Diagnostics of Early Changes in the Immune System Due to Low Concentration of N-Nitrosamines in the Blood.

The concentration of N-nitrosamines (N-nitrosodimethylamine and N-nitrosodiethylamine) was measured in blood samples from children after consumption of drinking water with high content of nitrates (main group) or water meeting health standards (reference group). N-nitrosodimethylamine level in the blood from children of the main group differed from that in the reference group by 2.6 times (0.00026±0.00012 and 0.0001±0.00092 mg/dm3, respectively; p<0.05). The specific immune response to N-nitrosodimethylamine exposure was manifested in an increase in the level of specific serum IgG (2 times higher than that in the reference group). An increase in the specific sensitivity to N-nitrosodimethylamine (by the criterion of IgG) was observed in 60.7% subjects. A correlation was found between an increase in the level of IgG to N-nitrosodimethylamine and rise in the concentration of N-nitrosodimethylamine in the blood (R 2 =0.35; p=0.021). Under these conditions the spontaneous and induced production of arachidonic acid metabolites (leukotrienes) increased by 2.1 times, while the expression of p53 transcription factor (responsible for oncosuppression) decreased by 1.9 times as compared to those in the reference group (p<0.05).

Metabolism and disposition of [(14)C]dimethylamine borane in male Harlan Sprague Dawley rats following gavage administration, intravenous administration and dermal application.

1. Dimethylamine borane (DMAB) is used as a reducing agent in the manufacturing of a variety of products and in chemical synthesis. National Toxicology Program is evaluating the toxicity of DMAB in rodents following dermal application. The objective of this study was to evaluate the metabolism and disposition of DMAB in male Harlan Sprague Dawley (HSD) rats. 2. Disposition of radioactivity was similar between gavage and intravenous administration of 1.5 mg/kg [(14)C] DMAB, with nearly 84%-89% of the administered radioactivity recovered in urine 24 h post dosing. At 72 h, only 1% or less was recovered in feces, 0.3% as CO2, and 0.5%-1.4% as volatiles and 0.3%-0.4 % in tissues. 3. The absorption of [(14)C]DMAB following dermal application was moderate; percent dose absorbed increased with the dose, with 23%, 32% and 46% of dose absorbed at 0.15, 1.5 and 15 mg/kg, respectively. Urinary and fecal excretion ranged from 18%-37% and 2%-4% of dose, respectively, and 0.1%-0.2% as CO2, and 1%-3% as volatiles. Tissue retention of the radiolabel was low ∼1%, but was higher than following the gavage or intravenous administration. 4. Following co-adminsitration of DMAB and sodium nitrite by gavage, N-nitrosodimethylamine was not detected in blood or urine above the limit of quantitation of the analytical method of 10 ng/mL. 5. Absorption of DMAB in fresh human skin in vitro was ∼41% of the applied dose: the analysis of the receptor fluid shows that the intact DMAB complex can be absorbed through the skin.

Salivary excretion of N-nitrosodimethylamine in dogs.

Carcinogenic N-nitroso compounds (NOCs) are not only ingested from the environment but are also formed endogenously from precursors. It has been reported that nitrate, an NOC precursor, has an enterosalivary cycle and that the cycle increases the chance of exposure to NOCs. However, there is no information on the salivary excretion of NOCs. In the present study, the toxicokinetics of N-nitrosodimethylamine (NDMA) in dogs was evaluated, focusing on the salivary excretion. Following intravenous injection of 2 mg/kg NDMA, the plasma concentration showed a monoexponential decline, and the total body clearance and apparent distribution volume were greatly in excess of the hepatic plasma flow and total body water, respectively. A high concentration of NDMA was immediately detected in the plasma after oral administration of the same dose, and the oral bioavailability was almost 100%. NDMA was rapidly excreted into the saliva after both treatments, and the concentration in saliva was higher than that in the plasma. These results suggest that NDMA also has an enterosalivary cycle: NDMA is partially excreted from blood into saliva, delivered into the gastrointestinal tract by swallowing the saliva, and then completely reabsorbed into the systemic circulation. This concept was also supported by kinetic analysis based on a compartment model. The enterosalivary cycle of NDMA cannot be ignored in the risk assessment of carcinogenesis.

