* Battelle Pacific Northwest Division, Richland, Washington 99352; The Dow Chemical Company, Midland, Michigan 48674
1 To whom correspondence should be addressed at Biological Monitoring & Modeling, P.O. Box 999, MSIN P7-59 Richland, WA 99352. Fax: (509)3769064. E-mail: rick.corley{at}pnl.gov.
Received October 26, 2004; accepted February 12, 2005
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ABSTRACT |
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Key Words: ethylene glycol; glycolic acid; PBPK modeling.
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INTRODUCTION |
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Given the many decades of use, EG has been the subject of numerous toxicity, metabolism, and pharmacokinetic studies in a variety of species. Although some variability in sensitivity has been observed across species, genders, or strains of animals, these studies have consistently identified the kidney as a primary target organ after acute or chronic exposures (Blood et al., 1962, 1965
; Coon et al., 1970
; Cruzan et al., 2004
; Depass et al., 1986
; Dunkelberg, 1987
; Gaunt et al., 1974
; Hanzlik et al., 1947
; Melnick, 1984
; Morris et al., 1942
; NTP, 1993
). In humans, renal toxicity, metabolic acidosis, and central nervous system (CNS) depression, have been the major findings in case reports of intentional or accidental overdosing (Blood, 1965
; Eder et al., 1998
; Hanzlik et al., 1947
; Jacobsen and McMartin, 1986; Morris et al., 1942
; Spillane et al., 1991) but not after typical occupational exposures or in controlled exposure studies (Carstens et al., 2003
; Gerin et al., 1997
; Laitinen et al., 1995
; Wills et al., 1974
). Ethylene glycol has also been demonstrated to cause developmental effects in rats and mice, but not in rabbits, although at dose levels greater than those associated with kidney toxicity (reviewed in Carney, 1994
). This latter effect (developmental toxicity) has been the subject of extensive research interest and regulatory review in recent years (Carney, 1994
; CERHR, 2004
).
The metabolism of EG and the ability to eliminate metabolites are factors closely associated with its toxicity. Depending on the dose, dose rate, and route of exposure, the main metabolites found in blood, tissues, or excreta in all species studied include unmetabolized EG, CO2, glycolic acid, and oxalic acid (or calcium oxalate) (Fig. 1). Intermediates such as glycoaldehyde, glyoxal, or glyoxylic acid have not been consistently found in vivo in animals or humans, presumably because of their very short half-lives and the presence of more efficient competitive metabolic pathways. The general metabolism of EG appears to be consistent across species, although there are species, strain, and sex differences in the pharmacokinetics of EG and its metabolites that are important in both renal and developmental toxicity (Bowen et al., 1978; Carney, 1994
; Carney et al., 1996
, 1999
; Frantz et al., 1996a
, 1996b
, 1996c
; Introna and Smialek, 1989
; Jacobsen et al., 1988
; Khera, 1991
; Klug et al., 2001
; Marshall, 1982).
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Throughout its history of use, EG has been the subject of extensive reviews by regulatory agencies to assess potential health risks and establish exposure guidelines. As reviews have progressed (e.g., EPA, 1998; Health Canada, 2001
; CERHR, 2004
), additional data have been collected on the toxicity, pharmacokinetics, and modes of action of EG developmental and renal toxicity to facilitate the risk assessment processes. Thus, the primary objective of this study was to provide the initial integration of what is now an extensive pharmacokinetic database on EG and one of its important metabolites, GA. Our goal was to create a physiologically based pharmacokinetic (PBPK) model for adult male and female rats and humans to reduce the uncertainties associated with dose, route, and species extrapolations in human health risk assessments. The model includes physiological descriptions and pharmacokinetic data from male and female Sprague-Dawley and Fischer 344 (F344) rats, and male Wistar rats because of their historical uses and differential sensitivities observed in numerous toxicity studies.
To develop this initial model, partition coefficients and metabolic rate constants for EG and GA were determined in rat and human tissues in vitro, and the clearances of each metabolite in urine were estimated from applicable in vivo studies. The resulting model was then validated against an extensive database in rats and a single human inhalation study, as summarized in Table 1. In a companion study, the initial human model was extended to describe the effect of various treatment regimens and thereby validate the model against several clinical case reports of accidental or intentional overdosing by humans (Corley and McMartin, 2005).
