1 567 138 BASIC PROPERTIES AND MOLECULAR MECHANISMS OF EXOGENOUS CHEMICAL CARCINOGENS. EXOGENOUS CHEMICAL CARCINOGENESIS IS AN EXTREMELY COMPLEX MULTIFACTORIAL PROCESS DURING WHICH GENE-ENVIRONMENT INTERACTIONS INVOLVING CHRONIC EXPOSURE TO EXOGENOUS CHEMICAL CARCINOGENS (ECCS) AND POLYMORPHISMS OF CANCER SUSCEPTIBILITY GENES ADD FURTHER COMPLEXITY. WE DESCRIBE THE PROPERTIES AND MOLECULAR MECHANISMS OF ECCS THAT CONTRIBUTE TO INDUCE AND GENERATE CANCER. A BASIC AND SPECIFIC PROPERTY OF MANY LIPOPHILIC ORGANIC ECCS INCLUDING POLYCYCLIC AROMATIC HYDROCARBONS AND POLYHALOGENATED AROMATIC HYDROCARBONS IS THEIR ABILITY TO BIOACCUMULATE IN THE ADIPOSE TISSUE FROM WHERE THEY MAY BE RELEASED IN THE BLOOD CIRCULATION AND TARGET PERIPHERAL TISSUES FOR CARCINOGENESIS. MANY ORGANIC ECCS ARE PROCARCINOGENS AND CONSEQUENTLY NEED TO BE ACTIVATED BY THE CYTOCHROME P450 (CYP) SYSTEM AND/OR OTHER ENZYMES BEFORE THEY CAN ADDUCT DNA AND PROTEINS. BECAUSE THEY CONTRIBUTE NOT ONLY TO THE COCARCINOGENIC AND PROMOTING EFFECTS OF MANY AROMATIC POLLUTANTS BUT ALSO TO THEIR MUTAGENIC EFFECTS, THE ARYL HYDROCARBON RECEPTOR-ACTIVATING AND THE INDUCIBLE CYP SYSTEMS ARE CENTRAL TO EXOGENOUS CHEMICAL CARCINOGENESIS. ANOTHER BASIC PROPERTY OF ECCS IS THEIR ABILITY TO INDUCE STABLE AND BULKY DNA ADDUCTS THAT CANNOT BE SIMPLY REPAIRED BY THE DIFFERENT REPAIR SYSTEMS. IN ADDITION, FOLLOWING ECC EXPOSURE, MUTAGENESIS MAY ALSO BE CAUSED INDIRECTLY BY FREE-RADICAL PRODUCTION AND BY EPIGENETIC ALTERATIONS. AS A RESULT OF COMPLEX MOLECULAR INTERPLAYS, DIRECT AND/OR INDIRECT MUTAGENESIS MAY ESPECIALLY ACCOUNT FOR THE CARCINOGENIC EFFECTS OF MANY EXOGENOUS METALS AND METALLOIDS. BECAUSE OF THESE MOLECULAR PROPERTIES AND ACTION MECHANISMS, WE CONCLUDE THAT ECCS COULD BE MAJOR CONTRIBUTORS TO HUMAN CANCER, WITH OBVIOUSLY GREAT PUBLIC HEALTH CONSEQUENCES. 2010 2 1407 36 DIETARY INFLUENCES ON MUTAGENESIS--WHERE IS THIS FIELD GOING? EARLY STUDIES ON DIETARY MUTAGENESIS WERE MOSTLY OBSERVATIONAL, WITH LARGE NUMBERS OF POTENTIAL DIETARY MUTAGENS BEING IDENTIFIED FROM EVERY CONCEIVABLE DIETARY SOURCE. THESE INCLUDED KNOWN DIETARY CARCINOGENS SUCH AS AFLATOXIN B1 AND BENZO[A]PYRENE, AND HITHERTO UNRECOGNIZED DIETARY MUTAGENS, SUCH AS THE PYROLYSIS PRODUCTS FORMED DURING THE HEATING OF PROTEINACEOUS MATERIALS (HETEROCYCLIC AMINES). THE 1993 EVALUATION OF 2-AMINO-3-METHYL-3H-IMIDAZO(4,5-J)QUINOLINE AS A PROBABLE HUMAN CARCINOGEN BY THE INTERNATIONAL AGENCY FOR RESEARCH ON CANCER WAS A LANDMARK, AS THIS WAS DONE IN THE ABSENCE OF SPECIFIC HUMAN CARCINOGENICITY DATA, AND STRONGLY INFLUENCED BY MUTAGENICITY TEST DATA. IN THE 21ST CENTURY, THE FIELD HAS MOVED FROM THE IDENTIFICATION OF MORE AND MORE MUTAGENS, TO MOLECULAR EPIDEMIOLOGIC APPROACHES THAT NOT ONLY SHOW A MUTAGENIC EFFECT BUT ALSO SEEK TO LINK IT TO A DIETARY (OR ENVIRONMENTAL) CAUSE. EFFECTS OF DIET IN STIMULATING CHRONIC INFLAMMATION MAY LEAD TO REACTIVE SPECIES AND THEREBY MUTATION AS A SECONDARY CONSEQUENCE, WHILE DIETARY DEFICIENCIES AND NUTRIENT IMBALANCES MAY BE STRONG SOURCES OF MUTAGENESIS. RECOGNITION OF THE ROLES OF NUTRIENTS IN CELL SIGNALING PROCESSES AND CONTROL OF MICRORNAS SUGGEST MAJOR INFLUENCES ON GENE EXPRESSION, IN THE ABSENCE OF PERMANENT DNA CHANGES. GENOME-WIDE ASSOCIATION STUDIES HAVE HIGHLIGHTED NEW PATHWAYS SUCH AS JAK/STAT SIGNALING THAT PROFOUNDLY INFLUENCE GENOMIC INSTABILITY AND RESPONSES TO DIETARY MUTAGENS. WITH IMPROVED METHODOLOGIES FOR DNA SEQUENCING AND EPIGENETIC CHANGES, IT IS TIME TO APPLY MORE SOPHISTICATED APPROACHES TO RECOGNIZING AND PROVING THE ROLE OF DIET AS A PRIMARY MODULATOR OF MUTAGENESIS IN HUMANS. 2010 3 3934 47 LIVER TUMOR INDUCTION. THE SIGNIFICANCE OF THE DEVELOPMENT OF NODULAR LIVER LESIONS IN RODENTS FOLLOWING THE ADMINISTRATION OF TEST AGENTS RAISES SEVERAL QUESTIONS WHICH COULD BE PLACED IN ONE OF TWO GENERAL CATEGORIES: DIAGNOSTIC AND INTERPRETATIONAL. FROM A DIAGNOSTIC POINT OF VIEW, THE PROPER CLASSIFICATION OF LIVER TUMORS INTO A BENIGN AND MALIGNANT CATEGORY HAS TO BE BASED ON THE DIRECT CORRELATION BETWEEN THE MORPHOLOGY AND THE BIOLOGIC BEHAVIOR OF THE LESIONS. THEREFORE, EXTREME CARE SHOULD BE TAKEN TO SEPARATE THE MALIGNANT TUMORS FROM THE BENIGN AND THE BENIGN NEOPLASIA FROM THE HYPERPLASIA. THE SUBSTITUTION OF THE TERM "NEOPLASTIC NODULE" FOR HYPERPLASTIC NODULE IN RATS IS MISLEADING. MOST OF THESE NODULES, WHEN INDUCED UNDER SPECIAL EXPERIMENTAL CONDITIONS, MAY REGRESS OR REMODEL AND THUS THEY ARE NOT NEOPLASTIC IN NATURE. CHRONIC CARCINOGENICITY BIOASSAYS SHOULD INCLUDE "STOP" TYPE OF TREATMENT LEAVING ENOUGH OF THE OBSERVATIONAL TIME TO ESTABLISH THE FATE