[Evaluation of the usefulness of extrelut(R) columns obtained from MERCK for isolation of N-nitrosodimethylamine (NDMA) in the water phase]. / Ocena przydatnosci kolumn Extrelut firmy MERCK do izolacji N-nitrozodimetyloaminy (NDMA) z fazy wodnej.

The aim of the study was to evaluate the method of N-nitrosodimethylamine (NDMA) isolation from the water phase using Extrelut columns (Merck). Results were compared with data obtained from isolation of NDMA by classic distillation method. The estimation was carried out on fortificated water and blood samples. Extraction Extrelut columns are found very useful in isolation of NDMA both in water and blood samples. Their advantage over the method of water vapour distillation is also indicated.

Biomodulation of the toxic and nutritional effects of small bowel bacterial overgrowth in end-stage kidney disease using freeze-dried Lactobacillus acidophilus.

Small bowel bacterial overgrowth (SBBO), well known to occur in end-stage kidney failure, is responsible for producing uremic toxins and contributing to the patient's decreased nutritional well-being. In this study, 8 hemodialysis patients were treated with a course of oral Lactobacillus acidophilus (LBA) in an attempt to alter this SBBO. LBA treatment was effective in lowering 2 compounds generated in vivo. Serum dimethylamine (DMA) levels dropped from 224 +/- 47 to 154 +/- 47 micrograms/dl at the end of LBA treatment (p < 0.001). Nitrosodimethylamine, a carcinogen, levels also decreased significantly from 178 +/- 67 (untreated) to 83 +/- 49 ng/kg (after LBA treatment). Patients nutritional status, assessed as serum albumin, body weight, caloric intake, midarm muscle area (MAMA) and appetite improved modestly, but not significantly. LBA changed small bowel pathobiology by modifying metabolic actions of SBBO, reducing in vivo generation of toxins and carcinogens and promoting nutrition with no adverse side effects.

Suppression of in vivo clearance of N-nitrosodimethylamine in mice by cotreatment with ethanol.

Oral cotreatment of mice with ethanol results in increased tumors in extrahepatic organs caused by some nitrosamines. This action, attributed in part to inhibition of hepatic first-pass carcinogen metabolism by ethanol, has possible relevance to the enhancing effect of alcoholic beverage consumption on human cancer risk. In this study, the effects of ethanol on clearance of N-nitrosodimethylamine (NDMA) were quantified in Swiss female and strain A male mice. In Swiss mice, a 1.6 g/kg ig ethanol dose preceding 1 or 5 mg/kg iv NDMA resulted in 20- to 30-fold increases in area-under-the-blood-concentration-vs.-time curves, mean residence times, and clearance half-times, and similar decreases in clearance. For a 0.5 mg/kg ig NDMA dose, the pharmacokinetic parameters were altered 30-fold and 450-fold by simultaneous ethanol doses of 0.08 and 0.8 g/kg, respectively. With 5 mg NDMA/kg ig, 0.4, 0.8, and 1.6 g/kg ethanol resulted in 6-, 10-, and 20-fold changes in clearance parameters. Comparison of the data with results obtained previously with patas monkeys indicated comparable effects of ethanol on tissue exposure to NDMA in the two species, confirming potential human applicability. In experiments with strain A mice, NDMA concentrations were also monitored in lung and liver. NDMA amounts in lung paralleled those in blood, and were more than sufficient to account for the previously reported increases in DNA adducts and tumors in lungs of similarly treated strain A mice.

Reduced blood clearance and increased urinary excretion of N-nitrosodimethylamine in patas monkeys exposed to ethanol or isopropyl alcohol.

Low concentrations of N-nitrosodimethylamine are metabolized in rodent and human liver by cytochrome P450IIE1, an activity competitively inhibitable by ethanol. In rodents coadministration of ethanol with N-nitrosodimethylamine results in increased tumorigenicity in extrahepatic organs, probably as a result of reduced hepatic clearance. To test this concept in a primate, the effects of ethanol cotreatment on the pharmacokinetics of N-nitrosodimethylamine were measured in male patas monkeys. Ethanol, 1.2 g/kg given p.o. before i.v. N-nitrosodimethylamine (1 mg/kg) or concurrently with an intragastric dose resulted in a 10-50-fold increase in the area under the blood concentration versus time curves and a 4-13-fold increase in mean residence times for N-nitrosodimethylamine. Isopropyl alcohol, 3.2 g/kg 24 h before N-nitrosodimethylamine, also increased these parameters 7-10-fold; this effect was associated with persistence of isopropyl alcohol and its metabolic product acetone, both IIE1 inhibitors, in the blood. While no N-nitrosodimethylamine was detected in expired air, trace amounts were found in urine. Ethanol and isopropyl alcohol pretreatment increased the maximum urinary N-nitrosodimethylamine concentration 15-50-fold and the percentage of the dose excreted in the urine by 100-800-fold. Thus ethanol and isopropyl alcohol greatly increase systemic exposure of extrahepatic organs to N-nitrosodimethylamine in a primate.

