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Screening the potential risks of toxic substances using a multimedia compartment model: estimation of human exposure.

Managing environmental health risks requires the assessment of environmental fate, exposure, and health risk of an ever-increasing list of contaminants. The magnitude of this list precludes an experimental evaluation of each contaminant. For this reason, computer models are being used more frequently to simulate the transport and transformation of chemicals based on physical and chemical properties. This paper describes a multimedia compartment model that we have developed for screening toxic substances. This model, referred to as GEOTOX, uses a combination of physical, chemical, and landscape properties to establish the partitioning, reaction, and interphase-transport characteristics of a chemical. These properties are used to estimate concentrations in the air, soil, water, and food of a representative or generic environment. We use these concentrations in exposure-pathway models to calculate the quantities absorbed by humans; then dose-response data are used to estimate health risks. The capability of GEOTOX as a screening tool is illustrated in a sample ranking of three chemicals (i.e., 2,4,6-trinitrotoluene, hexahydro-1,3,5-trinitro-1,3,5-triazine, and benzene) being continuously added to the upper-soil compartment. We find that ranking based on both toxic potency and environmental fate can enhance the risk-management process when compared to ranking based on toxic potency alone.

Environmental Exposure↗

Energy requirements for the transport of methylthio-beta-D-galactoside by Escherichia coli: measurement by microcalorimetry and by rates of oxygen consumption and carbon dioxide production.

The energy cost for maintenance of gradients of methylthio-beta-d-galactoside in Escherichia coli was evaluated. Information was also obtained concerning the energy flow associated with gradient establishment under some circumstances. Energy flow was evaluated from transport-induced changes in the rate of heat evolution, oxygen consumption, and carbon dioxide production in metabolically active cells. Heats were measured with an isothermal calorimeter. Energy expenditure behavior was characterized by a transition that depended on the level of accumulation. The data for steady-state maintenance could be rationalized in terms of the Mitchell hypothesis, two models for influx and efflux, and a transition between them. At low levels of uptake, steady-state proton-methylthio-beta-d-galactoside (TMG) symport for influx and efflux occurred via a nonenergy-requiring exchange process. The only energy requirement was that necessary to pump back in any TMG exiting via a leakage pathway (model I). Above the transition, all influx occurred with proton symport, but all exit, leak and carrier mediated, occurred without proton symport (model II). The H(+)/TMG stoichiometric ratio computed for the region of model II applicability (carbon source present, high level of uptake) approached 1. This value agreed with that of other workers for downhill beta-galactoside flow, suggesting that the energy cost for both downhill and uphill flow was approximately the same. For low levels of uptake, initial establishment of the gradient was followed by a burst of metabolism that was much larger than that expected on the basis of the chemiosmotic hypothesis. In the absence of carbon source, the stimulation in respiration was sufficient to produce 13 times more protons than are apparently necessary to establish the gradient. The results indicate also that the nature of the biochemical process stimulated by TMG depends on its level of uptake. Insight into several aspects of the nature of these processes was provided through analysis of the heat, oxygen, and CO(2) data. The key factor controlling the transition in energy flow behavior is suggested to be rate of flux. The present data suggest that it occurs at a flux of approximately 120 nmol/min per mg of protein.

Biological Transport, Active↗

Uncertainty in the analysis of tracer kinetics using dynamic contrast-enhanced T1-weighted MRI.

In recent years a number of physiological models have gained prominence in the analysis of dynamic contrast-enhanced T1-weighted MRI data. However, there remains little evidence to support their use in estimating the absolute values of tissue physiological parameters such as perfusion, capillary permeability, and blood volume. In an attempt to address this issue, data were simulated using a distributed pathway model of tracer kinetics, and three published models were fitted to the resultant concentration-time curves. Parameter estimates obtained from these fits were compared with the parameters used for the simulations. The results indicate that the use of commonly accepted models leads to systematic overestimation of the transfer constant, Ktrans, and potentially large underestimates of the blood plasma volume fraction, Vp. In summary, proposals for a practical approach to physiological modeling using MRI data are outlined.

Blood Volume↗

Biotechnological manufacture of lysine.

