Thymic Lymphomas in a 6-Month rasH2-Tg Mouse Carcinogenicity Study With the RORγt Inverse Agonist, BMS-986251.

BMS-986251 is a retinoid-related orphan receptor γt (RORγt) inverse agonist that was in development for the treatment of autoimmune diseases. RORγt is a nuclear hormone receptor and transcription factor that is involved in the differentiation and function of T helper 17 cells. RORγt-deficient (constitutive or conditional) mice develop thymic lymphomas with >50% mortality at 4 months, whereas heterozygous mice are normal. A 6-month study was conducted in rasH2-Tg hemizygous mice to assess the potential carcinogenicity of BMS-986251. BMS-986251 was administered once daily by oral gavage to groups of 27 mice/sex at doses of 0 (water control), 0 (vehicle control), 5, 25, or 75 mg/kg. The positive control, N-methyl-N-nitrosourea, was administered by a single intraperitoneal injection to 15 mice/sex at a dose of 75 mg/kg. There were no tumors attributed to BMS-986251 except for thymic lymphomas. Thymic lymphoma was observed in 1 male (3.7%) and 3 females (11.1%) at the mid dose, and 6 females (22.2%) at the high dose. No lymphomas were observed in the negative control groups whereas the incidence of lymphomas in the positive control group was 47-60%. The incidence of thymic lymphomas in the BMS-986251-treated groups was higher than published literature and test facility historical control data. Furthermore, increased thymic lymphoid cellularity (lymphoid hyperplasia) was observed at the mid dose in males and at all doses in females. Since lymphoid hyperplasia may represent a preneoplastic change, a no-effect dose for potential tumor induction was not identified in this study. These results led to the discontinuation of BMS-986251 and underscore the challenges in targeting RORγt for drug development.

Benzene exposure and risk of lymphohaematopoietic cancers in 25 000 offshore oil industry workers.

BACKGROUND: The aim of this work was to examine the risk of lymphohaematopoietic (LH) cancer according to benzene exposure among offshore workers. METHODS: Cancer registry data were used to identify 112 cancer cases diagnosed during 1999-2011 in a cohort of 24 917 Norwegian men reporting offshore work between 1965 and 1999. Analyses were conducted according to a stratified case-cohort design with a reference subcohort of 1661 workers. Cox regression was used to estimate hazard ratios with 95% confidence intervals, adjusted for other benzene exposure and smoking. RESULTS: Most workers were exposed to benzene for <15 years. The upper range values of average intensity and cumulative exposure were estimated to 0.040 p.p.m. and 0.948 p.p.m.-years, respectively. Risks were consistently elevated among exposed workers for all LH cancers combined and for most subgroups, although case numbers were small and yielded imprecise risk estimates. There was evidence of dose-related risk patterns according to cumulative exposure for acute myeloid leukaemia (AML), multiple myeloma (MM) (P trends 0.052 and 0.024, respectively), and suggestively so for chronic lymphocytic leukaemia (CLL) according to average intensity (P trend 0.094). CONCLUSIONS: Our results support an association between cumulative and intensity metrics of low-level benzene exposure and risk for AML, MM, and suggestively for CLL.

Mutagenicity and genotoxicity studies of arruva, an R,R-monatin salt isomer.

Arruva, the R,R-isomer of monatin (sodium/potassium 2R,4R-2-amino-4-carboxy-4-hydroxy-5-(3-indolyl) pentanoate), an intense sweetener originally identified in root bark of the South African shrub Schlerochitin ilicifolius, was examined for its mutagenic and genotoxic potential via bacterial reverse mutation, mouse lymphoma and in vivo mouse micronucleus assays, all accomplished in the presence and absence of S9 metabolic activation. In the bacterial reverse mutation assay, arruva was determined to not cause reverse mutations in four Salmonella typhimurium strains and one Escherichia coli strain at concentrations up-cells did not exhibit concentration-related increases in mutant frequency at test concentrations up to 3200µg/ml. In the in vivo micronucleus test, arruva was administered to male mice via single gavage doses at 500, 1000 or 2000mg/kg bw. At 24 or 48h post-dose, the mice were euthanized and femoral bone marrow cells were collected for evaluation of micronucleated polychromatic erythrocyte (MPCE) presence. No statistically significant increases of MPEs were observed relative to the respective vehicle control groups. Under the conditions of these studies, arruva was concluded to be negative in all three assays, thereby indicating the absence of its potential mutagenicity or genotoxicity under the conditions tested.

Malignancy concerns with psoriasis treatments using phototherapy, methotrexate, cyclosporin, and biologics: facts and controversies.

