Viral hepatitis in all its forms is a major public health problem throughout the world, affecting several hundreds of millions of people. Viral hepatitis is a cause of considerable morbidity and mortality both from acute infection and chronic sequelae which include, in the case of hepatitis B, C and D, chronic active hepatitis and cirrhosis. Hepatocellular carcinoma, which is one of the 10 commonest cancers worldwide, is closely associated with hepatitis B and, at least in some regions of the world, with hepatitis C virus. This timely monograph is a distillation of knowledge of hepatitis B, C and D, based on a review of 1000 studies by a small group of scientists. (It is interesting to note in passing that some 5000 papers on viral hepatitis are published annually in the world literature.) The epidemiological, clinical and experimental data on the association between infection with hepatitis B virus and primary liver cancer in humans are reviewed in a readable and succinct format. The available information on hepatitis C and progression to chronic infection is also evaluated and it is concluded (perhaps a little prematurely) that hepatitis C virus is carcinogenic. However, it is concluded that hepatitis D virus, an unusual virus with a number of similarities to certain plant viral satellites and viroids, cannot be classified as a human carcinogen. There are some minor criticisms: there are few illustrations and some complex tabulations (for example, Table 6) and no subject index. A cumulative cross index to IARC Monographs is of little value and occupies nearly 30 pages. This small volume is a useful addition to the overwhelming literature on viral hepatitis, and the presentation is similar to the excellent World Health Organisation Technical Reports series on the subject published in the past. It is strongly recommended as a readable up-to-date summary of a complex subject; and at a cost of 65 Sw.fr (approximately £34) is excellent value. A J ZUCKERMAN

https://jcp.bmj.com/content/jclinpath/48/7/691.1.full.pdf

IARC Monographs on the Evaluation of Carcinogenic Risks to Humans

Nanomaterials are engineered structures with at least one dimension of 100 nanometers or less. These materials are increasingly being used for commercial purposes such as fillers, opacifiers, catalysts, semiconductors, cosmetics, microelectronics, and drug carriers. Materials in this size range may approach the length scale at which some specific physical or chemical interactions with their environment can occur. As a result, their properties differ substantially from those bulk materials of the same composition, allowing them to perform exceptional feats of conductivity, reactivity, and optical sensitivity. Possible undesirable results of these capabilities are harmful interactions with biological systems and the environment, with the potential to generate toxicity. The establishment of principles and test procedures to ensure safe manufacture and use of nanomaterials in the marketplace is urgently required and achievable.

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Toxic Potential of Materials at the Nanolevel

Rapid growth in nanotechnology is increasing the likelihood of engineered nanomaterials coming into contact with humans and the environment. Nanoparticles interacting with proteins, membranes, cells, DNA and organelles establish a series of nanoparticle/biological interfaces that depend on colloidal forces as well as dynamic biophysicochemical interactions. These interactions lead to the formation of protein coronas, particle wrapping, intracellular uptake and biocatalytic processes that could have biocompatible or bioadverse outcomes. For their part, the biomolecules may induce phase transformations, free energy releases, restructuring and dissolution at the nanomaterial surface. Probing these various interfaces allows the development of predictive relationships between structure and activity that are determined by nanomaterial properties such as size, shape, surface chemistry, roughness and surface coatings. This knowledge is important from the perspective of safe use of nanomaterials.

Understanding biophysicochemical interactions at the nano–bio interface

Efforts to understand and mitigate the health effects of particulate matter (PM) air pollution have a rich and interesting history. This review focuses on six substantial lines of research that have been pursued since 1997 that have helped elucidate our understanding about the effects of PM on human health. There has been substantial progress in the evaluation of PM health effects at different time-scales of exposure and in the exploration of the shape of the concentration-response function. There has also been emerging evidence of PM-related cardiovascular health effects and growing knowledge regarding interconnected general pathophysiological pathways that link PM exposure with cardiopulmonary morbidity and mortality. Despite important gaps in scientific knowledge and continued reasons for some skepticism, a comprehensive evaluation of the research findings provides persuasive evidence that exposure to fine particulate air pollution has adverse effects on cardiopulmonary health. Although much of this research has been motivated by environmental public health policy, these results have important scientific, medical, and public health implications that are broader than debates over legally mandated air quality standards.

/pdf/health-effects-of-fine-particulate-air-pollution-lines-that-s831sp8jap.pdf

Health effects of fine particulate air pollution: lines that connect

In 2004, the first American Heart Association scientific statement on “Air Pollution and Cardiovascular Disease” concluded that exposure to particulate matter (PM) air pollution contributes to card...

https://cdr.lib.unc.edu/downloads/p2676x621

Particulate Matter Air Pollution and Cardiovascular Disease An Update to the Scientific Statement From the American Heart Association