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MATERIALS AND METHODS |
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Anatomical and physiological parameters for rats and humans listed in Table 2, and later in Table 4, were taken from Brown et al. (1997), Corley et al. (1994)
, and ICRP (1975)
. Rat strainspecific renal physiology parameters were taken from Powers (1995)
. In this adult rat and human model, tissue volumes were scaled linearly with body weight; alveolar ventilation and cardiac output were scaled as (body weight)0.74; tissue blood perfusion rates were set as fractions of cardiac output; and glomerular filtration, tubule urine volume, and total urine production were scaled as a fraction of kidney weights.
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Although the metabolism of EG appears complex (Fig. 1), the in vivo disposition of EG and GA in rats and humans can be described simply by using saturable Michaelis-Menten equations for the two critical rate-limiting steps in the liver: (1) metabolism of EG to GA and (2) metabolism of GA to glyoxylic acid. The elimination of EG into urine was described as a first-order clearance of arterial blood scalable by (body weight)0.70. Urinary elimination of GA was also described initially by a similar first-order equation. This simple assumption worked well for many of the high-dose pharmacokinetic studies in the early literature, but it significantly overpredicted the elimination of GA in urine at doses below 200 mg/kg. Therefore an alternative kidney model structure (Fig. 3) was developed, where GA that is filtered by the glomerulus can be reabsorbed from renal tubules by a saturable Michaelis-Mentenlike process.
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For in vitro metabolism studies, 13C2-ethylene glycol (lot no. 5190), was obtained from Icon Services Inc. (Summit, NJ). This test material was specified to contain a minimum of 99-atom% 13C. Nuclear magnetic resonance (NMR) analysis of this compound afforded a chemical purity of 68.6%, with water as the only identified impurity (31.4%). 13C2-GA (lot no. SN02941) was obtained from Isotec Inc. (Miamisburg, OH). This test material was specified to contain a minimum of 99-atom% 13C. The NMR analysis of this compound afforded a chemical purity of 83.1%, with 94.3% of the total 13C-labeled components identified as 13C2-GA, and four minor 13C-containing impurities observed, comprising 0.72.5% each (structures not identified). The remaining non-organic impurities in the 13C2-GA test material were assumed to be water and/or inorganic salts. The internal standards D4-ethylene glycol and unlabeled GA used in GC/MS analyses were obtained from Isotec and Sigma-Aldrich (Milwaukee, WI), respectively. Nicotine adenine dinucleotide (NAD+), and derivatization agents, pentafluorobenzoyl chloride (PFBCl) and pentafluorobenzyl bromide (PFBBr), were obtained from Sigma-Aldrich. All other compounds and solvents were reagent grade or better.
Test animals.
Adult female Sprague-Dawley rats used as blood and tissue donors for partition coefficient and protein binding determinations were purchased from Charles River Laboratories (Portage, MI). Upon arrival at the laboratory, the animals were housed in suspended plastic cages with chipped bedding and acclimated to the laboratory for at least 1 week prior to use. The rooms in which the animals were housed were on a 12-h light cycle (7 am7 pm) and were designed to maintain adequate temperatures, relative humidity, and airflows for the species under study. Deionized water and Purina Certified Rodent Chow #5002 (Purina Mills, Inc., St. Louis, MO) were provided ad libitum.
Partition coefficients.
Approximately 11-week-old female Sprague-Dawley rats were anesthetized by CO2 or i.p. injection with Nembutal (Abbott Laboratories, Abbott Park, IL) and killed by exsanguination to reduce residual tissue blood. Pooled human blood (female) was obtained from a local blood bank. Blood:air partition coefficients for EG were determined using the vial equilibration method of Gargas et al. (1989). Heparinized whole blood samples from rats and humans were evaluated undiluted. The concentrations of EG in the headspace of sample and reference vials were determined by gas chromatography/flame ionization detection (GC/FID) as described below for the ultrafiltration method.