Cancer is one of the several comorbidities that have been linked with psoriasis. Not surprisingly, tumors associated with well-documented risk factors for the dermatosis, such as smoking and obesity, have been found with increased incidence in psoriatic patients. They include lung, kidney, and colon cancers. For unknown reasons, the risk of lymphoma is also increased in psoriatic patients. Despite several difficulties with documenting risks, some systemic treatments for psoriasis have been linked with an increased risk of selected cancers. The best-documented association is nonmelanoma skin cancer with psoralen plus ultraviolet A therapy and cyclosporin. More recently, an increased risk of cancer has been a concern with newly introduced biologic agents. The documentation of such a purported increased risk requires long-term follow-up of treated patients.

Carcinogenic effect of arsenate in C57BL/6J/Han mice and its modulation by different dietary selenium status.

In this study, carcinogenic effects of arsenate in female C57BL/6J/Han mice exposed in drinking water to 50, 200 or 500microgAs/L for 24 months were investigated. All animals were fed low-selenium diet, however half of them were supplemented with sodium selenite in drinking water (200microgSe/L) to ensure the normal dietary level of selenium. Glutathione peroxidase activity in erythrocytes and plasma as well as selenium concentration in plasma after 3, 6, 12 and 18 months in satellite groups showed considerable decrease in animals from non-selenium supplemented groups in comparison to supplemented groups. A clear arsenic concentration-dependent increase in the number of malignant lymphoma associated with increase in the risk of death was observed (hazard ratio=0.91, 1.46, and 2.24, for 50, 200 and 500microgAs/L, respectively). No significant influence of selenium dietary status on arsenic carcinogenicity was shown. A significant association between selenium supplementation status and increased risk of death of the animals from causes other than malignant tumors was found (HR=1.79, p=0.04).

Iron-radiofrequency synergism in lymphomagenesis.

The parenteral iron administration effects on the acceleration of lymphomagenesis by radiofrequency exposure were investigated using an animal model that develops spontaneous lymphomas with ageing. Complementary studies of the in vivo uptake of 59Fe-labeled ferric gluconate and ferric-ATP complex showed differences ob absorption and excretion between both iron compounds. In vitro assays of their effects on calcium cellular uptake using a cell model and tissues homogenates showed a molecular structure-dependence. The current results (mortality, clinical and histopathological examinations) demonstrated a synergism between radiofrequency and ferric gluconate, and the increased risk of radiofrequency exposure when it is simultaneous to parenteral iron administration.

Review of cyclosporine immunosuppressive safety data in dermatology patients after two decades of use.

Cyclosporine is an immunosuppressive agent that has been shown to be effective in the treatment of psoriasis. However, its serious side effects in transplant patients have hindered many dermatologists from exploiting its therapeutic capabilities. The literature contains reports of lymphomas, internal malignancies, skin cancers, and serious infections in psoriasis patients on cyclosporine therapy. However, no study has evaluated the relative risk of these side effects in relation to the general population, nor monitored the patients for years after cyclosporine was discontinued. The recently published 5-year cohort study is the most rigorous data to date on the long-term safety of cyclosporine and shows no increased risk of lymphoma or internal malignancies. The study, however, illustrates increased risk of non-melanoma skin cancers, especially squamous cell carcinoma. Review of the literature does not suggest any increased risk of opportunistic infections or tuberculosis reactivation. These data suggest that cyclosporine in dermatologic dosage (3-5 mg/kg/d) is safe and dermatologists may consider using it.

Effect of Aerva lanata on solid tumor induced by DLA cells in mice.

Aerva lanata whole plant was extracted with petroleum ether, methanol and acetone. The partially TLC-purified fraction (PEF) of petroleum ether extract was proved to be cytotoxic to Dalton's lymphoma ascites (DLA), Ehrlich ascites (EA) and B16F10 cell lines in vitro. Since PEF was found to be more cytotoxic to DLA cell lines, it was used to study the pharmacological effect and its potential to reduce solid tumor induced by DLA cell lines in mice. The result indicated that PEF significantly reduced the development of solid tumor in mice.

Mortality study in an Italian oil refinery: extension of the follow-up.

This article present the results of the extension of the follow-up of a cohort of workers employed in an Italian oil refinery. 1,583 workers employed in 1949-1982 in a northern Italy oil refinery plant were followed-up for mortality as of May 31, 1991. Environmental measurements documented potential exposure to benzene. Standardized mortality ratios (SMR) and their 95% confidence intervals (95% CI) were calculated using as references national (1949-1968) and regional mortality rates (1969-1991). Elevated mortality from lymphoma (seven deaths, SMR 190, 95% CI 76-391) and leukemia (eight deaths, SMR 225, 95% CI 97-443) was observed. No consistent trends by length of employment or time since first exposure were apparent. Nonetheless, the excess risk was particularly and significantly increased among workers with 15 or more years of employment, and 30 or more years since first employment. The findings of elevated mortality from leukemia and lymphoma are in agreement with those of other oil refinery studies. Chance, confounding, or other biases might have played a marginal, if any, role in determining the results. Exposure to benzene is a biologically plausible explanation.

