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Pitaro M, Croce N, Gallo V, Arienzo A, Salvatore G, Antonini G. Coumarin-Induced Hepatotoxicity: A Narrative Review. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27249063. [PMID: 36558195 PMCID: PMC9783661 DOI: 10.3390/molecules27249063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Coumarin is an effective treatment for primary lymphoedema, as well as lymphoedema related to breast cancer radiotherapy or surgery. However, its clinical use is limited in several countries due to the possible occurrence of hepatotoxicity, mainly in the form of mild to moderate transaminase elevation. It is worth noting that only a few cases of severe hepatotoxicity have been described in the literature, with no reported cases of liver failure. Data available on coumarin absorption, distribution, metabolism, and excretion have been reviewed, focusing on hepatotoxicity studies carried out in vitro and in vivo. Finally, safety and tolerability data from clinical trials have been thoroughly discussed. Based on these data, coumarin-induced hepatotoxicity is restricted to a small subset of patients, probably due to the activation in these individuals of alternative metabolic pathways involving specific CYP450s isoforms. The aim of this work is to stimulate research to clearly identify patients at risk of developing hepatotoxicity following coumarin treatment. Early identification of this subset of patients could open the possibility of more safely exploiting the therapeutical properties of coumarin, allowing patients suffering from lymphoedema to benefit from the anti-oedematous activity of the treatment.
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Affiliation(s)
- Michele Pitaro
- INBB—Biostructures and Biosystems National Institute, Viale delle Medaglie d’Oro 305, 00136 Rome, RM, Italy
| | - Nicoletta Croce
- INBB—Biostructures and Biosystems National Institute, Viale delle Medaglie d’Oro 305, 00136 Rome, RM, Italy
| | - Valentina Gallo
- Department of Science, Roma Tre University, Viale Guglielmo Marconi 446, 00146 Rome, RM, Italy
| | - Alyexandra Arienzo
- INBB—Biostructures and Biosystems National Institute, Viale delle Medaglie d’Oro 305, 00136 Rome, RM, Italy
| | - Giulia Salvatore
- INBB—Biostructures and Biosystems National Institute, Viale delle Medaglie d’Oro 305, 00136 Rome, RM, Italy
| | - Giovanni Antonini
- INBB—Biostructures and Biosystems National Institute, Viale delle Medaglie d’Oro 305, 00136 Rome, RM, Italy
- Department of Science, Roma Tre University, Viale Guglielmo Marconi 446, 00146 Rome, RM, Italy
- Correspondence:
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Hsieh CJ, Sun M, Osborne G, Ricker K, Tsai FC, Li K, Tomar R, Phuong J, Schmitz R, Sandy MS. Cancer Hazard Identification Integrating Human Variability: The Case of Coumarin. Int J Toxicol 2019; 38:501-552. [PMID: 31845612 DOI: 10.1177/1091581819884544] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Coumarin is a naturally occurring sweet-smelling benzopyrone that may be extracted from plants or synthesized for commercial uses. Its uses include as a flavoring agent, fragrance enhancer, and odor-masking additive. We reviewed and evaluated the scientific evidence on the carcinogenicity of coumarin, integrating information from carcinogenicity studies in animals with mechanistic and other relevant data, including data from toxicogenomic, genotoxicity, and metabolism studies, and studies of human variability of a key enzyme, CYP2A6. Increases in tumors were observed in multiple studies in rats and mice in multiple tissues. Our functional pathway analysis identified several common cancer-related biological processes/pathways affected by coumarin in rat liver following in vivo exposure and in human primary hepatocytes exposed in vitro. When coumarin 7-hydroxylation by CYP2A6 is compromised, this can lead to a shift in metabolism to the 3,4-epoxidation pathway and increased generation of electrophilic metabolites. Mechanistic data align with 3 key characteristics of carcinogens, namely formation of electrophilic metabolites, genotoxicity, and induction of oxidative stress. Considerations of metabolism, human variability in CYP2A6 activity, and coumarin hepatotoxicity in susceptible individuals provide additional support for carcinogenicity concern. Our analysis illustrates the importance of integrating information on human variability in the cancer hazard identification process.