Partition coefficients (tissue or blood:saline) were determined for EG and GA in rats from heparinized whole blood, abdominal fat, kidney, liver, lung, brain, thigh muscle, back skin, stomach, small intestine, and cecum according to the methods of Jepson et al. (1994) under the following specific conditions: A weighed quantity (300500 mg) of each tissue or pooled blood was placed in a 20-ml borosilicate glass vial and incubated with 10 ml of either 10 mM EG or GA in phosphate buffered saline (pH 7.4) at 37°C for up to 18 h. Aliquots were taken from each incubation before and after filtration (Amicon MPS micropartition system; Amicon Div., W. R. Grace & Co., Danvers, MA) and analyzed by GC/FID (ethylene glycol) or GC/MS (glycolic acid).
Ethylene glycol was analyzed on a Hewlett Packard 6890 gas chromatograph with flame ionization detection. Separations were achieved with a J&W DB-wax fused silica column (15 m x 0.53 mm id x 1.0 df; J&W Scientific, Folsom, CA). Injections of 1.0 µl (splitless) of plasma, blood, or tissue samples before and after ultrafiltration were spiked with 2-butoxyethanol internal standard (250 µg/g) and injected at 220°C with an initial head pressure of 5 psi (helium) for 2 min, increasing to 10 psi at 20 psi/min. The initial oven temperature was 80°C, increasing to 125°C at 20°C/min, with a final ramp of 30°C/min to 230°C. A Restek 4-mm id cyclo-double gooseneck injection liner was also used.
Glycolic acid was analyzed by GC/MS with a Hewlett Packard 5973 Mass Selective Detector (electron impact ionization) equipped with a Hewlett Packard 6890 Plus gas chromatograph and 7683 autosampler (Hewlett Packard, Avondale, PA). Separations of tri-butylsilyl (TBS) derivatives were achieved with a Restec RTX-5MS fused silica capillary column (30 m x 0.25 mm id, 0.25-µm film thickness; Restec, Bellefonte, PA). Injections (1 µl) were splitless using an unpacked Restec 4-mm id cyclo-double gooseneck liner. Representative chromatography conditions for glycolic acid were as follows: injector temperature was 210°C, the initial oven temperature was 110°C, which was increased at 15°C/min to 200°C, with a final ramp of 25°C/min to 300°C; initial head pressure was a constant 25 psi with helium as the carrier gas. The masses used for quantitation for TBS derivatives of GA were 247 for glycolic acid and 249 for D2-glycolic acid. Preliminary studies were conducted to determine and correct for nonspecific losses to the filtration system.
Plasma protein binding of glycolic acid.
Plasma protein binding can be an important factor in the disposition of small molecular weight weak organic acids. Therefore, protein binding of GA was determined in plasma from female Sprague-Dawley rats and humans by an ultrafiltration method in conjunction with the partition coefficient determinations. Concentrations of GA ranging from 0.01 to 10 mM (rat) or 0.1 to 10 mM (human) were incubated for up to 2 h prior to ultrafiltration in 2 ml samples of plasma gassed with CO2 to achieve a pH of 7.4 (Amicon MPS micropartition system). Aliquots (100 µl) were taken before and after filtration for analysis by GC/MS. Phenol was also evaluated as a positive control, and preliminary studies were conducted to determine and correct for nonspecific losses of each substrate to the filtration system.
Metabolic rate constants for ethylene glycol.
The metabolism of EG has been studied in a variety of in vitro systems. Although EG is sequentially metabolized by alcohol and aldehyde dehydrogenases to GA or theoretically via glyoxal (Fig. 1), determination of the rate constants associated with each individual step has been problematic because of analytical difficulties and the lability of aldehyde intermediates. Therefore, apparent metabolic rate constants have been estimated from animal and human tissues or enzyme preparations to describe the formation of GA as a single, rate-limiting step. The parameters associated with this one-step approximation of EG metabolism correspond to the initial rate-limiting step in the metabolism of EG to glycoaldehyde (Fig. 1). Glycoaldehyde is predominately, and very rapidly, converted to GA via aldehyde dehydrogenase; thus, this step can effectively be ignored in this initial PBPK model.
