in 24 percent of the requests in 1982 to 1983; an increase from 18 percent in 1980 to 1981. We identified 81 different drug combinations in 1982 to 1983, up from 71 combinations in the first half of the study. Toxicology data may have significantly affected immediate therapy--either through the administration of an antidote or by initiation of aggressive intervention--in 7 percent of the patients whose specimens were analyzed in our laboratory. The laboratory technologist and the clinician should be cognizant of changing patterns of drug use to increase and maintain their effectiveness in the detection or treatment of drug intoxication. We have demonstrated that changes did occur in our facility over a 4-year period, and also when our data were compared to previous reports. Retrospective studies of this type are essential to meet those objectives.

Drug Combinations↗

[The animal experiment in toxicology. Current situation and further development].

In view of recent public reproaches against medical animal experimentation this article describes the present status of animal experimentation in the field of toxicology. Possible perspectives and the limitations of "alternative" methods are reviewed. Toxicological methods which are based on cell culture and metabolic in vitro-systems, as well as "short-term-tests" for mutagenicity and/or carcinogenicity are invaluable for screening purposes. However, a risk assessment, i.e., evaluation of hazard of chemical compounds to man, must be based on animal experiments. Further efforts must be directed towards improvement of extrapolation of toxicological results from one species to the other.

Animals↗

Clinical toxicology consultation by pharmacists.

The functions of pharmacists in a clinical toxicology consultation service are described. Pharmacists provided three basic services in conjunction with poisonings treated by the emergency department of a children's hospital: (1) assisted with obtaining the history and assessment of the toxicologic proglems, (2) recommended a plan for rational management, and (3) discussed poison prevention with the parents of the victims. Pharmacists were consulted for 189 poisoning cases over a six-month period; 80% of the cases were attended at the bedside and the remainder were monitored by telephone. Drugs were involved in 58% of the patient exposures. Median time for the pharmacist to reach the emergency room after the patient's arrival was 5 to 10 minutes. Physicians and nurses rated the pharmacists' contributions favorably. These results suggest that pharmacists can play an important role in clinical toxicology.

Adolescent↗

Toxicology test-ordering patterns in a large urban general hospital during five years: an update.

Analytical data from the clinical toxicology laboratory of a large urban hospital, the Los Angeles County--University of Southern California Medical Center, are reported for the year 1976 and are compared to similar data previously documented for the year 1972. Drugs assayed, number of tests requested, and number of positive results are collated. Data on 58 assays show that the overwhelming majority of the requests continue to be for those tests that were originally classified as tests with 4-h turn-around time in the patient-focused concept for a clinical toxicology service in 1972. Total workload increased by 70%. The number of patients on whom some toxicologic assay was requested doubled in spite of a decrease in the number of patients admitted to the hospital during this five-year period. The data show that assays for some socially and clinically significant drugs--ethanol diazepam, tricyclics, and phencyclidine--increased disproportionally while others remained relatively constant, or even decreased.

Amphetamines↗

Proficiency testing in forensic toxicology: a feasibility study.

This study has shown that a national proficiency testing program in forensic toxicology is feasible. Samples that resemble typical case specimens were prepared and shipped to approximately 100 laboratories. Participation varied between 61 and 73%. Tissue samples obtained from laboratory animals can be used to simulate those encountered by forensic toxicologists. This has been demonstrated using liver homogenates from animals administered pentobarbital and methaqualone and propoxyphene and acetaminophen. There was a large coefficient of variation however, for the quantitation of acetaminophen in liver. The qualitative data obtained during the course of this study showed a very low incidence of false positives. However, there was a disappointingly low percentage of positive responses for (a) low concentrations of secobarbital and (b) the opiate narcotics (morphine and codeine) in blood, despite the fact that sensitive immunoassay procedures are available for detecting these particular compounds in blood samples. The quantitative determination of drugs and metabolites, other than ethanol, shows wide interlaboratory variation. This variation is presumably not a result of the use of different analytical techniques, since gas liquid chromatography was used by the majority of participants to quantitate drugs and metabolites. Forensic toxicologists are willing to participate in a voluntary proficiency testing program conducted by an independent agency. The performance data developed in this study can serve as a baseline for current forensic toxicology laboratory functional capability in the assessment of future changes and improvements in analytical forensic toxicology.

Biotransformation↗

Analytical instrumentation in toxicology.