Estimation of the fraction of the dose of N-nitrosodimethylamine metabolized to methylamine in rats.

Despite many years of research on the metabolism of N-nitrosodimethylamine (NDMA) in rats, the significance of enzymatic denitrosation as a pathway remains unclear. To assess the role of this pathway of metabolism in rats, animals were administered NDMA by intravenous infusion at two infusion rates until steady state was achieved and the concentrations of NDMA (Css,NDMA) and methylamine (MA) (Css,MA), a product of the enzymatic denitrosation pathway, were determined in plasma. The clearance of NDMA (ClNDMA) from plasma was determined by dividing the infusion rate by Css,MA. The plasma clearance of MA (ClNDMA) was determined in a separate experiment. The fraction of the dose of NDMA metabolized by enzymatic denitrosation (fm) was calculated using the equation fm = (Css,MA*ClMA)/(Css,NDMA*ClNDMA). By this method it was estimated that 29% of the dose of NDMA was metabolized via the enzymatic denitrosation pathway. Thus enzymatic denitrosation is an important pathway in the metabolism of NDMA in rats.

Analysis of human blood for volatile N-nitrosamines by gas chromatography-chemiluminescence detection.

A method was developed to separate and measure trace levels of volatile N-nitrosamines (NAs) in human blood that either eliminated or accounted for in vitro artifactual formation of N-nitrosodimethylamine (NDMA) through the use of water blanks, added inhibitor (ascorbic acid) and added morpholine. The absolute minimum detectable limit was 8 pg; minimum level of reliable measurement was 0.05 microgram/kg for a 20-g blood specimen. Recovery of NDMA from blood was 93 +/- 5%. Coefficient of variation was 25%. Bloods from 242 people were analyzed for volatile NAs. NDMA was the only NA found. Positive specimens were presumptively confirmed by their non-detection after ultraviolet photolysis and/or mass spectrometry. This paper presents additional evidence that in vivo NA formation occurs.

Low-dose in vivo pharmacokinetic and deuterium isotope effect studies of N-nitrosodimethylamine in rats.

The rates of elimination of N-nitrosodimethylamine (NDMA) and its fully deuterated analogue (N-nitrosodi[2H6]methylamine, [2H6]NDMA) were studied in vivo to explore the origins of the difference in their carcinogenicity. Male Fischer 344 rats, 7.5 weeks of age, were given nitrosamine bolus doses of 1.35 mumol/kg by tail vein injection and 2.02 or 4.05 mumol/kg by p.o. gavage. Animals were sacrificed at various time points from 2.5 to 180 min after i.v. administration or 5 to 120 min after p.o. dosage, and their blood was analyzed for NDMA by gas chromatography-high resolution mass spectrometry. After i.v. injection, blood nitrosamine concentrations declined in an apparently biexponential manner with a terminal half-life of 10 min for NDMA and 12 min for [2H6]NDMA. The apparent total systemic blood clearances for NDMA and [2H6]NDMA were 39 and 26 ml/min/kg, respectively. The apparent steady-state volumes of distribution were nearly identical (297 and 309 ml/kg, respectively). The areas under the curve after 2.02- and 4.05-mumol/kg p.o. doses were proportional to dose. The apparent bioavailability of NDMA was 8%, while that of [2H6]NDMA was 21%. Isotope effects calculated as the ratios of first-pass metabolism, total systemic clearances, bioavailabilities, and intrinsic hepatic clearances were 1.2, 1.5, 2.6, and 3.2, respectively. The isotope effect determined from blood concentrations measured after simultaneous administration of NDMA and [2H6]NDMA by steady-state infusion (each at 1.5 mumol/kg/h) was 2.6 +/- 0.9 (SD). This study thus provides quantitative reference data on the time course of the disappearance of both N-nitrosodimethylamine and its deuterated analogue from blood (over 5 to 8 half-lives) after doses similar to those used to elicit liver tumors in chronic feeding studies, confirms the first-pass effect on their metabolism using direct blood measurements, and permits estimation of their bioavailabilities from actual blood concentrations. The results suggest that elimination pathways not involving alpha-hydroxylation are more important than is currently recognized.