OF INDUCED NODULAR LESIONS. THE INDUCTION OF HISTOCHEMICALLY CHANGED FOCI CAN SERVE ONLY AS AN INDICATION OF POTENTIAL HEPATOCARCINOGENICITY AND SHOULD NOT BE EQUATED WITH THE INDUCTION OF BONA FIDE CANCER. THE BIOLOGIC INTERPRETATION OF NODULAR LIVER LESIONS, ESPECIALLY IN MICE, NEEDS FURTHER SCRUTINY BECAUSE THESE LESIONS HAVE A TENDENCY TO DEVELOP SPONTANEOUSLY WITH HIGH INCIDENCE IN SOME STRAINS. THIS CHARACTERISTIC THEN RAISES THE QUESTION AS TO THE MECHANISM BY WHICH VARIOUS AGENTS AUGMENT AND/OR ACCELERATE THE DEVELOPMENT OF SUCH TUMORS. IS THIS ACTION PRIMARILY PROMOTING OR INITIATING IN NATURE OR DOES IT REPRESENT THE INDUCTION OF TUMORS DE NOVO? THE ANSWER TO THIS DILEMMA MAY HAVE A DECISIVE BEARING ON CARCINOGENIC RISK ASSESSMENT AND THE TYPE OF REGULATORY ACTION, SINCE THE PROMOTING AGENTS POSSESS A THRESHOLD EFFECT AND THE PROMOTED CHANGES MAY REGRESS FOLLOWING WITHDRAWAL OF TREATMENT. THE INTERPRETATION OF HEPATOCARCINOGENESIS IS FURTHER COMPLICATED BY THE FACT THAT SEVERAL FACTORS, SUCH AS SEX HORMONAL ENVIRONMENT, INCREASED MITOTIC ACTIVITY FOLLOWING AN EXCESSIVE LOSS OF PARENCHYMAL CELLS, DEGREE OF CALORIC INTAKE, ENZYMATIC COMPLEMENT, AND ANIMALS' AGE AT THE TIME OF THE EXPOSURE TO A TEST AGENT, MAY INFLUENCE THE OUTCOME OF LIVER TUMOR DEVELOPMENT BY MODULATING "INITIATION" AND/OR "PROMOTION" OF CARCINOGENESIS. BROAD FLUCTUATION IN THE HISTORIC INCIDENCE OF LIVER TUMORS FURTHER COMPOUNDS THE COMPLEXITY OF THE PROPER BIOASSAY INTERPRETATION. THE SPECIFICALLY DESIGNED EXPERIMENTS MAY HAVE THE OBJECTIVE TO EXPLORE PREDOMINANTLY THE INITIATING OR PROMOTING EFFECTS OF THE AGENT. SUCH PROTOCOLS SHOULD BE USED WHENEVER NECESSARY TO DIFFERENTIATE BETWEEN THESE TWO MECHANISMS OF ACTION. IN THE CAUCASIANS, THE "SPONTANEOUS" DEVELOPMENT OF THE PRIMARY HEPATOCELLULAR TUMORS IS RARE. THE MAJORITY OF THESE TUMORS ARE MALIGNANT AND RAPIDLY FATAL. ACCORDING TO SOME HUMAN PATHOLOGISTS, THE BENIGN VARIETY OF LIVER TUMORS IS RARE AND IT DOES NOT REPRESENT NECESSARILY A PREMALIGNANT STAGE IN TUMOR DEVELOPMENT. CARCINOMA OF THE LIVER MAY OCCUR IN INFANCY, ESPECIALLY IN MALES BEFORE THE AGE OF 2 YEARS. THIS SUGGESTS A GENETIC CAUSATION OR CARCINOGENIC EXPOSURE IN UTERO. ONE OF THE GEOGRAPHIC FACTORS WHICH SIGNIFICANTLY ENHANCES THE INCIDENCE OF HEPATOCELLULAR CARCINOMA IN HUMANS IS EXPOSURE TO AFLATOXIN B(1) WHICH IS APPARENTLY POTENTIATED BY CONCURRENT LIVER CIRRHOSIS. BECAUSE MANY MORE AGENTS HAVE BEEN FOUND TO BE HEPATOCARCINOGENIC IN MICE AND RATS THAN IN MEN, A QUESTION ARISES AS TO THE DIRECT RELEVANCE OF RODENT STUDIES TO HUMANS. A BALANCED ASSESSMENT OF THE CARCINOGENICITY OF THE AGENT COULD ONLY BE REACHED IN CONSIDERING BOTH THE PHARMACOKINETICS AND THE DEVELOPMENT OF MALIGNANT NEOPLASIA IN OTHER ORGANS. IN THE CASE OF POSITIVE CARCINOGENICITY ASSESSMENT, THE OUTCOME OF THE MUTAGENICITY BIOASSAYS CAN SUGGEST GENIC (GENOTOXIC) OR PARAGENIC (EPIGENETIC) MODE OF ACTION IN MAMMALIAN SYSTEMS. 1982 4 5493 27 REVIEW OF IN VITRO TEST SYSTEMS USING DNA DAMAGE AND REPAIR FOR SCREENING OF CHEMICAL CARCINOGENS. CHEMICAL CARCINOGENS ARE MECHANISTICALLY CLASSIFIED AS GENOTOXIC WHICH INTERACT DIRECTLY WITH DNA, AND EPIGENETIC WHICH CAUSE CHRONIC TISSUE INJURY, HORMONAL IMBALANCE, AND PROMOTIONAL EFFECTS. THIS REVIEW EVALUATES IN VITRO TESTS FOR THEIR CONTRIBUTION TO A BATTERY FOR IDENTIFYING GENOTOXIC CHEMICAL CARCINOGENS. IN ADDITION TO BACTERIAL MUTAGENIC ASSAYS, NONSPECIFIC DNA DAMAGE/REPAIR TESTS ARE RECOMMENDED FOR SCREENING CHEMICALS, IN PARTICULAR THE HEPATOCYTE PRIMARY CULTURE/DNA REPAIR TEST. 1979 5 2961 37 GENETIC AND EPIGENETIC MECHANISMS IN METAL CARCINOGENESIS AND COCARCINOGENESIS: NICKEL, ARSENIC, AND CHROMIUM. CHRONIC EXPOSURE TO NICKEL(II), CHROMIUM(VI), OR INORGANIC ARSENIC (IAS) HAS LONG BEEN KNOWN TO INCREASE CANCER INCIDENCE AMONG AFFECTED INDIVIDUALS. RECENT EPIDEMIOLOGICAL STUDIES HAVE FOUND THAT CARCINOGENIC RISKS ASSOCIATED WITH CHROMATE AND IAS EXPOSURES WERE SUBSTANTIALLY HIGHER THAN PREVIOUSLY THOUGHT, WHICH LED TO MAJOR REVISIONS OF THE FEDERAL STANDARDS REGULATING AMBIENT AND DRINKING WATER LEVELS. GENOTOXIC EFFECTS OF CR(VI) AND IAS ARE STRONGLY INFLUENCED BY THEIR INTRACELLULAR METABOLISM, WHICH CREATES SEVERAL REACTIVE INTERMEDIATES AND BYPRODUCTS. TOXIC METALS ARE CAPABLE OF POTENT AND SURPRISINGLY SELECTIVE ACTIVATION OF STRESS-SIGNALING PATHWAYS, WHICH ARE KNOWN TO CONTRIBUTE TO THE DEVELOPMENT OF HUMAN CANCERS. DEPENDING ON THE METAL, ASCORBATE (VITAMIN C) HAS BEEN FOUND TO ACT EITHER AS A STRONG ENHANCER OR SUPPRESSOR OF TOXIC RESPONSES IN HUMAN CELLS. IN ADDITION TO GENETIC DAMAGE VIA BOTH OXIDATIVE AND