An ever-growing number of analytical instruments are appearing in forensic and toxicology laboratories. The demand for increased instrumentation has resulted from the rigid qualitative and quantitative requirements placed on the modern toxicologist, as well as from the need for control of the proliferation of toxic substances. This demand is definitely apparent in the toxicological investigation of aircraft accidents, with which the authors are currently concerned. The advent of microporcessor-controlled instrumentation plus an improvement in instrument reliability and efficiency has turned the traditional toxicology laboratory into a highly complex, electronic testing facility. The advantages of analytical instrumentation and the inherent dangers and precautions confronting the forensic scientist and the toxicologist will be presented.

Chromatography, Gas↗

[Current problems of clinical toxicology].

Information, toxicometry, and detoxication are the most pressing problems of present-day clinical toxicology. The author discusses some aspects in the information provision of a physician specialized in toxicology, creation of a toxicological data base, and systemic analysis making use of computer software. Special attention is paid to the assessment of methods of efferent therapy of poisonings, such as hemodialysis, hemosorption, physiohemotherapy, and their combinations.

Acute Disease↗

Genetic variation in outbred rats and mice and its implications for toxicological screening.

There are two basic types of laboratory rodent used in toxicological screening. Isogenic (inbred) strains are rather like clones of genetically identical individuals whereas outbred stocks are usually more variable, though the amount of variability depends on the previous history of the colony. In some cases outbred stocks may be genetically quite uniform. Many different strains of both types are available. Both types and a variety of strains are used for toxicological screening. There is clear evidence of important genetic variation both in spontaneous disease and in response to toxic agents, yet little account is taken of this in choosing suitable animals. Three options appear to be available. The first is to ignore genetic variation and use a single isogenic strain. However, if the strain happens to be insensitive to the test chemical, a toxic chemical may be judged to be relatively safe. The second option would be to synthesize a genetically heterogeneous stock by crossing two or more strains. However, this could lead to both increased false positive and false negative results as experimental "noise" either obscures true treatment effects, or is mistaken for a treatment effect. The third option is to use more than one strain, but without increasing the total number of animals used. This would provide a broad range of genotypes, so reducing the chance that they are all insensitive, without increasing experimental noise. This appears to be the only sensible way of broadening the genetic base in toxicological screening. Where strain differences are found, they may provide a tool for studying toxic mechanisms, which may be helpful in extrapolating to human populations.

Animals↗

Impact of pharmacogenetics on toxicological studies. Statistical implications.

Genetic differences in response to chemicals are probably ubiquitous. The implications of such genetic differences for the design of toxicological experiments is reviewed. The inclusion of genetic differences as factors in factorial experimental designs is illustrated by an experiment to investigate differences between inbred strains of mice in the length of anaesthesia following the administration of pentobarbitone to control and phenobarbitone pre-treated animals. The effects of including genetic differences as a factor in the standard toxicological studies such as the long-term rodent carcinogenicity bioassay (LTRCB) are reviewed. Such designs are likely to result in more chemicals being identified as carcinogens based upon the criteria of a positive result in the LTRCB. However, they are unlikely to provide any improvement in the estimation of risk to the human population from low level exposures to the chemicals because of the limitations of the existing extrapolation methods. Information on the degree of genetic variability in response to chemical exposure should, though, help in the more qualitative biologically-based risk assessment approaches favoured by some toxicologists. The presence of genetic differences in response also provides potential models for investigation of the mechanisms underlying toxicological responses.

Animals↗

[Health hazards due to industrial substances. A toxicologic environmental problem].

Work-site chemicals are substances which are employed in manufacturing industrial operations. Contact with such materials may present a hazard to health. Substantial hygienic significance is to be attached to the detection of such injurious potentials by experimental and theoretical toxicology. The preparation of toxicologic expertises on industrial materials presents many problems. The standard approach is to utilize scientific methods on the basis of defined experimental models and quantitative relationships. Judgment of the toxicologic relevance is guided by well-documented epidemiologic or experimental data and the study of case histories. After scientific validation the result is used in practice for setting threshold limit values (MAK's, MIK's) for occupational health purposes.

Environmental Exposure↗

Analytical toxicology: from environmental monitoring to residue analysis.

Analytical toxicology is more than analytical chemistry. Although it does imply much analytical work, it should not stop with a statement about the more or less accurate level of a certain chemical in some biological or ecological matrix. The toxicologist performing analytical toxicology has to make clear which conclusions can be drawn from his/her analysis, and maybe even more important, which conclusions cannot be drawn. Generally, the analytical toxicologist has to find the balance between a very reliable analysis (which is often quite laborious and expensive) and the time and money available for performing the analysis; often the two demands are contradictory. In future, particular attention has to be paid to the quality assurance of toxicological analyses, to a more international collaboration, and to the development of new analytical approaches.

Animals↗

[Industrial hygiene and toxicology at the hospital department of occupational medicine].