L-Lysine has been manufactured using Corynebacterium glutamicum for more than 40 years. Nowadays production exceeds 600,000 tons per year. Based on conventionally bred strains, further improvement of lysine productivity has been achieved by genetic engineering. Pyruvate carboxylase, aspartate kinase, dihydrodipicolinate synthase, homoserine dehydrogenase and the specific lysine exporter were shown to be key enzymes for lysine production and were characterized in detail. Their combined engineering led to a striking increase in lysine formation. Pathway modeling with data emerging from 13C-isotope experiments revealed a coordinated flux through pentose phosphate cycle and tricarboxylic acid cycle and intensive futile cycling between C3 compounds of glycolysis and C4 compounds of tricarboxylic acid cycle. Process economics have been optimized by developing repeated fed-batch techniques and technical continuous fermentations. In addition, on-line metabolic pathway analysis or flow cytometry may help to improve the fermentation performance. Finally, the availability of the Corynebacterium glutamicum genome sequence has a major impact on the improvement of the biotechnological manufacture of lysine. In this context, all genes of the carbon flow from sugar uptake to lysine secretion have been identified and are accessible to manipulation. The whole sequence information gives access to post genome technologies such as transcriptome analysis, investigation of the proteome and the active metabolic network. These multi-parallel working technologies will accelerate the generation of knowledge. For the first time there is a chance of understanding the overall picture of the physiological state of lysine overproduction in a technical environment.

Bioreactors↗

Sorting and activity-dependent secretion of BDNF require interaction of a specific motif with the sorting receptor carboxypeptidase e.

Activity-dependent secretion of BDNF is important in mediating synaptic plasticity, but how it is achieved is unclear. Here we uncover a sorting motif receptor-mediated mechanism for regulated secretion of BDNF. X-ray crystal structure analysis revealed a putative sorting motif, I(16)E(18)I(105)D(106), in BDNF, which when mutated at the acidic residues resulted in missorting of proBDNF to the constitutive pathway in AtT-20 cells. A V20E mutation to complete a similar motif in NGF redirected a significant proportion of it from the constitutive to the regulated pathway. Modeling and binding studies showed interaction of the acidic residues in the BDNF motif with two basic residues in the sorting receptor, carboxypeptidase E (CPE). (35)S labeling experiments demonstrated that activity-dependent secretion of BDNF from cortical neurons was obliterated in CPE knockout mice. Thus, we have identified a mechanism whereby a specific motif I(16)E(18)I(105)D(106) interacts with CPE to sort proBDNF into regulated pathway vesicles for activity-dependent secretion.

Amino Acid Motifs↗

Complementary roles of two excitatory pathways in retinal directional selectivity.

The two major excitatory synapses onto ON-OFF directionally selective (DS) ganglion cells of the rabbit retina appear to be nicotinic cholinergic and NMDA glutamatergic. Blockade of either of these synapses with antagonists does not eliminate directional selectivity. This suggests that these synapses may have complementary roles in the computation of the direction of motion. To test this hypothesis, quantitative features of the DS cell excitatory pathways were determined by collecting responses, under nicotinic and/or NMDA blockade, to a sweeping bar, hyperacute apparent motions, or a drifting sinusoidal grating. Sweeping bar responses were reduced, but directional selectivity not eliminated, by blockade of either excitatory path, as previously shown (Cohen & Miller, 1995; Kittila & Massey, 1997). However, residual responses under combined blockades were not statistically significantly DS. NMDA blockade reduced responses more than nicotinic blockade for each protocol, and shifted hyperacute motion thresholds to higher values. This supported the notion that glutamate provides the main excitatory drive to DS cells, that is, the one responsible for contrast sensitivity. In turn, nicotinic, but not NMDA blockade eliminated directional selectivity to a drifting low spatial-frequency sinusoidal grating in these cells. This suggested that acetylcholine (ACh) is the main excitatory input with regards to directional selectivity for some textured stimuli, that is, those with multiple peaks in their spatial luminance profile. Moreover, nicotinic blockade raised the low temporal-frequency cutoff of the grating responses, consistent with the proposal that preferred-direction facilitation, which is temporally sustained, is dependent on the cholinergic input. These different properties of the NMDA and nicotinic pathways are consistent with a recently proposed two-asymmetric-pathways model of directional selectivity.