NONOXIDATIVE (DNA ADDUCTS) MECHANISMS, METALS CAN ALSO CAUSE SIGNIFICANT CHANGES IN DNA METHYLATION AND HISTONE MODIFICATIONS, LEADING TO EPIGENETIC SILENCING OR REACTIVATION OF GENE EXPRESSION. IN VITRO GENOTOXICITY EXPERIMENTS AND RECENT ANIMAL CARCINOGENICITY STUDIES PROVIDED STRONG SUPPORT FOR THE IDEA THAT METALS CAN ACT AS COCARCINOGENS IN COMBINATION WITH NONMETAL CARCINOGENS. COCARCINOGENIC AND COMUTAGENIC EFFECTS OF METALS ARE LIKELY TO STEM FROM THEIR ABILITY TO INTERFERE WITH DNA REPAIR PROCESSES. OVERALL, METAL CARCINOGENESIS APPEARS TO REQUIRE THE FORMATION OF SPECIFIC METAL COMPLEXES, CHROMOSOMAL DAMAGE, AND ACTIVATION OF SIGNAL TRANSDUCTION PATHWAYS PROMOTING SURVIVAL AND EXPANSION OF GENETICALLY/EPIGENETICALLY ALTERED CELLS. 2008 6 835 40 CHEMICAL CARCINOGEN MECHANISMS OF ACTION AND IMPLICATIONS FOR TESTING METHODOLOGY. CHEMICAL CARCINOGENS ARE OF TWO DISTINCT TYPES, DNA-REACTIVE AND EPIGENETIC. TESTING METHODOLOGY CAN BE DIRECTED TOWARD DETECTING EFFECTS OF BOTH TYPES OF CARCINOGEN. CARCINOGENS OF THE DNA-REACTIVE TYPE ARE DEFINED BY THE FORMATION OF COVALENTLY BOUND DNA ADDUCTS. THESE CHEMICALS HAVE STRUCTURES THAT YIELD ELECTROPHILIC REACTANTS EITHER DIRECTLY OR AFTER BIOACTIVATION. THESE AGENTS CAUSE GENOMIC ALTERATION IN THE STRUCTURE OR FUNCTION OF DNA IN THE TARGET CELL. IN ADDITION, THESE COMPOUNDS CAN EXERT OTHER CELLULAR AND TISSUE EPIGENETIC EFFECTS, SUCH AS CELL PROLIFERATION AND GROWTH PROMOTION. CARCINOGENS OF THE EPIGENETIC (PARAGENETIC) TYPE, IN CONTRAST, DO NOT REACT WITH DNA, BUT RATHER DISPLAY CELLULAR EFFECTS SUCH AS NEOPLASM GROWTH PROMOTION, CYTOTOXICITY, INHIBITION OF TISSUE GROWTH REGULATION, PEROXISOME PROLIFERATION, ENDOCRINE MODIFICATION, IMMUNOSUPPRESSION AND/OR SUSTAINED TISSUE ISCHEMIA THAT CAN BE THE BASIS FOR INCREASES IN NEOPLASIA. THEIR CHEMICAL STRUCTURE IS SUCH THAT THEY DO NOT GIVE RISE TO A REACTIVE ELECTROPHILE. THE TESTING METHODOLOGIES TO IDENTIFY EITHER TYPE FOLLOW A DECISION POINT APPROACH DESIGNED TO IDENTIFY POTENTIAL CARCINOGENICITY AND YIELD MECHANISTIC INFORMATION ON THE PRODUCTION OF EFFECTS THAT UNDERLIE CARCINOGENICITY. IT HAS 5 STAGES FOCUSING ON THE CHEMICAL STRUCTURE, DNA-REACTIVITY, EPIGENETIC EFFECTS, LIMITED BIOASSAYS AND FINALLY THE APPLICATION OF THE ACCELERATED BIOASSAY (ABA). ABA REQUIRES 40 WEEKS AND APPLIES THE USE OF SENSITIVE MARKERS FOR INDUCTION OF NEOPLASIA IN COMPARISON TO POSITIVE CONTROL COMPOUNDS FOR IMPORTANT ORGANS IN HUMAN CARCINOGENESIS. IT ENABLES DATA ACQUISITION OF THE ENTIRE CARCINOGENIC PROCESS DIRECTED TOWARD DEVELOPING MECHANISTIC INFORMATION. THE ABA HAS THE POTENTIAL TO REPLACE THE CHRONIC BIOASSAY IN RODENTS IN SOME CIRCUMSTANCES AND CAN SERVE AS AN ALTERNATIVE TO A CHRONIC BIOASSAY IN A SECOND SPECIES. 1996 7 6296 36 THE PROSPECTS FOR A SIMPLIFIED AND INTERNATIONALLY HARMONIZED APPROACH TO THE DETECTION OF POSSIBLE HUMAN CARCINOGENS AND MUTAGENS. IT IS PROPOSED THAT THE MANY SETS OF REGULATORY GUIDELINES FOR THE ASSESSMENT OF CHEMICAL CARCINOGENICITY AND MUTAGENICITY SHOULD BE SIMPLIFIED AND HARMONIZED IN LIGHT OF CURRENT EXPERIMENTAL DATA. DATA ARE DISCUSSED WHICH ILLUSTRATE THAT AN ABSOLUTE DISTINCTION WOULD BE DRAWN BETWEEN ASSAYS CONDUCTED IN VITRO FROM THOSE IN VIVO, AND THAT THE GENOTOXICITY OF A CHEMICAL CAN BE ADEQUATELY DEFINED USING A COMBINATION OF THE SALMONELLA MUTATION ASSAY AND ONE FOR THE ASSESSMENT OF CHROMOSOME ABERRATIONS IN VITRO. IT IS SPECIFICALLY RECOMMENDED THAT ONCE A CHEMICAL HAS SHOWN A CLEAR POSITIVE RESPONSE IN VITRO, FURTHER SHORT-TERM ASSAYS SHOULD BE CONDUCTED IN VIVO; THIS AVOIDS CONSIDERING THE 'WEIGHT OF EVIDENCE' OF IN VITRO DATA, THE DANGERS OF WHICH ARE ILLUSTRATED. IT HAS NOW BEEN UNEQUIVOCALLY ESTABLISHED THAT NOT ALL IN VITRO GENOTOXINS PROVE CARCINOGENIC TO MAMMALS. IT IS THEREFORE RECOMMENDED THAT ALL NEW IN VITRO GENOTOXINS SHOULD BE ASSESSED IN VIVO USING THE MOUSE BONE MARROW MICRONUCLEUS ASSAY, AND IF A NEGATIVE RESPONSE IS OBSERVED, A LIVER GENOTOXICITY TEST. AT PRESENT AN ASSAY FOR THE INDUCTION OF UNSCHEDULED DNA SYNTHESIS (UDS) IN THE LIVER IS THE MOST WELL DEVELOPED FOR THIS PURPOSE. CURRENT DATA INDICATE THAT AN IN VITRO GENOTOXIN FOUND TO BE INACTIVE IN THESE TWO IN VIVO ASSAYS WILL BE NEITHER CARCINOGENIC NOR MUTAGENIC TO THE GERM CELLS OF MAMMALS. EQUALLY, GENOTOXICITY PRODUCED IN MAMMALS INDICATES A CARCINOGENIC AND MUTAGENIC POTENTIAL WHICH CAN USUALLY ONLY BE COUNTERED BY APPROPRIATE CHRONIC BIOASSAYS. THE USE OF SHORT-TERM IN VIVO ASSAYS IN THIS CRITICAL ROLE REQUIRES ATTENTION TO THE SELECTION OF APPROPRIATE DOSE-LEVELS AND ROUTES OF EXPOSURE - THESE ISSUES ARE DISCUSSED. THE