Stochastic pharmacokinetic-pharmacodynamic modeling for assessing the systemic health risk of perfluorooctanoate (PFOA)

Convertino, M., Church, T. R., Olsen, G. W., Liu, Y., Doyle, E., Elcombe, C. R., Barnett, A. L., Samuel, L. M., MacPherson, I. R. and Evans, T. R.J. (2018) Stochastic pharmacokinetic-pharmacodynamic modeling for assessing the systemic health risk of perfluorooctanoate (PFOA). Toxicological Sciences, 163(1), pp. 293-306. (doi: 10.1093/toxsci/kfy035) (PMID:29462473) (PMCID:PMC5920327)

Abstract

A phase 1 dose-escalation trial assessed the chemotherapeutic potential of ammonium perfluorooctanoate (APFO). Forty-nine primarily solid-tumor cancer patients who failed standard therapy received weekly APFO doses (50mg-1200mg) for six-weeks. Clinical chemistries and plasma PFOA (anionic APFO) were measured pre-dose and weekly thereafter. Several clinical measures including total cholesterol, high-density lipoproteins (HDL), thyroid stimulating hormone (TSH), and free thyroxine (fT4), relative to PFOA concentrations, were examined by: standard statistical analyses using general estimating equations (GEE) and a probabilistic analysis using probability distribution functions (pdf) at various PFOA concentrations; and a two-compartment pharmacokinetic/pharmacodynamic (PK/PD) model to directly estimate mean changes. Based on the GEE, the average rates of change in total cholesterol and fT4 associated with increasing PFOA were approximately -1.2x10−3mmol/L/μM and 2.8x10−3pmol/L/μM, respectively. The PK/PD model predicted more closely the trends observed in the data as well as the pdfs of biomarkers. A decline in total cholesterol was observed, with a clear transition in shape and range of the pdfs, manifested by the maximum value of the Kullback-Leibler (KL) divergence, that occurred at plasma PFOA between 420 and 565 μM (175,000–230,000 ng/mL). HDL was unchanged. An increase in fT4 was observed at a higher PFOA transition point, albeit TSH was unchanged. Our findings are consistent with some animal models and may motivate re-examination of the epidemiological studies to PFOA at levels several orders of magnitude lower than this study. These observational studies have reported contrary associations, but currently understood biology does not support the existence of such conflicting effects.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacPherson, Professor Iain and Evans, Professor Jeff
• Authors: Convertino, M., Church, T. R., Olsen, G. W., Liu, Y., Doyle, E., Elcombe, C. R., Barnett, A. L., Samuel, L. M., MacPherson, I. R., and Evans, T. R.J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences
• Journal Name: Toxicological Sciences
• Publisher: Oxford University Press
• ISSN: 1096-6080
• ISSN (Online): 1096-0929
• Published Online: 16 February 2018
• Copyright Holders: Copyright © 2018 The Authors
• First Published: First published in Toxicological Sciences 163(1):293-306
• Publisher Policy: Reproduced under a Creative Commons License

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