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Affiliation(s)
- ChingYi Jennifer Hsieh
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA
| | - Meng Sun
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA
| | - Gwendolyn Osborne
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA
| | - Karin Ricker
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA
| | - Feng C Tsai
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA
| | - Kate Li
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA
| | - Rajpal Tomar
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA.,Retired
| | - Jimmy Phuong
- Department of Biomedical and Health Informatics, University of Washington, Seattle, WA, USA
| | - Rose Schmitz
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA
| | - Martha S Sandy
- Office of Environmental Health Hazard Assessment, CalEPA, Sacramento and Oakland, CA, USA
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3
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RIFM fragrance ingredient safety assessment, coumarin, CAS Registry Number 91-64-5. Food Chem Toxicol 2019; 130 Suppl 1:110522. [PMID: 31129255 DOI: 10.1016/j.fct.2019.05.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/17/2019] [Indexed: 11/23/2022]
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Smith RL, Cohen SM, Fukushima S, Gooderham NJ, Hecht SS, Guengerich FP, Rietjens IMCM, Bastaki M, Harman CL, McGowen MM, Taylor SV. The safety evaluation of food flavouring substances: the role of metabolic studies. Toxicol Res (Camb) 2018; 7:618-646. [PMID: 30090611 PMCID: PMC6062396 DOI: 10.1039/c7tx00254h] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/21/2018] [Indexed: 12/13/2022] Open
Abstract
The safety assessment of a flavour substance examines several factors, including metabolic and physiological disposition data. The present article provides an overview of the metabolism and disposition of flavour substances by identifying general applicable principles of metabolism to illustrate how information on metabolic fate is taken into account in their safety evaluation. The metabolism of the majority of flavour substances involves a series both of enzymatic and non-enzymatic biotransformation that often results in products that are more hydrophilic and more readily excretable than their precursors. Flavours can undergo metabolic reactions, such as oxidation, reduction, or hydrolysis that alter a functional group relative to the parent compound. The altered functional group may serve as a reaction site for a subsequent metabolic transformation. Metabolic intermediates undergo conjugation with an endogenous agent such as glucuronic acid, sulphate, glutathione, amino acids, or acetate. Such conjugates are typically readily excreted through the kidneys and liver. This paper summarizes the types of metabolic reactions that have been documented for flavour substances that are added to the human food chain, the methodologies available for metabolic studies, and the factors that affect the metabolic fate of a flavour substance.
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Affiliation(s)
- Robert L Smith
- Molecular Toxicology , Imperial College School of Medicine , London SW7 2AZ , UK
| | - Samuel M Cohen
- Dept. of Pathology and Microbiology , University of Nebraska Medical Centre , 983135 Nebraska Medical Centre , Omaha , NE 68198-3135 , USA
| | - Shoji Fukushima
- Japan Bioassay Research Centre , 2445 Hirasawa , Hadano , Kanagawa 257-0015 , Japan
| | - Nigel J Gooderham
- Dept. of Surgery and Cancer , Imperial College of Science , Sir Alexander Fleming Building , London SW7 2AZ , UK
| | - Stephen S Hecht
- Masonic Cancer Centre and Dept. of Laboratory Medicine and Pathology , University of Minnesota , Cancer and Cardiovascular Research Building , 2231 6th St , SE , Minneapolis , MN 55455 , USA
| | - F Peter Guengerich
- Department of Biochemistry , Vanderbilt University School of Medicine , 638B Robinson Research Building , 2200 Pierce Avenue , Nashville , Tennessee 37232-0146 , USA
| | - Ivonne M C M Rietjens
- Division of Toxicology , Wageningen University , Tuinlaan 5 , 6703 HE Wageningen , The Netherlands