ABOVE TESTING STRATEGY WILL NOT DETECT CERTAIN ANIMAL CARCINOGENS, SOME OF WHICH ARE SPECIFICALLY DISCUSSED. THESE CARCINOGENS HAVE BEEN VARIOUSLY REFERRED TO IN THE LITERATURE AS EPIGENETIC/NON-GENOTOXIC/HORMONAL/TOXIC/AMBIGUOUS OR AMBIVALENT CARCINOGENS. IT IS SUGGESTED THAT THEY PRESENT A MINOR POTENTIAL HAZARD TO MAN WHEN COMPARED WITH THAT OF GENOTOXIC CARCINOGENS AND THAT THEIR SHORT-TERM DETECTION CAN ONLY BE ACHIEVED BY THE DEVELOPMENT OF NEW WHOLE MAMMAL ASSAYS EMPLOYING NON-GENETIC ENDPOINTS. THIS IS IN CONTRAST TO THE PRESENT TENDENCY TO EMPLOY ADDITIONAL GENOTOXICITY ASSAYS FOR THEIR DETECTION IN THE UNJUSTIFIED BELIEF THAT THEY POSSESS AN EXQUISITE SPECIFICITY OF GENOTOXIC ACTION. THIS ARTICLE REPRESENTS A PERSONAL VIEW, BUT THE TESTING STRATEGY PROPOSED IS BASED TO A LARGE EXTENT ON THE ORIGINAL THREE-TIER APPROACH OF BRIDGES.(ABSTRACT TRUNCATED AT 400 WORDS) 1986 8 495 38 ASSESSMENT OF THE HEALTH EFFECTS OF TRICHLOROETHYLENE. THE EPIDEMIOLOGICAL STUDIES PERFORMED THUS FAR HAVE PRESENTED ONLY LIMITED EVIDENCE FOR THE CARCINOGENICITY OF TRICHLOROETHYLENE (TRI) TO HUMANS. HOWEVER, THESE STUDIES HAD DRAWBACKS SUCH AS INSUFFICIENT SIZE OF COHORT, SHORT OBSERVATION PERIOD, AND INADEQUATE TRI EXPOSURE ASSESSMENT; THEREFORE, NO CONCRETE CONCLUSION HAS BEEN REACHED CONCERNING TRI CARCINOGENICITY TO HUMANS. DESPITE THE LIMITED EPIDEMIOLOGICAL EVIDENCE AS TO THE CARCINOGENICITY OF TRI, THE INTERNATIONAL AGENCY FOR RESEARCH ON CANCER (IARC) HAS CHANGED THE CARCINOGENICITY CLASSIFICATION OF TRI FROM GROUP 3 (NOT CLASSIFIABLE AS TO CARCINOGENICITY TO HUMANS) TO GROUP 2A (PROBABLY CARCINOGENIC TO HUMANS). IN REGARD TO THE NEW CLASSIFICATION BY THE IARC, THE COMMITTEE FOR OCCUPATIONAL EXPOSURE LIMITS OF THE JAPAN SOCIETY FOR OCCUPATIONAL HEALTH HAS MADE A PROPOSAL THAT IT IS TOO EARLY TO CLASSIFY THE CARCINOGENICITY OF TRI AS GROUP 2A AND THAT IT IS PROPER TO PROMOTE EXPOSURE CONTROL WITH THE CARCINOGENICITY BEING CLASSIFIED AS 2B FOR THE MOMENT. THERE ARE SPECIES DIFFERENCES IN TRI CARCINOGENICITY, PARTICULARLY BETWEEN RATS AND MICE. ALTHOUGH EXPERIMENTAL STUDIES HAVE FOUND NO EVIDENCE THAT TRI INDUCES LIVER CANCER IN RATS, THERE IS AMPLE EVIDENCE THAT TRI PROMOTES THE DEVELOPMENT OF LIVER CANCER IN MICE, PARTICULARLY IN B6C3F1 MICE. THE CARCINOGENICITY OF TRI IN THIS STRAIN OF MICE MAY BE BASED ON AN EPIGENETIC MECHANISM RATHER ON A GENOTOXIC MECHANISM AND THE LIVER CANCER MAY BE INDUCED ONLY AFTER TRI HAS BEEN INHALED FOR A LONG PERIOD OF TIME AT CONCENTRATIONS HIGH ENOUGH TO CAUSE CYTOTOXICITY. CONVERSELY, WITH NO REPORTS SHOWING TRI-INDUCED RENAL TUMORS IN MICE, THE POSSIBILITY HAS BEEN SUGGESTED THAT THIS CHEMICAL INDUCES SUCH TUMORS IN MALE RATS. THE SPECIES DIFFERENCES ARE MAINLY ACCOUNTED FOR BY DIFFERENCES IN THE METABOLISM OF TRI BETWEEN RATS AND MICE. FROM A GENERAL SURVEY OF THE LITERATURE, IT CAN BE CONCLUDED THAT TRI ITSELF IS NOT MUTAGENIC. HOWEVER, THE CONJUGATION OF TRI WITH GLUTATHIONE (GSH), A MINOR PATHWAY OF TRI METABOLISM, RESULTS IN MUTAGENIC METABOLITES IN THE KIDNEY OF RATS. THE ACUTE TOXICITY OF TRI IS NEUROTOXICITY BASED ON ITS ANESTHETIC ACTION. AN EXPOSURE TO EXTREMELY HIGH LEVELS OF TRI MAY CAUSE THE LIVER AND KIDNEY DISORDERS. REPEATED EXPOSURES TO HIGH LEVELS OF TRI MAY RESULT IN NEURO-, HEPATO-, AND/OR NEPHROTOXICITY. THE MAIN SYMPTOMS APPEARING AFTER CHRONIC EXPOSURE AT LOW LEVELS ARE NEUROLOGICAL CHANGES REPRESENTED BY SUBJECTIVE SYMPTOMS RELATING TO CENTRAL AND AUTONOMIC NERVOUS SYSTEMS, OR BY A LOWERED CONDUCTION VELOCITY OF THE NERVES OR A PROLONGED LATENCY OF THE NERVE RESPONSES. FOR THE PRESENT, IT IS REASONABLE TO USE THE NEUROLOGICAL FINDINGS FOR ESTABLISHING THE REFERENCE VALUES OF TRI FOR BOTH WORK AND GENERAL ENVIRONMENTS. A VALUE OF 25 PPM (135 MG/M3) IS PROPOSED AS A REFERENCE VALUE FOR WORK ENVIRONMENTS, AND 25-50 PPB (135-270 MICROGRAMS/M3) FOR THE GENERAL ENVIRONMENT (1/1,000 OF THE VALUE FOR WORK ENVIRONMENT). 1997 9 6842 26 [MECHANISTIC ISSUES AND PREVENTION STRATEGIES TARGETING OCCUPATIONAL CARCINOGENESIS]. CARCINOGENESIS CAN BE VISUALIZED EITHER AS A MULTISTEP PROCESS (INITIATION, PROMOTION, PROGRESSION, INVASION, AND METASTASIS) OR AS A CONTINUUM OF MUTAGENIC AND MITOGENIC EVENTS, WITH THE CONTRIBUTION OF EPIGENETIC MECHANISMS. THE EXPONENTIAL GROWTH OF THE NEOPLASTIC MASS EXPLAINS THE IMPORTANCE OF SECONDARY PREVENTION (EARLY DIAGNOSIS) AND OF TERTIARY PREVENTION. PRIMARY PREVENTION, WHICH WAS SUCCESSFUL IN CONTROLLING OCCUPATIONAL CANCERS, AIMS AT MINIMIZING EXPOSURES TO CARCINOGENS IN HEALTHY SUBJECTS AND AT FAVORING THE INTAKE OF CHEMOPREVENTIVE AGENTS WITH DIETARY AND PHARMACOLOGICAL AGENTS. BESIDES CHEMICAL CARCINOGENS, OFTEN IN THE FORM OF COMPLEX MIXTURES, THE WORKPLACE MAY INVOLVE EXPOSURES TO PHYSICAL AGENTS, SUCH AS SUNLIGHT AND ARTIFICIAL ILLUMINATION SYSTEMS DELIVERING UV RADIATION, OR TO BIOLOGICAL AGENTS, SUCH AS CHRONIC VIRAL INFECTIONS (HBV, HCV, AND HIV) ASSOCIATED WITH CANCERS. A CONTROVERSIAL ISSUE IS THE OCCURRENCE OF THRESHOLD DOSES FOR CARCINOGENS IN THE WORKPLACE AND THE ENVIRONMENT. 