Toxicology Exam 2 Flashcards
What are the reactions catalyzed by CYP450?
- Hydroxylation
- Epoxidation
- Oxidative group transfer
- Cleavage of esters
- Dehydrogenation
How are electrons are transferred from NADPH?
- NADPH-cytochrome P450 oxidoreductase (ER)
- Cytochrome b5 (mitochondria)
What is happening in step 1 of this enzymatic cycle?
Substrate binds in proximity to the heme group. Substrate binding induces a change in the conformation of the active site, displacing an H2O molecule and changing the state of the heme iron (Ferric 3+ –> ferrous 2+).
What is happening in step 2 of this enzymatic cycle?
Substrate binding induces electron transfer from NAD(P)H via cytochrome P450 reductase.
What is happening in step 3 of this enzymatic cycle?
Molecular oxygen binds to the resulting ferrous (Fe2+) heme center, initially giving dioxygen (O2) adduct.
What is happening in step 4 of this enzymatic cycle?
A second electron is transferred, from either cytochrome P450 reductase, or cytochrome b5, reducing the Fe-O2 adduct to give a peroxo state.
What is happening in step 5 of this enzymatic cycle?
The peroxo group formed is rapidly protonated twice, releasing one molecule of H2O and forming the highly reactive species, P450 Compound 1, an iron(IV) oxo (or ferryl 5+) species.
What happens to the enzyme after this cycle is complete?
After the product has been released from the active site, the enzyme returns to its original state, with an H2O molecule returning to occupy the coordination position of the iron nucleus.
How does ethanol cause apoptosis and necrosis?
Apoptosis: Ethanol –> TNFa
Necrosis: Ethanol –> CYP2E1 –> RIP3
What are the two mechanisms of ethanol-induced liver injury?
- Cell damage and formation of non-functional scar tissue
- Alterations in transport and synthetic processes
Where can ethanol be found?
Ethanol, Carbon tetrachloride (CCl4, refrigerants and fire extinguishers), Acetaminophen
What happens when ethanol/alcohol is consumed in excess through an oxidative pathway?
Excess alcohol –> CYP2E1 –> acetaldehyde (ROS) –> lipid accumulation, inflammation, fibrosis
What happens when ethanol/alcohol is consumed normally through an oxidative pathway?
Alcohol –> ADH –> acetaldehyde –> ALDH –> Acetate –> circulation
What type of damage can alterations in transport and synthetic processes through ethanol-induced liver injury?
- Fibrosis and Cirrhosis
- Tumors
- Bile duct damage
- Sinusoidal damage
- Disruption of the cytoskeleton
- Canalicular Cholestasis
- Fatty liver (Steatosis)
What are the consequences of direct liver injury?
Fibrosis and Cirrhosis
What do fibrosis and cirrhosis cause in the liver?
- Accumulation of collagen fibers (Stellate cells)
- Mediated by both injury and Inflammation
- Lower functional capacity of the liver
What are fibrosis and cirrhosis?
Liver fibrosis is the excessive accumulation of extracellular matrix proteins, including collagen, that occurs in most chronic liver diseases. Advanced liver fibrosis results in cirrhosis, liver failure, and portal hypertension and often requires liver transplantation.
What is Canalicular Cholestasis?
Decrease in the volume of bile formed or impaired secretion of solutes.
- Bilirubin (byproduct of Heme catabolism, jaundice)
- Bile salts are made of bile acids that are conjugated with glycine or taurine.
What are the mechanisms involved in Canalicular Cholestasis?
Increased biliary reabsorption in the cholangiocytes of the bile duct
What are the types of alterations in liver function induced by xenobiotics?
Canalicular Cholestasis and Fatty liver
What is fatty liver?
Fatty liver disease (steatosis) is a common condition caused by having too much fat build up in your liver. A healthy liver contains a small amount of fat. It becomes a problem when fat reaches 5% to 10% of your liver’s weight.