Effect of Sobatum on tumour development and chemically induced carcinogenesis.

The partially purified component of Solanum trilobatum named Sobatum was obtained from the petroleum ether/ethyl acetate (75:25) extractable portion. It was found to be cytotoxic in Dalton's Lymphoma ascites (DLA), Ehrlich ascites (EA) cell lines and tissue culture cells (L929 and Vero). Sobatum significantly inhibited peritoneal tumours induced by DLA and EA tumour cells. Sobatum was also found to reduce solid tumour growth in mice, when given either simultaneously or prophylactically, and is more active in simultaneous administration (EA). It was found that Sobatum was more active against EA cells-induced solid tumour than DLA-induced solid tumours. On exposure to 7,12-dimethylbenz(a)anthracene (DMBA), about 85.67% animals had induced skin carcinogenesis, which was significantly inhibited to 44.4% by the application of Sobatum. It can be concluded that the Sobatum has the ability to retard the development of solid tumours and DMBA-induced carcinogenesis.

Retrospective benzene and total hydrocarbon exposure assessment for a petroleum marketing and distribution worker epidemiology study.

A quantitative exposure-estimating algorithm for benzene and total hydrocarbons was developed for a case control study of petroleum marketing and distribution workers. The algorithm used a multiplicative model to adjust recently measured quantitative exposure data to past scenarios for which representative exposure measurement data did not exist. This was accomplished through the development of exposure modifiers to account for differences in the workplace, the materials handled, the environmental conditions, and the tasks performed. Values for exposure modifiers were obtained empirically and through physical/chemical relationships. Dates for changes that altered exposure potential were obtained from archive records, retired employee interviews, and from current operations personnel. Exposure modifiers were used multiplicatively, adjusting available measured data to represent the relevant exposure scenario and time period. Changes in exposure modifiers translated to step changes in exposure estimates. Though limited by availability of data, a validation exercise suggested that the algorithm provided accurate exposure estimates for benzene (compared with measured data in industrial hygiene survey reports); the estimates generally differed by an average of less than 20% from the measured values. This approach is proposed to quantify exposures retrospectively where there are sufficient data to develop reliable current era estimates and where a historical accounting of key exposure modifiers can be developed, but where there are insufficient historic exposure measurements to directly assess historic exposures.

Chronic toxic and carcinogenic effects of cadmium chloride in male DBA/2NCr and NFS/NCr mice: strain-dependent association with tumors of the hematopoietic system, injection site, liver, and lung.

Although the acute toxic effects of cadmium in mice vary greatly with strain, relatively little is known about strain differences in cadmium carcinogenesis. Therefore, this work was performed to assess the chronic toxic and carcinogenic effects of cadmium in two strains of mice generally thought to be susceptible to the acute effects of cadmium. Male DBA/2NCr (DBA) and NFS/NCr (NFS) mice were given CdCl2 (40 mumol/kg, sc) either as a single dose (1 x 40) or as weekly doses for 16 weeks (16 x 40) starting at 8 weeks of age. Controls received saline. The animals were observed for the next 104 weeks and mice at risk were defined as those surviving to the time of appearance of a particular tumor. Cadmium-induced dose-related increases in lymphoma (primarily follicular center cell) incidence (1 x 40, 11 cases/23 mice at risk; 16 x 40, 16/28) over control (7/27) in DBA mice but not in NFS mice. Only NFS mice receiving repeated cadmium injections (16 x 40) showed sarcoma development at the injection site (9/35), as no sarcomas occurred in control NFS mice or any group of DBA mice. On the other hand, cadmium-treated (16 x 40) NFS mice, but not DBA mice, had more hepatocellular adenomas and carcinomas (9/27) than control (1/15) but only at the high dose (16 x 40). More cadmium-treated NFS mice had pulmonary tumors than controls, but only at the lower dose (1 x 40). Although testicular tumors were rare, nonneoplastic lesions (fibrosis and mineralization) were induced by cadmium to a similar extent in both strains. Clearly cadmium carcinogenicity varies widely with strain, indicating a genetic basis to susceptibility. The basis of these strain differences deserves further study.

Experimentally induced malignant lymphoma due to chronic antigen stimulation.

