Mechanisms of fibre carcinogenesis.

It addresses the strengths, weaknesses and gaps in the present knowledge on genotoxicity, fibre characterization, cell proliferation and activation, and animal studies, and provides answers to specific questions on the relevance of mechanistic data from in-vitro and in-vivo assays in the assessment of the carcinogenic risk of fibres to humans.

Oncogenes and Tumor Suppressor Genes in the Carcinogenicity of Fibers and Particles.

Asbestos fibers and crystalline silica are carcinogenic to humans when inhaled into the lungs. Asbestos fibers and cigarette smoke most likely act as cofactors in the induction of lung cancer. Point mutations in the K-ras oncogene and the p53 tumor-suppressor gene are frequent in lung cancers and are consistent with the known mutagenic spectrum of tobacco-smoke carcinogens. The FHIT tumor suppressor gene is also frequently inactivated in lung cancers of smokers and in workers who were exposed to asbestos. Recent molecular studies of p53 tumor suppressor gene mutations and p53 protein expression in the lungs of patients with lung cancer and occupational exposure to crystalline silica and other dusts have been conducted. Mutations in the p53 gene were detected at a frequency similar to those in smoking-related lung cancers. Expression of p53 protein can be detected by immunohisto-chemistry in preneoplastic epithelial lesions in the lungs of smokers and workers. Human malignant mesotheliomas frequently show overexpression of p53 protein; however, point mutations at the p53 tumor suppressor gene or ras oncogene locus are rare. Most cases of malignant mesotheliomas have codeletions of the p15 and p16 tumor suppressor genes and alterations at the NF2 tumor suppressor gene locus with monosomy of chromosome 22. The molecular alterations characteristic of malignant mesotheliomas may develop during later stages of tumor progression and may not reflect the direct genotoxic effects of fibers on the target cell population.

Susceptibility of p53-deficient mice to induction of mesothelioma by crocidolite asbestos fibers.

Exposure of mesothelial cells to asbestos fibers in vitro has been shown to induce DNA damage mediated by oxidants. An early cellular response to DNA damage is increased expression of the p53 protein. This protein induces transcription of genes that activate cell cycle checkpoints or induce apoptosis. A murine mesothelial cell line that spontaneously acquired a point mutation in the p53 gene shows increased sensitivity to DNA damage induced by crocidolite asbestos fibers. It is hypothesized that p53-deficient mice will show increased sensitivity to the genotoxic effects of asbestos and accelerated development of malignant mesotheliomas.

Mesothelial cell proliferation and biopersistence of wollastonite and crocidolite asbestos fibers.

The mesothelial lining is a target for the fibrotic and carcinogenic effects of mineral fibers. Fiber geometry, dimensions, chemical composition, surface reactivity, and biopersistence at the target tissue have been proposed to contribute to these toxic endpoints. We established a dose-response relationship between the number of fibers delivered to the parietal peritoneal lining, inflammation, and mesothelial cell proliferation induced by intraperitoneal injection of crocidolite asbestos fibers in mice. Persistence of these inflammatory and proliferative responses depended on persistence of fibers at the target tissue. Intraperitoneal injection of wollastonite fibers induced an early inflammatory and proliferative response that subsided after 21 days. Approximately 50% of wollastonite fibers were recovered by bleach digestion after 21 days and only 2% were recovered after 6 months. In contrast, the number of fibers recovered from tissue digests had not declined 6 months after injection of crocidolite asbestos. These results support the hypothesis that biopersistent fibers cause persistent inflammation and chronic mesothelial cell proliferation.

Growth factor responses and protooncogene expression of murine mesothelial cell lines derived from asbestos-induced mesotheliomas.

Repeated intraperitoneal injections of crocidolite asbestos fibers induced diffuse malignant mesotheliomas in mice. A series of mesothelial cell lines was isolated from mice at different stages in the development of these tumors. The cell lines isolated from mice with mesotheliomas recapitulated their growth pattern in vivo and were tumorigenic when reinjected into syngeneic mice. Similar to human mesothelial cells, growth of the murine cell lines was stimulated by epidermal growth factor. Reactive mesothelial cells and mesotheliomas expressed the receptor for this growth factor. Crocidolite asbestos fibers have been reported to induce sustained expression of the c-fos and c-jun protooncogenes in rat pleural mesothelial cells in vitro (Heintz et al, Proc. Natl. Acad. Sci. USA 90: 3299-303, 1993). Human malignant mesotheliomas have been shown to express c-fos in situ (Ramael et al, Histol. Histopathol. 10: 639-643, 1995). Two of the cell lines derived from highly invasive murine mesotheliomas overexpressed c-fos and c-jun. This murine model recapitulates the histopathology, growth factor responses, and protooncogene expression of human malignant mesotheliomas.