| | - Maria Bastaki
- Flavor and Extract Manufacturers Association , 1101 17th Street , NW Suite 700 , Washington , DC 20036 , USA . ; ; Tel: +1 (202)293-5800
| | - Christie L Harman
- Flavor and Extract Manufacturers Association , 1101 17th Street , NW Suite 700 , Washington , DC 20036 , USA . ; ; Tel: +1 (202)293-5800
| | - Margaret M McGowen
- Flavor and Extract Manufacturers Association , 1101 17th Street , NW Suite 700 , Washington , DC 20036 , USA . ; ; Tel: +1 (202)293-5800
| | - Sean V Taylor
- Flavor and Extract Manufacturers Association , 1101 17th Street , NW Suite 700 , Washington , DC 20036 , USA . ; ; Tel: +1 (202)293-5800
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Hu M, Piller NB. Strategies for Avoiding Benzopyrone Hepatotoxicity in Lymphedema Management-The Role of Pharmacogenetics, Metabolic Enzyme Gene Identification, and Patient Selection. Lymphat Res Biol 2017; 15:317-323. [PMID: 29087786 DOI: 10.1089/lrb.2017.0020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Benzopyrones are plant-derived chemicals which have an evidenced degree of clinical efficacy in lymphedema management indicated in past trials. Unfortunately, in some of these cases idiosyncratic hepatotoxicity have been documented in a minority of patients. This review aims to tackle the problem of benzopyrone (particularly coumarin) toxicity by considering their metabolic pathways and identifying relevant alleles needed to take a targeted pharmacogenetic approach in its future use. METHODS AND RESULTS The nontoxic 7-hydroxylation and the toxic heterocyclic "ring-splitting" epoxidation pathways are the two main detoxification pathways in the hepatometabolism of coumarin, the former catalyzed by CYP2A6 and the latter by possibly CYP1A and CYP2E. Acetaldehyde dehydrogenase (ALDH) clears toxic aldehyde intermediates. CYP2A6 polymorphism screening methods, including genotyping, by real-time polymerase chain reaction and chromatography-mass spectroscopy functional metabolite assays; efficiency of these techniques are continually improving. ALDH polymorphisms have also been implicated, with clinically viable screening tests, rapid genotyping, and sensitive questionnaires already available for ALDH2*1/ALDH2*2. Dysfunctional polymorphisms of the above genes and others are significantly more prevalent in Eastern Asian populations, uncommon in Caucasian populations. The role of other enzymes/genes in the pathway is yet to be clarified. CONCLUSION Although screening techniques are becoming increasingly clinically feasible, uncertainty remains on the link between the genotype, metabolic phenotype, and the exact gene products involved. These must be elucidated further before a targeted pharmacogenomic approach is fully viable. In the meantime, treatment should be avoided in those with vulnerable familial and ethnic descents if used.
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Affiliation(s)
- Minhao Hu
- 1 School of Medicine, Flinders University , South Australia, Australia
| | - Neil B Piller
- 2 Lymphoedema Clinical Research Unit , Department of Surgery, Flinders Medical Centre, South Australia, Australia
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Gokce B, Gencer N, Arslan O, Karatas MO, Alici B. In vitro inhibition effect of some coumarin compounds on purified human serum paraoxonase 1 (PON1). J Enzyme Inhib Med Chem 2015; 31:534-7. [PMID: 25982292 DOI: 10.3109/14756366.2015.1043297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Human serum paraoxonase 1 (PON1; EC 3.1.8.1) is a high-density lipoprotein associated, calcium-dependent enzyme that hydrolyses aromatic esters, organophosphates and lactones and can protect the low-density lipoprotein against oxidation. In this study, in vitro effect of some hydroxy and dihydroxy ionic coumarin derivatives (1-20) on purified PON1 activity was investigated. Among these compounds, derivatives 11-20 are water soluble. In investigated compounds, compounds 6 and 13 were found the most active (IC50 = 35 and 34 µM) for PON1, respectively. The present study has demonstrated that PON1 activity is very highly sensitive to studied coumarin derivatives.