Although humans have been exposed to airborne nanosized particles (NSPs; < 100 nm) throughout their evolutionary stages, such exposure has increased dramatically over the last century due to anthropogenic sources. The rapidly developing field of nanotechnology is likely to become yet another source through inhalation, ingestion, skin uptake, and injection of engineered nanomaterials. Information about safety and potential hazards is urgently needed. Results of older bio-kinetic studies with NSPs and newer epidemiologic and toxicologic studies with airborne ultrafine particles can be viewed as the basis for the expanding field of nanotoxicology, which can be defined as safety evaluation of engineered nanostructures and nanodevices. Collectively, some emerging concepts of nanotoxicology can be identified from the results of these studies. When inhaled, specific sizes of NSPs are efficiently deposited by diffusional mechanisms in all regions of the respiratory tract. The small size facilitates uptake into cells and transcytosis across epithelial and endothelial cells into the blood and lymph circulation to reach potentially sensitive target sites such as bone marrow, lymph nodes, spleen, and heart. Access to the central nervous system and ganglia via translocation along axons and dendrites of neurons has also been observed. NSPs penetrating the skin distribute via uptake into lymphatic channels. Endocytosis and biokinetics are largely dependent on NSP surface chemistry (coating) and in vivo surface modifications. The greater surface area per mass compared with larger-sized particles of the same chemistry renders NSPs more active biologically. This activity includes a potential for inflammatory and pro-oxidant, but also antioxidant, activity, which can explain early findings showing mixed results in terms of toxicity of NSPs to environmentally relevant species. Evidence of mitochondrial distribution and oxidative stress response after NSP endocytosis points to a need for basic research on their interactions with subcellular structures. Additional considerations for assessing safety of engineered NSPs include careful selections of appropriate and relevant doses/concentrations, the likelihood of increased effects in a compromised organism, and also the benefits of possible desirable effects. An interdisciplinary team approach (e.g., toxicology, materials science, medicine, molecular biology, and bioinformatics, to name a few) is mandatory for nanotoxicology research to arrive at an appropriate risk assessment.

/pdf/nanotoxicology-an-emerging-discipline-evolving-from-studies-pb7art8sfp.pdf

Nanotoxicology: An Emerging Discipline Evolving from Studies of Ultrafine Particles

Wittmaack (2007) did not agree with our suggestion (Oberdorster et al. 2005) that particle surface area is a more appropriate dose metric than particle mass or particle number when evaluating dose–response relationships of nanoparticle-induced pulmonary inflammation. According to his understanding of nanotoxicology and based on his calculations, he found particle number to work best as a dose metric. Throughout our review we pointed out that the surface area concept should be considered in the context of nanoparticle surface properties such as chemistry, charge, coating, crystallinity, porosity, and reactivity. For example, nano-titanium dioxide (TiO2) or nano-copper particles, very distinct from one another, will predictively create separate well-fitting surface area dose–response relationships. Yes, particle number is of importance as well, as we indicated in our review, but not as a direct dose metric.

We would like to address some of the issues Wittmaack (2007) raised in his article. First, Wittmaack suggested that when expressing a pulmonary inflammatory response, a response metric is better done using the ratio of lavaged neutrophils (PMN; polymorphonuclear leukocytes) to macrophages instead of using the fraction of PMNs. Because the purpose of our review (Oberdorster et al. 2005) was not to describe these responses in mathematical terms (whether threshold, linear, or nonlinear) but rather to illustrate that dose–response relationships on a mass basis—but not on a surface area basis—are very different, the choice of the response metric is irrelevant. To demonstrate this, we present our data again (Figure 1), expressed as absolute numbers of elicited PMNs and as PMN/macrophage ratios as a function of administered mass (Figure 1A,B), number (Figure 1C,D), or surface area (Figure 1E,F) of fine and ultrafine (nanosized) TiO2. The dose–response relationships based on mass and surface area are essentially the same as those shown in our review (Oberdorster et al. 2005) using the percentage of elicited neutrophils.



Figure 1

Inflammatory cell response in lung lavage 24 hr after intratracheal instillation of fine (~ 250 nm) and ultrafine (20–30 nm) TiO2 expressed by different dose metrics [particle mass (A,B), number (C,D), and surface area (E,F)] and different response ...



Second, regarding the issue of particle number being the best dose metric, the particle number dose–response relationships (Figure 1B) are several orders of magnitude apart for fine and ultrafine TiO2, whereas the surface area plot (Figure 1C) shows a good fit for the combined particle sizes. The reviewers of Wittmaack’s article (2007) apparently overlooked this flaw in his argument.

Finally, Wittmaack (2007) calculated that the surface area for ultrafine TiO2 should be 77 m2/g and not 50 m2/g, as we reported (Oberdorster et al. 2005). He derived his value on the basis of the specific density of TiO2 (anatase) and a spherical primary particle size of 20 nm. BET surface area for this TiO2 (Degussa P25) has been measured independently by a number of investigators, including our group (Jwo et al. 2005; Long et al. 2006; Wahl et al. 2005), and ranges between 48 and 55 m2/g. There is no reason to mathematically manipulate this number to a value that is completely at odds with actual measurements. In contrast to the well-established surface area, the average primary particle size of TiO2 has not been firmly established, with values of 20–30 nm. Indeed, a size of 30 nm (calculated surface area, 51.2 m2/g) conforms best to the measured BET surface. Thus, we added particle number dose–response data for 30 nm TiO2 to Figure 1C and 1D; the order of magnitude difference of the dose response between fine and ultrafine particles is obvious, regardless of whether the ultrafines are considered to be 20 or 30 nm in size.

We have concluded that of the three dose metrics discussed, particle number is the worst to describe nanoparticle-induced pulmonary inflammatory effects.

/pdf/concepts-of-nanoparticle-dose-metric-and-response-metric-1h5fxodg5l.pdf

Jan Oberdörster

Papers

Nanotoxicology: An Emerging Discipline Evolving from Studies of Ultrafine Particles

Concepts of Nanoparticle Dose Metric and Response Metric