Spontaneous p53 mutation in murine mesothelial cells: increased sensitivity to DNA damage induced by asbestos and ionizing radiation.

The p53 gene regulates the G1 cell cycle checkpoint in response to DNA damage. A primary murine mesothelial cell line (D9) spontaneously acquired a point mutation at codon 135 in exon 5 of the p53 gene, resulting in substitution of alanine for proline; early passage D9 cells expressed wild-type p53. The growth rate of late passage D9 cells that acquired the p53 mutation was increased compared to that of early passage cells; however, this mutation was not sufficient to confer tumorigenicity to this cell line. Mammalian cells that express wild-type p53 show a transient arrest in G1 after exposure to ionizing radiation. Early passage D9 cells showed a G1 arrest following ionizing radiation, while late passage D9 cells arrested in G2 or mitosis. The clastogenic effects of ionizing radiation can be demonstrated by the cytokinesis-arrested micronucleus assay. Following treatment with cytochalasin B to arrest cytokinesis, ionizing radiation induced micronuclei in 50% of late passage D9 cells compared to 15% of early passage cells. After exposure to 15 micrograms/cm2 of crocidolite asbestos fibers, 18% of late passage cells had micronuclei compared to 4% of early passage cells. It is hypothesized that loss of the G1 cell cycle checkpoint contributes to genetic instability in murine mesothelial cells.

Oxygen radicals and asbestos carcinogenesis.

Asbestos fibers have been shown to generate reactive oxygen species using a variety of in vitro assays. It is hypothesized that these highly reactive metabolites mediate the development of malignant mesothelioma induced by asbestos fibers. DNA is a potential target of oxidant attack. Adaptive responses to oxidant injury have been described during exposure of mesothelial cells to asbestos fibers in vitro. Failure of these adaptive responses may lead to genetic instability and alterations in oncogenes and tumor suppressor genes that confer a proliferative advantage to emerging neoplastic mesothelial cells.

The status of women in medicine at the Brown University School of Medicine.

Although the number of women medical faculty appointed and promoted at the School of Medicine has increased gradually since 1987, the extent to which women have advanced in academic medicine and the timeliness of their movement forward are of concern. With women constituting nearly 20% of the medical faculty at Brown, and comprising only 5% of professorial appointments, it is easy to see the disparities. While the Brown University School of Medicine stands out as one of less than a dozen medical schools with an Office of Women in Medicine, clearly there is still much to accomplish in this domain. Progress may be accelerated through networking and advocacy promoted by professional development programs sponsored by offices for women in medicine and organizations as RIMWA. Offering women medical faculty a forum to discuss issues as departmental promotion criteria in academic medicine and to link up with other women physicians, ultimately serves not only women faculty but their institution. Providing role models is critical to assist women medical students in looking well ahead to plan for their own career development. In creating opportunities for dialogue among women in medicine at all levels in the medical school environment and among women physicians in the nearby community, institutions take an essential step forward towards supporting women's advancement in medicine.

Pathogenesis of mesothelial reactions to asbestos fibers. Monocyte recruitment and macrophage activation.

Exposure to asbestos fibers leads to a variety of mesothelial reactions: pleural effusions, fibrotic pleural plaques, and malignant mesotheliomas. An animal model was developed to reproduce these lesions in C57B1/6 mice using weekly intraperitoneal injections of asbestos fibers. After exposure to asbestos fibers, monocytes were recruited into the abdominal cavity and acquired the characteristics of inflammatory or nonspecifically activated macrophages. Nontoxic titanium dioxide or toxic silica particles did not produce activation of the free peritoneal macrophage population. Aggregates of asbestos fibers were found on the diaphragm and other peritoneal surfaces within only 24 h after a single injection. Macrophage recruitment to these sites peaked between 3 and 5 days, while activated macrophages persisted up to 14 days. Recruitment and activation of macrophages by repeated exposures to asbestos fibers may contribute to chronic damage of the mesothelial lining caused by these mineral fibers.

Approaches to evaluating the toxicity and carcinogenicity of man-made fibers: summary of a workshop held November 11-13, 1991, Durham, North Carolina.