2011 10 1970 27 EPIGENETIC ALTERATIONS AND OCCUPATIONAL EXPOSURE TO BENZENE, FIBERS, AND HEAVY METALS ASSOCIATED WITH TUMOR DEVELOPMENT (REVIEW). THE CHRONIC OCCUPATIONAL EXPOSURE TO CONTAMINANTS AND CARCINOGENS LEADS TO THE DEVELOPMENT OF CANCER. OVER THE PAST DECADES, MANY CARCINOGENS HAVE BEEN FOUND IN THE OCCUPATIONAL ENVIRONMENT AND THEIR PRESENCE IS OFTEN ASSOCIATED WITH AN INCREASED INCIDENCE OF CANCER. ACCORDING TO THE INTERNATIONAL AGENCY FOR RESEARCH ON CANCER (IARC), THE MAJORITY OF CARCINOGENS ARE CLASSIFIED AS 'PROBABLE' AND 'POSSIBLE' HUMAN CARCINOGENS, WHILE, DIRECT EVIDENCE OF CARCINOGENICITY IS PROVIDED IN EPIDEMIOLOGICAL AND EXPERIMENTAL STUDIES. ADDITIONALLY, ACCUMULATING EVIDENCE SUGGESTS THAT EPIGENETIC ALTERATIONS MAY BE EARLY INDICATORS OF GENOTOXIC AND NON-GENOTOXIC CARCINOGEN EXPOSURE. IN THE PRESENT REVIEW, THE RELATIONSHIP BETWEEN EXPOSURES TO BENZENE, MINERAL FIBERS, METALS AND EPIGENETIC ALTERATIONS ARE DISCUSSED AS THE MOST IMPORTANT CANCER RISK FACTORS DURING WORK ACTIVITIES. 2017 11 3803 40 INTESTINAL METAPLASIA OF THE STOMACH. A STATUS REPORT. INTESTINAL METAPLASIA IN THE STOMACH INCREASES THE RISK OF GASTRIC CANCER, AND THE INCREASED RISK IS PROPORTIONAL TO THE EXTENT OF THE METAPLASIA. THIS RISK COULD BE GENERATED BY ONE OR MORE MECHANISMS: (1) THE METAPLASTIC TISSUE IS AN EARLY STEP IN A MULTISTEP INDUCTION PROCESS; (2) THE METAPLASTIC TISSUE IS AN EPIGENETIC CHANGE THAT RAISES THE PH OF GASTRIC JUICE BY REPLACING OXYNTIC MUCOSA, FAVORING THE GROWTH OF A BACTERIA CAPABLE OF GENERATING ENDOGENOUS MUTAGENS; AND/OR (3) THE METAPLASIA IS ONLY A MARKER FOR CHRONIC GASTRITIS DUE TO H. PYLORI INFECTION OR PERNICIOUS ANEMIA. WITH THE LAST MECHANISM, THE INFLAMMATORY RESPONSE FAVORS INTRAMURAL MUTAGENESIS THAT MIGHT RESULT IN METAPLASIA OR NEOPLASIA AS INDEPENDENT EVENTS. FINDING GENE REARRANGEMENTS COMMON TO BOTH METAPLASTIC AND NEOPLASTIC TISSUE MAY ESTABLISH A DIRECT LINK BETWEEN THEM, BUT TOO FEW HAVE BEEN IDENTIFIED TO ACCOUNT FOR THE LARGE NUMBER OF STOMACH CANCERS THAT DEVELOP IN HIGH RISK POPULATIONS. HISTOCHEMICAL AND IMMUNOCHEMICAL STAINS THAT IDENTIFY ENZYMES OR MUCOSUBSTANCES MAY SUGGEST THAT METAPLASTIC EPITHELIAL CELLS RESEMBLE SMALL OR LARGE INTESTINAL CELLS, BUT THEY ARE DISTINCTLY DIFFERENT FROM BOTH. MOREOVER, THESE STAINS DO NOT INDICATE WHETHER A GIVEN CYTOLOGIC CHANGE IS GENETIC OR EPIGENETIC; THEREFORE, THEY CANNOT BE USED TO DEFINE THE RELATIONSHIP BETWEEN METAPLASIA AND NEOPLASIA. IT IS UNNECESSARY FOR PRACTICING PHYSICIANS TO AWAIT RESOLUTION OF THIS QUESTION. IT CAN BE ASSUMED THAT ANY PERSON WITH EXTENSIVE METAPLASIA IS AT HIGH RISK FOR GASTRIC CANCER AND SHOULD BE SUBJECT TO PERIODIC SCREENING. THE EXTENT OF THE METAPLASTIC PROCESS IS PROBABLY MORE IMPORTANT THAN THE METAPLASTIC SUBTYPE. 1994 12 5057 25 PHENOBARBITAL MECHANISTIC DATA AND RISK ASSESSMENT: ENZYME INDUCTION, ENHANCED CELL PROLIFERATION, AND TUMOR PROMOTION. CHRONIC EXPOSURE TO HIGH DOSES OF PHENOBARBITAL (PB) CAUSES HEPATOCELLULAR ADENOMAS IN BOTH MICE AND RATS AND HEPATOCELLULAR CARCINOMAS IN SOME STRAINS OF MICE. LONG-TERM PB THERAPY HAS NOT BEEN FOUND TO CAUSE HUMAN TUMORS. PB IS NOT DNA REACTIVE, AND MOST GENOTOXICITY TESTS HAVE YIELDED NEGATIVE RESULTS. PB HAS BEEN EXTENSIVELY STUDIED AS AN EPIGENETIC, RODENT LIVER TUMOR PROMOTER. AT EXPOSURES CAUSING RODENT LIVER TUMORS, PB HAS MEASURABLE EFFECTS ON HEPATOCYTES: PB INHIBITS CELL-TO-CELL COMMUNICATION; PB INDUCES ENZYMES, INCLUDING P450 CYTOCHROMES; PB STIMULATES PROLIFERATION AND INHIBITS APOPTOSIS OF HEPATOCYTES IN NEOPLASTIC FOCI. THRESHOLD EXPOSURES FOR SOME OF THESE ENDPOINTS COINCIDE WITH THE THRESHOLD EXPOSURE FOR TUMORIGENESIS. 