CURRENT AWARENESS DOCUMENT
PYRROLIZIDINE DERIVATIVE ALKYLATING AGENTS AND
           RELATED  PLANT ALKALOIDS:
    CARCINOGENICITY AND STRUCTURE ACTIVITY
 RELATIONSHIPS.  OTHER BIOLOGICAL PROPERTIES.
   METABOLISM.  ENVIRONMENTAL SIGNIFICANCE.
                 Prepared by:
              David Y.  Lai ,  Ph.D.
         Yin-Tak Woo, Ph.D., D.A.B.T.
 Science Applications  Internation Corporation
              8400 Westpark Drive
           McLean, Virginia   22102
          EPA Contract  No.  68-02-3948
         SAIC Project  No.  2-813-07-409
   EPA Project  Officer  and  Scientific Editor
            Joseph C. Arcos, D.Sc.
       Extradi vi sional  Scientific  Editor
             Mary F. Argus, Ph.D.
                   June  1986

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5.3.2.3  Plant Alkaloids


     Plant alkaloids comprise a large group of natural products which are


generally basic, nitrogenous heterocyclic compounds designated by the ending


"ine."  Close to 4,000 of the structurally defined alkaloids are distributed


among 8-10% of the flowering plant species (34 out of 60 orders in the higher


plant system of Engler) were reported in 1978 (1).  Many plant alkaloids are


toxic and display a wide spectrum of physiological activities; some of the


alkaloids discussed here are also carcinogenic and genotoxic.  At one time,


colchicine and aristolochic acid were thought to be basic, nitrogenous hetero-


cyclics and were classified as alkaloids.  The carcinogenicity of these two

                            • ^
compounds is covered in Section 5.3.2.6.4.  Arecoline and other betel nut


alkaloids are discussed in Section 5.3.2.6.1.


     A number of alkaloids also occur in animals, insects, algae, fungi and


bacteria (1).  Ergot alkaloids, for instance, are present in the fungus,


Claviceps purpurea (see Section 5.3.1.4).  Information on the toxicology of


alkaloids derived from organisms other than plants is still meager.


     5.3.2.3.1  Pyrrolizidine Alkaloids


     5.3.2.3.1.1  INTRODUCTION


     Pyrrolizidine alkaloids constitute a large groups of compounds which


occur in plants of a wide botanical and geographical distribution.  Close to


200 pyrrolizidine alkaloids have so far been found, distributed among more


than 350 plant species belonging to 12 families (principally Compositae,


Boraginaceae and Leguminosae) of the angiospermae.  Many of these alkaloids


are highly hepatotoxic causing acute and chronic  illness of grazing livestock


and farm animals in many parts of the world.  Pyrrolizidine alkaloid poisoning


of humans has also occurred through the consumption of contaminated food
                                      276

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grains.  In Africa, Asia and other places, some pyrrolizidine alkaloid-


containing plants are used as food and folk medicines.  Increased interest in


pyrrolizidine alkaloids has been stimulated by the findings that a number of


these naturally-occurring chemicals, when tested in long-term experiments in


animals, are tumorigenic.  It is suspected that the high incidence of liver


cancer in some populations of the world may be related to the consumption of


pyrrolizidine alkaloid-containing plants.



     In 1968, Bull, Culvenor and Dick (2) authored a comprehensive monograph


on the botanical distribution, chemistry, pathogenicity and other biological


properties of pyrrolizidine alkaloids.  Subsequently, several periodic
                            i >

reviews, updating information on research in the field, particularly on the


toxicology, metabolism and carcinogenic action of the increasing number of


pyrrolizidine alkaloids have appeared (e.g., 3-10).  Table XLIII lists the


names and uses of some plants in which carcinogenic pyrrolizidine alkaloids


have been found.



     5.3.2.3.1.2  PHYSICOCHEMICAL PROPERTIES AND BIOLOGICAL EFFECTS



5.3.2.3.1.2.1  Physical and Chemical Properties.  All alkaloids of this class


contain in their molecules the pyrrolizidine nucleus bearing a hydroxyl and a


hydroxymethyl group; this moiety is termed a necine.  Necines form esters with


various Cc-Cjn branched-chain acids, called necic acids.  Four types of


necines are recognized among the hepatotoxic and carcinogenic pyrrolizidine


alkaloids:  (a) heliotridine, (b) retronecine, (c) isatinecine (N-oxide of


retronecine) and (d) otonecine.  The necic acids are saturated or unsaturated,


hydroxylated or epoxidized mono- or di-carboxylic acids.  Esters formed


between necines and necic acids can be classified into:  (a) mono-esters, (b)


diesters and (c) macrocyclic diesters.  The chemical structures of some pyr-
                                      277

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                                                                                                          c 2
                                                Table  XLIII
        Names and Uses of Some Plants in Which Carcinogenic Pyrrolizidine Alkaloids Have Been Found3
    Botanical name
   Common name
        Human use
       Carcinogenic
  pyrrolizidine alkaloid
Family Compos itae:

  Senecio spp.



  Tussilago farfara



  Petasite japonicus


  Farfugium japonicurn


  Ligularla dentata

Family Boraginaceae:

  Heliotropium spp.
  Amsinckia intermedia
Ragwort, groundel,
stinking Willie,
Dan's cabbage, etc,

Coltsfoot
Coltsfoot
"Tsuwabuki"
(Japanese)
Common heliotrope,
caterpillar weed,
potato weed, etc.
Fireweed, tarweed,
fiddleneck, yellow
forget-me-not, etc.
Medicinal herbs in Africa,
Asia, Europe and Jamaica;
food in Japan

A cough medicine -in China,
Japan, and Europe^ food in
Japan

Food or a herbal remedy in
Japan

Food in Japan
Medicinal herbs in India,
Greece, and Eastern
Mediterranean, Africa and
South Africa
Retrorsine, isatidine,
riddelliine, senkirkine,
jacobine, seneciphylline

Senkirkine
Petasitenine, senkirkine
Petasitenine, senkirkine
                                                      Clivorine
Heliotrine, lasiocarpine
                               Lycopsamine, intermedine

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                                          Table XL1IT  (continued)
    Botanical name
   Common name
        Human use
       Carcinogenic
  pyrrolizidine alkaloid
  Symphytum officinale
Comfrey
Family Leguminosae

  Crotalaria spp.
Rattle box, rattle
pad, wild lucerne,
earring plant, white
back, etc.
Green vegetable and tonic
in Japan; medicinal herb
in Europe and the United
States
Food and medicinal herbs in
India and Africa*/ "bush tea"
in West Indies
Symphyt ine
Retronecine, monocrotaline,
retrorsine, isatidine,
riddelliine, hydroxysen-
kirkine, seneciphylline
aSummarized from L.B. Bull, C.C.J. Culvenor and A.T. Dick  [The Pyrrolizidine Alkaloids.  Their Chemistry,
 Pathogenicity and Other Biological Properties.  Wiley, New York, 1968, 293 pp.], E.K. McLean [Pharmacol.
 Rev. 22, 429 (1970)], IARC Monographs, Vol. 10 (1976) and Vol. 31 (1983), and I. Hirono, I. Ueno, S. Aiso,
 T. Yamaji and M. Haga, Cancer Lett., 20, 191 (1983).

 See Table XLIV for structural formulas and Table XLIX for carcinogenicity.

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rolizidine alkaloids which have been tested for carcinogenic activity are

shown in Table XLIV.


     In pyrrolizidine alkaloids containing a ring oxo group (such as in


senkirkine, petasitenine and clivorine) the dotted lines represent fractional


valence bonds resulting from resonance between the limit structures:


                                      ,-                -0
                  /0\               o8                 ioi
                    - ^
                    ')
                   CHo              ^'•3                CHj



     Except for symphytine, which is an oil, the pyrrolizidine alkaloids dis-


cussed in this section are cr\staline colorless solids, mostly of low to


medium melting points.  They are all optically active substances.  In general,


the base strength and solubility in water and organic solvents of pyrrolizi-


dine alkaloids decrease in the order of:  non-esters > mono-esters > diesters


> macrocyclic diesters.  Hydrolysis and dehydrogenolysis of the ester groups


are the most important chemical reaction of these alkaloids.  Also of


importance is the ready interconversion of the pyrrolizidine tertiary bases


and their N-oxides which are highly water soluble.  Some physicochemical


properties of pyrrolizidine alkaloids are summarized in Table XLV.


5.3.2.3.1.2.2  Biological Effects Other Than Carcinogenicity


     Toxic effects.  Pyrrolizidine alkaloid-containing plants have long been


recognized as toxic to grazing animals and are responsible  for many diseases


in farm stock (2).  The prominent toxic effects in domestic animals are acute


and chronic liver  lesions, lung damage, neurological symptoms and hemolytic


syndromes (3, 11).  In experimental studies with rodents,  the most frequently


affected organ is  the liver.  High doses of pyrrolizidine  alkaloids cause


acute  liver necrosis.  Small doses produce chronic liver lesions characterized
                                      278

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                                                                                                  1 or 2
                                         Table XLIV


           Pyrrollzidine Alkaloids Which Have Been Tested for Carcinogenic  Activity
H3C   CH2OH

 V'C
Isatidine
  H      .

   C^/A  / V
H- C/ ^ H dH C


  0^Cx       /°
      Ov   0  CH2
                                                 H    HsC\   f"3
                                                  \  ON   C—C

                                               H,CX ^9* H OH r'
•^     /

    0^C\
                                                               0
                                                       CH3
                          Senkirkine R=-H           Petasitenine
                       Hydroxysenkirkine R=-OH
                                                                          o=c
                                                                             s
                                                                              °*  °

                                                              CH3


                                                           Clivorine
RZ      PHg-R|
                      R?      CH2-R|
                                       0
                               o
                                                     H
                                                                               /c
                                                                                       OH
                                                                           0=C
                          B
                                                               D

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                                                                                                        -»f 2
                                           Table XLIV (Continued)
                          Substituents  to Fundamental Ring Structures A, B, C, & D

Heliotridine
Heliotrine
Lasiocarpine

Retrorsine
Monocrotal ine

Jacob ine
A
Rl R2
-OH -OH
CH(CH )
*l * J i
-0-C — C — CH-CH, -OH
II 1 1 3
0 OH OCH
HO-C-(CH-) CH3
-0-C— C— CH-CH. -0-C-C=CHCH,
II 1 1 3 II 3
0 OH OCH3 0
C
Ri Ro RT
-CH2OH -H =CH-CH3
— CH-> — H ( — CH-i
1 -H
/°X
r*\\ 1] PU Pll
— Vflln — 11 v»n V>«»T
K J
B
Rl R2
Retronecine -OH -OH
CH(CH3)2
Lysopsamine -0-C— C — CH-CH. -Oil
nil3
0 OH OH
CH(CH-). CH
4 1 It 1
Symphytine -0-C— C — CH-CH, -0-C-C=CHCH,
Illl3 H 3
0 OH OH 0
D
Senec iphyll ine R = -CH3
Riddel 1 ine R = -CH2OH


*asymmetric carbon

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                                                                                                          >f 2
                                                  Table XLV
                  Physicochemical Properties of Some Carcinogenic Pyrrolizidine Alkaloids3
Compound
Heliotrine0
Lasiocarpine0
Retronecine
Lycopsaraine
In termed ine
Symphyt ine
Retrorsine
M.p. (°C)
128
96.5-97
117-118

146.5-147

216-216.5
pKa
In 80% In
(fX]D (solvent) MCSd water
+17.6° (EtOH) 7.82 8.52
-3.0° (EtOH) 6.55 7.64
+49.6° (EtOH) 8.38 '
+3.3° (EtOH) 8.5
+4.7° (EtOH) 8.5
+3.65° (EtOH)
-18.0° (EtOH)
Solubility
2.64 g/dl; soluble in ethanol
0.68 g/dl; soluble in ethanol and
most non-polar solvents
Soluble in ethanol
Soluble in water and ethanol
Soluble in water and ethanol
Soluble in ethanol
Soluble in chloroform; slightly
Monocrotaline1
Jacobine
RiddelLiine
Senec iphy11ine
202-203
  228
  198
  217
-62.0° (CHC13)

-15.0° (EtOH)
-55.0° (CHC13)

-46.3° (CHC13)
6.04
-109.5° (CHC13)    6.30


-139.0° (CHC13)    6.20     7.6
soluble in water and ethanol

1.21 g/dl; soluble in ethanol and
chloroform

Soluble in chloroform; sparingly
soluble in water, ethanol and
ether

Soluble in chloroform; slightly
soluble in water and ethanol

Soluble in chloroform; slightly
soluble in water and ethanol

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                                            Table  XLV  (continued)
                                                                                                          f 2
Compound
Isat idine
Senkirkine
M.p. (°C)
138
197-198
(<*}
-8.2
-12.
pKa
In 80% In
D (solvent) MCS water
0 (H20)
0° (EtOH)
Solubility
Soluble in water and
Soluble in chloroform

ethanol
and ethyl
Hydroxysenkirkine       124-125


Petasitenine            129-131

Clivorine               149-150
                                    -2.0° (CHC13)
+5.3° (EtOH)
+63.8° (CHC13)

+80.2° (CHCU)
acetate; less soluble in water and
ethanol

Soluble in water, ethanol,
chloroform and hot acetone

Highly soluble in water

Soluble in chloroform
aSuramarized from L.B. Bull, C.C.J. Culvenor and A.T. Dick, "The Pyrrolizidine Alkaloids.  Their Chemistry,
 Pathogenicity and Other Biological properties."  Wiley, New York, 1968, 293 pp.];  IARC Monograph Vol. 10,
 International Agency for Research on Cancer, Lyon, France, 1976; T. Furuya, M. Hikichi and Y. litaka [Chem.
 Pharm. Bull. 24, 1120 (1976)1; and K. Kuhara, H. Takanashi, I. Hirono, T. Furuya and Y. Asada [Cancer Lett.
 JJ), 117 (19807T.
 See Table XLIV for structural  formulas.

cHalf-lives of alkaloids (in 0.5N NaOH at  25°C) in  1:1 aqueous ethanol:  heliotrine = 8 days, lasiocarpine =
 20 min., and monocrotaline =  18 min.; partition coefficients of alkaloids in oleyl alcohol/pH 7.3 buffer:
 heliotrine = 0.11, lasiocarpine = 2.5, and monocrotaline = 0.082.
dMSC = methyl cellosolve.