The Workshop on Approaches to Evaluating the Toxicity and Carcinogenicity of Man-Made Fibers (MMF) was held in Durham, North Carolina, on November 11-13, 1991. The goal of the workshop was to reach a consensus, or to determine the extent to which a consensus existed, in two areas. Participants were asked to identify scientifically sound approaches for evaluating the toxicity and carcinogenicity of man-made fibers based on today's science and to determine research appropriate for study during the next 5 years that can provide an improved scientific basis for future revisions of approaches used to evaluate man-made fiber toxicity and carcinogenicity. During the first day, a series of "state of knowledge" presentations were made to provide all participants with a common data base from which to interact and discuss scientific issues. The workshop participants were assigned to one of four discussion groups, which met separately in three half-day sessions following the first day of presentations. All groups discussed the same topics: exposure assessment, hazard identification, and dose-response information needed to integrate to characterize risk in the first session; approaches to obtaining the needed information in the second session; and recommended approaches and guidelines for evaluating the toxicity and carcinogenicity of MMF and research needs in the third session. The workshop participants reconvened as a whole after each discussion session, and one member from each group reported the group's conclusions. A closure period was also included at the end of the workshop for review and discussion of items that had been considered during the workshop. The primary conclusions reached were the following: -All fiber types capable of depositing in the thorax are not alike in their pathogenic potential. -Only fiber samples with dimensions similar to those to which humans can inhale should be tested. -A complete characterization (i.e., dimensions, fiber number, mass, and aerodynamic diameter) of the fiber aerosol and retained dose is essential. -Appropriate aerosol generation methods must be used for inhalation studies in order to preserve fiber lengths. -A tiered approach to toxicity evaluation is recommended that includes: 1. In vitro screening for durability, surface properties, cytotoxicity, and similar properties, etc; 2. Short-term inhalation or other in vivo studies; 3. That chronic inhalation studies are the "gold standard" (i.e., provide most appropriate data for risk characterization). -The rat is the most appropriate species for inhalation studies. -In chronic inhalation studies, animals should be retained to at least 20% survival after 2-year exposure. -Serial lung burden analyses are an essential component of inhalation studies and are essential for understanding exposure-dose-response relationships. -Studies oriented to understanding mechanisms of toxicity and carcinogenicity are important adjuncts to traditional toxicity studies. -Histopathological analyses of tissues of the respiratory tract represent primary endpoints for evaluating effects of inhaled fibers. Major effects include pulmonary fibrosis, lung tumors, and mesotheliomas. Experimental tissues should be archived for future studies; wherever possible, handling and preservation of tissues should be done in a way that maximizes their future use in mechanistic studies. -Potential human exposures throughout the entire life-cycle of the fiber must be considered and fibrous material for toxicologic studies prepared accordingly. -Intracavity studies are inappropriate for risk characterization but can play a useful screening role in assessing fiber toxicity.(ABSTRACT TRUNCATED AT 400 WORDS)

Cytotoxicity of long and short crocidolite asbestos fibers in vitro and in vivo.

Fiber length and diameter are important factors in the pathogenicity of asbestos. We examined the relative toxicity of long and short crocidolite asbestos fibers in vitro and in vivo. Both long and short crocidolite asbestos fibers were toxic to elicited macrophages in vitro. Similar to native crocidolite asbestos, long and short fibers stimulated the release of reactive oxygen metabolites from elicited macrophages in vitro. We evaluated whether in vitro cytotoxicity was dependent on the production of reactive oxygen metabolites. In the presence of the reactive oxygen metabolite scavenging enzymes, superoxide dismutase or catalase, the toxicity of long and short crocidolite fibers to macrophages was prevented. Furthermore, macrophages were not killed when either long or short fibers were soaked in the iron chelator, deferoxamine. Native, long, and short crocidolite fibers also caused depolarization of the mitochondrial membrane potential prior to cell death. In vivo, a single i.p. injection of long crocidolite fibers stimulates an intense inflammatory reaction, release of reactive oxygen metabolites near sites of fiber deposition, and cell death. In contrast, these events were minimal after a single injection of short fibers due to the removal of fibers from the peritoneal cavity. After five daily injections of short fibers, however, fibers were present on the surface of the mesothelium and provoked an inflammatory response. Cell death was observed on the surface of the mesothelium. Reactive oxygen metabolites were also produced near accumulations of short fibers. Our results suggest that both long and short crocidolite asbestos fibers are toxic to macrophages in vitro via an oxidant and iron-dependent mechanism. In vivo, short fibers are cytotoxic when the clearance of these fibers is prevented.

Altered calcium homeostasis in irreversibly injured P388D1 macrophages.