Rajagopal and Ramakrishnan (1994) estimated the Michaelis constant, Km (11.7 mM), in male Sprague-Dawley rat liver homogenates by measuring the loss of EG. Kukielka and Cederbaum (1991)
indirectly determined the apparent Km (25 mM) and Vmax (0.36 µmol/h/mg protein) for EG in liver microsomes from male Sprague-Dawley rats by measuring formaldehyde formation. Booth et al. (2004)
attempted to compare the metabolism of EG by measuring the formation of GA in liver slices from female Sprague-Dawley rats, New Zealand White Rabbits, and human accident victims incubated with EG. Booth et al. (2004)
were only able to calculate the apparent metabolic rate constants for the rat (Km = 23.8 mM; Vmax = 0.164 µmol/h/mg protein) because little or no GA was detected in rabbit and human liver slices, presumably because of further metabolism. However, these studies generally indicate that the apparent Km for the metabolism of EG appears to be consistent across species, given the limited data, and it is considerably higher than that reported for ethanol (12.7 mM; Blair and Vallee, 1966
; Pastino et al., 1997
).
The liver slice metabolism data of Booth et al. (2004) provided a reasonable starting point for development of the PBPK model. However, simply incorporating the measured Km values and Vmax values (adjusted to liver mass using measured protein yields), led to significant underpredictions of the rates of metabolism in vivo. This result was not unexpected because the Vmax calculated from rat liver slice data was likely an underestimate of the actual rate of GA production because it was likely to be further metabolized as it was formed. Attempts to measure the Vmax for ethylene glycol more accurately in rat and human liver S9 and cytosolic fractions by measuring the simultaneous disappearance of 13C2-ethylene glycol with the glycolate formed were unsuccessful because of the very low yield in metabolism (<1%). Therefore, the apparent Km (23.8 mM) measured in female Sprague-Dawley rats by Booth et al. (2004)
was used as the in vivo Km for both rats and humans, and the measured Vmax values for EG metabolism were increased based upon simulations of the in vivo data of Pottenger et al. (2001)
for non-pregnant female Sprague-Dawley rats and Carstens et al. (2003)
for humans, and were scaled within species to (body weight)0.7.
Metabolic rate constants for glycolic acid.
Booth et al. (2004) also evaluated the metabolism of glycolic acid in liver slices from female Sprague-Dawley rats, New Zealand White rabbits, and humans by measuring the formation of GA. Because of the degradation in radiochemical purity of the 14C-GA substrate that occurred over the time needed to procure viable human liver samples, only the apparent metabolic rate constants for rats and rabbits were considered for PBPK model development. However, as with EG as a substrate, liver slices maintain all of the enzymes necessary for further metabolism of GA. Therefore, apparent Vmax may also underestimate the total glycolic acid metabolism. Therefore, additional in vitro metabolism studies were conducted using cytosolic fractions isolated from female Sprague-Dawley rats and humans.
Pooled, liver cytosols from female Sprague-Dawley rats (lot 120397C) were obtained from XenoTech LLC (Kansas City, KS). This material contained 25.9 mg protein/ml cytosol. As defined by the vendor, 1 ml of rat liver cytosol was obtained from each 0.539 g of fresh liver tissue. Pooled liver cytosol from 10 female human donors (lot 101998B) was obtained from XenoTech LLC. This material contained 20 mg protein/ml cytosol. According to the vendor, 1 ml of human pooled liver cytosol was estimated to be obtained from each 0.651 g of liver tissue. These protein yields were used to convert in vitro metabolic rates (per mg protein) to in vivo rates (per mg tissue).