Animal experiments were started in 1988 with the aim of inducing malignant lymphomas. 52 guinea pigs were exposed to potassium dichromate using the TINA test (plus 39 control animals). Following the sensitization procedure, the test animals and 15 control guinea pigs were exposed daily (5 x a week) epicutaneously to the antigen up to the present time. Currently, 30 exposed and 17 control animals are still in the experiment. In 3 out of 17 post-mortem examinations, histologically evident lymphomas were found. In the control animals, no tumor has been seen. The experiments support lymphoma causation by chronic antigen stimulation. The experiments are continuing.

Carcinogenicity studies of tobacco extract in vitamin A-deficient Sprague-Dawley rats.

Long-term carcinogenicity studies were carried out in male Sprague-Dawley rats maintained on vitamin A-sufficient (SLO+) and vitamin A-deficient (SLO-) diets and treated with tobacco extract (TE). Three-week-old rats received by gavage a total dose of 860 mg of TE at a daily dose of 3 mg/rat over a period of 21 months. Besides tumorigenicity, drug-metabolizing phase I and phase II enzymes in lung and liver as well as vitamin A and C levels in plasma and liver were measured at 12 and 21 months of age. The cumulative tumor incidence in TE-treated SLO- rats was significantly higher (77-100%) than that observed in TE-treated SLO+ rats (20-22%). Furthermore, SLO+ rats treated with TE showed lung and forestomach tumors, whereas TE-treated SLO- rats showed a preponderance of pituitary adenomas (87%). It was observed that TE treatment increased the activity of the hepatic and pulmonary phase I enzymes and decreased the glutathione/glutathione S-transferase detoxification system at both time points in SLO- rats. On TE treatment the vitamin A levels in the liver and plasma were significantly decreased with a concurrent increase in vitamin C levels. The data show that a vitamin A-deficient diet renders male Sprague-Dawley rats more susceptible to TE treatment than the vitamin A-sufficient diet, an effect which was associated with the augmented induction of P-450 content and activities and depletion of the glutathione/glutathione S-transferase pathway by TE.

Changes in the expression of idiotype antigen on murine B-cell lymphoma after hyperthermia alone and in combination with interferon and tumour necrosis factor.

The effect of interferon (IFN) and tumour necrosis factor (TNF), either alone or combined with hyperthermia, on cell proliferation and expression of idiotype antigen on a murine B-cell lymphoma has been studied. Incubation with same doses of IFN-alpha and IFN-gamma reduced cell proliferation to the same extent. Hyperthermia potentiated the antiproliferative activity of IFN-alpha and IFN-gamma. Pretreatment with IFN-gamma induced a synergistic response with heat, while IFN-alpha and heat had an additive effect. Tumour necrosis factor (TNF) alone did not affect cell proliferation, nor did TNF modify the heat-induced delay in cell growth. The quantitative expression of surface idiotype antigen was studied by flow cytometry using an anti-idiotype monoclonal antibody (MAb). Heat reduced the expression of idiotype antigen approximately 50%. The duration of the reduction depended on the heat-dose. Recovery of antigen expression correlated with recovery of cell growth, and 2-5 days after the treatment antigen expression returned to the normal level for untreated cells. IFN-gamma and TNF increased antigen expression (30-50%) which lasted for 4-6 days after treatment. When cells were incubated with IFN-gamma or TNF for 2 days prior to hyperthermia, the increase in antigen expression was observed immediately after heating, but by the following day, antigen expression was similar to that after heat treatment alone. Expression of idiotype antigen recovered within 2-5 days to the same values as after heat treatment alone. IFN-alpha alone or combined with hyperthermia did not have any significant effect on antigen expression.

Lymphoma in a black patient with actinic reticuloid treated with PUVA: possible etiologic considerations.

A 47-year-old black man with a chronic photocontact dermatitis that evolved into actinic reticuloid was treated with systemically administered PUVA for 15 months. Subsequently an isolated nodule of non-mycosis fungoides T cell lymphoma developed. The use of PUVA may have predisposed this patient to the development of a frank malignancy.

Effect of 13-cis-retinoic acid on the spontaneous thymic lymphoma development in AKR mice.

The aim of the study was to analyze the incidence of spontaneous thymic lymphomas in AKR mice kept on a diet with normal and excess retinoid content. The mice whose diet was supplemented with 13-cis-retinoic acid (250 mg per kg chow) developed less lymphomas than those kept on a standard diet (15 mg per kg chow). The effect of cyclophosphamide on the early stage of lymphomogenesis was tested using a single dose (100 mg per kg body weight), injected intraperitoneally to AKR mice. Increased incidence of lymphoma following cyclophosphamide administration was observed as result of a) low sensitivity of prelymphoma and lymphoma cells and/or b) immunosuppressive effect of cyclophosphamide.