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by the appearance of large parenchymal cells, "megalocytes."  Some alkaloids,

especially mono-crot aline and seneciphylline, also cause lesions of the lung

(12).  Liver necrosis and hepatic "veno-occlusive disease" are frequently seen

in humans ingesting pyrrolizidine alkaloid-containing plants as contaminants

of grain or as herbs for medicinal purposes (3, 13-16).


     There is an inverse relationship between the acute hepatotoxicity and

both the water solubility and base strength of the pyrrolizidine alkaloids

(17).  In order to be toxic, the compounds must contain the 1-hydroxymethyl-

pyrrolizidine structure, be unsaturated at the 1,2-position, and esterified at

one of the hydroxy groups.  In general, macrocyclic diesters of retronecine,
                           i- N
such as retrorsine, are the most toxic alkaloids.  Among the open esters,

diesters are more toxic than the monoesters; those of heliotridine are more so

than those of retronecine (12,  18).  As compared with the corresponding

alkaloids, pyrrolizidine N-oxides are less acutely toxic when administered

parenterally but are similar in chronic effects (18).  The acute toxicities

(LDcQ values) of some pyrrolizidine alkaloids in rats and mice are given in

Table XLVI.


     Considerable evidence supports the conclusion that the hepatotoxic

effects of pyrrolizidine alkaloids are attributable to the pyrrolic metabo-

lites formed in the liver by enzymatic dehydrogenation (see Section

5.3.2.3.1.4).  The enzyme system(s) involved has many characteristics of

mixed-function oxidases (20, 25).  Factors such as species, age, sex, diet and

drug pretreatment, all of which influence the activity of mixed-function

oxidases, alter the hepatotoxicity of pyrrolizidine alkaloids in animals

(e.g., 26-28).  Among livestock species, for instance, cattle and horses are

more susceptible than sheep and goat to pyrrolizidine alkaloid toxicity (2,

29).  In laboratory animals, rats, mice and hamsters are more susceptible than


                                      279

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                                  Table XLVI
                Acute  Toxicity of Some Pyrrolizidine Alkaloids
Compound3
Retrorsine




Lasiocarpine



Monocrotaline



Isatidine


Heliotrine


Senkirkine
Seneciphylline


Jacob ine

Riddelliine
Lycopsamine +
intermediate
Symphytine

Species and route
Rat, i.p.
i .v .
Mouse, i.v.
i.p.
Hamster, i.p.
Rat, i.p.
i .v .
Mouse , i.v.
Hamster, i.v.
Rat , i.p.
i .v .
Mouse , oral
,i>v.
Rat , oral
i.p.
Mouse, i.v.
Rat, i.p.
i .v .
Mouse, i.v.
Rat , i.p.
Rat , i.p.
i .v .
Mouse , i .v .
Ra t , i.p.
Mouse, i.v.
Mouse, i.v.
Rat , i.p.

Mouse, i.p.
Rat , i.p.
LD50 (mg/kg)b
35 (M); 153 (F)
38
59
65 (M); 69 (F)
81
72 (M) , 79 (F)
88
85
68
95 (M) , 180 (F)
92
166
261
48
250
835
300 (M)
274
254
220
77 (M), 83 (F)
80
90
138 (F)
77
105
M.OOO (M)

300
130
Reference
(18,
(2)
(2)
(2)
(20)
(2)
(2)
(2)
(2)
(19)
(2)
(2)
(2)
(21)
(19,
(22)
(2)
(2)
(2)
(23)
(2)
(2)
(2)
(2)
(2)
(2)
(2)

(24)
(23)
19)













21)















aSee Table XLIV for structural formulas
 Abbreviation:  M = male, F = female.

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rabbits and guinea pigs (20, 30).  In general, the males are more sensitive

than females and the newborns are more susceptible than older animals (26).

The protective effect of zinc on pyrrolizidine alkaloid-induced hepatotoxicity

in rats is primarily due to the blockage by the metal of the microsomal

conversion of the parent compounds to their toxic metabolites (28).


     Acting either as mono- or bi-functional alkylating agents, the pyrrolic

metabolites of many pyrrolizidine alkaloids bind to, and inhibit, the

synthesis of cellular macromolecules (e.g., 17, 31-33).  These metabolites are

also known to arrest mitosis of liver cells resulting in the development of

the chronic liver lesions, megalocytosis (31, 34).
                           ? • >

     Mutagenic effects.  The mutagenic and genotoxic activities of some car-

cinogenic pyrrolizidine alkaloids have been demonstrated in several assay

systems.  The results of these studies are summarized in Table XLVII.


     In microbial systems, preincubation of those alkaloids with S-9 mix is

required for the appearance of mutagenic activity.  Yamanaka and coworkers

(35) noted that several pyrrolizidine alkaloids of the heliotridine (e.g.,

heliotrine and lasiocarpine) and otonecine (e.g., clivorine, petasitenine and

senkirkine) base types give positive mutagenic response in the Salmonella/

mammalian microsomal test.  On the other hand, pyrrolizidine alkaloids of

retronecine base type (e.g., lycopsamine, raonocrotaline, retronecine and

seneciphylline) were not mutagenic under the same study conditions.  These

observations led Yamanaka and associates to suggest that pyrrolizidine

alkaloid mutagenicity might be related to the necine base type of the com-

pounds.  This view appears to be supported by findings of other investigators

that lasiocarpine (36) but not monocrotaline and jacobine (38), exhibit

mutagenic response in Ames strains of Salmonella typhimurium.  Moreover,
                                      280

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                                                   Table XLVII
                  Mutagenicity and  Related  Genotoxic Activities of  Some Pyrrolizidine Alkaloids
Compound3
Heliotrine (H)
Lasiocarpine (H)
Senkirkine (0)
Petasitenine (0)
Clivorine (0)
Retrorsine (R)
Symphytine (R)
Monocrotaline (R)
Jacobine (R)
Seneciphylline (R)
Retronecine (R)
Lycopsamine (R)
Isatidine (I)
Salmonella Escherichia
typhimurium coli

+ (35) + (39)
+ (35, 36)
+ (35)
+ (35)
+ (35)
+ (37)
+ (9)
- (35, 38) + (39)
- (38)
- (35)
- (35)
- (35)

Aspergillus Drosophila V79 Chinese,
nidulans melanogasterc hamster cell

+ (40) + (41) + (44)
+ (40) + (41) + (44)
+ (42) + (44)
+ (44)
.
+ tt3)
+ (44)
+ (41)
+ (41)
+ (42)


+ (43)
DNA
repair

+ (45)
+ (45)
+ (45)
+ (45)
+ (46)

+ (45)





Chromosomal
aberrations
+ (44)
+ (44)
+ (44)
+ (44)



+ (47)





aLetters in parentheses are necine base types:  H = heliotridine; 0 = otonecine; R = retronecine; I = isatinecine;
 see Table XL1V for structural formulas.
 In the presence of S-9 mix; "+" = positive; "-" = negative; numbers in parentheses are references.
cRelative mutagenic activity:  lasiocarpine = 1.0; heliotrine = 0.9; monocrotaline = 1.6; jacobine =
 8-Azaguanine-resistant mutation assay.
0.08.

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retrorsine (37) and symphytine (cited in ref. 10), both of retronecine base


type, induce mutation in these bacterial strains in the presence of S-9 mix.


The genotoxic DNA-damaging activity of monocrotaline and heliotrine could,


however, be shown in some repair-deficient strains of Escherichia coli which


proved to be more sensitive than Salmonella (39).  Heliotrine and lasiocarpine


are also mutagenic in the fungus, Aspergilj.us nidulans (40).



     Early studies with Drosophila melanogaster have indicated that monocrota-


line, lasiocarpine and heliotrine are potent mutagens; their N-oxides are less


active.  Jacobine is only weakly mutagenic.  The relative potencies of these


alkaloids with respect to mutagenicity in Drosophila are:  lasiocarpine = 1.0;
                           t  ^

heliotrine = 0.9; monocrotaline = 1.6; jacobine = 0.08 (41).  More recently,


retrorsine, isatidine, senkirkine and seneciphylline have also been shown to


induce sex-linked recessive lethals in Drosophila (42, 43).



     When tested in V79 cells derived from Chinese hamster lung, heliotrine,


lasiocarpine, petasitenine and senkirkine all induced chromosomal aberrations


and an 8-azaguanine-resistant mutation (44).  Clastogenic activity was also


observed in Chinese hamster ovary cells following exposure to monocrotaline in


the presence of a microsomal  activation system (47).



     Wi 11 iams _et_ _al_. (45) have demonstrated the genotoxicity of lasiocarpine,


petasitenine, senkirkine, clivorine and monocrotaline in the hepatocyte


primary culture/DNA repair test.  Retrorsine induces DNA repair replication in


livers of the rat (46).



     A number of pyrrolizidine alkaloid-containing plants have also been


evaluated for the presence of mutagenic substances.  With the addition of


liver microsomes from various mammalian species, an acetone extract of tansy


ragwort (Senecio jacobaea) produced positive mutagenic response in the tester
                                      281

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strains of TA1535, TA1537, TA98 and TA100 of Salmonella typhimurium (38).  A




methanol extract of coltsfoot (Petasites japonicus) was also shown to be




mutagenic in the Salmonella strain, his G46, in an in vivo host-mediated assay




(48).  Extracts of fresh leaves of the Russian comfrey, Symphyton officinale,




are mutagenic in the sex-linked recessive lethal test in Drosophila (49).  The




mutagenic substance(s) in extracts of these plants remains to be investigated.





     Teratogenic effects.  Experimental data on teratogenic studies of pyr-




rolizidine alkaloids are surprisingly scanty.  In the light of the alkylating




potential and antimitotic activity of their metabolites (see Section




5.3.2.3.1.4), it is likely that pyrrolizidine alkaloids might be terato-




genic.  Green and Christie (50) have demonstrated a positive teratogenic




effect of heliotrine in the rat.  Various skeletal malformations were observed




in offspring of rats receiving single doses (100 mg/kg) of heliotrine intra-




peritoneally during the second week of gestation.  Other investigators have




shown that the administration of lasiocarpine to pregnant (51) or to lactating




(52) rats, in doses non-toxic to the dams, caused significant liver lesions in




the newborns and weanlings.





     5.3.2.3.1.3  CARCINOGENICITY ANQ STRUCTURE-ACTIVITY RELATIONSHIPS





     Overview.  Pyrrolizidine alkaloids are among the first naturally occurr-




ing carcinogens found in products of plant origin.   A report of tumor induc-




tion by pyrrolizidine alkaloids dates back to 1950 when Cook, Duffy and




Schoental (53) described the development of hepatomas in rats following




feeding with an alkaloidal fraction from tansy ragwort (Senecio jacobaea).




Since then,  several other plants or plant extracts containing pyrrolizidine




alkaloids were shown to produce neoplasms in laboratory animals (rev. in  8,




54).  The results of these studies are presented in Table XLVIII.  While most
                                     282

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                                                 Table XLVIII
                       Carcinogenicity of Some Pyrrolizidine Alkaloid-Containing  Plants
       Plant
      Part
                                 a
  Care inogenic it y
           Major
  pyrrolizidine alkaloids
Reference
Senecio jacobaea
 *
S. longilobus


S. cannabifol ius


Farfugium japonicum

Hel iotropium supinum
H. ramosissimum

Amsinckia intermedia

Petasites japonicus


Tussilago farfara

Symphytum offinale
Stem and leaf or
plant extract
Stem and leaf
Stem and leaf
Stem and leaf

Stem and leaf or
plant extract
Stem and leaf

Seeds

Flower stalk


Flower

Root and leaf
Liver tumors in rats
and chicks
Liver tumors in rats

Liver tumors in rats


Liver tumor in rats


Liver tumors in rats

Pancreas and kidney
tumors in rats
Seneciphylline , jacobine ,
senecionine, jaconine,
jacoline, jacodine

Seneciphylline
Brain tumors in rats

Kidney tumors in rats

Liver tumors in rats
and mice
Seneciphylline , retrorsine ,
riddelliineb
 *
Seneciphylline , senecican-
nabine, jacozine

Senkirkine , petasitenine

Supinine, echinatine, helio-
supine, trachelanthyl-7-
angelylheliotridine, viri-
dofloryl-7-angelylhelio-
tridine

Heliotrine

Lycopsamine , intermedine

Petasitenine
Liver tumors in rats   Senkirkine ,  senecionine
Liver tumors in rats
Symphytine , echimidine
(53, 55, 56)



(57)

(58)


(59)


(59)

(60, 61)
(62)

(61)

(54, 63-65)


(54, 66)

(54, 66)
aPlant parts were mixed and fed with the diet; plant extracts were injected intravenously.

 Carcinogenic activity has been tested; see Table XLIX.