Substrate concentration dependency of N-nitrosodimethylamine and N-nitrosomethylbenzylamine metabolism in rat liver.

Metabolism of N-nitrosodimethylamine (NDMA), a hepatocarcinogen, and N-nitrosomethylbenzylamine (NMBeA), an esophageal carcinogen, was comparatively investigated in rat liver. When these nitrosamines (25 micromole/kg) were administered orally to rats, the clearance of NDMA from the serum and liver was faster than that of NMBeA. The metabolic decomposition of NDMA by rat isolated hepatocytes was slower than that of NMBeA at high concentration (0.5 mM). However, at low concentration (6.7 microM) the metabolic decomposition of NDMA was faster than that of NMBeA. The ratio of NDMA demethylation to NMBeA demethylation and debenzylation by hepatic microsomes also changed depending on nitrosamine concentrations (1 microM to 1 mM), and low concentration of NDMA was demethylated rapidly. These results suggest that NDMA is metabolized to a methylating agent more effectively than NMBeA in liver, when carcinogenic doses of nitrosamines are administered.

Measurement of nitrosodimethylamine by capillary gas chromatography-mass spectrometry with the 15N-labelled compound as an internal standard.

Artifactual formation of N-nitrosodimethylamine during the extraction procedure from aminopyrine and nitrite was examined. The use of the basic pH condition was the most effective in preventing artifactual formation. Sulfamic acid or ascorbic acid was partially effective in preventing artifactual formation. Since significant losses of volatile N-nitrosodimethylamine occur during the extraction and concentration steps, we analyzed N-nitrosodimethylamine by combined gas chromatography mass spectrometry with 15N-nitrosodimethylamine as an internal standard. The use of a fused silica capillary column enabled us to obtain a fine separation of the chromatogram. This methodology was applied to our model experiment, which was performed to locate the formation of N-nitrosodimethylamine when a rabbit was exposed to NO2 after the administration of aminopyrine. SO3 inhaled together with NO2 was found to increase the nitrosation.

Effect of disulfiram on N-nitroso-N-methylbenzylamine metabolism. Biochemical aspects.

The present biochemical experiments show that disulfiram inhibits N-nitroso-N-methylbenzylamine metabolism in the rat. More N-nitroso-N-methylbenzylamine may therefore reach extrahepatic tissues. The pathological lesions observed in the lungs in the present system can be explained by the finding that alkylation of lung DNA is increased and repair processes are impaired by enhanced cell proliferation in this organ.

Recreational drugs: relationship to AIDS.

Current data suggest that a transmissible agent causes AIDS, but undefined cofactors may also play a role. This paper reviews published data on the relationship between recreational drugs and immune alterations, with particular emphasis on nitrite inhalant (NI) use by homosexual men. In our original cohort of 15 homosexual men, helper:suppressor (H:S) T-cell ratios are stable, but persistently lower in the NI users. A recent analysis of 245 homosexual men shows that NI use is associated with low H:S ratios in homosexual men in Washington, D.C., but not in New York. Although NI use could increase the risk of AIDS by direct or indirect effects, it could also be a surrogate for a lifestyle practice that predisposes homosexual men to the putative AIDS agent. The current evidence concerning use of NI and the risk of AIDS is inconclusive, as is true for two other recreational drugs, heroin and cocaine. Future studies may not be able to dissect the complex interrelationships of drug use and other variables until precise laboratory tests are available for defining exposure to the putative AIDS agent and suspect cofactors.

Evidence for generation of the precarcinogen nitrosodimethylamine in the small intestine in chronic renal failure.