Sequestration of calcium by mitochondria is an important mechanism to maintain normal intracellular calcium homeostasis. Anoxic or toxic damage to these organelles has been postulated to disrupt intracellular calcium compartmentalization, leading to cell death. The authors examined the potential relationship between mitochondrial dysfunction, altered calcium homeostasis, and irreversible injury in a model system of silica-induced toxicity to P388D1 cells. Exposure to toxic silica particles, but not to nontoxic latex heads, disrupted mitochondrial membrane potential, increased membrane-associated calcium, elevated free cytosolic calcium, and killed 50% to 60% of the cell population after 6 to 8 hours. To test whether disruption of the mitochondrial membrane potential was sufficient to cause irreversible injury, P388D1 cells were exposed to either the proton ionophore, carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP) or to the mitochondrial inhibitor, antimycin A. Over 90% of the treated cells showed depolarization of the mitochondrial membrane as indicated by the fluorescent probe rhodamine 123. Carbonyl cyanide p-trifluoromethoxyphenylbydrazone also caused an elevation in free cytosolic calcium as monitored by fura-2. However, even after 6 hours of exposure to these proton ionophores or mitochondrial inhibitors, P388D1 cells did not show increased chlorotetracycline (CTC)-induced fluorescence or loss of viability. P388D1 cells exposed to silica have been shown previously to lose 80% of their adenosine triphosphate (ATP) content. The effect of reduced ATP levels on intracellular calcium homeostasis and viability was assessed by exposing P338D1 cells to FCCP in the presence of sodium azide and 2-deoxyglucose, which reduced ATP content by more than 90%. Under these conditions, none of the cells were killed, and only 5.5% showed increased CTC-induced fluorescence after 6 hours. These data indicate that disruption of the mitochondrial membrane potential, even in combination with reduced ATP content, is not sufficient to kill P388D1 cells.

Evaluation of the causal relationship between crocidolite asbestos-induced lipid peroxidation and toxicity to macrophages.

In vitro, crocidolite asbestos toxicity to macrophages is mediated by the production of reactive oxygen metabolites. We examined whether exposure of macrophages to crocidolite asbestos induced lipid peroxidation as measured by the thiobarbituric acid assay. When elicited mouse peritoneal macrophages were exposed to crocidolite, a dose- and time-dependent increase in lipid peroxidation breakdown products accompanied cell death. Superoxide dismutase plus catalase or deferoxamine prevented both lipid peroxidation and loss of viability caused by crocidolite. We tested whether crocidolite-induced lipid peroxidation was causally responsible for cell death. Macrophages were not killed by crocidolite when incubated with 10 mM 3-aminobenzamide. The level of thiobarbituric acid-reactive material was the same, however, for cells incubated with crocidolite in the presence or absence of 3-aminobenzamide. When macrophagaes were pretreated for 24 h with 25 microM vitamin E and then incubated with crocidolite, no thiobarbituric acid-reactive products were detected. Vitamin E, however, did not prevent crocidolite cytotoxicity. These results suggest that exposure of macrophages to crocidolite asbestos produces lipid peroxidation as measured by thiobarbituric acid-reactive products. This reaction, however, is not directly responsible for irreversible injury in this model system.

Induction of angiogenesis by intraperitoneal injection of asbestos fibers.

Tumors and activated macrophages release angiogenic factors that stimulate migration and proliferation of capillaries. We studied the development of angiogenesis before the appearance of mesotheliomas in C57B1/6 mice. Weekly i.p. injections of crocidolite asbestos fibers produced mesotheliomas after 30-50 wk. The initial histologic response to asbestos fibers was a nodular lesion on the peritoneal lining composed of clusters of fibers, activated macrophages, and proliferating mesenchymal cells. The earliest visible evidence of angiogenesis was seen surrounding 7% of these lesions 14 days after a single injection of 200 micrograms of crocidolite asbestos fibers. After six weekly injections, 30% of the lesions containing asbestos fibers were surrounded by a capillary network radiating toward the center of the lesion. Other mineral fibers, including chrysotile asbestos and fiberglass, also induced angiogenesis after six weekly injections. In contrast, only 8% of the lesions containing short asbestos fibers (90.6% less than or equal to 2.0 microns) and 9% of the lesions containing silica particles showed evidence of angiogenesis. We conclude that tumorigenic mineral fibers induce angiogenesis in the peritoneal lining, whereas nontumorigenic mineral particles or short asbestos fibers are less effective. Ingrowth of new blood vessels around clusters of asbestos fibers may facilitate the later emergence of mesotheliomas at these sites.

Selective purine release from P388D1 macrophages injured by silica.

Silica particles are toxic to primary cultures of macrophages or the P388D1 cell line in vitro. Loss of viability in these model systems is accompanied by depletion of ATP content within 3 to 6 hours. The mechanisms responsible for ATP depletion will be explored in this paper. After prelabeling for 1 hour with 3H-adenine, silica-treated cells released 60-80% of their labeled acid-soluble pool into the culture medium. This release did not occur after phagocytosis of nontoxic titanium dioxide particles and was specific for purines. ATP depletion was accompanied by purine catabolism: inosine, hypoxanthine, xanthine, and uric acid were detected in the culture medium using thin layer or high-performance liquid chromatography. The final xanthine oxidase step in purine catabolism generates reactive oxygen metabolites. Silica toxicity was not prevented by the xanthine oxidase inhibitor allopurinol nor exogenous purines. It is concluded that adenine nucleotide depletion and purine catabolism are not solely responsible for irreversible injury in silica toxicity. It is hypothesized that purine catabolism and release from injured macrophages may lead to generation of reactive oxygen species, injury to surrounding tissue, and fibrosis.