-------
of these plants (or their extracts) induce tumors in the liver of rats, dried


plants (stems and leaves) of the genus Heliqtropium elicit neoplasms of the


pancreas, the kidney (Ji. supinum) and the brain Ul. ramosissimum) in the rat


(60-62).  Heliotropium supinum and JI. ramosissimum are medicinal herbs used in


East Africa (60, 62).  Senecio cannabifolius, Petasites japonicus, Tussilago


farfara, Farfugium japonicum and Symphytum officinale are regarded as edible


plants in Japan (54, 59).



     To date, only a few alkaloidal constituents of these plants have been


studied in long-term experiments for carcinogenic activity.  However, all


hepatotoxic pyrrolizidine alkaloids and their metabolites, tested to date
                            i %

under adequate conditions have been found to be carcinogenic in the rat,


inducing tumors not only in the liver, but also in various other organs.  The


carcinogenic pyrrolizidine alkaloids encompasses members of the monoester,


diester and macrocyclic diester categories (see Table XLIV for structural


formulas).  The macrocyclic diester alkaloids appear to be more potent car-


cinogens than the monocyclic, open esters.  Retronecine, which is not hepato-


toxic, is also carcinogenic when given to newborn rats.  The carcinogenicity


studies of these compounds are summarized in Table XLIX.  Retrorsine, mono-


crotaline, dehydroretronecine (85) and petasitenine (54) also exhibit positive


effects in in vitro cell transformation assays.  Structure-activity relation-


ship analysis suggest that the double bond in the necine ring (1,2-dehydro-


pyrrolizidine) is essential for transforming cells in vitro (85).



     Heliotrine.  The possible carcinogenic effect of heliotrine, which occurs


in Heliotropium ramosissimum and several other species (2, 86), has been


investigated by Schoental (67) in male weanling Porton-Wistar rats.  All


animals given one or two doses of heliotrine (300 mg/kg body weight) by


stomach tube died within 5 months.  When the dose of heliotrine was reduced to




                                      283

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                                                                    p. i ot 2
                                Table XLIX
                Carcinogenicity of Pyrrolizidine Alkaloids
Compound3
Heliotrine
Lasiocarpine


Dehydrohelio-
t rid ine
Retronecine
Lycopsamine ,
in termed ine
(mixture)
Symphytine
Retrorsine

Isat idine

Monoc rot aline



Dehydromono-
Species and strain
Rat ,
Rat ,
Rat,
Rat,
Rat ,
Rat ,
Rat ,
Rat ,
Rat ,
Rat ,
Rat ,

Rat,
Rat ,
Rat ,
Rat ,
Porton-Wistar
Fischer
Fischer 344
Fischer 344
hooded >
Wistar
Porton-Wistar
AC I
Wistar
Wistar
Wistar

Wistar
Sprague-Dawley
Spr ague-Da wley
Sprague-Dawley
Mouse , LAC A
Route
oral
i .p.
oral
oral
i.p.
s .c .
oral
i.p.
oral
or i.p.
oral
oral ,
i.p. or
topical
oral ,
i.p. or
topical
oral
s .c .
s .c .
topical
Principal organ
affected
Pancreas, liver,
urinary bladder
and testis
Liver , skin
Liver, hetnato-
poietic tissue
Liver, hemato-
poietic tissue
Multiple sites
CNS
Pancreas
Liver
Liver
Kidney
Liver

Liver, lung
Liver
Multiple sites
Pancreas
Skin
Reference
(67)
(6,
69)
(70,
(72)
(73)
(62)
(60)
(23)
(55,
75)
(61)
(55,

(76)
(77)
(78,
(80)
(81)

68,
71)





74,

74)



79)


crotaline

-------
                            Table XLIX (continued)
                                                                           O- L
Compound8 Species and strain
Jacob ine, sene- Chick, —
ciphylline
(mixture)
Riddelliine Rat, Wistar
Dehydroretro- Rat , Sprague-Dawley
nee ine
Mouse, Swiss

Mouse , LACA
Senkirkine Rat , ACI
Hydroxysenkir- Rat, Wistar
kine
Petasitenine Rat, ACI
(Fukinotoxin)
Clivorine Rat, ACI
Route
i.v.
oral
and i.p.
s .c.

s ,c .
and/or
topical
topical
i.p.
i.p.
oral
oral
Principal organ
affected Reference
Liver
Liver
Muscle

Skin

Skin
Liver
CNS
Liver
Liver
(56)
(74)
(78, 79)

(82)

(81)
(23)
(62)
(83)
(84)
aSee Table XLIV for structural formulas.

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230 mg/kg, one rat survived 27 months and developed adenomas of the pancreatic

islet cells.  Co-administration of nicotinamide was proved to prevent liver

necrosis and suppress the toxicity of heliotrine.  Six of 12 rats receiving

one or two intragastric doses of heliotrine (230 mg/kg) together with nicotin-

amide (350 mg/kg) by intraperitoneal injections, survived 22 months or

longer.  Among the survivors, 3 had pancreatic islet cell tumors, accompanied

in one of them by a hepatoma and in another by tumors of the urinary bladder

and testis.  Such tumors were not found in control rats.


     Lasiocarpine.  The carcinogenicity of lasiocarpine has been repeatedly

demonstrated in Fischer rats by Reddy and his coworkers (68-71).  In one
                            i >
experiment, lasiocarpine was administered intraperitoneally to 25 male rats at

doses of 7.8 mg/kg body weight, twice weekly for 4 weeks and then once weekly

for 52 weeks.  Of the animals surviving after the treatment period, 61%

(11/18) developed hepatocellular carcinomas, 33% (6/18) developed squamous-

cell carcinomas of the skin, and 28% (5/18) had pulmonary adenoma (68, 69).

Both the carcinomas of the liver (68) and of the skin (69) were transplant-

able.  At doses of 0.39, 0.78 and 1.56 mg/kg, lasiocarpine also induced low

incidences of liver neoplasms in male and female rats by repeated i.p. injec-

tions (6).  When lasiocarpine was fed to 20 male rats in the diet (50 ppm)  for

55 weeks, malignant tumors were found in 17 animals between 48 and 59 weeks:

9 developed angiosarcomas of the liver (1 of these also had carcinomas of the

skin), 7 developed hepatocellular carcinomas, and one developed lymphomas.

The angiosarcoma from one rat was successfully transplanted through 4 genera-

tions (70).  Administration of thioacetamide, a liver carcinogen which

stimulates cell proliferation (see section 5.2.2.6, Vol. IIIB) stimulates the

development of hyper plastic nodules and carcinomas of the liver of rats

treated with lasiocarpine (71, 87).
                                     284

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     Under the bioassay conditions of the U.S. National Cancer Institute (72),

lasiocarpine is also carcinogenic in Fischer 344 rats, producing angiosarcomas

arid hepatocellular tumors in both sexes and hematopoietic tumors in female

animals.  Statistically significant incidences of these neoplasms were

observed when groups of 24 rats of each sex were administered lasiocarpine in

the diet at doses of 7, 15 or 30 ppm for 104 weeks.


     Dehydroheliotridine.  Dehydroheliotridine is a major metabolite of helio-

tridine-base alkaloids such as heliotrine and lasiocarpine (see Section

5.3.2.3.1.4 on Metabolism and Mechanism of Action).  When a group of 24 hooded

strain rats was injected with dehydroheliotridine intraperitoneally once every
                           >• ^
4 weeks for 32 weeks (first dose, 76.5 rag/kg; second dose, 65 mg/kg; remainder

of doses, 60 mg/kg), 11 malignant and benign tumors emerged in 6 animals.  In

addition to one cystic cholangioma in the liver, other neoplasms occured in

the pancreas, lung, adrenal gland, forebrain and the gasotrintestinal tract.

This wide spectrum of tumors  indicates that the tissue targets of dehydro-

heliotridine are predominantly extrahepatic.  Co-administration of thioacet-

amide enhances the hepatic toxicity but not the carcinogenicity of dehydro-

heliotridine (73).


     Retronecine.  Retronecine is the only non-hepatotoxic and non-ester ifled

pyrrolizidine alkaloid that is carcinogenic.  In a small-scale study, a spinal

cord tumor was noted in one of 10 male Wistar rats 201 days after a single

s.c. dose (600 mg/kg) of retronecine, administered when the rats were new-

born.  Such tumors were not found in hundreds of historical control rats.

Among 6 female newborn rats given a single s.c. injection of 1,000 mg/kg

retronecine, 5 developed pituitary tumors and one had a mammary tumor (62).
                                     285

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     Lycopsamine and Internedine.  These two alkaloids are stereoisomers which


may be isolated from tarweed (Amsinckia intermedia), a plant known to cause


severe livestock losses from liver injuries in the United States.  One adenoma


and one adenocarcinoma of the islet cells and one adenoma of the exocrine


pancreas were observed in 3 of 15 male Wistar rats given single doses (500-


1,500 mg/kg) of a mixture of lycopsamine and intermedine by stomach tube.


Pancreatic tumors of these types were considered to be very rare in these


animals (60) .


     Symphytine.  The carcinogenicity of Russian comfrey (Symphytum


officinale)  is attributed to symphytine.  Among 20 male ACI rats which
                           i  >

received i.p. injections of symphytine at the dose of 13 mg/kg body weight


(10% of the LDCQ), twice weekly for 4 weeks and then once a week for 52 weeks,


one had a liver cell adenoma and 3 developed hemangioendothelial sarcomas in


the liver.  These tumors were similar to the ones observed in rats fed diets


containing roots and leaves of Russian comfrey (88).


     Retrorsine.  The chronic liver lesions produced in rats by this highly


toxic alkaloid were noted by Schoental et al. (55) in early 1954.  Fourteen


Wistar rats  (10 male and 4 female) which were administered 0.03-0.05 mg/ral


retrorsine in the drinking water 3 days a week, survived from 10 to 24


months.  On examination, nodular or microscopic foci of hyperplasia of the


liver were found in 9 of the 10 male rats.  The nodules in 4 of these rats


were histologically identified as hepatomas.  Subsequent studies, in which


weanling Wistar rats were given repeated i.p. doses (74) or single large doses


(30 mg/kg) of retrorsine by stomach tube (75), also showed significant inci-


dences of tumors.  In addition to hepatomas, other neoplasms observed in the


retrorsine-treated rats were tumors of the lung (55, 75), mammary gland,


spleen, uterus (75) and kidney (61).



                                      286

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     Isatidine (Retrorsine-N-oxide).  The N-oxide of retrorsine seems to be
even more hepatocarcinogenic than its parent compound.  Of 29 Wistar rats of

both sexes receiving 0.03-0.05 mg/ml of isatidine in the drinking water, 13

developed neoplasms and hyperplastic nodules of the liver; the tumors in one

of the rats metastasized.  Although no tumors were found in the liver, 8 other

rats treated with isatidine had preneoplastic nodules.  Supplements with

choline did not protect the liver from the carcinogenic action of isatidine


(55).  Liver tumors are also induced in the rat when isatidine is administered

by painting on the neck (55) or by i.p. injection (74).


     Monocrotaline.  Although monocrotaline has long been implicated as a car-
                           f %
cinogen, conclusive data have not been reported until recently.  In 1955,

Schoental and Head (76) noted lesions of the liver and lung indicative of neo-

plasia in Wistar rats exposed chronically to monocrotaline.  Newberne and


Rogers (77) reported later that hepatocellular carcinomas were produced in 31%

(24/77) of Sprague-Dawley rats receiving repeated doses (25 mg/kg for 4 weeks

then 8 mg/kg for 38 weeks) of the alkaloid by stomach tube.  Allen and

coworkers (78, 79) administered monocrotaline (5 mg/kg body weight) biweekly,

by s.c. injection to a group of 60 male Sprague-Dawley rats for a year.

Twelve months after the treatment, 10 animals had pulmonary adenocarcinomas, 5

had well-differentiated hepatocellular carcinomas and 4 developed rhabdomyo-


sarcomas.  Additionally, 8 adrenal adenomas, 3 acute myelogenous leukemias and


one renal adenoma were observed in the treated rats.  A high incidence (70%)

of insuloma of the pancreas also occurred in 23 male Sprague-Dawley rats 500

days after a single subcutaneous injection of 40 mg/kg monocrotaline (80).


     Dehydromonocrotaline.  The carcinogenic potential of dehydromonocrota-

line, a putative primary metabolite of monocrotaline (see Section 5.3.2.3.1.4

on Metabolism and Meghanism of Action) has been assayed by mouse skin-



                                      287

-------
painting.  Repeated topical doses (2.5^nnol) of dehydromonocrotaline, followed




by repeated treatment with croton oil, resulted in the development of malig-




nant tumors of the skin in 5 of 10 LACA strain mice (81).  Without the tumori-




genesis promoter, no carcinogenic effect was observed (81, 89).





     Jacobine and Seneciphylline.  A mixture of jacobine and seneciphylline




(primarily seneciphylline), purified from ragwort (Senecio jacobaea), was




tested for carcinogenic activity in the chick (56).  Primary liver tumors




occurred in 6 of 24 chicks receiving weekly i.v. doses (20-35 mg/kg) of the




alkaloid mixture for up to 8 weeks or until death.





     The chronic changes in,tjie liver of rats caused by seneciphylline are




closely similar to those in rats given lasiocarpine or other carcinogenic




pyrrolizidine alkaloids.  Liver hyperplastic nodules developed in Wistar rats




after a single oral dose (40 mg/kg) of seneciphylline (90).  Plants containing




seneciphylline and jacobine have been shown to produce liver tumors in the rat




(see Table XLVII).