2-Amino-5-phosphonovalerate↗

Dissociation of pathways for object and spatial vision: a PET study in humans.

A positron emission tomography (PET) study was conducted to determine which brain regions are differentially involved in visual object identification and object localization. Subjects engaged in a spatial task in which they matched the location of common objects, and an object task in which they matched the identity of common objects. In both tasks the stimulus arrangements used were of the same kind. Regional cerebral blood flow data showed that a right-sided region in the inferior parietal lobule was more activated during spatial than during object matching. In contrast, bilateral occipitotemporal regions, with the left more predominant, were more activated during object than spatial matching. These results provide support for Ungerleider and Mishkin's dual pathway model of vision and indicate important patterns of lateralization in the human visual system.

Brain↗

A transfer-function representation for regulatory responses of a controlled metabolic pathway.

A transfer-function representation for the response of a controlled metabolic pathway to the changes in influx and efflux rates of metabolites is formulated to describe analytically and approximately the regulatory behavior of the pathway around a steady state. The pathway model analyzed is an open and homogeneous system which consists of two consecutive enzymatic reactions catalyzed by an allosteric enzyme of Monod-Wyman-Changeux (MWC) dimeric model and a Michaelis-Menten-type enzyme, respectively, and undergoes the feedback inhibition by the end product. The rate equation for the system (a system of ordinary differential equations) is linearized about a steady state, so that the responses of the reaction rates to the changes in influx rate of the substrate and efflux rate of the end product are expressed in a form of transfer function. The formulation leads to the transfer function for the response of production rate of the end product to the change in its efflux rate to clarify the regulatory response of feedback mechanism in controlled metabolic pathways. The relationship among the chemical species in the system at steady states also supports a reasonable assumption that the regulatory mechanisms in metabolic pathways are to control the production of end product against the change in its demand from the cellular environments.

Allosteric Regulation↗

Modeling with measured genotypes: effects of the vitamin D receptor gene, age, and latent genetic and environmental factors on bone mineral density.

We use empirical data to demonstrate a recently proposed framework for including measured genotypes in structural equation models (Van den Oord and Snieder, 2002). The sample consisted of 227 MZ pairs, 197 DZ pairs, and 41 DZ twins without co-twin. The mean age of the female twins was 57 years. The analysis aimed at studying the effect of the vitamin D receptor (VDR) gene polymorphism (VDRGP) on bone mineral density (BMD). Whereas age affected the BMD measures via independent pathways, the effects of the VDRGP plus latent genetic and environmental factors were consistent with a common pathway model. VDRGP explained 0.3% to 0.5% of the variance. These analyses demonstrated that (i) regardless of how much is known about the gene and its products at a molecular level, meaningful questions can be addressed concerning how genes co-act with other variables at a "higher" phenotypic level; (ii) measured genotypes can be treated like any other variable so that the whole structural equation models framework can in principle directly be applied; and (iii) measured genotypes do not need to have large effects to study mechanisms underlying complex traits, and it may even be argued that particularly genes with small effects are better studied within the context of models with multiple variables.

Age Factors↗

Enantiomer/enantiomer interaction of (S)- and (R)-propafenone for cytochrome P450IID6-catalyzed 5-hydroxylation: in vitro evaluation of the mechanism.