1996 13 474 30 ARSENIC BIOTRANSFORMATION AS A CANCER PROMOTING FACTOR BY INDUCING DNA DAMAGE AND DISRUPTION OF REPAIR MECHANISMS. CHRONIC EXPOSURE TO ARSENIC IN DRINKING WATER POSES A MAJOR GLOBAL HEALTH CONCERN. POPULATIONS EXPOSED TO HIGH CONCENTRATIONS OF ARSENIC-CONTAMINATED DRINKING WATER SUFFER SERIOUS HEALTH CONSEQUENCES, INCLUDING ALARMING CANCER INCIDENCE AND DEATH RATES. ARSENIC IS BIOTRANSFORMED THROUGH SEQUENTIAL ADDITION OF METHYL GROUPS, ACQUIRED FROM S-ADENOSYLMETHIONINE (SAM). METABOLISM OF ARSENIC GENERATES A VARIETY OF GENOTOXIC AND CYTOTOXIC SPECIES, DAMAGING DNA DIRECTLY AND INDIRECTLY, THROUGH THE GENERATION OF REACTIVE OXIDATIVE SPECIES AND INDUCTION OF DNA ADDUCTS, STRAND BREAKS AND CROSS LINKS, AND INHIBITION OF THE DNA REPAIR PROCESS ITSELF. SINCE SAM IS THE METHYL GROUP DONOR USED BY DNA METHYLTRANSFERASES TO MAINTAIN NORMAL EPIGENETIC PATTERNS IN ALL HUMAN CELLS, ARSENIC IS ALSO POSTULATED TO AFFECT MAINTENANCE OF NORMAL DNA METHYLATION PATTERNS, CHROMATIN STRUCTURE, AND GENOMIC STABILITY. THE BIOLOGICAL PROCESSES UNDERLYING THE CANCER PROMOTING FACTORS OF ARSENIC METABOLISM, RELATED TO DNA DAMAGE AND REPAIR, WILL BE DISCUSSED HERE. 2011 14 1993 31 EPIGENETIC AND EPITRANSCRIPTOMIC MECHANISMS OF CHROMIUM CARCINOGENESIS. HEXAVALENT CHROMIUM [CR(VI)], A GROUP I CARCINOGEN CLASSIFIED BY THE INTERNATIONAL AGENCY FOR RESEARCH ON CANCER (IARC), REPRESENTS ONE OF THE MOST COMMON OCCUPATIONAL AND ENVIRONMENTAL POLLUTANTS. THE FINDINGS FROM HUMAN EPIDEMIOLOGICAL AND LABORATORY ANIMAL STUDIES SHOW THAT LONG-TERM EXPOSURE TO CR(VI) CAUSES LUNG CANCER AND OTHER CANCER. ALTHOUGH CR(VI) IS A WELL-RECOGNIZED CARCINOGEN, THE MECHANISM OF CR(VI) CARCINOGENESIS HAS NOT BEEN WELL UNDERSTOOD. DUE TO THE FACT THAT CR(VI) UNDERGOES A SERIES OF METABOLIC REDUCTIONS ONCE ENTERING CELLS TO GENERATE REACTIVE CR METABOLITES AND REACTIVE OXYGEN SPECIES (ROS) CAUSING GENOTOXICITY, CR(VI) IS GENERALLY CONSIDERED AS A GENOTOXIC CARCINOGEN. HOWEVER, MORE AND MORE STUDIES HAVE DEMONSTRATED THAT ACUTE OR CHRONIC CR(VI) EXPOSURE ALSO CAUSES EPIGENETIC DYSREGULATIONS INCLUDING CHANGING DNA METHYLATION, HISTONE POSTTRANSLATIONAL MODIFICATIONS AND REGULATORY NON-CODING RNA (MICRORNA AND LONG NON-CODING RNA) EXPRESSIONS. MOREOVER, EMERGING EVIDENCE SHOWS THAT CR(VI) EXPOSURE IS ALSO CAPABLE OF ALTERING CELLULAR EPITRANSCRIPTOME. GIVEN THE INCREASINGLY RECOGNIZED IMPORTANCE OF EPIGENETIC AND EPITRANSCRIPTOMIC DYSREGULATIONS IN CANCER INITIATION AND PROGRESSION, IT IS BELIEVED THAT CR(VI) EXPOSURE-CAUSED EPIGENETIC AND EPITRANSCRIPTOMIC CHANGES COULD PLAY IMPORTANT ROLES IN CR(VI) CARCINOGENESIS. THE GOAL OF THIS CHAPTER IS TO REVIEW THE EPIGENETIC AND EPITRANSCRIPTOMIC EFFECTS OF CR(VI) EXPOSURE AND DISCUSS THEIR ROLES IN CR(VI) CARCINOGENESIS. BETTER UNDERSTANDING THE MECHANISM OF CR(VI) CARCINOGENESIS MAY IDENTIFY NEW MOLECULAR TARGETS FOR MORE EFFICIENT PREVENTION AND TREATMENT OF CANCER RESULTING FROM CR(VI) EXPOSURE. 2023 15 4822 29 OCHRATOXIN A: 50 YEARS OF RESEARCH. SINCE OCHRATOXIN A (OTA) WAS DISCOVERED, IT HAS BEEN UBIQUITOUS AS A NATURAL CONTAMINANT OF MOLDY FOOD AND FEED. THE MULTIPLE TOXIC EFFECTS OF OTA ARE A REAL THREAT FOR HUMAN BEINGS AND ANIMAL HEALTH. FOR EXAMPLE, OTA CAN CAUSE PORCINE NEPHROPATHY BUT CAN ALSO DAMAGE POULTRIES. HUMANS EXPOSED TO OTA CAN DEVELOP (NOTABLY BY INHALATION IN THE DEVELOPMENT OF ACUTE RENAL FAILURE WITHIN 24 H) A RANGE OF CHRONIC DISORDERS SUCH AS UPPER UROTHELIAL CARCINOMA. OTA PLAYS THE MAIN ROLE IN THE PATHOGENESIS OF SOME RENAL DISEASES INCLUDING BALKAN ENDEMIC NEPHROPATHY, KIDNEY TUMORS OCCURRING IN CERTAIN ENDEMIC REGIONS OF THE BALKAN PENINSULA, AND CHRONIC INTERSTITIAL NEPHROPATHY OCCURRING IN NORTHERN AFRICAN COUNTRIES AND LIKELY IN OTHER PARTS OF THE WORLD. OTA LEADS TO DNA ADDUCT FORMATION, WHICH IS KNOWN FOR ITS GENOTOXICITY AND CARCINOGENICITY. THE PRESENT ARTICLE DISCUSSES HOW RENAL CARCINOGENICITY AND NEPHROTOXICITY CAUSE BOTH OXIDATIVE STRESS AND DIRECT GENOTOXICITY. CAREFUL ANALYSES OF THE DATA SHOW THAT OTA CARCINOGENIC EFFECTS ARE DUE TO COMBINED DIRECT AND INDIRECT MECHANISMS (E.G., GENOTOXICITY, OXIDATIVE STRESS, EPIGENETIC FACTORS). ALTOGETHER THIS PROVIDES STRONG EVIDENCE THAT OTA CARCINOGENICITY CAN ALSO OCCUR IN HUMANS. 2016 16 1925 27 ENVIRONMENTAL EPIGENETICS IN METAL EXPOSURE. ALTHOUGH IT IS WIDELY ACCEPTED THAT CHRONIC EXPOSURE TO ARSENITE, NICKEL, CHROMIUM AND CADMIUM INCREASES CANCER INCIDENCE IN INDIVIDUALS, THE MOLECULAR MECHANISMS UNDERLYING THEIR ABILITY TO TRANSFORM CELLS REMAIN LARGELY UNKNOWN. CARCINOGENIC METALS ARE TYPICALLY WEAK MUTAGENS, SUGGESTING THAT GENETIC-BASED MECHANISMS MAY NOT BE PRIMARILY RESPONSIBLE FOR METAL-INDUCED CARCINOGENESIS. GROWING EVIDENCE SHOWS THAT ENVIRONMENTAL METAL EXPOSURE INVOLVES CHANGES IN EPIGENETIC MARKS, WHICH MAY LEAD TO A POSSIBLE LINK BETWEEN HERITABLE CHANGES IN GENE EXPRESSION AND DISEASE SUSCEPTIBILITY AND DEVELOPMENT. HERE, WE REVIEW RECENT ADVANCES IN THE UNDERSTANDING OF METAL EXPOSURE AFFECTING EPIGENETIC MARKS AND DISCUSS ESTABLISHMENT OF HERITABLE GENE EXPRESSION IN METAL-INDUCED CARCINOGENESIS. 