     Riddelliine.  Riddelliine occurs in the carcinogenic plant Senecio




longilobus, as well as in several other Senecio species (2).  Chronic admini-




stration of this alkaloid to rats produced liver lesions characteristic of




many hepatocarcinogenic alkaloids of this class.  In a chronic study in which




20 male and female Wistar rats were given riddelliine in their drinking water




(0.02 mg/kg) and by i.p. injections (25 mg/kg), 9 animals had hyperplastic




nodules of the liver and one had a hepatic sarcoma.  No such lesions were




found in 15 controls (74).





     Dehydroretronecine.  Dehydroretronecine is the secondary metabolite of




monocrotaline and perhaps of other retronecine-based alkaloids (see Section




5.3.2.3.1.4 on Metabolism and Mechanism of Action).  The direct-acting car-




cinogenic effects of this metabolite have been studied in both rats and mice.
                                      288

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     Of 60 male Sprague-Dawley rats receiving biweekly s.c. injections of




dehydroretronecine (20 mg/kg for 4 months, then 10 mg/kg for 8 months), 39




developed rhabdomyosarcomas at the injection site.  Metastasis occurred in 5




cases (78, 79).  Significant incidences of basal cell and squamous cell car-




cinomas of the skin were found in 92 Swiss mice given repeated s.c. injections




and/or topical applications of dehydroretronecine (82).   Repeated topical




doses (5 iimol/dose) of dehydroretronecine also induced skin tumors, in mice of




the BALB/c and LACA strains (81, 89).   Similar carcinogenicity toward the skin




of LACA strain mice were shown by the  synthetic compounds, 2,3-bistrimethyl-




acetoxymethyl-1-raethylpyrrole and 2,3-bis-hydroxyraethyl-l-methylpyrrole but




not by 2,3-bis-hdyroxymethyl-5-methyl-l-phenylpyrrole (see Table L).





     Senkirkine.   The active compound  in coltsfoot (Tussij.ago farfara) is sen-




kirkine.  When a group of 20 ACI strain rats were given  i.p. injections of




senkirkine (22 mg/kg) freshly prepared from the flowers  of the plant, twice




weekly for 4 weeks and then once a week for 52 weeks, 9  animals developed




liver cell adenomas similar to those observed in rats fed diets containing the




flowers of coltsfoot (23).





     Hydroxysenkirkine.  Schoental and Scavanagh (62) reported that a single




i.p. dose of hydroxysenkirkine (300 mg/kg), isolated from an East African




plant Crotalaria laburnifolia (a variety of laburnifolia) , induced an astro-




cytoma of the cerebrum in one of 4 male rats of the Wistar-Porton strain.




Tumors of this type were not seen among hundreds of historical controls.





     Petasitenine (Fukinotoxin).  There is evidence indicating that petasi-




tenine may be responsible for the carcinogenic activity of Petasites




japonicus, a variety of coltsfoot (83).  The same types  of tumors (i.e.,




hemangioendothelial sarcomas and liver cell adenomas) were found in 8/10 ACI
                                      289

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 Relative  Carcinogenic
      Compound
                  Table L
Activity of Dehydroretronecine and Structurally-Related Compounds
       Toward the Skin of LACA Mice
                                     Structure
                                                                    Dose
                                                                (uraol/mouse)     incidence
Dehydroretronec
                                      HO
                                                                     5.0
                                                                                  25%
2,3-Bis-trimethylacetoxy-
  methyl-1-methyl pyrrole
                             (CH3)3C
             — C-O
                                                     O
                                                     II
0-C-C(CH3).
                                                                     0.5
                                                                                  90%
 2,3-Bis-hydroxymethyl-l-
   methylpyrrole
                                                                      5.0
                                                                                   25%
 2,3-Bis-hydroxymethyl-5-
   methyl-1-phenylpyrrole
                                                                       5.0
                                                                                     9%c
  Modified from:  A.R. Mattocks and J.R.P. Cabral [Cancer Lett. 17. 61 (1982)
   Applied to the shaved backs of mice at weekly intervals for up to 47 weeks.
  cStatistically not significant as compared with control incidence.

-------
strain rats receiving a 0.01% solution of petasitenine in the drinking water,

as in the rats fed a diet containing the flower stalks of Petasites japonicus

(54, 63, 64).


     Clivorine.  Like senkirkine, hydroxysenkirkine and petasitenine,

clivorine is a pyrrolizidine alkaloid of the macrocyclic diester type con-

taining otonecine as the necine base.  Among 12 ACI strain rats ingesting a

0.005% solution of clivorine in drinking water for 340 days, 2 developed

hemangioendothelial sarcomas and 6 had neoplastic nodules of the liver.  The

hemangioendothelial sarcoma in one rat showed metastasis in the lung.  No

liver tumors or nodules were found in the controls (84).
                           i • ^

     5.3.2.3.1.4  METABOLISM AND MECHANISM OF ACTION


     There is considerable evidence that the toxicological effects of pyrro-

lizidine alkaloids are not due to the compounds themselves but to metabolites

formed in the liver.  Much of the metabolic studies of these toxic alkaloids

have been carried out in the laboratory of Mattocks, White and associates in

Great Britain (20, 91-94).  The general scheme for the metabolism of some car-

cinogenic pyrrolizidine alkaloids is shown in Fig. 11.


     Pyrrolizidine alkaloids which are esters of heliotridine (e.g., helio-

trine, lasiocarpine) or retronecine (e.g., lycopsamine, symphytine, retror-

sine, monocrotaline, jacobine, riddelliine and seneciphylline) undergo

N-oxidation to yield N-oxide derivatives, and C-hydroxylation to give dehydro-

alkaloids (primary pyrrolic derivatives) in the liver of the rat.  In vitro

studies have shown that both reactions are catalysed by typical mixed-function

oxidases in the microsomes (91).  The formation of N-oxides, which are more

water soluble and have low toxicity, is considered to be a detoxifying reac-

tion.  The toxic effects observed following administration of N-oxide
                                     290

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                                   CH,OR
                            N-oxide
                           derivatives
Esters of
Heliotridineor
Retronecine
                                    CHOR
                           Dehydroalkaloids
                        (Pyrrolic derivatives)
                                  -HoO
Esters of otonecine
                                                HO        Cri>OH
                                                   \*
                                                                                        CHoNu
                                                                              Reaction products
                                                                               with nucleophile
             Fig. 11.   General scheme for the bioactivation of some pyrrolizidine


         alkaloids.  Asterisks (*)  denote asymmetric carbon atoms;  Nu denotes nucleophiK

-------
alkaloids depend on the reduction back to their parent compounds — a reaction

which has been shown to occur in the gut of the rat (21) and in the rumen of

sheep (2).  Both the C-7 and C-9 of the dehydroalkaloids are highly electro-

philic, especially when they bear an acyloxy grouping.  However, under

slightly acid conditions, the C-7 and C-9 dehydroalkaloids are also strongly

electrophilic when they bear a hydroxyl group.  The dehydroalkaloids thus are

potentially bi- or mono-functional alkylating agents which may readily react

with nucleophilic constituents in the cell or may react with water to yield

more stable dehydroaminoalcohols, such as dehydroheliotridine and dehydro-

retronecine (secondary pyrrolic derivatives).

                            i ^
     Esters of otonecine (e.g., senkirkine, hydroxysenkirkine, petasitenine

and clivorine) also yield reactive pyrrolic metabolites by initial N-de-

methylation, to give an 8-hydroxypyrrolizidine, and then the dehydroalkaloid

of the corresponding ester.


     Strong evidence has pointed to the pyrrolic metabolites as the major

metabolites involved in the hepatotoxic, mutagenic and carcinogenic activities

of pyrrolizidine alkaloids.  However, it is not known whether either or both

the dehydroalkaloids and the dehydroaminoalcohols are proximate carcinogens.

Black and Jago (95) demonstrated that dehydroheliotridine, the major pyrrolic

metabolite of heliotrine and lasiocarpine, can interact with calf thymus DNA

in vitro.  Alkylation of DNA by dehydroretronecine has also been shown in

vitro (32, 96-98) and in vivo (32, 99).  Chemical and spectral analyses have

revealed that the major reaction product of dehydroretronecine with deoxy-

guanosine (dGuo) is 7-(deoxyguanosine-N -yDdehydroretronecine, indicating

that the reactive electrophile derived from the protonated dehydroretronecine

readily alkylates deoxyguanosine (dGuo) at the N  position (98).
                                     291

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                                       CH2OH       dGuo     CH2OH

                                             dGuo
         Dehydroretronecine                    deoxyguanosine adduct


     Following i.p. administration of monocrotaline to Sprague-Dawley rats,


DNA-DNA interstrand cross-links and DNA-protein cross-links are formed in the


liver cells.  These DNA cross-links have been suggested to be instrumental in


the hepatocarcinogenicity of monocrotaline (99).


     An alternative hypothesis is that epoxide derivatives may be the hepato-


toxic and carcinogenic metabolites of pyrrolizidine alkaloids (5, 100).  That


the open diester alkaloids are less toxic and carcinogenic than the macro-


cyclic esters may be explained by steric hindrance of the epoxidation of the
                            i >

C1-C2 double bond by the ester side chain at C-l in the open ester alkaloids


(100).


     Recent research shows that jacobine, the pyrrolic derivative of dehydro-


retronecine, and isobutyryl retronecine, but not retronecine nor the pyrroLic


derivative of isobutyryl dehydroretronecine pyrrole, induce gene expression of


endogenous avian tumor virus in cultured chick embryo fibroblasts (101).


     5.3.2.3.1.5  ENVIROIMENTAL SIGNIFICANCE


     Plants containing pyrrolizidine alkaloids are so abundant and widespread


that they are found in almost every region of the world.   As many as 6,000


species, or 3Z of the world's flowering plants are estimated to contain some


levels of pyrrolizidine alkaloids (cited in ref. 86).  For example,  among the


24 species of Heliotropium, currently collected along the border of  Mexico and


the United States, all contain various amounts of unsaturated pyrrolizidine


alkaloids (102).   The number of species listed in a recent compilation (86)


are believed to be only a small proportion of the pyrrolizidine alkaloid-


containing plants which actually exist world-wide.   According to Smith and
                                     292

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Culvenor (86), all species in the family of Boraginaceae and the genera


Senecio, Crotalaria and Eupatorium should be regarded as potentially hepato-


toxic .


      Sporadic outbreaks of diseases and death in agricultural livestock and


farm  animals due to consumption of grass or hay contaminated with pyrrolizi-


dine  alkaloid-containing plants have occurred in many parts of the world.


Several species, in particular those belonging to the genera of Senecio,


Crotalaria and Heliotopium, are classic poisonous plants.  Senecio jacobaea


(Tansy ragwort or Stinking Willie), for instance, is a common contaminant in


pastures and is responsible for the "Pictou disease" of cattle and horses in

                           f >
Canada and the "Winton disease" of livestock in New Zealand (2).  Livestock


poisoning by consumption of S. jacobaea and other pyrrolizidine alkaloid-


containing plants in Australia and the Pacific Northwest of the United States


has been a serious problem of considerable economic importance (11).


     Human exposure to pyrrolizidine alkaloids may occur through the consump-


tion of plant materials contaminating cereal grains.  For example, from 1935


to the mid-1950"s, an epidemic of poisoning took place in the U.S.S.R. because


of the contamination of bread made from wheat, barley or millet containing


Heliotropium lasiocarpum  (see  16).     During 1974-1975, an outbreak of


veno-occlusive disease in northwestern Afghanistan was identified to be due to


the consumption of flour made from wheat contaminated with seeds of


Heliotropium popovii subsp. gillianum, which contains heliotrine and lasio-


carpine (13, 103).  Another outbreak of veno-occlusive disease in central


India between 1975 and 1976 has been correlated with the ingest ion of cereals


mixed with seeds of a plant, of the Crotalaria species, containing hepatotoxic


pyrrolizidine alkaloids (14).  Many incidences of poisoning through consump-


tion of food, contaminated with plants of the genus Senecio, were reported in


South Africa (see  3, 16).



                                      293

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     Exposure of humans to these alkaloids also occurs as a result of the use


of pyrrolizidine alkaloid-containing plants as medicinal herbs.  In partic-


ular, many species in the genera of Senecio, Heliotropium and Crotalaria are


used in countries of Asia, Africa and Europe as herbal remedies for the treat-


ment of a wide range of ailments (see Table XLIII).  Cases of human poisoning


due to the consumption of these plants or plant extracts for medicinal


purposes have been recorded (see  11,16).


     In addition, humans may be exposed to pyrrolizidine alkaloids through


food products since several pyrrolizidine alkaloid-containing plants such as


coltsfoot (Petasite japonicus) or comfrey (Symphytum officinale) have been


used in Japan, Australia, Europe and the United States as vegetables and for


the preparation of herb teas (see Table XLIII).  Furthermore, small amounts of


pyrrolizidine alkaloids have been detected in the milk of tansy-fed cows (104)


as well as in honey produced from the nectar of Senecio jacobaea (105) and

                            -^
EChiurn plantagineum (106).


     So far, there is no epidemiologic evidence that links pyrrolizidine


alkaloids with carcinogenesis in humans.  However, the high incidence of liver


cancer in the Bantu population of South Africa has been related to the use of


Senecio plants for medicinal and other purposes (18).  The desert  Bedouins in


Kuwait, who use Heliotropium ramosissimum (which contains heliotrine) as an


herbal remedy and for certain other purposes, have a higher incidence of liver


cancer than do town dwellers (15).