What are the mechanisms involved in Fatty liver disease (steatosis)?
a) Increased synthesis of lipids
b) Impairment of very low-density lipoprotein (vLDL) release to the plasma, which facilitates the movement of fats and cholesterol
- Inhibition of lipoprotein synthesis
2.Reduced conjugation of triglycerides with lipoprotein (ApoB) to form vLDL
3.Impaired transfer of vLDL across the plasma membrane
How does the liver metabolize and transport fats?
The liver is the central organ for fatty acid metabolism. Fatty acids accrue in the liver by hepatocellular uptake from the plasma and by de novo biosynthesis. Fatty acids are eliminated by oxidation within the cell or secretion into the plasma within triglyceride-rich, very low-density lipoproteins.
How does the liver metabolize and transport cholesterol?
Free cholesterol can be excreted as neutral sterols into bile or transformed into bile acids, or it can be esterified and either stored in the liver as cholesterol esters or assembled into VLDL and secreted into circulation.
What is Immune-mediated hepatotoxicity?
Autoimmune hepatitis occurs when the body’s immune system, which ordinarily attacks viruses, bacteria and other pathogens, instead targets the liver. This attack on your liver can lead to chronic inflammation and serious damage to liver cells.
What are the mechanisms of immune-mediated hepatotoxicity?
These mechanisms include bile acid-induced liver cell injury during cholestasis, pathophysiological effects of mitochondrial dysfunction, and cell damage by reactive oxygen and nitrogen species.
What are the different types of xenobiotic toxicity in the sinusoidal unit?
1) Toxin injury to hepatocytes
2) Injured hepatocyte signals Kupffer and Ito (Stellate) cells
3) Kupffer cells (macrophages) release cytotoxins –> inflammation
4) Ito cells secrete collagen –> Fibrosis
What makes the kidney (and its different regions) susceptible to xenobiotics? Give Examples
- Excretion of metabolic wastes
- Hormones: Renin (angiotensinogenase) and erythropoietin
- Regulation of fluid volume, electrolyte composition, and acid-base balance (180L of fluid that is filtered per day (rate); 90% reabsorbed)
- Xenobiotics are delivered in high amounts to the kidney (25% of cardiac output); and similar to urine, they get concentrated (tubular fluid)
- Renal transport, accumulation, and biotransformation
What are the two types of kidney injury?
Acute and chronic kidney injury
What is acute kidney injury?
*Abrupt decline in glomerular filtration rate (GFR, blood across the glomeruli)
*Multiple causative factors
*Chemically-induced changes are counteracted with compensatory adaptations.
What is chronic kidney injury?
- Long-term exposure to chemicals
- Maladaptive alterations lead to glomerulosclerosis and mechanical damage to capillaries
What is the important intermediate/ enzyme in the drug metabolism of the kidney?
Cysteine conjugateB-lyase
What is developmental toxicology?
Study of pharmacokinetics, mechanisms, pathogenesis, and outcome following exposure to agents or conditions leading to abnormal development
Teratogenic effects
Malformations in a fetus that result from exposure to chemicals in utero
Teratology
Study of structural birth defects
When does developmental toxicology occur?
At all stages during development
Gametogenesis
Process of forming the haploid germ cells: egg or sperm
Organogenesis
The period during which most bodily structures are established
- Extensive proliferation, differentiation, and organization
What are the developmental alterations induced by xenobiotics?
Alterations in development include death, malformations, growth retardation, function/cognitive defects
Examples (classes) of human developmental toxicants
Thalidomide
Ethanol
What was thalidomide originally used for? What effects did it have on human development? What is its mechanism of effect?
Original use:
- Aleviate nausea and vomiting during pregnancy
- Considered safe –> prolonged sleep, not death
- No apparent toxicity or addiction in adults
Effects on development:
- Retardation or absence of limb growth
- Heart, ocular, intestinal, and renal abnormalities
Mechanism:
No clear mechanism of toxicity has been identified
What effects does ethanol have on human development?