Many drugs are used as racemates, and the enantiomers may differ in terms of pharmacological properties and disposition. Stereoselective disposition of the enantiomers can arise from metabolism of the enantiomers via different routes catalyzed by different enzymes. In contrast, the enantiomers may be metabolized by the same enzyme at different rates. In the latter case, the enantiomers can compete for this metabolic step, giving rise to the possibility of an enantiomer/enantiomer interaction. We have chosen the antiarrhythmic propafenone, for which in vivo data indicated an interaction between (S)- and (R)-propafenone, as a model substance to study the mechanism underlying that interaction in human liver microsomes. We used the cytochrome P450IID6-mediated 5-hydroxylation of propafenone as a model pathway, because this metabolic step constitutes the major route of biotransformation of propafenone. The Michaelis-Menten kinetics for 5-hydroxylation were determined after incubation of (R)- and (S)-propafenone and a pseudoracemate consisting of (S)-[2H4]propafenone and (R)-propafenone. Inhibition experiments were performed using (S)-[2H4]propafenone as an inhibitor of the 5-hydroxylation of (R)-propafenone, and vice versa. The kinetic model of mixed alternative substrates was used to simulate inhibition experiments. Experimental data were compared with those predicted by this model. We observed a substantial stereoselectivity after incubation of the individual enantiomers [(S)-propafenone: Vmax, 10.2 pmol/micrograms/hr, and Km, 5.3 microM; (R)-propafenone: Vmax, 5.5 pmol/micrograms/hr, and Km, 3.0 microM]. In contrast, no substrate stereoselectivity was observed after incubation of the pseudoracemate [3.1 pmol/micrograms/hr for (S)-[2H4]propafenone and 3.3 pmol/micrograms/hr for (R)-propafenone]. Application of the model revealed Ki values of 2.9 and 5.2 microM for the inhibition of 5-hydroxylation of (S)-[2H4]-propafenone by (R)-propafenone and for inhibition of 5-hydroxylation of (R)-propafenone by (S)-[2H4]-propafenone, respectively. The predicted and the experimental data were in good agreement, and both indicated the mode of inhibition to be competitive. In conclusion, the enantiomers of propafenone interact with respect to 5-hydroxylation, with (R)-propafenone being a more potent inhibitor than the S-enantiomer with respect to cytochrome P450IID6-mediated 5-hydroxylation. Because beta-blocking properties of propafenone reside in the S-enantiomer, inhibition of metabolism of this enantiomer by (R)-propafenone may have therapeutic consequences.

Adolescent↗

Characterizing the fluorescence intermittency and photobleaching kinetics of dye molecules immobilized on a glass surface.

The blinking behavior of single Atto565 molecules on a glass surface is studied under air or nitrogen atmospheres using confocal microscopy. The broad distributions for both on- and off-time durations obey power law kinetics that are rationalized using a charge tunneling model. In this case, a charge is transferred from the Atto565 molecule to localized states found on the glass surface. Subsequent charge recombination by back charge tunneling from trap to Atto565 cation (i.e., dark state) restores the fluorescence. The off-time distribution is independent of excitation intensity (I), whereas the on-time distribution exhibits a power law exponent that varies with I. Two pathways have been identified to lead to the formation of the radical dark state. The first involves direct charge tunneling from the excited singlet S1 state to charge traps in the surrounding matrix, and the second requires charge ejection from the triplet T1 state after intersystem crossing from S1. Monte Carlo simulation studies complement the two-pathway model. Photobleaching curves of both single and ensemble molecules do not exhibit monoexponential decays suggesting complex bleaching dynamics arising from triplet and radical states.

Journal Article↗

Who treats whom? An application of the Pathways to Care model in Australia.

OBJECTIVE: The present paper applies Goldberg and Huxley's Pathways to Care (PTC) model to the Australian health-care system to ask: who is treated in each sector and what does this tell us about the performance of the health-care system? It examines the factors associated with reaching primary care, outpatient and inpatient sectors, as well as private and public mental health services. METHOD: Data from the Australian National Survey of Mental Health and Wellbeing were used to determine the proportion of the population treated in each sector. Sociodemographic and clinical characteristics were examined and logistic regression was used to determine which factors were associated with use of different sectors of care. RESULTS: Of the total population, 80.5% reached primary care, 8.2% primary care for mental health problems, 6.5% outpatient care and 0.4% reached the mental health inpatient sector. Clinical severity increased across these sectors and was an important determinant of access to care. Those consulting private practitioners were clinically similar to those consulting in the public sector. Sociodemographic characteristics were important determinants of access to primary, specialist and private mental health care. Being aged over 55 years or living in a rural area was associated with lower access to several sectors. CONCLUSIONS: Although at a broad level the health-care system is performing as expected, limited access among some groups is cause for concern. Applying the PTC model to a population sample offered useful insights into the performance of the Australian health-care system.