     5.3.2.3.2  Plant Alkaloids Other Than Pyrrolizidine


     5.3.2.3.2.1  INTRODUCTION


     In addition to pyrrolizidine alkaloids,  several other plant alkaloids


have received considerable attention because  of their therapeutic  and pharraa-
                                      294

-------
cologic actions.  The medicinal use of plants containing reserpine, sanguin-


arine, emetine and quinine in various parts of the world dates back almost to


antiquity.  Despite the advent of synthetic drugs, reserpine and quinine are


still prescribed presently for the treatment of hypertension and malaria,


respectively.  Recent research has discovered that vinblastine, vincristine,


acronycine and emetine are effective against certain neoplasms and are valu-


able agents in cancer chemotherapy.  Nicotine and caffeine have no important


clinical application; however, their pharmacological actions have been well


established.  Experimental studies indicate that several of these plant alka-


loids are genotoxic and teratogenic.  The possibility that they may produce

                           '  ^
neoplasms in animals and humans has also been investigated.  A number of


general reviews on these alkaloids has appeared (1, 107-114).


     5.3.2.3.2.2  PHYSICOCHEMICAL PROPERTIES AND BIOLOGICAL EFFECTS


5.3.2.3.2.2.1  Physical and Chemical Properties.  The structural formulas of


some plant alkaloids tested for carcinogenic activity are shown in Table LI.


Like many other alkaloids, they contain nitrogen atom(s) within a heterocyclic


ring system.  Except for caffeine, which is a xanthane derivative, others are


biosynthesized from amino acids and are basic.  Nicotine is one of the few


liquid alkaloids; others are colorless crystalline solids with well defined


melting points.  They are highly susceptible to decomposition by heat or


light; however, salification with inorganic acids increases their stability.


Some important physicochemical properties of these alkaloids are given in


Table LII.


5.3.2.3.2.2.2  Biological Effects Qther Than Carcinogenicity


     Pharmacological effects.  For decades, many of these alkaloids received


much more attention from pharmacologists than from toxicologists.  The phar-
                                      295

-------
                                                                                            .1 of 2
                                        Table LI


           Sane Plant Alkaloids Which Have Been Tested for Carcinogenic Activity
CH30
             H.COOC
                         OCH
                Reserpine
                Acronycine
OCH,
                                        Q     CH,
                                     Caffeine
                           Sanguinarine
                                                                                    OCH,
                                                         CH.O
                                  ^N


                                   Quinine
                                                                                    CH2

                                                                              H?C-C—CHCH = CH2
                                                                               2    H

-------
                                 21'
                          47  20'/CH3
Vinblastine  R=-CH3      Vincristine
              Table  LI  (p.2 of 2)

-------
                                   Table  LII
              Physicochemical  Properties  of Some  Plant  Alkaloids'
  Compound
m.p. (°C)     [0(]D (solvent)
                          Solubility
Resetpine
  264-265
Sanguinarine
Nicotine'(liquid)
Acronycine
Emetine
  190-191
Caffeine
Quinine
Vinblastine
Vincristine
    238
    177
-118° (chloroform)  Insoluble in water; soluble
                    in chloroform, dichloro-
                    methane, acetic acid, ben-
                    zene and ethyl acetate;
                    slightly soluble in methanol
                    and ethanol

                    Soluble in ethanol, chloro-
                    form, acetone and ethyl
                    acetate
            -169C
            -50° (chloroform)
-169° (ethanol)
  284-285    -28° (methanol)
  273-281    +8.5° (methanol)
Soluble in ethanol, chloro-
form and ether

Sparingly soluble in water;
soluble in organic solvents

Sparingly soluble in water;
soluble in chloroform,
methanol, ethanol, ether and
acetone

Soluble in water, chloro-
form, ethanol, acetone and
benzene

Slightly soluble in water;
soluble in ethanol, chloro-
form, benzene and glycerol

Soluble in water and chloro-
form; slightly soluble in
ethane; insoluble in diethyl
ether

Soluble in water and chloro-
form; slightly soluble in
ethanol; insoluble in di-
ethyl ether
 Summarized from IARC Monographs, Vols. 24 and 26, International Agency for
 Research on Cancer, Lyon, France, 1980 and 1981; The Merck  Index, 10th ed.,
 Merck and Co., Rahway, N.J., 1983.
bSee Table LI for structural formulas.

-------
macological properties of reserpine (109), quinine (110), nicotine (112) and




caffeine  (1, 113) have been reviewed.  It has become clear that the antihyper-




tensive and sedative effects of reserpine are due to depletion of stores of




catecholamines and 5-hydroxytyrosine in the brain and adrenal medulla.  The




primary antimalarial action of quinine is schizontocidal.  In addition, thera-




peutic doses of quinine cause analgesia and antipyresis and have curare-like




effects on skeletal muscle.  Nicotine exerts actions on the central and peri-




pheral nervous systems, the cardiovascular system, the gastrointestinal tract




and on exocrine glands.  In general, the effects of this alkaloid have both




stimulant and depressant phases.  Five principal pharmacological actions of




caffeine  are known:  respiratory stimulation, skeletal muscle stimulation,




diuresis, cardiac stimulation, smooth muscle relaxation, and central nervous




system effects.





     Toxic effects.  Many of these alkaloids are highly toxic to rodents.




Their LDcn values in the rat, mouse or rabbit are shown in Table LIII.





     Undesirable effects of reserpine observed in patients are primarily asso-




ciated with the gastrointestinal tract and the central nervous system.  The




following untoward responses are common:  abdominal cramps, diarrhea, ulcer,




insomnia, nightmares and depression.  Single parenteral doses of reserpine




produce gastric haemorrhage and erosion (122) and suppress the immune response




of lymph  node cells (123) in mice.





     Sanguinarine is the active poison in argemone seed oil.  Epidemics of




poisoning from argemone seed oil have been frequently recorded in India.  The




most common effects include dropsy, diarrhea, edema of the legs, glaucoma,




anaemia,  fever, redness of the skin, alopecia and dyspnea.  All these toxic




effects have been experimentally produced in animals with sanguinarine
                                     296

-------
                                  Table LIII
                   Acute Toxicity of Some Plant Alkaloids8
Compound
Reserpine


Sanguinarine
Nicotine

Emetine
Caffeine
Quinine
Vinblast ine




Vincristine



Species and route
Rat , i .v .
Mouse, oral
i.p.
Mouse, i.p.
Rat , oral
i .v .
Rat , oral
Rat , oral
Rabbit , oral
Rat , i.p.
i.v.
Mouse, oral
i.p.
i .v .
Rat , i.p.
i .v .
Mouse, i.p.
i .v .
LD^Q (mg/kg)
18
500
70
18
55
1.0
12.1
200
800
2.2
2.9
15
5.6
10
1.2
1.0
4.7
1.7
Reference
(108)
(115)
(115)
(116)
(117)
(117)
(118)
(117)
(117)
(119)
(120)
(119)
(119)
(120, 121)
(119)
(120)
(119)
(121)
aSee Table LI for structural formulas,

-------
(116).  In vitro studies with the pigeon brain homogenates showed that san-



guinarine hydrochloride inhibits some -SH group-containing enzymes (124).




     Both acronycine and emetine have cytotoxic and antineoplastic proper-



ties.  Acronycine inhibits the synthesis of nucleic acids by interferring with



the transport of nucleosides across the cell membrane (125, 126).  Subchronic



i.p. administration of acronycine to rats and mice at doses higher than 25



mg/kg resulted in high mortality.  At lower doses, inflammation and fibrosis



of the peritoneal cavity were noted (127).  Bnetine is a potent protein



synthesis inhibitor in eukaryotes by blocking the transfer of amino acids from



t-RNA to the polypeptide chain being formed (128).  Structure-activity rela-
                           i %


tionship studies on a number of benzoisoquinoline alkaloids indicate that a



planar molecule with 2 aromatic rings and the presence of a nucleophilic



element, such as a nitrogen atom at a certain distance from the aromatic



rings, are required for protein synthesis inhibitory activity.   The distance



between the 2 aromatic rings, the angle between the nitrogen atom and the



rings, the electronegative character of the rings and the planarity of the



structure are important features in determining the activity (129).  Clinical



toxic manifestations of emetine include nausea, diarrhea, vomiting, epidermal



inflammation, aching, tenderness and weakness of muscle and effects on the



cardiovascular system (110).




     The toxic response of vinblastine and vinicristine are quite different



despite their similarity in chemical structures.  Vincristine is more toxic in



animals and produces, more frequently, peripheral neuropathy, abdominal pain,



alopecia and liver impairment.   The most important toxic effect of vinblastine



is leukopenia.  The cytotoxic activity of these agents are related to their



ability to inhibit the formation of microtubules of the mitotic spindle,



resulting in arrest of dividing cells in metaphase.  Structure-activity rela-





                                     297

-------
tionship analysis reveal that either hydrogenation of the double bonds, reduc-




tive formation of carbinols, removal of the acetyl group at C-4 or acetylation




of the hydroxyl group diminishes the cytotoxicity of vinblastine and vincris-




tine (111).  The configurations at C2" and CIS1 as well as the presence of the




methoxycarbonyl group on CIS1 (see Table LI) also play an important role in




determining biological activity (130).





     Quinine is a strong local irritant.  The acute toxic effects of quinine




in humans are characterized by a spectrum of symptoms referred to as




"cinchonism."  These symptoms involve hearing and vision, the gastrointestinal




tract, the nervous, cardiovascular and renal excretory systems, and the




skin.  The fatal oral dose of quinine for humans is about 8 grams (110).





     Nicotine can be rapidly absorbed through skin and mucous membranes.  The




major symptoms of acute nicotine poisoning in humans include nausea, vomiting,




abdominal pain, diarrhea, cold sweat, headache, mental confusion and convul-




sions.  An oral dose of 40 rag is fatal for an adult.  Death may result from




respiratory failure caused by paralysis of muscles of the respiratory system.





     In humans, overdoses of caffeine (15 mg/kg or more)  cause pharmacological




responses predominantly in the central nervous system and the circulatory




system — insomnia, restlessness,  excitement, sensory disturbances, tachycar-




dia and extrasystoles.  Lower doses may cause nausea, nervousness, insomnia




and diuresis (113, 117).  Caffeine is cytotoxic and affects the mitotic rate




of a wide range of cell types (rev. in   107).





     Mutagenic effects.  The genotoxic potential of these plant alkaloids has




been investigated in a number of systems.   The results, which are summarized




in Table LIV, indicate that many of them possess clastogenic properties but




are probably not potent mutagens.
                                     298

-------
                                   Table  LIV
      Mutagenic  and  Related  Genotoxic  Activities  of Some  Plant  Alkaloids3
Compound
Reserpine
Chromosomal
Ames test aberrations
- (131-133) + (143)
- (144)
Other test0
- [A-D] (132, 133, 154, 155)
Sanguinarine    + (134)

Vinblastine     - (135, 136)



Vincristine     - (135)
Quinine
Nicot ine
Caffeine
+ (137)

- (138)

- (139-141)



- (136, 137,

  139, 142)
+ (145)       + [E.F] (136, 146)

- (146)       - [D.G-J] (155-158)

+ (147)       + [K.K.L] (149, 159, 160)

- (148-150)   - [I.J.L] (149, 157, 158, 161)

+ (138)       - [F.M.N] (137)

              + [F.L] (138)

              + [F.L.M] (141, 162)
+ (151)

- (151)

+ (152, 153)
              + [A.K-M] (107, 151, 163, 164)

              - [D,F,J,K,M,N] (137, 155, 165-

                              169)
  "•»•" * positive; "-" = negative; numbers in parenthesis are references.

  See Table LI for structural formulas.

  A "  Bacillus  subtilus; B  s Aspergillus  nidulans;  C  =  Unscheduled  DNA  syn-
  thesis;  D  » Dominant  lethal assay;  E »  Sperm  abnormality test;  F  = Micro-
  nucleus  formation; G  * Chlamydomonas reinhardi;  H = Schizosaccharomyces  pombe;
  I «  host-mediated  assay;  J »  Chinese hamster  cell/HGPRT  assay;  K  = Mouse
  lymphoma cell/L5178Y; L * Sister-chromatid  exchange;  M » Escherichia  coli;
  N «  Sex-linked  recessive  lethal  in  Drosophila.

  Pyrolysate.

  Hydrochloride or dihydrochloride  salt.

-------
     In the Ames Salmonella assay, only the pyrolysate of sanguinarine (134)

and the dihydrochloride salt of quinine (137) gave positive results when

tested in the presence of S-9 fraction; other alkaloids were negative either

with or without metabolic activation (131-133, 135-137, 139-142, 149).


     Reserpine was also non-mutagenic in Bacillus subtil is (132) and in

Aspergillus nidulans (154).  It did not induce dominant lethality in mice

(155) or unscheduled DNA synthesis in primary rat hepatocytes (133).  Cyto-

genetic studies on human lymphocytes in culture (132, 151), in Chinese hamster

cells in vitro, or in bone marrow cells from rats treated in vivo (132) did

not reveal any significant clastogenic activity of reserpine.  However,
                           f ^
Jameela and Subramanyam (143) have reported that reserpine causes chromosomal

aberrations in meiotic cells of grasshoppers and in bone marrow cells of mice.