The effects of protein concentrations and cofactor additions were evaluated in preliminary studies to determine optimal incubation conditions. Representative conditions for the incubation of 13C2-GA at substrate concentrations of 0.5611.2 mM with liver cytosol were as follows: liver cytosol (0.05 ml; approximately 1 mg protein) was added to a 4-ml glass vial containing 1.2 ml KH2PO4 buffer (0.1 M, pH 7.4) and 0.1 ml EDTA solution (2.9 mM in KH2PO4 buffer). Samples were pre-incubated at 37°C for 10 min. Test material, as a stock solution in deionized water, was then added (20 µl), and the samples were incubated at 37°C for 124 h. Aliquots (100 µl) of each sample were transferred to 4-ml glass vials, deactivated with 10 µl acetonitrile, and fortified with 1 ml of internal standard solution (25 µg D4-ethylene glycol + 2.4 µg unlabeled glycolic acid/ml acetone). To each sample was added 0.1 ml 5 N aq. NaOH, 50 µl each PFBCl and PFBBr. Sample aliquots were then vortexed at 50°C for 30 min (Labconco Corporation, Kansas City, MO) to form the diester derivatives of the test materials. The derivatized samples were then diluted with 1.5 ml deionized water and the derivatized analytes were extracted into 1.0 ml toluene (vortex-mixed for approximately 15 s). The toluene layers were isolated after centrifugation at 1278 x g for 10 min and transferred to 2-ml glass GC vials for GC/MS analysis.
The GC/MS analyses were performed on a Hewlett Packard 5989X mass spectrometer (Hewlett Packard, Avondale, PA), equipped with a Hewlett Packard 5890 gas chromatograph and a 7673A autosampler. Separations were achieved in a Phenomenex ZB-5MS fused silica capillary column (30 m x 0.25 mm id x 0.5 µM film; Torrance, CA); helium carrier gas (25 psig) at a flow rate of approximately 1 ml/min; gas chromatograph oven temperature program; 80°C (0.5 min initial hold) to 290°C at 12°/min; injector and capillary transfer line both at 280°C; 1 µl autosampler injection (0.2 min splitless). The mass spectrometer conditions were negative-ion chemical ionization (NCI): ion source temperature, 250°C; ionizing current, 0.37 mA; electron energy, 157 eV; methane reagent gas, 2 torr. Quantitation of the diester derivatives of 13C2-EG or 13C2-GA was achieved by selected ion monitoring at m/z 269 (GA int. std.), 271 (13C2-GA), 452 (13C2-EG), and 454 (D4- EG int. std.) @ 100150 ms/ion/scan.
Adjusted substrate concentrations were calculated from the means of S0 and S2h substrate concentrations, as described by Lee and Wilson (1971). These adjusted substrate concentrations were used in the determination of the kinetic constants Km and Vmax. All calculations were performed with Microsoft Excel, v. 97.SR-2, in full precision mode.
Clearance of ethylene glycol and glycolic acid in urine.
The elimination of EG and GA in urine was initially simulated as first-order clearances of arterial blood scaled as a function of (body weight)0.7. This simple approach worked well for EG over a broad range of doses, but it overpredicted glycolic acid levels in urine of rats at dose levels under 200 mg/kg. To account for the decreased clearances of GA at lower dose levels of EG, the kidney compartment was modified to include glomerular filtration, saturable reabsorption of GA from renal tubules and urine output (Fig. 3). Once the strain-, sex- and species-specific renal physiology parameters were incorporated into the model, parameters for the saturable reabsorption of GA from renal tubules (assuming Michaelis-Menten kinetics) were estimated from the data of Pottenger et al. (2001) for female Sprague-Dawley rats, Harris and Richardson (1980)
for male Wistar rats, and Carstens et al. (2003)
for male humans, using the maximum likelihood estimate function of SimuSolv and the values reported in Table 4.
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RESULTS |
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Plasma protein binding.
Essentially no binding of glycolic acid to proteins was detected in plasma from female Sprague-Dawley rats over a concentration range of 0.0110 mM. Low levels of saturable plasma protein binding were detected in human plasma (13% at 0.1 mM, the lowest concentration used, and 2% at 10 mM). The positive control, phenol (60 µg/ml), was bound at expected levels of 40% in rat plasma and 48% in human plasma (Liao and Oehme, 1981
) under identical assay conditions. Given the very low (human) or absent (rat) levels of protein binding detected in plasma, no equations for protein binding were included in the PBPK model.
Metabolism and urinary clearance of ethylene glycol.