Fetal Alcohol Spectrum Disorders (FASD)
- A group of conditions that can occur as a result of alcohol consumption during pregnancy
- Alterations:
Craniofacial dysmorphism
Growth retardation
Retarded development
Microcephaly
What are the mechanisms of effect of ethanol in developmental toxicosis?
- The placenta allows free entry of ethanol and toxic metabolites (acetaldehyde).
- Fetal liver is incapable of metabolizing ethanol. No Alcohol (ADH) or Aldehyde (ALDH) dehydrogenases
- The nervous system appears to be particularly sensitive
to ethanol during the development
Neurogenesis, Migration, Differentiation, Plasticity, Survival, and Synaptogenesis.
Stages of susceptibility to xenobiotics during prenatal development
- Pre-differentiation stage
- Embryonic stage
- Fetal stage
Pre-differentiation stage of susceptibility to xenobiotics during prenatal development
- Embryo is not susceptible to teratogenic agents.
- Death only occurs when most or all cells are damaged
- Remaining cells can compensate and form a normal embryo (5-9 days)
Embryonic stage of susceptibility to xenobiotics during prenatal development
- Cells undergo extensive differentiation, mobilization, and organization
Most of organogenesis takes place. - Very susceptible to teratogens
*Not all organs are susceptible at the same time.
Fetal stage of susceptibility to xenobiotics during prenatal development
- Growth and functional maturation
- Unlikely morphological effects now
- Maybe functional effects
Mechanisms of action susceptibility to xenobiotics during prenatal development
- Interference with gene replication and transcription
Ionizing radiation & genotoxic carcinogens - Oxidative stress
Lipid, protein, and DNA-damage - Energy deficiency
- Enzyme inhibition
Alterations in growth and differentiation
What do the teratogenic effects of thalidomide stem from?
The teratogenic effects of thalidomide stem from the drug binding to cereblon (CRBN), a component in an E3 ubiquitin ligase complex. This E3 complex ubiquitinates its substrates, allowing subsequent proteasome degradation. Inhibition of the E3 ligase function by
thalidomide leads to the aberrant accumulation of substrates and irregular signaling during development.
The oxidative metabolite of thalidomide[α-(N-phthalimido)glutarimide], dihydroxy thalidomide, is responsible for generating ROS and causing DNA damage.
What are the maternal factors affecting development?
- Genetics background
- Disease state
- Nutritional state
- Stress
- Placental toxicity
- Maternal toxicity
How does genetic background from the maternal side affect development?
Incidence of cleft lip and/or palate is higher in offsprings of white mothers
How does disease state from the maternal side affect development?
Diabetes, infections, and hyperthermia
How does the nutritional state from the maternal side affect development?
Folate supplementation reduces neural tube defects by 70%
How does stress from the maternal side affect development?
Low birth weight and congenital malformations
How does placental toxicity from the maternal side affect development?
- Nutrition and waste removal
- Hormones
- Metabolizing enzymes
- Metals, cigarette smoke, ethanol, APAP
What are the paternal factors affecting development?
- Toxicants primarily affect spermatogenesis (formation of
sperm cells) and spermiogenesis (final maturation stage) - Exposures positively associated with adversely affecting semen
quality –>
Viability and motility
Count (# of germ cells)
Morphology (spermiogenesis) - Genetic damage is difficult to detect in human sperm
Epidemiological studies have demonstrated an increased frequency of spontaneous abortions in pregnancies from men working as motor vehicle mechanics
What is cancer?
- Second leading cause of death in the US (heart disease is 1st)
- A disease of cellular mutation, proliferation, and aberrant cell growth associated with the accumulation of neoplastic lesions.
What is a Neoplastic lesion?
- Neoplastic lesion or neoplasm (tumor) is a heritably altered, relatively autonomous tissue growth with abnormal gene expression.Benign or Malign. Cancer is always malign.