     The genotoxic effects of vinblastine and vincristine have been reviewed

(170-172).  Most studies showed no mutagenic and related genotoxic activity of

these vinca alkaloids.  Negative responses were observed for vinblastine in

the forward mutation assay in Schizosaccharomyces ppmbe and in the backward

mutation assay in Chamydomonas reinhardi (156).  Neither vinblastine nor

vincristine displayed mutagenic action in host-mediated assays in rats (149,

157), in dominant lethal assays in mice (155, 156) or in V79 Chinese hamster

cells in vitro (158).  No increase in chromosomal aberrations (146, 148-150)

or in sister chromatid exchange (161) were found by some authors with vincris-

tine in several test systems.  Other investigators, however, have reported

that vincristine is mutagenic in mouse lymphoma L5178Y cells (159) and induces

micronucleus formation (146, 149), sister chromatid exchange (160), chromo-

somal translocations (173) and other chromosomal aberrations (147).  Vinblas-

tine produces increase in chromosomal translocations (173), bone marrow micro-

nucleus formation and sperm abnormalities in mice (136), in addition to


                                     299

-------
various chromosomal aberrations in cultures of a cell line from the lung of




the Chinese hamster (145).





     Quinine dihydrochloride is a frameshift mutagen in strains TA98 and




TA1538 of Salmonella typhimurium in the presence of S-9 mix, but shows no




responses in the following test systems:  Escherichia coli, host-mediated




assay in mice, sex-linked recessive lethal test in Drosophila melanogaster and




micronucleus test in bone marrow cells of mice (137).  Quinine hydrochloride,




on the other hand, appeared inactive in the Ames test but showed a dose-




dependent increase of sister chromatid exchange, enhanced incidence of micro-




nuclei, and elevated chromatid breaks (138).





     No mutagenic effect was observed with nicotine in the Ames test (139-




141).  Cytogenetics studies on human leukocytes in vitro did not disclose any




clastogenic activity of nicotine (151).  However, the alkaloid induces DNA




damage in the E. coli pol A+/A~ system (141), chromosomal aberrations in mice




in vivo (151) and sister chromatic exchange in Chinese hamster ovary cells




(162).





     No information on the mutagenic activity of acronycine is available.




finetine was reported to exhibit a mutagenic effect when tested in




Corynebacterium (cited in  174).





     Concern over the genetic hazards involved in the consumption of caffeine-




containing beverages have stimulated much research on the mutagenic and




related genotoxic activities of caffeine in recent years.  The possibility




that caffeine might be an environmental mutagen is a subject of many reviews




(e.g., 107, 175, 176).  Although there exists a series of negative results in




a variety of assay systems (e.g., 136, 137, 139, 142, 155, 165-169), the




mutagenic and clastogenic actions of caffeine in systems ranging from micro-
                                     300

-------
organisms and plant cells, to mammalian cells had been established more than




twenty years ago (see 107, 175, 176).  Recent research has also shown that




caffeine induces high frequency of mutations in Bacillus subtilis (163), point




mutations and chromosomal breakage in mouse lymphoma cells (153), sister




chromatid exchanges in mice in vivo (164), and various types of chromosomal




aberrations in somatic ganglia of Drosophila melanogaster (152).  Furthermore,




a number of studies demonstrate that caffeine has a synergistic effect on the




mutagenic and chromosome-damaging activities produced by other chemical




mutagens or by radiation (e.g., 177-182).  Since caffeine inhibits the activ-




ity of DNA polymerase I (183) , it is believed that inhibition of excision




repair of DNA by caffeine i'S ^responsible for its potentiation of mutagenicity.





     Structure-activity relationship analysis indicate that caffeine




(1,3,7-trimethylxanthine) is more clastogenic in human lymphocytes in culture




than 1,3-dimethyl- or 3,7-dimethyl-xanthine; 1,7-dimethyl, 1-methyl-,




3-methyl-, and 7-methyl-xanthines are not clastogenic (184).  Caffeine is also




more active than its 8-substituted analogs (8-methoxy-, 8-ethoxy-, or




8-chloro-caffeine) as a mutagen in Jj_. coli or as a co-clastogen with thio-TEPA




(triethylenethiophosphoramide) or maleic hydrazide in the production of




chromosomal aberrations in Chinese hamster cells and Vicia faba root tips




(107).





     Teratogenic effects.  Reserpine is teratogenic in the rat.  Spina bifida




and eye defects were induced in the offspring of rats administered 0.8-1.5




mg/kg body weight reserpine on day 9, or 1.5-2.0 mg/kg body weight on day 10




of gestation (185).  When pregnant rats were parenterally administered 1 mg/kg




body weight reserpine daily for 3 days during the last week of gestation,




hydronephrosis and deformities of the brain ventricles developed in the




newborns (186).  In addition, reserpine affects the reproduction and the






                                      301

-------
                                                 A A,
postnatal neuroendocrine function of rodents (rev. 108).  In humans, a
                                                  A

correlation with malformation has been implicated in a study of 475 pregnant


women treated with reserpine and other anti-hypertensive drugs (see ref.


108).  There are also reports of nasal congestion with cyanosis, costal


retraction, lethargy, congenital lung cysts and stillbirth of babies whose


mothers were treated with reserpine during pregnancy (187, 188).



     The teratogenic action of antimitotic agents is well documented (see


171, 189).  Vinblastine has been shown to be teratogenic in the mouse (190),


the rat (191, 192) and the hamster (193).  Evidence for the teratogenicity of


vincristine has been found also in the monkey (194), the mouse (147, 195), the

                           t ^
rat (196) and the hamster (193).  In general, both alkaloids induce a similar


pattern of effects which include fetal mortality, growth retardation, skeletal


defects and malformations of a wide variety of organs.  The most effective


teratogenic doses of vinblastine and vincristine in these animals are between


0.1 mg/kg and 0.25 mg/kg body weight.  In several case reports, no birth


defects were found in infants of women receiving various doses of these


alkaloids during pregnancy (rev. in 171).



     Growth retardation, delay in teeth eruption and in eye opening, and


various congenital malformations were noted in the progeny of female rats


ingesting quinine (0.25 mg/ml) from drinking water during the pre-gestative,


gestative and lactating periods (197).  Robinson _et__al_. (198) reported that


two of 200 women treated with quinine during early pregnancy gave birth to


congenitally deaf babies.  In 21 cases of attempted abortion by taking large


doses of quinine, congenital malformation involving the central nervous


systems, limbs, face and the digestive and urogenital systems resulted


(199).  Abortion may also result from sanguinarine poisoning (116).
                                     302

-------
     Nicotine, at doses of 0.4, 1.5 and 5.0 mg/kg body weight, has adverse




effects on the formation of the cardiovascular system and ossification of the




skeleton in embryos of Wistar rats (200).  Nishimura and Nakai (201) found




skeletal defects and cleft palates in the newborns of mice administered




nicotine at 25 mg/kg body weight on days 9, 10 and 11 of gestation.





     There was no significant teratogenic response in rats injected i.p. with




emetine at 5.0 mg/kg body weight on the 12th day of gestation.  However, this




inhibitor of protein synthesis potentiates embryolethality and teratogenicity




of caffeine and other teratogens (202, 203).





     Much information on the Xeratogenicity of caffeine was obtained from




experimental studies in rats, mice, rabbits and hamsters.  Thayer and Palm




(176) reviewed extensively the teratogenic potential of caffeine and have




tabulated the findings reported between 1960 and 1974.  The subject has also




been covered in update reviews in 1977 (107) and in 1981 (114).  Several




recent studies confirm most of the earlier observation that at high doses,




caffeine is teratogenic in animals.  In Charles River CD1 mice, a single dose




of 100 mg/kg caffeine injected intraperitoneally on day 14 of pregnancy or




single oral doses of caffeine of 200 and 300 mg/kg caused cleft palate in some




fetuses (204).  Low incidence of retarded skeletal ossification, missing or




hypoplastic nails and cleft palate was observed in fetuses of pregnant mice




and rats given about 150 mg/kg caffeine in the drinking water (205, 206).




Young and Kimmel (207) also noted a dose-related increase in skeletal malfor-




mations in the offspring of rats treated intravenously with caffeine on day 11




of gestation at 112.5 mg/kg or 150 mg/kg.  Moreover, the potentiating effect




of caffeine on the teratogenicity of other agents have been reported (e.g.,




202, 208, 209).
                                      303

-------
     Caffeine and its metabolites readily cross the human placenta (210).   An




increase in the half-life of the excretion of caffeine has been reported in




women during pregnancy (211).  However, a number of studies which attempted to




correlate the intake of caffeine with birth defects in humans showed no




definite causal relationship (rev. 114).  Nonetheless, an inordinately high




incidence of abortion or stillbirth was noted in a subgroup of 16 women during




a retrospective survey involving 800 women, three-fourths of whom were




Mormons.  The 16 women in the subgroup were identified as having an estimated




daily intake of caffeine of 600 mg or more (212).  A recent nationwide case-




control study in Finland, comparing the mothers drinking at least four cups of




coffee a day during pregnancy, with those not drinking coffee at all, showed a




relative risk of coffee consumption with respect to congential malformation




(213).





     Several short-term teratogenesis assays have also disclosed the terato-




genic action of reserpine,  quinine, vinblastine, nicotine and caffeine (214-




216).





     5.3.2.3.2.3  CARCINOGENICITY AND STRUCTURE-ACTIVITY RELATIONSHIPS





5.3.2.3.2.3.1  Carcinqgenicity of Pj.ant Alkaloids Other Than Pyrrolizidine.




The carcinogenesis studies  of some plant alkaloids are summarized in Table




LV.  Positive carcinogenic  effects in experimental animals have been reported




with reserpine, sanguinarine, nicotine, acronycine, and most recently with




caffeine.  In limited studies, no evidence of carcinogenicity was found in




rats or mice following chronic exposure to emetine, quinine, vinblastine,  or




vincristine.





     Reserpine.  Reserpine  is carcinogenic in rats and mice.  In a two-year




bioassay, in which groups of 50 F344 rats and 50 B6C3Fj mice of each sex were
                                     304

-------
                                                     p.  1  of  2
                Table  LV
Carcinogenicity of Some Plant Alkaloids
Compound3
Reserpine






Sanguinarine
(or argemone
oil)




Nicotine

Acronycine


Emetine

Caffeine




Species and strain
Rat, Fischer 344
Rat , Wistar

Rat, Wistar
Mouse, BSCSFj

Mouse, C3H; XVIInc
Rat , —
! ^

Rat, mouse, hamster
and guinea pig
Mouse, Swiss

Rat, Wistar
Mouse, Swiss
Rat , Sprague-Dawley

Mouse, B6C3?!
Rat , Sprague-Dawley
Mouse, B6C3Fj
Rat , Sprague-Dawley

Rat , Wistar
Rat , Wistar
Mouse, C57BL/6
Route
oral
oral

oral
oral

oral
implantation


i.v .

topical

oral
oral
i .p.

i.p.
i .p.
i.p.
oral

oral
oral
oral
Principal organs
affected
Adrenal gland
Liver, hematopoietic
t issue
Noneb
Seminal vesicle,
mammary gland
None0
Bladder


(Sarcomas)

Skin

Intestine, liver
None
Mammary gland, bone
and peritoniura
None6
Nonef
Nonee'f
None

None
Pituitary gland
None
Reference
(115)
(217)

(218)
(115)

(219)
(116,
220, 221)

(116)

(116,
220, 221)
(222)
(223)
(127)

(127)
(224)
(224)
(225,
226)
(227)
(228)
(229)

-------
                              Table LV (continued)
                                                                         p.  2 of 2
Compound3
Quinine

Vinblastine


Vincristine

Species and strain
Rat, Leeds
Mouse, Stock
Rat , BR-46
Rat , Sprague-Dawley
Mouse, Swiss
Rat , Sprague-Dawley
Mouse, Swiss
Route
oral
intravaginal ,
bladder
implantation
i.v .
i.p.
i.p.
i.p.
i.p.
Principal organs
affected
None
None
None
None
None
None
None
Reference
(230)
(231,
232)
(233,
234)
(235)
(235)
(235)
(235)
aSee Table LI for structural formulas.
 Treatment for only 75 weeks.
cAt a dose level of 0.24 jig/day.
^Nicotine pyrolysates or nicotine hydrochloride.
eHigh early mortality rate of treated animals.
^Experiment terminated after 84 weeks.

-------
administered reserpine in the feed at doses of 5 ppm or 10 ppm, dose-related




neoplasms occurred in both species.  Adrenal medullary pheochromocytomas were




induced in 24 of the 48 surviving the high-dose, and in 18 of the 49 low-dose




male rats.  In the mice, 7 cases of mammary carcinomas were found in 48 high-




dose as well as in 49 low-dose females; carcinomas of the seminal vesicles,




which were not seen in 50 control males, developed in 5 of the 49 high-dose




and in one of the 50 low-dose males (115).  Low incidences (13-16%) of




hepatomas and lymphosarcomas were reported in groups of 43-50 male and 80-92




female Wistar rats receiving reserpine (100 mg/kg) in a semi-liquid diet for




18 months (217).  However, administration of 30 or 60 mg/kg body weight of




dietary reserpine to groups -of 25 male and 25 female Wistar rats for 75 weeks




did not result in significant tumor incidence (218).  Lacassagne and Duplan




(219) detected no tumorigenic activity of reserpine in a group of 24 female




C3H mice and in a group of 11 female XVIInc mice, receiving an average of 0.24




iig reserpine per day in the diet for life.  The failure of the last two




experiments to confirm the carcinogenic activity of reserpine may have been




due to the short exposure period and the low dose used.