Pottenger et al. (2001) conducted an extensive pharmacokinetic study with 13C2-ethylene glycol using a broad range of oral gavage doses (102500 mg/kg) in pregnant (gestation day 10) and non-pregnant female Sprague-Dawley rats and modern GC/MS methods for analysis of ethylene glycol, glycolic acid, and oxalic acid. In their study, Pottenger et al. demonstrated that the kinetics of EG and GA in blood and urine are unaffected by pregnancy status, at least over a 24-h period starting on gestational day 10, which is during the critical window of susceptibility to developmental toxicity as reviewed by Carney (1994)
. Thus, these data were used in developing and validating estimates of the Vmax for metabolism of EG (after setting the apparent Km to that of Booth et al., 2004
) and the renal clearances of both EG and GA, once the metabolism and tissue partition parameters were established as described in the methods section.
The Vmax for EG metabolism and the first-order clearance of EG were estimated through repeated iterations of simulations and visual comparisons with the concentrations of EG and GA in blood and cumulative amounts of EG eliminated in urine. The first-order clearance of EG, scaled by (body weight) 0.70, estimated from the data of Pottenger et al. (2001) was used for all strains of rats and for humans in all subsequent simulations. Results from these simulations are shown in Figure 4, and final parameter estimates are given in Tables 3 and 4.
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There was some potential non-linearity in Lineweaver-Burke plots of the rates of metabolism of GA at various substrate concentrations (data not shown), especially in human liver cytosol. Such non-linearities may be a reflection of GA oxidation by more than one hepatic enzyme or isoform. Glycolate oxidase has been shown to exist as two isozymes (Duley and Holmes, 1976). As a result, the Km and Vmax parameters in the current study should be defined as apparent values. The apparent Km and Vmax values determined in this study were used directly in the PBPK model after normalizing cytosolic protein yields to whole liver weight (Table 4).
Once the EG metabolism and clearance and GA metabolism parameters were obtained, the parameters for the clearance of GA in female Sprague-Dawley rats were estimated from the data of Pottenger et al. (2001) by repeated iterations of simulations and visual comparisons with the concentrations of GA in blood and cumulative amounts of EG eliminated in the urine.
As discussed previously, using a first-order clearance process for urinary excretion of GA provided good fits to the high-dose groups used by Pottenger et al. (2001), as well as to the other high-dose kinetic studies summarized below (simulations shown in Fig. 4e), but it failed to describe the kinetics of GA in blood and urine at the two lower dose levels (10 and 150 mg/kg). At these two lower dose levels, the measured amounts of GA eliminated in the urine were significantly less than that predicted by a linear excretion process, suggesting that GA was likely being reabsorbed from the renal tubules, as are many other small molecular weight amino acids or other essential nutrients. Because the first-order process worked well for the higher doses in this and other studies (from 500 to as high as 5000 mg/kg), it is likely that reabsorption was a saturable process. Thus, the alternative model structure shown in Figure 3 was used in place of a simple first-order clearance process, and the data of Pottenger et al. (2001)
were used to estimate the Michaelis-Menten constants associated with renal tubule reabsorption. Final estimates of the parameters associated with the urinary clearance of GA in female Sprague-Dawley rats are summarized in Tables 3 and 4. Simulations of the concentrations of GA in blood and cumulative amounts excreted in the urine of the pregnant female Sprague-Dawley rats are shown in Figure 4.
Male Wistar rats appear to be unusually susceptible among rat strains to the renal toxicity of EG after subchronic and chronic dietary administration (Cruzan et al., 2004; DePass et al., 1986
; Gaunt et al., 1974
). This susceptibility may be explained, at least partially, by differences in the kinetics of EG metabolites, most notably oxalic acid (Cruzan et al., 2004
) and its precursor, GA (Harris and Richardson, 1980
; Richardson, 1973). Harris and Richardson (1980)
determined the dose-dependent conversion of glycolate to glyoxylate, oxalic acid, and CO2, as well as the elimination of glycolate in urine in male Wistar rats administered sodium glycolate by oral gavage. Using the glycolate metabolism rate constants derived from female Sprague-Dawley rats, the urinary clearance parameters were estimated from the data of Harris and Richardson, with the results provided in Table 4 and the simulations shown in Figure 6.