We have previously reported raised concentrations of dimethylamine and also bacterial overgrowth in the small intestine in CRF. Evidence for in vivo NDMA formation in the same site in CRF is now presented. Gastroduodenal intubation was performed in 9 healthy volunteers and 7 patients with advanced chronic renal failure. Blood, gastric, and duodenal aspirates were analyzed for NDMA. NDMA levels in control and CRF patients for blood were normal, but for gastric aspirate they were 67 +/- 13 and 312 +/- 68 (P less than 0.001) and for duodenal aspirate they were 70 +/- 21 and 319 +/- 47 (P less than 0.001), respectively. The results of bacterial cultures confirmed small intestinal bacterial overgrowth. We thus demonstrated statistically significant differences between NDMA concentrations in the control subjects and patients for both gastric and duodenal aspirates. This suggests that there is increased intestinal generation of NDMA in uremia. The presence of this precarcinogen may be linked with the reported increase in the incidence of cancer in CRF.

Generation of dimethylnitrosamine in water purification systems. Detection in human blood samples during hemodialysis.

Dimethylnitrosamine (DMNA), a carcinogen, was detected at levels up to 32 micrograms/L in dialysate from five of 16 dialysis units surveyed. Blood drawn from patients at one of these units in which DMNA was raised in the dialysate showed a significant increase in the amount of DMNA in the patient's blood when predialysis levels were compared with 15-minute intradialysis levels. The presence of a mixed-bed deionizer without an antecedent carbon filter appeared to be necessary for DMNA production. These data suggest that DMNA is generated in certain water purification systems and may then diffuse into the patient's blood. Guidelines for deionizer-treated water should be revised to include an activated carbon filter.

An examination of human blood for the presence of volatile nitrosamines.

Human blood was examined for the presence of volatile nitrosamines. Nitrosamines were detected by chemiluminescence and mass spectrometry after separation from blood by distillation and solvent extraction. N-nitrosodimethylamine was detected in all but one of 51 blood samples taken from 23 different people, at concentrations from the detection limit (0.1 microgram/litre) to 1.4 microgram/litre with a mean concentration of 0.5 microgram/litre. N-Nitrosodiethylamine was detected in 11 samples, the detection limit being 0.1 microgram/litre. No other volatile nitrosamines were detected. After a test meal of bacon, spinach, bread and beer, the concentration of N-nitrosodimethylamine increased. There was no appreciable difference between the nitrosamine concentrations in the blood of laboratory workers and in the blood of other people. Salivary nitrite concentrations measured semi-quantitatively concurrently with blood sampling varied considerably but showed no apparent correlation with blood nitrosamine levels. Measurements in rabbits given a continuous infusion of N-nitrosodimethylamine gave a clearance rate approximately equal to the blood flow through the liver and a volume of distribution of 1.2 litre/kg body weight. By applying these results to man, the body burden after the meal was calculated as 40-50 microgram. This is substantially higher than the estimated weekly intake of volatile nitrosamines from food.

Inhibition of dimethylnitrosamine metabolism by some heterocyclic compounds and by substrates and inhibitors of monoamine oxidase in the rat.

Pretreatment of rats with a number of nitrogen-containing heterocyclic compounds was found to inhibit markedly the metabolism of dimethylnitrosamine (DMN) in terms of both CO2 excretion and decline in blood DMN concentration. However, many of these compounds had either much less or no inhibitory effect on the in vivo metabolism to CO2 of a typical mixed-function oxidase substrate, aminopyrine. In addition, a number of model inhibitors of monoamine oxidase (MAO) activity also inhibited DMN metabolism in the intact animal, and a number of primary amines, known substrates of hepatic MAO, inhibited DMN metabolism but not that of aminopyrine in the isolated perfused liver system. These results, together with in vitro data and previously reported studies on the effect of MAO inhibitors and substrates on the mutagenicity of DMN, suggest that the metabolism and bioactivation of DMN may be in part mediated by a MAO type of enzyme activity.

Microsome-dependent methylation of erythrocyte proteins by dimethylnitrosamine.

The precarcinogen, N-[methyl-14C]dimethylnitrosamine, rat liver microsomes and NADPH were incubated in the presence of intact human erythrocytes. Uptake of radioactivity into erythrocytes was time-dependent and analysis of an acid hydrolysate of the erythrocyte proteins showed several radioactive peaks which were identified as 3-N-methyl- and 1-N-methyl-histidine, S-methyl-cysteine. Since no binding occurs in the absence of microsomes, the alkylating species from dimethylnitrosamine metabolism can clearly penetrate the erythrocyte plasma membrane.