     Sanguinarine.  Hakim (116, 220, 221) has established in several experi-




ments that sanguinarine and its major metabolite, benz[c]acridine, are




complete carcinogens, inducing bladder tumors in rats and skin tumors in




mice.  The author induced tumors of the bladder by implanting paraffin pellets




(15 mg) containing 25% sanguinarine or benz[c]acridine into the bladder of




rats.  Skin tumors were induced by repeated painting with solutions of san-




guinarine or benz[c]acridine on the skin of mice.  Metastasizing sarcomas have




also been produced in rats, mice, hamsters and guinea pigs with a single i.v.




injection of 0.05 to 0.1 ml argemone oil (containing about 0.1 mg sanguin-




arine).  The carcinogenicity and structure-activity relationships of benzacri-




dines have been discussed in Section 5.1.1.4, Volume IIA.
                                      305

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     Nicotine.  Truhaut and DeClercq (222) have described the development of




malignant teratomas and chronic inflammatory lesions in the intestine and




liver of some Wistar rats 12-17 months following ingestion of nicotine or




nicotine pyrolysates in the drinking water at a dose level of 10 mg/kg body




weight.  Control animals or rats s.c. injected with 5 mg/kg nicotine




pyrolysate once weekly for life did not bear such tumors.  The authors and




associates (236, 237) further showed that cotinine (see Fig. 12 for structural




formula^, the major metabolite of nicotine, is also carcinogenic inducing




lymphoid sarcomas or lymphoid leukemia in the alimentary tract, the liver, the




lung and the spleen in 12 of 15 rats given cotinine (500 rag/liter)  in the




drinking water for 8-18 months.  Schmahl and Osswald (238), however, failed to




confirm the carcinogenic action of cotinine in a group of 100-day-old Wistar •




rats given approximately 30 mg/kg body weight of cotinine in the drinking




water for 17-21 months.  Administration of nicotine hydrochloride to groups of




50 male and 50 female Swiss mice (5-6 weeks old) in the drinking water at a




concentration of 0.0625% or 0.09375% for life, did not produce a significant




tumor incidence (223).  There was also no tumorigenic effect of nicotinic acid




(pyridine-fi-carboxylic acid), a vitamin that occurs in legumes, corn and




other plants, under similar study conditions (223).





     Nicotine sulfate, which was used together with copper sulfate  as a drench




to combat parasites on a large farm in South Africa from 1952 to 1962, was




incriminated in the high incidence of esophageal tumors in sheep (239).





     Acronycine.  Acronycine is carcinogenic in Sprague-Dawley rats, inducing




tumors of the mammary gland in females, osteosarcomas in males, and sarcomas




and other tumors of the peritoneum in both sexes.  These findings arose in a




chronic study in which groups of 35 rats of each sex were administered acro-




nycine 3 times weekly by i.p. injection at a dose of 3.75 mg/kg body weight







                                      306

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for about one year.  In groups of B6C3Fj mice, receiving either 2, 6, 12.5 or


25 mg/kg acronycine, the high mortality rates precluded an evaluation of the

carcinogenic effect of acronycine in this species (127).  The mouse pulmonary

tumor assay, in which a total dose of 0.5, 1.3 or 2.6 g/kg acronycine was

given to A/He mice in 5 i.p. injections over 8 weeks, did not reveal the car-

cinogenic effect of acronycine (240).


     Emetine.  The carcinogenic potential of emetine has been studied in


Sprague-Dawley rats and B6C3Fi mice by administering the alkaloid via i.p.

injection at doses of 0.5 or 1 mg/kg body weight for rats and 1.6, 3.2 or 6.4

mg/kg body weight for mice 3 times/week for up to 52 weeks.  At the termina-
                           i- ^
tion of the studies (at week 83 or 84), no tumors occurred at a statistically

significant incidence in treated rats'or mice compared with controls.  How-

ever, it was noted that the survival of the treated mice was low in this

study.  The study was conducted only for 84 weeks instead of two years (224).


     Emetine did not exhibit a positive response in the mouse pulmonary tumor

assay at the dose levels of 40, 100 and 185 mg/kg body weight (240).


     Caffeine.  Caffeine was found to be non-tumorigenic in animals by several

investigators.  No significant increase in tumor incidence was found in mice


or rats given caffeine in the diet (225, 229) or in the drinking water (226,

227) for up to two years, at doses exceeding the maximum tolerated level.


Similarly, oral administration of freshly brewed or instant coffee to mice or

rats for life did not result in higher incidence of tumors in various organs

(241-244).  However, Yamagami et_ al_. (228) reported in 1983 that caffeine

caused pituitary tumors in female Wistar rats.  Microadenomas, papillary (or


sinusoidal) macroadenomas, and diffuse macroadenomas or hyperplasia of the

pituitary were found in 27 of the 40 rats receiving caffeine at a concentra-
                                      307

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tion of 2 mg/ml in the drinking water for 12 months.  Such lesions were found


only in 9 of 30 control rats.



     Quinine.  There is no evidence that quinine is carcinogenic.  Early


experiments conducted by Boyland and associates (231, 232) did not yield


significant incidence of neoplasms of the uterine cervix or the bladder in


mice following application of quinine sulfate intravaginally or by implanta-


tion of the compound in the urinary bladder.  More recently, the effects of


chronic oral dosing with quinine sulfate in the rat have been examined by


Flaks (230).  A group of 48 male albino rats of Leeds strain received 0.1%


quinine sulfate in the drinking water for up to 15 months.  No tumors or pre-
                           t  ^

neoplastic lesions were noted in the rats autopsied during the course of the


experiment or in the 13 survivors after 15 months of treatment.



     Vinblast ine.  Vinblastine did not produce significant tumor incidence in


rats or mice wnen tested by i.v. or i.p. administration.  In a group of 36


male BR46 rats given i.v. injections of 0.33 mg/kg body weight (17% of the


LDCQ) vinblastine sulfate once every two weeks for 10 weeks, a 12% tumor inci-


dence was found.  However, 11% had tumors among the 689 controls (233, 234).


In another study, in which 48 male BR46 rats were injected intravenously with


0.14 mg/kg body weight vinblastine sulfate once weekly for 52 weeks, only one


of the 25 surviving rats bore a benign thymoma 18 months after start of


treatment (233).  When groups of 25 Sprague-Dawley (CD) rats and 25 Swiss-


Webster mice of either sex were administered the compound by i.p. injection, 3


times weekly for 26 weeks at doses of 0.1 and 0.2 mg/kg body weight (rats) or


0.09 and 0.18 mg/kg body weight (mice), the tumor frequencies in the treated


animals were not statistically different from the control values (52% vs. 34%


in male rats; 72% vs. 58% in female rats; 16% vs. 26% in male and female mice)


(235).



                                      308

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     Vincristine.  As with vinblastine, there is no evidence for carcinogenic



activity in rats and mice after i.p. administration of vincristine.   The tumor



incidences in groups of 25 Sprague-Dawley (CD) rats and 25 Swiss-Webster mice



of each sex, given i.p. injections of vincristine sulfate at 0.06 and 0.12



mg/kg body weight (to rats) or 0.075 and 0.15 mg/kg body weight (to mice) 3



times/week for 26 weeks, were not significantly higher than those in the



controls (235).  The compound did not produce morphological transformation of



mouse C3H/10Tj/2 clone 8 cells (148) or hamster embryo cells (245) .




5.3.2.3.2.3.2  Modification of Carcinogenesis.  Experimental studies in



animals have demonstrated both enhancing and protecting effects of plant
                           i • ^


alkaloids upon carcinogenesis with other chemicals, depending on the time of



treatment and dose level.




     Reserpine, for instance, stimulated the induction of mammary tumors by



7,12-dimethylbenz[a] anthracene (CUBA) or by N-nitrosomethylurea (NytU) in the



rat, when it was given after  the administration of the carcinogen; however,



when reserpine was administered before or concurrently with EMBA or N4U, it



suppressed mammary tumorigenesis (246, 247).  Retardation by reserpine of



hepatocarcinogenesis by diethylnitrosamine in rats (248) and of mouse skin



tumorigenesis by 3-methylcholanthrene (249) was observed when the animals were



treated with reserpine and the carcinogen simultaneously.




     Nicotine has long been suspected to be one of the cocarcinogens in



cigarette smokers.  In studies using the two-stage mouse skin model, nicotine



promotes the tumorigenesis of EMBA.   It enhances, at dose levels between 2.5



and 5.0 mg/kg body weight, and inhibits, at higher doses, the carcinogenic



activity of mixtures of benzopyrene  and 12-0-tetradecanoylphorbol-13-acetate



(TPA) on the mouse skin (250).  A tumorigenesis-promoting activity has also
                                     309

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been observed with cotinine but not with nicotine-1'-N-oxide.  It was sug-




gested that metabolism of nicotine to cotinine might account for the cocar-




cinogenic effect and metabolism to nicotine-1'-N-oxide might account for the




inhibitory effects of nicotine at high doses (250).  Nicotine has also been




shown to enhance stomach carcinogenesis by N-methyl-N'-nitro-N-nitrosoguani-




dine (MNNG) in the rat; combined treatment of rats with MNNG and nicotine led




to an earlier development and an increased incidence of stomach tumors (251).





     Welsch j^t__al_. (252) observed that the administration of caffeine in the




drinking water (250 and 500 mg/1) to female Sprague-Dawley rats, 3 days after




treatment with EMBA (5 mg, i.g.) for 21 weeks, resulted in an increase in




mammary carcinoma incidence.  The same effect was found when caffeine was




given to the rats for 6 weeks beginning 20 weeks after exposure to EMBA.




However, administration of caffeine prior to and during EMBA treatment did not




significantly affect mammary tumor incidence in the rats.  On the other hand,




caffeine markedly increased the incidence of papillomas on the skin of mice,




when it was given 6-9 hours before urethan administration.  Application of




caffeine to the skin of mice 6 hours after urethan, however, led to lower




incidence of skin tumors (253).  Nomura (254) found that when lung tumors were




induced in young adult mice or in mouse fetuses by s.c. injection of either




urethan or 4-nitroquinoline-l-oxide, the tumor incidences were significantly




reduced by caffeine after treatment with the carcinogen.  The caffeine-




sensitive period for suppression of lung neoplasia was found to parallel the




generation time of the stem cells in the lung of mouse fetuses and young adult




mice.  It has been suggested that the inhibition by caffeine of the error-




prone post-replication repair of DNA or the alteration of the metabolism of




carcinogens by caffeine may be the mechanism of the generally observed modifi-




cation of chemically-induced neoplasia by caffeine (253, 254).  The effects of
                                      310

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caffeine on the hepatic mixed-function oxidases in various species have been




described (255) .





     Ranadive et al. (256) observed, in the mouse, the cocarcinogenic effect




of argemone-oil (which contains sanguinarine as the principal constituent) and




of a market sample of mustard oil from India.





     Recent research indicates that many chemicals, which induce viral gene




expression in human lymphoblastoid cells latently infected with Epstein-Barr




virus (EBV), are mouse skin tumorigenesis promoters.  Although vinblastine




possesses EBV-activating property, it fails to show any significant tumori-




genesis- promo ting activity i,n^the mouse skin (257).





     5.3.2.3.2.4  METABOLISM AND POSSIBLE MECHANISMS OF ACTION





     The pharmacokinetics and metabolic fate of many of these alkaloids have




been investigated in various laboratory animals as well as in humans.  Except




for sanguinarine and nicotine, metabolic activation does not appear to be




required for their biological and carcinogenic activities.





     Reserpine.  Reserpine is rapidly absorbed and metabolized in most tissues




of rats, mice, dogs and rhesus monkeys.  In the rat, reserpine is hydrolyzed




to methyl reserpate which is excreted primarily in the urine (258).  In the




mouse, the major urinary metabolites after oral or i.v. administration of




reserpine is trimethoxybenzoic acid (259).





     As reserpine has not been shown to be mutagenic, a possible mechanism by




which reserpine exerts its mammary carcinogenic effects may be via certain




endocrine functions.  In rodents, reserpine administration has been




demonstrated to be associated with elevated levels of serum prolactin and it




is known that a correlation exists between the duration and extent of increase




in prolactin levels and the development of mammary neoplasms (252, 260).







                                     311

-------
Recently, it has been shown that chronic reserpine treatment increases the




mammary tumor estrogen receptor and peroxidase activity in the rat, indicating




that there is increased estrogenic stimulation of specific protein production




(247).  Furthermore, reserpine has been shown to impair the immune system of




rats, inhibit oxidative phosphorylation in isolated mitochondria, and to




interfere with transport systems in the cell membrane (see ref. 261).





     It is interesting to note that unlike reserpine, yohimbine, another




indole alkaloid, which differs from reserpine in lacking an acetyl group and




the trimethoxybenzoic moiety in the molecule, does not modify chemically




induced carcinogenesis in the liver of the rat (262).





     Sanguinarine.  In the rat, sanguinarine is readily absorbed after feed-




ing, is stored in the liver, and is biotransformed to at least four different




fluorescent metabolites which are excreted as protein complexes in milk, bile




and urine.  Following parenteral administration into five species of animals,




this carcinogenic alkaloid distributes into the stomach and esophagus where




metabolism occurs.  One of the metabolites has been identified as benz[c]acri-




dine (116).  The carcinogenic activity of sanguinarine and benz[c]acridine may




be related to their intercalation into DNA (263, 264; see also Notes to




Section 5.1.1.6.2.3, Volume HA).





     Nicotine.  Nicotine is well absorbed through the respiratory tract,




intestine and skin.  Radioactivity was detectable in the bronchial wall, the




melanin-containing tissues and in the urinary bladder wall, for up to a month




after i.v. injection of 1^C-methyl- or 2'-^C-labelled nicotine into the mouse




(265).  The compound is metabolized mainly in the liver but also in the lung




and kidney.  The major metabolites are cotinine, formed by oxidation at the




o^-carbon, and nicotine-1'-N-oxide, formed by N-oxidation of the pyrrolidine
                                      312

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ring (266).  N-Demethylated metabolites and CC^ are produced in the lung (267-


269).  Nicotine and its metabolites are mainly excreted through the kidney;


they have also been detected in the milk of lactating women who smoke (270).



