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Journal Article 
A reexamination of the PPAR-alpha activation mode of action as a basis for assessing human cancer risks of environmental contaminants 
Guyton, KZ; Chiu, WA; Bateson, TF; Jinot, J; Scott, CS; Brown, RC; Caldwell, JC 
Environmental Health Perspectives
ISSN: 0091-6765
EISSN: 1552-9924 
BACKGROUND: Diverse environmental contaminants, including the plasticizer di(2-ethylhexyl)phthalate (DEHP), are hepatocarcinogenic peroxisome proliferators in rodents. Peroxisome proliferator-activated receptor-alpha (PPAR-alpha) activation and its sequelae have been proposed to constitute a mode of action (MOA) for hepatocarcinogenesis by such agents as a sole causative factor. Further, based on a hypothesized lower sensitivity of humans to this MOA, prior reviews have concluded that rodent hepatocarcinogenesis by PPAR-alpha agonists is irrelevant to human carcinogenic risk. DATA SYNTHESIS: Herein, we review recent studies that experimentally challenge the PPAR-alpha activation MOA hypothesis, providing evidence that DEHP is hepatocarcinogenic in PPAR-alpha-null mice and that the MOA but not hepatocarcinogenesis is evoked by PPAR-alpha activation in a transgenic mouse model. We further examine whether relative potency for PPAR-alpha activation or other steps in the MOA correlates with tumorigenic potency. In addition, for most PPAR-alpha agonists of environmental concern, available data are insufficient to characterize relative human sensitivity to this rodent MOA or to induction of hepatocarcinogenesis. CONCLUSIONS: Our review and analyses raise questions about the hypothesized PPAR-alpha activation MOA as a sole explanation for rodent hepatocarcinogenesis by PPAR-alpha agonists and therefore its utility as a primary basis for assessing human carcinogenic risk from the diverse compounds that activate PPAR-alpha. These findings have broad implications for how MOA hypotheses are developed, tested, and applied in human health risk assessment. We discuss alternatives to the current approaches to these key aspects of mechanistic data evaluation. 
Animals; Diethylhexyl Phthalate/toxicity; Environmental Pollutants/*toxicity; Humans; Liver Neoplasms/*chemically induced; Liver Neoplasms, Experimental/chemically induced; Mice; Mice, Knockout; PPAR alpha/*agonists/metabolism; Peroxisome Proliferators/toxicity; Risk Assessment/methods; Species Specificity 
• Biphenyl
     Cited References
          Other studies
               Studies Supporting Mode-of-Action
• tert-Butanol
     Cited in Document
     Cited in Document
     Not in Lit Search
• Phthalates – Targeted Search for Epidemiological Studies
     Source – all searches
     Source – no date limit through June 2013 (Private)
• Tetrachloroethylene (Perc) (Final, 2012)
• Trichloroacetic acid (TCA) (Final, 2011)
• Trichloroethylene (TCE) (Final, 2011)
     All References
     Liver Issues
     Protocol References