2011 17 5282 32 PROMOTION OF HEPATOCARCINOGENESIS IN HUMANS AND ANIMAL MODELS. RISK ASSESSMENT BASED ON RODENT CARCINOGENICITY DATA DEPENDS ON THE ASSUMPTION OF SIMILARITY BETWEEN RODENTS AND HUMANS. WHILE THIS ASSUMPTION IS CONCEIVABLE IN THE CASE OF GENOTOXIC INITIATING CARCINOGENS, CONSIDERABLE SPECIES DIFFERENCES HAVE BEEN OBSERVED WITH NONGENOTOXIC TUMOR PROMOTERS. THIS HETEROGENEOUS GROUP OF AGENTS INCREASES THE PROBABILITY OF CANCER BY STIMULATING SELECTION AND CLONAL EXPANSION OF CELLS TRANSFORMED DURING TUMOR INITIATION. SINCE TUMOR PROMOTERS DIFFERENTIALLY AFFECT NORMAL TISSUE AND PRENEOPLASTIC CELL CLONES, THEIR ACTION CANNOT BE DISCUSSED WITHOUT KNOWLEDGE OF PERSISTENT GENOMIC AND EPIGENETIC ALTERATIONS OCCURRING DURING INITIATION AND FORMATION OF PRENEOPLASTIC CELLS. CHEMICAL CARCINOGENESIS, AND IN PARTICULAR, TUMOR PROMOTION, IS KNOWN TO BE TISSUE SPECIFIC. WE FOCUS ON HEPATOCARCINOGENESIS IN HUMANS AND IN ANIMAL MODELS AND EMPHASIZE TWO DIFFERENT MODES OF ACTION: (1) CHRONIC CYTOTOXICITY LEADING TO PROMOTION OF LIVER CARCINOGENESIS IN BOTH HUMANS AND ANIMAL MODELS; (2) SUSTAINED ACTIVATION OF ORPHAN RECEPTORS SUCH AS CAR, PPARALPHA AND AH RECEPTOR LEADING TO PROMOTION OF RODENT BUT PROBABLY NOT HUMAN HEPATOCARCINOGENESIS. FURTHER STUDIES ON THE DIFFERENT MODES OF ACTION MAY HELP TO AVOID OVERESTIMATION OF THE RISK OF LIVER TUMOR PROMOTION. 2008 18 2655 37 EPIMUTAGENESIS: A PROSPECTIVE MECHANISM TO REMEDIATE ARSENIC-INDUCED TOXICITY. ARSENIC TOXICITY IS A GLOBAL ISSUE, ADDRESSED BY THE WORLD HEALTH ORGANIZATION AS ONE OF THE MAJOR NATURAL CALAMITIES FACED BY HUMANS. MORE THAN 137 MILLION INDIVIDUALS IN 70 NATIONS ARE AFFECTED BY ARSENIC MAINLY THROUGH DRINKING WATER AND ALSO THROUGH DIET. CHRONIC ARSENIC EXPOSURE LEADS TO VARIOUS TYPES OF PATHO-PHYSIOLOGICAL END POINTS IN HUMANS INCLUDING CANCERS. ARSENIC, A XENOBIOTIC SUBSTANCE, IS BIOTRANSFORMED IN THE BODY TO ITS METHYLATED SPECIES BY USING THE PHYSIOLOGICAL S-ADENOSYL METHIONINE (SAM). SAM DICTATES METHYLATION STATUS OF THE GENOME AND ARSENIC METABOLISM LEADS TO DEPLETION OF SAM LEADING TO AN EPIGENETIC DISEQUILIBRIUM. SINCE EPIGENETICS IS ONE OF THE MAJOR PHENOMENON AT THE INTERFACE BETWEEN THE ENVIRONMENT AND HUMAN HEALTH IMPACT, ITS DISEQUILIBRIUM BY ARSENIC INFLICTS UPON THE CHROMATIN COMPACTION, GENE EXPRESSION, GENOMIC STABILITY AND A HOST OF BIOMOLECULAR INTERACTIONS, THE INTERACTOME WITHIN THE CELL. SINCE ARSENIC IS NOT MUTAGENIC BUT IS CARCINOGENIC IN NATURE, ARSENIC INDUCED EPIMUTAGENESIS HAS COME TO THE FOREFRONT SINCE IT DETERMINES THE TRANSCRIPTIONAL AND GENOMIC INTEGRITY OF THE CELL. ARSENIC TOXICITY BRINGS FORTH SEVERAL PATHOPHYSIOLOGICAL MANIFESTATIONS LIKE DERMATOLOGICAL NON-CANCEROUS, PRE-CANCEROUS AND CANCEROUS LESIONS, PERIPHERAL NEUROPATHY, DNA DAMAGE, RESPIRATORY DISORDERS AND CANCERS OF SEVERAL INTERNAL ORGANS. RECENTLY, SEVERAL DISEASES OF SIMILAR MANIFESTATIONS HAVE BEEN EXPLAINED WITH THE RELEVANT EPIGENETIC PERSPECTIVES REGARDING THE POSSIBLE MOLECULAR MECHANISM FOR THEIR ONSET. HENCE, IN THE CURRENT REVIEW, WE COMPREHENSIVELY TRY TO INTERCALATE THE INFORMATION ON ARSENIC-INDUCED EPIGENETIC ALTERATIONS OF DNA, HISTONES AND MICRORNA SO AS TO UNDERSTAND WHETHER THE ARSENIC-INDUCED TOXIC MANIFESTATIONS ARE BROUGHT ABOUT BY THE EPIGENETIC CHANGES. WE HIGHLIGHT THE NEED TO UNDERSTAND THE ASPECT OF EPIMUTAGENESIS AND SUBSEQUENT ALTERATIONS IN THE CELLULAR INTERACTOME DUE TO ARSENIC-INDUCED MOLECULAR CHANGES, WHICH MAY BE UTILIZED TO DEVELOP PUTATIVE THERAPEUTIC STRATEGIES TARGETING BOTH OXIDATIVE POTENTIAL AND EPIMUTAGENESIS IN HUMANS. 2015 19 3272 37 HEPATOCELLULAR CARCINOMA: AN UPDATE. HEPATOCELLULAR CARCINOMA (HCC) IS THE MOST COMMON MALIGNANT TUMOR OF MALES IN THE WORLD, WITH AN INCIDENCE OF 1,000,000 NEW CASES A YEAR. IT IS ENDEMIC IN SOUTHEAST ASIA AND SUB-SAHARAN AFRICA. RISK FACTORS INCLUDE CHRONIC INFECTION WITH HEPATITIS B VIRUS (HBV) AND HEPATITIS C VIRUS (HCV), AFLATOXIN B1 UPTAKE, HEMOCHROMATOSIS, AND ALPHA1 -ANTITRIPSIN DEFICIENCY. EPIDEMIOLOGICAL STUDIES PROVIDE EVIDENCE FOR THE ASSOCIATION OF HCC WITH HBV INFECTION. THE INCIDENCE OF HCC IS HIGH IN REGIONS HYPERENDEMIC FOR HBV. CHRONIC CARRIER STATE AND MATERNAL-INFANT TRANSMISSION ARE IMPORTANT FACTORS IN THE DEVELOPMENT OF HCC. EVIDENCE OF DIRECT ONCOGENIC EFFECT OF H BV IS WELL ESTABLISHED, HCCS CONTAIN VIRAL DNA SEQUENCES INTEGRATED INTO HEPATOCYTE DNA THAT ACT AS RANDOM INSERTIONAL MUTAGENS, AND THESE SITES ARE NEAR GENES INVOLVED IN THE CONTROL OF PROLIFERATION AND DIFFERENTIATION. THE MECHANISM OF HEPATITIS C VIRUS IN HEPATOCARCINOGENESIS IS STILL IMPRECISE BUT A HIGH PERCENTAGE OF CASES