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Model Validation
There are numerous metabolism and pharmacokinetic studies in a variety of strains of rats. Although simulations have been conducted with all available data sets, those studies that provided information on the kinetics of both EG and GA were considered the most important for model development and validation. Data sets from studies that were not used in the development of model parameter estimates were used to validate the PBPK model (Table 1). In these cases, only the appropriate sex-, strain-, or species-specific biology, scaled according to experiment-specific body weights and exposure regimens, were changed in the model to perform each simulation. If the simulations were in reasonable agreement with the new data (generally within a factor of two of the measured values and/or with similar kinetic behavior over the uptake, distribution, and clearance phases), the model was considered "validated." For the few cases where agreement was not achieved, as was the case with the simulations of GA clearance in urine at low doses, plausible explanations for the disparity were presented or, just as importantly, insights into underlying biochemical behaviors were postulated and an alternate model structure was proposed.
Because of the large number of studies used in the validation of the PBPK model for rats, only representative results are presented. The remaining data and simulations used to validate the PBPK model are provided as Supplementary Material online and include simulations of data from Pottenger et al. (2001), Lenk et al. (1989)
, Hewlett et al. (1989), Richardson (1973)
, Marshall (1982), McChesney et al. (1971)
, and Cruzan et al. (2004)
.
Female Sprague-Dawley rat data of Sun (1994).
Female Sprague-Dawley rats were administered 14C-ethylene glycol at either 10 or 1000 mg/kg by oral gavage (Sun, 1994). Simulations of the concentrations of EG and GA, assuming that plasma is equivalent to whole blood, are shown in Figure 7. The model provided a reasonable description of the concentrations of EG at both dose levels and of GA at the highest dose, but it significantly overpredicted the concentrations in plasma at the lowest dose. This lowest dose level, 10 mg/kg, was also used in the Pottenger et al. (2001)
study, where the concentrations of glycolic acid were below the limits of reliable quantitation (2.1 mg/l). In the Sun (1994)
study, GA was determined by high-performance liquid chromatography (HPLC) with refractive index and radiodetection; thus, much lower levels (0.01 mg/l) were detected. Because there were no corresponding data in urine, it is possible that the parameters for renal tubule reabsorption of GA derived from the data of Pottenger et al. (2001)
result in a higher rate of reabsorption than warranted. However, a reduction in the reabsorption of GA would result in a reduced ability to fit the Pottenger et al. (2001)
data, which reflect both the blood and urine levels of GA over a comparable dose range (102500 mg/kg).
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DISCUSSION |
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In this model, the metabolism of EG to GA was described as a single saturable, rate-limiting step. This simplification was justified based on the lack of data to either parameterize or validate the individual steps in the metabolism of EG to GA (both the ability to measure the individual steps shown in Figure 1 and the lack of detection of glycoaldehyde or glyoxal in vivo). Furthermore, differences associated with isoforms of ADH and ALDH, which are important for describing the kinetics of ethanol, have not been clear enough to warrant segregation of these steps based upon the available animal and human case report data for ethylene glycol (see Corley and McMartin, 2005).
The renal clearance of GA in urine was also described by means of a more physiologically realistic model than simple use of an empirical, first-order clearance term, like that used for EG. One of the advantages of this approach is that species-, sex-, and strain-specific urine production parameters, which could be important to the toxicity of terminal metabolites of EG, such as oxalic acid, could be used. Furthermore, it was possible to compensate for the measured increases in urine output (osmotic diuresis) that occurred during the subchronic dietary toxicity/pharmacokinetic study of Cruzan et al. (2004; see Supplementary Material online) in a physiologically meaningful way. This osmotic diuresis, presumably caused by high concentrations of EG in tubule urine (a high percentage of the dose is excreted unchanged), did not affect filtration, but it did influence the reabsorption of GA, as it must compete with urine output. Thus, while the number of model parameters may increase over the use of simple, first-order clearance terms, such parameters had to be supported by experimental measurements. This support effectively reduces the overall uncertainties in the PBPK model and focuses attention on areas where fewer data are available (i.e., the effect of renal toxicity on urinary clearance mechanisms).