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Affiliation(s)
- Basak Gokce
- a Department of Biochemistry, Faculty of Pharmacy , Suleyman Demirel University , Isparta , Turkey
| | - Nahit Gencer
- b Department of Chemistry, Faculty of Art and Sciences , Balikesir University , Balikesir , Turkey , and
| | - Oktay Arslan
- b Department of Chemistry, Faculty of Art and Sciences , Balikesir University , Balikesir , Turkey , and
| | - Mert Olgun Karatas
- c Department of Chemistry, Faculty of Arts and Sciences , Inonu University , Malatya , Turkey
| | - Bulent Alici
- c Department of Chemistry, Faculty of Arts and Sciences , Inonu University , Malatya , Turkey
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Ceylon cinnamon does not affect postprandial plasma glucose or insulin in subjects with impaired glucose tolerance. Br J Nutr 2011; 107:1845-9. [PMID: 21929834 DOI: 10.1017/s0007114511005113] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Previous studies on healthy subjects have shown that the intake of 6 g Cinnamomum cassia reduces postprandial glucose and that the intake of 3 g C. cassia reduces insulin response, without affecting postprandial glucose concentrations. Coumarin, which may damage the liver, is present in C. cassia, but not in Cinnamomum zeylanicum. The aim of the present study was to study the effect of C. zeylanicum on postprandial concentrations of plasma glucose, insulin, glycaemic index (GI) and insulinaemic index (GII) in subjects with impaired glucose tolerance (IGT). A total of ten subjects with IGT were assessed in a crossover trial. A standard 75 g oral glucose tolerance test (OGTT) was administered together with placebo or C. zeylanicum capsules. Finger-prick capillary blood samples were taken for glucose measurements and venous blood for insulin measurements, before and at 15, 30, 45, 60, 90, 120, 150 and 180 min after the start of the OGTT. The ingestion of 6 g C. zeylanicum had no significant effect on glucose level, insulin response, GI or GII. Ingestion of C. zeylanicum does not affect postprandial plasma glucose or insulin levels in human subjects. The Federal Institute for Risk Assessment in Europe has suggested the replacement of C. cassia by C. zeylanicum or the use of aqueous extracts of C. cassia to lower coumarin exposure. However, the positive effects seen with C. cassia in subjects with poor glycaemic control would then be lost.
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8
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Abraham K, Wöhrlin F, Lindtner O, Heinemeyer G, Lampen A. Toxicology and risk assessment of coumarin: Focus on human data. Mol Nutr Food Res 2010; 54:228-39. [DOI: 10.1002/mnfr.200900281] [Citation(s) in RCA: 169] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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9
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Rietjens IMCM, Punt A, Schilter B, Scholz G, Delatour T, van Bladeren PJ. In silico
methods for physiologically based biokinetic models describing bioactivation and detoxification of coumarin and estragole: Implications for risk assessment. Mol Nutr Food Res 2009; 54:195-207. [DOI: 10.1002/mnfr.200900211] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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10
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Satarasinghe RL, Jayawardana MAR. Lympidem (a coumarin derivative) induced reversible hepatotoxicity in an adult Sri Lankan. DRUG METABOLISM AND DRUG INTERACTIONS 2009; 24:89-94. [PMID: 19354003 DOI: 10.1515/dmdi.2009.24.1.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Lympidem is a coumarin derivative which is advocated for treatment of mainly chronic lymphedema by the manufacturer. Since its introduction there had been several reports with regard to coumarin-induced hepatotoxicity from Europe. We report an adult Sri Lankan middle-aged female who presented with abnormal liver functions due to Lympidem, which resulted in discontinuation of the drug, while no other etiology could be found. To the best of our knowledge, this is the first reported case from South East Asia. We recommend monitoring of liver functions while on coumarin therapy to prevent irreversible damage.