Adolescent↗

The health care cost of drug-related morbidity and mortality in nursing facilities.

BACKGROUND: Preventable drug-related morbidity and mortality within nursing facilities represent a serious problem urgently requiring expert medical attention. The health care costs of drug-related problems can be both immense and avoidable. However, the research to date has been narrow in scope, focusing on the drug costs avoided and failing to consider the wider range of possible negative outcomes and potential drug-related problems. OBJECTIVES: To develop a model of therapeutic outcomes resulting from drug therapy within nursing facilities, to estimate the magnitude of the cost of drug-related morbidity and mortality within nursing facilities in the United States, and to assess the impact of pharmacist-conducted, federally mandated, monthly, retrospective review of nursing facility residents' drug regimens in reducing the cost of drug-related morbidity and mortality. METHODS: Using decision analysis techniques, a probability pathway model was developed to estimate the cost of drug-related problems within nursing facilities. An expert panel consisting of consultant pharmacists and physicians with practice experience in nursing facilities and geriatric care was surveyed to determine conditional probabilities of therapeutic outcomes attributable to drug therapy. Health care utilization and associated costs derived from negative therapeutic outcomes were estimated. RESULTS: Baseline estimates indicate that the cost of drug-related morbidity and mortality with the services of consultant pharmacists was $4 billion compared with $7.6 billion without the services of consultant pharmacists. CONCLUSIONS: Drug-related morbidity and mortality in nursing facilities represent a serious economic problem. For every dollar spent on drugs in nursing facilities, $1.33 in health care resources are consumed in the treatment of drug-related problems. With the current federally mandated drug regimen review, it is estimated that consultant pharmacists help to reduce health care resources attributed to drug-related problems in nursing facilities by $3.6 million.

Cost of Illness↗

Comparison of linear-scaling semiempirical methods and combined quantum mechanical/molecular mechanical methods for enzymic reactions. II. An energy decomposition analysis.

QM/MM methods have been developed as a computationally feasible solution to QM simulation of chemical processes, such as enzyme-catalyzed reactions, within a more approximate MM representation of the condensed-phase environment. However, there has been no independent method for checking the quality of this representation, especially for highly nonisotropic protein environments such as those surrounding enzyme active sites. Hence, the validity of QM/MM methods is largely untested. Here we use the possibility of performing all-QM calculations at the semiempirical PM3 level with a linear-scaling method (MOZYME) to assess the performance of a QM/MM method (PM3/AMBER94 force field). Using two model pathways for the hydride-ion transfer reaction of the enzyme dihydrofolate reductase studied previously (Titmuss et al., Chem Phys Lett 2000, 320, 169-176), we have analyzed the reaction energy contributions (QM, QM/MM, and MM) from the QM/MM results and compared them with analogous-region components calculated via an energy partitioning scheme implemented into MOZYME. This analysis further divided the MOZYME components into Coulomb, resonance and exchange energy terms. For the model in which the MM coordinates are kept fixed during the reaction, we find that the MOZYME and QM/MM total energy profiles agree very well, but that there are significant differences in the energy components. Most significantly there is a large change (approximately 16 kcal/mol) in the MOZYME MM component due to polarization of the MM region surrounding the active site, and which arises mostly from MM atoms close to (<10 A) the active-site QM region, which is not modelled explicitly by our QM/MM method. However, for the model where the MM coordinates are allowed to vary during the reaction, we find large differences in the MOZYME and QM/MM total energy profiles, with a discrepancy of 52 kcal/mol between the relative reaction (product-reactant) energies. This is largely due to a difference in the MM energies of 58 kcal/mol, of which we can attribute approximately 40 kcal/mol to geometry effects in the MM region and the remainder, as before, to MM region polarization. Contrary to the fixed-geometry model, there is no correlation of the MM energy changes with distance from the QM region, nor are they contributed by only a few residues. Overall, the results suggest that merely extending the size of the QM region in the QM/MM calculation is not a universal solution to the MOZYME- and QM/MM-method differences. They also suggest that attaching physical significance to MOZYME Coulomb, resonance and exchange components is problematic. Although we conclude that it would be possible to reparameterize the QM/MM force field to reproduce MOZYME energies, a better way to account for both the effects of the protein environment and known deficiencies in semiempirical methods would be to parameterize the force field based on data from DFT or ab initio QM linear-scaling calculations. Such a force field could be used efficiently in MD simulations to calculate free energies.