Although a more complete description of the kinetics of EG and GA in the developing rat embryo is under way, there are currently no approaches available, either ethically or technically, that can be used to validate such models for EG in the developing human embryo (Corley et al., 2003). Thus, it is likely that extrapolations of internal dose surrogates for human health risks associated with developmental toxicity will be limited to maternal blood levels of GA as described below. As a result, the current PBPK model described in this article was extended to simulate the kinetics of EG and GA in controlled human pharmacokinetic studies conducted at low doses or exposures and using human-specific physiology, blood:air partition coefficients, and metabolic rate constants coupled with biochemical parameters scaled from rats.
As discussed in the companion article (Corley and McMartin, 2005), there are numerous case reports in the literature where large quantities of EG, generally as the primary constituent in antifreeze, have been consumed intentionally or accidentally by men, women, or children. In several of these case reports, blood or urine samples were collected and analyzed for EG, and occasionally for GA as well. Although the actual dose levels, timing of blood samples from consumption, effect of other constituents consumed (drugs, alcohol), impact of toxicity, and the various treatment regimens employed by hospitals, all may contribute to alterations in the pharmacokinetics of EG and GA, the model was structured to accommodate several of these effects in a biologically meaningful manner. Thus, the human case report data served to validate the current human PBPK model developed from in vitro and controlled in vivo studies for high dose/exposure scenarios as well as the controlled, low dose/exposures described herein.
Thus, internal dose surrogates that could potentially be included in developmental toxicity risk assessments were compared across dose, route of exposure, and species. Potential dose surrogates consisted of either the maximum concentration (Cmax) or the area under the curve (AUC) for GA in blood. Both of these dose surrogates have their strengths and weaknesses. Of the two choices, Cmax offers the advantage of being highly sensitive to dose rate, which according to Carney et al. (1999) is critical to the developmental toxicity of GA. One of the potential disadvantages to using Cmax is its sensitivity to the first-order absorption rate constant, KAS. Fortunately, in this, and the companion study of Corley and McMartin (2005)
, KAS was remarkably consistent across numerous rat and human oral studies and case reports, which effectively reduces the concern for using this internal dose surrogate. Thus, the Cmax simulations for GA in blood after either oral bolus dosing or 6-h inhalation exposures were conducted for male and female humans, female Sprague-Dawley rats, and male F344 and Wistar rats (for simplification, only the results from the female Sprague-Dawley rat and female human are shown in Figure 10a). At oral bolus dose levels <150 mg/kg, higher Cmax values of GA in blood are predicted in all of the rat strains than in humans. However, higher Cmax levels are predicted in humans at higher dose levels with a rank order of human male > human female > female SD rat > male F344 rat > male Wistar rat, primarily because of the saturation in metabolism of glycolic acid. The species and strain differences are primarily associated with differences in rates of metabolism and urinary clearance of GA. Similar results were observed if the AUC for GA was used as a dose surrogate (simulations not shown).
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Given the low volatility of EG (0.06 mm Hg at 20°C), the theoretical maximum vapor concentration for ethylene glycol is only 79 ppm (
200 mg/m3). This low volatility, coupled with the potential irritancy of EG aerosols, effectively limits the possibility for developmental toxicity in humans after inhalation exposures to EG. For example, Wills et al. (1974)
conducted a controlled human inhalation exposure study at various maximum tolerated inhalation concentrations of EG aerosol. At 188 mg/m3, exposures were conducted for only 15 min. At higher levels, volunteers tolerated only 2 min of exposure to 244 mg/m3 or two breaths of exposure to 308 mg/m3. Simulations were conducted for each of these exposure scenarios to predict the Cmax for GA in blood and to calculate the margin of safety between peak blood levels of GA and the 2 mM threshold determined by Carney et al. (2002)
for developmental effects in rats, as shown in Table 5. Based on these simulations, it is unlikely that humans can inhale enough EG to cause developmental effects. Also, humans could only achieve the 2 mM threshold (determined in rats) if they consumed bolus oral doses >350 mg/kg (>20 g EG for a 58 kg female) during the critical window of susceptibility based on simulations of peak (Cmax) blood concentrations of GA.
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SUPPLEMENTARY MATERIAL |
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ACKNOWLEDGMENTS |
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REFERENCES |
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