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Affiliation(s)
- R L Satarasinghe
- Department of Medicine, Sri Jayewardenepura General Hospital and Postgraduate Training Center, Thalapathpitiya, Nugegoda, Sri Lanka
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Differences in simulated liver concentrations of toxic coumarin metabolites in rats and different human populations evaluated through physiologically based biokinetic (PBBK) modeling. Toxicol In Vitro 2008; 22:1890-901. [DOI: 10.1016/j.tiv.2008.09.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Revised: 09/09/2008] [Accepted: 09/10/2008] [Indexed: 11/17/2022]
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12
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Coumarin in flavourings and other food ingredients with flavouring properties ‐ Scientific Opinion of the Panel on Food Additives, Flavourings, Processing Aids and Materials in Contact with Food (AFC). EFSA J 2008. [DOI: 10.2903/j.efsa.2008.793] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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13
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Farinola N, Piller NB. CYP2A6 polymorphisms: is there a role for pharmacogenomics in preventing coumarin-induced hepatotoxicity in lymphedema patients? Pharmacogenomics 2007; 8:151-8. [PMID: 17286538 DOI: 10.2217/14622416.8.2.151] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Lymphedema is a chronic progressive and significantly disabling disease that affects over 150 million people worldwide. Coumarin is an effective pharmacological treatment, but is banned in some countries due to incidences of hepatotoxicity in rats and mice, and the rare finding of similar hepatotoxicity in humans. Cytochrome P450 (CYP)2A6 is the major enzyme involved in metabolizing coumarin to 7-hydroxycoumarin. A reduction in CYP2A6 activity will lead to shunting of coumarin into other metabolic pathways. In particular, coumarin is metabolized by CYP3A4 to form 3-hydroxycoumarin, the major metabolite in mice and rats. It has been shown that an increase in the 3-hydroxycoumarin ratio is associated with an increased production of the significant cytotoxic product o-hydroxyphenylacetylacetaldehyde (o-HPA), suggesting that a shunting of coumarin metabolism away from 7-hydroxylation is the cause of the toxicity. Hence, poor CYP2A6 metabolizers are more likely to metabolize coumarin via the cytotoxic pathway. Identifying these patients, and not treating them with coumarin, may reduce the incidence of toxicity associated with this drug. The technology to do so exists, but more information is required regarding the mechanism of coumarin toxicity.
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Affiliation(s)
- Nicholas Farinola
- Lymphedema Assessment Clinic, Department of Surgery, School of Medicine, Flinders University and Flinders Medical Centre, Bedford Park, South Australia, 5042, Australia
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Felter SP, Vassallo JD, Carlton BD, Daston GP. A safety assessment of coumarin taking into account species-specificity of toxicokinetics. Food Chem Toxicol 2006; 44:462-75. [PMID: 16203076 DOI: 10.1016/j.fct.2005.08.019] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Revised: 08/19/2005] [Accepted: 08/22/2005] [Indexed: 11/16/2022]
Abstract
Coumarin (1,2-benzopyrone) is a naturally occurring fragrant compound found in a variety of plants and spices. Exposure to the general public is through the diet and from its use as a perfume raw material in personal care products. High doses of coumarin by the oral route are known to be associated with liver toxicity in rodents. Chronic oral bioassays conducted in the 1990s reported liver tumors in rats and mice and lung tumors in mice, raising concerns regarding the safety of coumarin. Since then, an extensive body of research has focused on understanding the etiology of these tumors. The data support a conclusion that coumarin is not DNA-reactive and that the induction of tumors at high doses in rodents is attributed to cytotoxicity and regenerative hyperplasia. The species-specific target organ toxicity is shown to be related to the pharmacokinetics of coumarin metabolism, with data showing rats to be particularly susceptible to liver effects and mice to be particularly susceptible to lung effects. A quantitative human health risk assessment that integrates both cancer and non-cancer effects is presented, confirming the safety of coumarin exposure from natural dietary sources as well as from its use as a perfume in personal care products.
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Affiliation(s)
- S P Felter
- The Procter & Gamble Company, Miami Valley Innovation Center, 11810 E. Miami River Road, Cincinnati, OH 45252, USA.