Binding Sites↗

Pharmacoeconomic analysis of sequential treatment pathways in the treatment of onychomycosis.

This study examines the budgetary effect of using ciclopirox, itraconazole (pulse treatment), terbinafine, or itraconazole (continuous treatment) as first-, second-, or third-line therapy in the treatment of toenail onychomycosis by determining which therapeutic sequence is most cost effective. Using a disease treatment pathway model, alternative agents were compared based on cost per clinical response. The results from this sequential treatment analysis demonstrated that ciclopirox followed by itraconazole pulse and then terbinafine provides the lowest-cost approach to the treatment of onychomycosis (dollar 757.89 per clinical response), followed by the sequence of ciclopirox, terbinafine, and itraconazole pulse (dollar 796.13 per clinical response). This study provides a framework for formulary decision makers to evaluate a sequential treatment pathway that resembles actual practice.

Antifungal Agents↗

The relation between insulin resistance and hemostasis: pleiotropic genes and common environment.

Risk factors for coronary heart disease (CHD), including prethrombotic changes in hemostasis, cluster with the insulin resistance (IR) syndrome. The aim of the present study was to investigate to what extent the relation between IR and hemostatic risk factors is due to shared genes or environmental factors. Multivariate genetic analysis was performed using a total of 314 (107 monozygotic and 207 dizygotic) twin pairs on IR assessed by HOMA, fibrinogen, plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (tPA), factor VIII (FVIII), von Willebrand factor (vWF) and factor XIII B-subunit. The relationship between IR and the 6 hemostatic factors could best be explained by an independent pathway model consisting of 2 common genetic factors, one of which influenced IR and all hemostatic factors, and 3 common environmental factors, each representing the shared variance between IR and different aspects of the hemostatic system. Genetic correlations between IR and hemostatic proteins were larger than their environmental counterparts. Since IR and prethrombotic changes are features of both diabetes and CHD, the finding of one set of pleiotropic genes warrants the identification of these common pathways which may provide new avenues for treatment and prevention of both diabetes and CHD.

Adolescent↗

Social and biological pathways linking early life and adult disease.

Evidence is presented for a pathways model linking early life factors and adult disease, which takes account of the inter-relationships between social and biological risks throughout the lifecourse. Few studies, if any, have yet recorded adequate birth to death information which could be used to quantify the effects of different factors and their timing. Hence, there is only limited understanding of the extent to which biological and social risks experienced at different life stages combine to influence adult disease. However, some of the pathways between early and later life are suggested when evidence from earlier stages of the lifecourse is linked to that from studies at older ages, in which adult disease risk factors have been established. Further support for pathway effects is provided by studies showing that health outcomes of early biological insults can depend on the subsequent social and biological environment. Thus, it is argued that adult disease will be more fully understood when account is taken of the combined effects of social and biological risk occurring at different life stages.

Adolescent↗

ECOSYS-87: a dynamic model for assessing radiological consequences of nuclear accidents.

The time-dependent radioecological simulation model ECOSYS-87 has been developed to assess the radiological consequences of short-term depositions of radionuclides. Internal exposure via inhalation and ingestion, as well as external exposure from the passing cloud and from radioactivity deposited on the ground, are included in the model. The site-specific parameter values of the model are representative of Southern German agricultural conditions; however, the model design facilitates adaption to other situations. The ingestion dose is calculated as a function of time considering 18 plant species, 11 animal food products, and 18 processed products. The ingestion and inhalation exposure is estimated for six age groups using age-dependent consumption and inhalation rates and age-dependent dose factors. Results demonstrate a pronounced influence regarding the time of year (season) of deposition on the ingestion dose and on the relative importance of the exposure pathways. Model results compare well with activities in foods measured after the Chernobyl accident.

Accidents↗