ARE RELATED TO THIS VIRUS. CHRONIC ALCOHOL CONSUMPTION AND CIRRHOSIS ARE COFACTORS THAT INCREASE THE DEVELOPMENT OF HCC IN PATIENTS WITH CHRONIC VIRAL INFECTION. IN EXPERIMENTAL CARCINOGENESIS A MULTIPOTENTIAL ELEMENT CALLED OVAL CELL PROLIFERATES IN THE EARLY STAGES. THE CELLULAR EVENTS ARE ACCOMPANIED BY INCREASED EXPRESSION OF SEVERAL GROWTH FACTORS THAT ENHANCE THE SURVIVAL OF CARCINOGEN-ACTIVATED CELLS BY SUPPRESSING APOPTOSIS AND INCREASING ELEMENTS ENTERING THE CELL CYCLE. HEPATIC CARCINOGENESIS IS A COMPLEX PROCESS ASSOCIATED WITH ACCUMULATION OF GENETIC AND EPIGENETIC CHANGES THAT RUN THROUGH STEPS OF INITIATION, PROMOTION AND PROGRESSION. ACTIVATION OF ONCOGENES OF THE "RAS" FAMILY AND OTHERS HAS BEEN DETECTED DURING CHEMICALLY-INDUCED HCC IN RODENTS, BUT THERE IS LITTLE EVIDENCE OF SUCH ACTIVATION IN HUMAN TUMORS. THE ROLE OF TUMOR SUPRESSOR GENES SUCH AS RETINOBLASTOMA (RB) AND P53 GENES HAS BEEN DOCUMENTED. AFLATOXIN B1 THAT CONTAMINATES FOODS IN ENDEMIC AREAS HAS A CLEAR ROLE IN HEPATOCARCINOGENESIS. METABOLITES OF THIS TOXIN PROMOTE APURINIC SITES AND G TO T MUTATIONS IN CHROMOSOMAL DNA, THE THIRD BASE OF CODON 249 OF THE P53 GENE IS PREFERENTIALLY TARGETED TO FORM ADUCTS WITH AFLATOXIN B1, AND THIS MUTATION HAS BEEN SPECIFICALLY IDENTIFIED IN HBV INFECTION. HISTOLOGICAL AND CYTOLOGICAL CRITERIA FOR THE DIAGNOSIS OF HCC ARE WELL ESTABLISHED AND ARE BASED IN ARCHITECTURAL AND CYTOLOGICAL CHANGES. AN IMPORTANT ISSUE IS THE DIAGNOSIS OF LIVER "NODULES" DETECTED BY IMAGE, FROM WHICH SMALL BIOPSIES OR ASPIRATION MATERIAL IS OBTAINED. SPECIAL STUDIES SUCH AS RETICULIN, CD34, CYTOKERATIN PROFILE, AND MOC-31 CAN BE VERY USEFUL FOR THE DIFFERENTIAL DIAGNOSIS OF PRIMARY AND METASTATIC TUMORS. TELOMERASE ACTIVITY HAS BEEN FOUND IN HCC AND NEGATIVE IN PERICANCEROUS TISSUE. IT IS MORE PRONOUNCED IN POORLY DIFFERENTIATED TUMORS AND CORRELATES WITH FACTORS OF CLINICAL IMPORTANCE, SUCH AS PROGNOSIS AND RECURRENCES. CELLS OF WELL-DIFFERENTIATED HCC HAVE AN ULTRASTRUCTURAL APPEARANCE SIMILAR TO NORMAL HEPATOCYTES. DURING THE PROCESS OF DEDIFFERENTIATION, THERE IS PROGRESSIVE LOSS OF ORGANIZATION OF INTRACELLULAR ORGANELLES. THE CELL COHESION IS LOST, INTERCELLULAR GAPS WITH MICROVILLI APPEAR, THE SINUSOIDS BECOME CAPILLARIZED, AND REPARATIVE CHANGES ARE SEEN IN THE SPACES OF DISSE. A VARIETY OF INCLUSIONS, SUCH AS MALLORY BODIES, GRANULAR MATERIAL, SECONDARY LYSOSOMES, AND DUBIN-JOHNSON PIGMENT, HAVE BEEN DESCRIBED. FIBROLAMELLAR CARCINOMA HAS A CHARACTERISTIC HISTOLOGICAL PICTURE AND ULTRASTRUCTURALLY ONCOCYTIC FEATURES. NEUROENDOCRINE GRANULES AND COMBINATION OF HCC WITH BILE DUCT CARCINOMA ARE SEEN BY ELECTRON MICROSCOPY. 2001 20 5450 29 REPRODUCTIVE TOXICITY OF COMBINED EFFECTS OF ENDOCRINE DISRUPTORS ON HUMAN REPRODUCTION. CONFLUENCE OF ENVIRONMENTAL, GENETIC, AND LIFESTYLE VARIABLES IS RESPONSIBLE FOR DETERIORATION OF HUMAN FECUNDITY. ENDOCRINE DISRUPTORS OR ENDOCRINE DISRUPTING CHEMICALS (EDCS) MAY BE FOUND IN A VARIETY OF FOODS, WATER, AIR, BEVERAGES, AND TOBACCO SMOKE. IT HAS BEEN DEMONSTRATED IN EXPERIMENTAL INVESTIGATIONS THAT A WIDE RANGE OF ENDOCRINE DISRUPTING CHEMICALS HAVE NEGATIVE EFFECTS ON HUMAN REPRODUCTIVE FUNCTION. HOWEVER, EVIDENCE ON THE REPRODUCTIVE CONSEQUENCES OF HUMAN EXPOSURE TO ENDOCRINE DISRUPTING CHEMICALS IS SPARSE AND/OR CONFLICTING IN THE SCIENTIFIC LITERATURE. THE COMBINED TOXICOLOGICAL ASSESSMENT IS A PRACTICAL METHOD FOR ASSESSING THE HAZARDS OF COCKTAILS OF CHEMICALS, CO-EXISTING IN THE ENVIRONMENT. THE CURRENT REVIEW PROVIDES A COMPREHENSIVE OVERVIEW OF STUDIES EMPHASIZING THE COMBINED TOXICITY OF ENDOCRINE DISRUPTING CHEMICALS ON HUMAN REPRODUCTION. ENDOCRINE DISRUPTING CHEMICALS INTERACT WITH EACH OTHER TO DISRUPT THE DIFFERENT ENDOCRINE AXES, RESULTING IN SEVERE GONADAL DYSFUNCTIONS. TRANSGENERATIONAL EPIGENETIC EFFECTS HAVE ALSO BEEN INDUCED IN GERM CELLS, MOSTLY THROUGH DNA METHYLATION AND EPIMUTATIONS. SIMILARLY, AFTER ACUTE OR CHRONIC EXPOSURE TO ENDOCRINE DISRUPTING CHEMICALS COMBINATIONS, INCREASED OXIDATIVE STRESS (OS), ELEVATED ANTIOXIDANT ENZYMATIC ACTIVITY, DISRUPTED REPRODUCTIVE CYCLE, AND REDUCED STEROIDOGENESIS ARE OFTEN REPORTED CONSEQUENCES. THE ARTICLE ALSO DISCUSSES THE CONCENTRATION ADDITION (CA) AND INDEPENDENT ACTION (IA) PREDICTION MODELS, WHICH REVEAL THE IMPORTANCE OF VARIOUS SYNERGISTIC ACTIONS OF ENDOCRINE DISRUPTING CHEMICALS MIXTURES. MORE CRUCIALLY, THIS EVIDENCE-BASED STUDY ADDRESSES THE RESEARCH LIMITATIONS AND INFORMATION GAPS, AS WELL AS PARTICULARLY PRESENTS THE FUTURE RESEARCH VIEWS ON COMBINED ENDOCRINE DISRUPTING CHEMICALS TOXICITY ON HUMAN REPRODUCTION. 2023