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15
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Rietjens IMCM, Martena MJ, Boersma MG, Spiegelenberg W, Alink GM. Molecular mechanisms of toxicity of important food-borne phytotoxins. Mol Nutr Food Res 2005; 49:131-58. [PMID: 15635687 DOI: 10.1002/mnfr.200400078] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
At present, there is an increasing interest for plant ingredients and their use in drugs, for teas, or in food supplements. The present review describes the nature and mechanism of action of the phytochemicals presently receiving increased attention in the field of food toxicology. This relates to compounds including aristolochic acids, pyrrolizidine alkaloids, beta-carotene, coumarin, the alkenylbenzenes safrole, methyleugenol and estragole, ephedrine alkaloids and synephrine, kavalactones, anisatin, St. John's wort ingredients, cyanogenic glycosides, solanine and chaconine, thujone, and glycyrrhizinic acid. It can be concluded that several of these phytotoxins cause concern, because of their bioactivation to reactive alkylating intermediates that are able to react with cellular macromolecules causing cellular toxicity, and, upon their reaction with DNA, genotoxicity resulting in tumors. Another group of the phytotoxins presented is active without the requirement for bioactivation and, in most cases, these compounds appear to act as neurotoxins interacting with one of the neurotransmitter systems. Altogether, the examples presented illustrate that natural does not equal safe and that in modern society adverse health effects, upon either acute or chronic exposure to phytochemicals, can occur as a result of use of plant- or herb-based foods, teas, or other extracts.
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Opinion of the Scientific Panel on food additives, flavourings, processing aids and materials in contact with food (AFC) related to Coumarin. EFSA J 2004. [DOI: 10.2903/j.efsa.2004.104] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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17
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Vassallo JD, Hicks SM, Daston GP, Lehman-McKeeman LD. Metabolic Detoxification Determines Species Differences in Coumarin-Induced Hepatotoxicity. Toxicol Sci 2004; 80:249-57. [PMID: 15141102 DOI: 10.1093/toxsci/kfh162] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hepatotoxicity of coumarin is attributed to metabolic activation to an epoxide intermediate, coumarin 3,4-epoxide (CE). However, whereas rats are most susceptible to coumarin-induced hepatotoxicity, formation of CE is greatest in mouse liver microsomes, a species showing little evidence of hepatotoxicity. Therefore, the present work was designed to test the hypothesis that detoxification of CE is a major determinant of coumarin hepatotoxicity. CE can either rearrange spontaneously to o-hydroxyphenylacetaldehyde (o-HPA) or be conjugated with gluatathione (GSH). o-HPA is hepatotoxic and is further detoxified by oxidation to o-hydroxyphenylacetic acid (o-HPAA). In vitro experiments were conducted using mouse liver microsomes to generate a constant amount of CE, and cytosols from F344 rats, B6C3F1 mice, and human liver were used to characterize CE detoxification. All metabolites were quantified by HPLC methods with UV detection. In rats and mice, GSH conjugation occurred non-enzymatically and through glutathione-S-transferases (GSTs), and the kinetics of GSH conjugation were similar in rats and mice. In rat liver cytosol, oxidation of o-HPA to o-HPAA was characterized with a high affinity K(m) of approximately 12 microM, and a V(max) of approximately 1.5 nmol/min/mg protein. In contrast, the K(m) and V(max) for o-HPA oxidation in mouse liver cytosol were approximately 1.7 microM and 5 nmol/min/mg protein, respectively, yielding a total intrinsic clearance through oxidation to o-HPAA that was 20 times higher in mouse than in rats. Human cytosols (two separate pools) detoxified CE through o-HPA oxidation with an apparent K(m) of 0.84 microM and a V(max) of 5.7 nmol/min/mg protein, for a net intrinsic clearance that was more than 50 times higher than the rat. All species also reduced o-HPA to o-hydroxyphenylethanol (o-HPE), but this was only a major reaction in rats. In the presence of a metabolic reaction replete with all necessary cofactors, GSH conjugation accounted for nearly half of all CE metabolites in rat and mouse, whereas the GSH conjugate represented only 10% of the metabolites in human cytosol. In mouse, o-HPAA represented the major ring-opened metabolite, accounting for the remaining 50% of metabolites, and in human cytosol, o-HPAA was the major metabolite, representing nearly 90% of all CE metabolites. In contrast, no o-HPAA was detected in rats, whereas o-HPE represented a major metabolite. Collectively, these in vitro data implicate o-HPA detoxification through oxidation to o-HPAA as the major determinant of species differences in coumarin-induced hepatotoxicity.
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Affiliation(s)
- Jeffrey D Vassallo
- Miami Valley Laboratories, The Procter and Gamble Company, 11810 East Miami River Road, Cincinnati, Ohio 45252, USA.
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