In the Hospital Services of Occupational health stated in Lombardy Region from seventies, among the other sections laboratories of Industrial Hygiene and Toxicology have been organized. These laboratories performed the routinary analyses and some of them deepened specific toxicological aspects (metals in Brescia, solvents in Pavia, neurotoxicants in Milan). During 1996 about 50,000 analytical determinations and several investigations and researches have been carried out. The laboratories, moreover, took active art in several national and international quality control programs. They might be identified therefore as reference units for promoting and controlling the analytical quality in Occupational Hygiene and Toxicology.

Hospital Units↗

The Drug Abuse Warning Network (DAWN) Program. Toxicologic verification of 1,008 emergency room 'mentions'.

One thousand eight emergency room patient records from which reports were contributed to the federal Drug Abuse Warning Network (DAWN) system from the Los Angeles County/University of Southern California Medical Center in 1977 were studied. The drugs reported to DAWN for these patients were compared with the available toxicology laboratory reports for some of these same patients. The purpose was to test the validity of the data reported to DAWN. Toxologic analyses had been performed on only 528 patients (52%) of the entire sample. Eighty percent of these tested had some positive toxicology result. The DAWN reports were verified in 20% of the tested sample, found to be incorrect in 11%, and partially correct or partially incorrect in 69%. Drugs identified toxicologically had varied concentrations, some below or within therapeutic range and some at toxic levels. This study suggests that the reliability of DAWN REPORTS SHOULD BE TESTed prospectively in an unbiased definitive material study.

Alcohol Drinking↗

Single cell gel/comet assay: guidelines for in vitro and in vivo genetic toxicology testing.

Atthe International Workshop on Genotoxicity Test Procedures (IWGTP) held in Washington, DC, March 25-26, 1999, an expert panel met to develop guidelines for the use of the single-cell gel (SCG)/Comet assay in genetic toxicology. The expert panel reached a consensus that the optimal version of the Comet assay for identifying agents with genotoxic activity was the alkaline (pH > 13) version of the assay developed by Singh et al. [1988]. The pH > 13 version is capable of detecting DNA single-strand breaks (SSB), alkali-labile sites (ALS), DNA-DNA/DNA-protein cross-linking, and SSB associated with incomplete excision repair sites. Relative to other genotoxicity tests, the advantages of the SCG assay include its demonstrated sensitivity for detecting low levels of DNA damage, the requirement for small numbers of cells per sample, its flexibility, its low costs, its ease of application, and the short time needed to complete a study. The expert panel decided that no single version of the alkaline (pH > 13) Comet assay was clearly superior. However, critical technical steps within the assay were discussed and guidelines developed for preparing slides with agarose gels, lysing cells to liberate DNA, exposing the liberated DNA to alkali to produce single-stranded DNA and to express ALS as SSB, electrophoresing the DNA using pH > 13 alkaline conditions, alkali neutralization, DNA staining, comet visualization, and data collection. Based on the current state of knowledge, the expert panel developed guidelines for conducting in vitro or in vivo Comet assays. The goal of the expert panel was to identify minimal standards for obtaining reproducible and reliable Comet data deemed suitable for regulatory submission. The expert panel used the current Organization for Economic Co-operation and Development (OECD) guidelines for in vitro and in vivo genetic toxicological studies as guides during the development of the corresponding in vitro and in vivo SCG assay guidelines. Guideline topics considered included initial considerations, principles of the test method, description of the test method, procedure, results, data analysis and reporting. Special consideration was given by the expert panel to the potential adverse effect of DNA degradation associated with cytotoxicity on the interpretation of Comet assay results. The expert panel also discussed related SCG methodologies that might be useful in the interpretation of positive Comet data. The related methodologies discussed included: (1) the use of different pH conditions during electrophoreses to discriminate between DNA strand breaks and ALS; (2) the use of repair enzymes or antibodies to detect specific classes of DNA damage; (3) the use of a neutral diffusion assay to identify apoptotic/necrotic cells; and (4) the use of the acellular SCG assay to evaluate the ability of a test substance to interact directly with DNA. The alkaline (pH > 13) Comet assay guidelines developed by the expert panel represent a work in progress. Additional information is needed before the assay can be critically evaluated for its utility in genetic toxicology. The information needed includes comprehensive data on the different sources of variability (e.g., cell to cell, gel to gel, run to run, culture to culture, animal to animal, experiment to experiment) intrinsic to the alkaline (pH > 3) SCG assay, the generation of a large database based on in vitro and in vivo testing using these guidelines, and the results of appropriately designed multilaboratory international validation studies.

Animals↗