     Since both carcinogenic and cocarcinogenic activity have been shown for


cotinine (see previous Sections), the biotransfonnation of nicotine to


cotinine appears to be important for the carcinogenic action of nicotine.   It


has been postulated (271) that oxidative N-demethylation of nicotine (or coti-


nine) may yield chemically active N-methyleniminium species that can interact


with cellular nucleophiles (see Fig. 12).



     Acronycine.  Metabolic studies of acronycine in rats, mice, dogs, cats,
                            r %

rabbits, guinea pigs and humans have shown that hydroxylation of the compound


at C-9 and C-ll (see Table LI) occurs in all species.  The gem-dimethyl groups


(C-3) of acronycine are hydroxylated in rats, mice, dogs and humans but not  in


guinea pigs.  The mouse and the guinea pigs also metabolize acronycine by


0-demethylation (272).



     The mechanism(s)  of the carcinogenic action of acronycine is obscure.   It


is not known if its interaction with cell-surface components and interference


with some transport systems on the cell membrane (125, 126) may result in


impaired cellular activities leading to alterations of gene expression.  On


the other hand, acronycine and its metabolites may act by intercalation with


DNA by virtue of the acridine moiety in the molecule.



     Emetine.  Following parenteral administration, the alkaloid can be found


in the liver and, to lesser extent, the lung, kidneys and spleen of humans.


Emetine is metabolized slowly; considerable levels of the compound can still


be found in the urine  40 to 60 days after treatment (110).
                                     313

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^N^     CHU
                        [O]   ^
                                              CH2OH
                        [o]
•o
                                               CH2OH
                               •O
            Fig.  12.   Proposed metabolic pathway for the activation of nicotine.

-------
     Caffeine.  The pharmacokineti.es and metabolism of caffeine in humans and




animal species have been reviewed (107, 114).  Recent investigations (273,




274) confirm that the major pathways in the metabolism of caffeine in humans




are N-demethylation and ring oxidation to paraxanthine (1,7-dimethylxanthine),




theophylline, theobromine and 1,3,7-trimethyluric acid.  These compounds are




further degraded to dimethylated uric acids, monomethylated uric acids, and




monomethylxanthines.  An acetylated metabolite, 5-acetylamino-6-amino-3-




methyluracil, has also been detected in the urine of humans after oral uptake




of caffeine (274, 275).  In the mouse, the major urinary metabolites of




caffeine arc 1,3,7-trimethyluric acid, 1,3-dimethyluric acid, 1-methyluric




acid, 1,7-dimethylxanthine, 3-methylxanthine and 6-amino-5-(N-formylmethyl-




amino)-!,3-dimethyluracil (114, 276).  Metabolism of caffeine in rats also




involves hydrolyt'ic ring-opening, resulting in the formation of diaminouracil




derivatives up to 30-40% of recovered metabolites (277).





     Despite its genotoxic action in some test systems, caffeine does not bind




covalently to DNA from perfused liver of the rat (278).  The inhibition of




post-replication repair of DNA has been suggested to be related to the induc-




tion of rat pituitary tumors by caffeine (228).





     Quinine.  Quinine is rapidly absorbed in the small intestine and is




largely metabolized in the liver.  The metabolic products, many of them iden-




tified as hydroxy derivatives, are excreted in the urine and to a lesser




extent in the feces, bile and saliva (110).





     Vinblastine and Vincristine.  The metabolism of these two vinca alkaloids




in various animal species (171) and in humans (111) have been reviewed.  They




are distributed to most tissues in rats and mice following parenteral admini-




stration.  Appreciable amounts of these alkaloids are excreted unchanged,
                                      314

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indicating that they are not metabolized to a great extent in rodents (279).




Metabolism of vinblastine and vincristine in humans involves only alteration




of side chains but not the ring system itself (280, 281).  In humans (280) as




well as in dogs (282), one of the metabolic products of vinblastine is




deacetylvinblast ine.





     5.3.2.3.2.5  ENVIRONMENTAL SIGNIFICANCE





     For centuries, humans have been exposed to many of these alkaloids since




they occur in a wide variety of plants which serve as raw materials for the




preparation of a number of medicinal agents, edible oils, stimulating




beverages and tobacco products.  The botanical sources and uses of these




alkaloids are presented in Table LVI.  Long-term exposure to reserpine,




sanguinarine, caffeine or nicotine has been suspected to be the cause of




several human cancers.





     Reserpine.  The therapeutic uses in India of extracts of Rauwolfia




serpentia in the treatment of hypertension, insomnia, insanity and snake-bite




dates back many centuries.  The root of the plant has long been known in




traditional Chinese medicine to have an antihypertensive effect.  Reserpine,




the active agent of the plant, is still an important drug in modern medicine




for the treatment of hypertension and psychoses.  It has been estimated that




millions of people in the United States have used reserpine.  In 1974, reser-




pine was used in some 25% of all cases of diagnosed hypertension in the United




States and in 1976 in some 80% of cases in West Germany (see ref. 283).





     The possible association between the use of reserpine and the development




of breast cancer in women has been a much debated subject.  However, the epi-




demiological data from 14 case-control and 2 cohort studies, involving female




populations from various cities in the United States and Europe, do not lead
                                      315

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                                  Table LVI
           The Botanical Sources and Uses of Some Plant Alkaloids3
  Compound
        Plants
            Uses
Reserpine


Sanguinarine



Nicotine


Acronycine

Emetine


Caffeine
Quinine
Vinblastine,
Vincristine
Rauwolfia spp.
Argemone mexicana;
Chelidonium maius; etc.
Nicotina tabacum;
Duboisia hopwoodii

"Australia scrub ash"

Cephaelis impecacuanha;
C. acuminata
           t •»
Coffea spp.; Cola spp.;
Thea sinensis; Paulinia
spp.; Ilex paraguensis;
Theobroma Cacao

Cinchona officinalis;
C. succirubrum; C^.
calisaya; C. ledgeriana
Treatment of hypertension and
psychoses

A medicinal herb in India,
China, Africa, and West Indies;
adulteration of edible oil

A major constituent of tobacco;
agricultural insecticide

Experimental cancer chemotherapy

Treatment of amebic infections;
experimental cancer chemotherapy

An analgesic; preparation of
coffee, tea and other beverages
Treatment of malaria and noc-
turnal leg cramps, a bitter-
flavored constituent of some
carbonated beverages
Vinca rosea (Catharanthus    Cancer chemotherapy
roseus); Catharanthus spp.
aSummarized from IARC Monographs Vols. 24 and 26, International Agency for
 Research on Cancer, Lyon, France, 1980, 1981; A.G. Gilman, L.S. Goodman, and
 A. Gilman (eds.), "The Pharmacological Basis of Therapeutics," MacMillan, New
 York, 1980; The Merck Index, 10th ed. , Merck and Co., Rahway, N.Y., 1983.

 See Table LI for structural formulas.

-------
to an unequivocal conclusion of relationship between reserpine use and breast




cancer.  Although several studies found a positive relationship, there is only




a small increase in risk for long-term users  (see 108, 172). This




apparent slight increase in risk may even be confounded by socio-economic




variables or other breast cancer risk factors ( cited   In    283).  Studies on




the effects of reserpine on prolactin level and on the incidence of breast




cancer in postmenopausal women suggest that slight increases in prolactin




level would not greatly increase the relative risk of breast cancer (284).





     A case-control study (285) negates the hypothesis that reserpine exacer-




bates prostate cancer by stimulating serum prolactin production.





     Sanguinarine.  Sanguinarine has been found in Argemone mexicana (argemone




weed; yellow-flowered prickly poppy) and 49 other plant species belonging to




14 genera of the poppy-fumaria family (Papaveraceae).  These plants grow




abundantly in both the tropical and the temperate regions of the globe.  In




India, China, Africa and West Indies, argemone weed is used as a medicine.




People in these and other areas are also exposed to Sanguinarine through the




consumption of edible oils contaminated with argemone oil and/or the intake of




milk, liver and eggs from animals which fed on weeds producing Sanguinarine.




Hakim (161, 221) has noted a correlation between the geographical distribution




and density of sanguinarine-producing plants and the local  incidences of




oesophageal cancer and stomach cancer.  The high incidence  of nasopharyngeal




cancer in some Chinese and Pillipinos populations is suspected to be related




to the smoking of opium which also contains Sanguinarine (221).





     Nicotine.  Nicotine is one of the alkaloids to which humans are most fre-




quently exposed, since it is a major constituent of tobacco Nicotiana tabacum




and Duboisia hopwoodii.  The very strong statistical association of lung
                                      316

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cancer and cigarette smoking is well established.   It is also known that

tobacco ingredients are initiators and/or promoters of carcinogenesis.

Although the principal carcinogenic and co-carcinogenic agents in tobacco

smoke are polycyclic aromatic hydrocarbons (see ref. 286),  it is possible that

nicotine may play the role  of a cocarcinogen and/or promoter.  The tobacco

specific nitrosamines, N'-nitrosonornicotine and 4-(methylnitrosoamino)-l-(3-

pyridyl)-l-butanone, which have been found to be carcinogenic in rodents (see

Section 5.2.1.2, Volume IIIA), are derived from nicotine.

     In the United  States, a large quantity of nicotine sulfate was used as an

agricultural insecticide before being replaced by other chemicals.
                           •  ^
     Acronycine and Emetine.  In experimental and clinical  studies, both

alkaloids have been demonstrated to be effective agents against a broad

spectrum of tumors.  Acronycine is obtained from the bark of the Australian

scrub ash whereas emetine is obtained from ipecac ("Brazil  root"), the dried

root of Cephael is ipecacuanha or C_. acuminata (127, 224) .   The emetine-

producing plants are native to Central America and Brazil but can also be

found in India and Malaysia.  Since 1912 emetine is widely  used for the treat-

ment of intestinal  amebiasis, amebic hepatitis and other severe amebic infec-

tions (see  110) .      A review in 1978 (1) estimated that  11-14 metric tons

of ipecac, which contains 12-14% of emetine, is imported into the United

States annually, mainly from Brazil.

     Caffeine.  Caffeine is a constituent of coffee, tea and other

beverages.  It has  a limited use in medicine, mainly as an  analgesic and a

stimulant (107, 113).  Most of the world population is exposed to caffeine to

a greater or lesser extent.  In 1961, the Expert Panel of the Flavor and

Extract Manufacturers' Association of the United States considered caffeine to
                                      317

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be GRAS ("Generally Regarded as Safe") for use in non-alcoholic beverages.

However, on October 15, 1980, the U.S. Food and Drug Administration proposed

that caffeine be no longer listed as GRAS, on the basis of more recent

research data (see 114).


     A number of epidemiologic studies on the carcinogenic and teratogenic

effects of caffeine consumed in coffee and tea are available (revs. 114,

287).  Stocks (288) compared the age-adjusted death rates due to cancer at

various sites and the annual consumption of coffee and tea in 20 countries

during 1964-1965.  The author concluded that consumption of coffee positively

correlates with leukemia and cancer of the pancreas, prostate and ovary.  A
                            i •%
positive correlation also exists between the consumption of tea and cancer of

the intestine, larynx, lung and breast.  However, Heyden (289) found several

flaws in this study.  Cole (290) found an association between coffee-drinking

and bladder cancer in a case-control study.   Later studies from the same

author (291) and from other investigators (292), however, failed to substan-

tiate the observed association.  Shennan (293) reported a strong correlation

between coffee consumption and the rates of mortality from renal cancer in 16

countries.  On the other hand, studies by others (294, 295) did not find such

association.  More recently, MacMahon et al. (296) drew the attention to a

strong correlation between coffee consumption and pancreatic cancer in both

men and women.  Review of the available data shows only ambiguous evidence for

reproductive or teratogenic effects due to ingestion of caffeine from coffee

(see 114).


     Quinine.  Quinine is the principal alkaloid of cinchona, the dried bark

of various Cinchona species.  The history of this antimalarial agent dates

back for more than 300 years.  In fact, quinine was the sole remedy for

malaria until World War II.  This agent is still used for the management of


                                      318

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malaria and for the relief of nocturnal leg cramps (110).  It also finds use




as a bitter-flavored constituent of a widely used type of carbonated beverage




(230).





     Vinblastine and Vincristine.  In folk medicine, these two alkaloids from




the periwinkle plant (Vinca rosea) were used for controlling hemorrhage, for




the treatment of scurvy and toothache, and for healing chronic wounds.  Since




the early 1960's, they have proved to be important agents, either singly or in




combination with other antineoplastic drugs, in the therapy of Hodgkins




disease, lymphosarcomas, choriocarcinomas, testicular tumors and other forms




of human neoplasms (1, 111, 297).  Several case reports and epidemiologic




studies on the carcinogenic activity of these two drugs in humans have been




reviewed (171).  In chemotherapy, with drug combinations including vincristine




or vinblastine, the two agents have been associated with the subsequent




development of leukemias.









                         REFERENCES TO SECTION  5.3.2.3




   1.   Cordell, G.A.:   Kirk-Othmer Encycl. Chem. Techno!. (3rd ed.), J_, 883




       (1978).




   2.   Bull, L.B., Culvenor, C.C.J.,  and Dick, A.T.:  "The Pyrrolizidine




       Alkaloids.  Their Chemistry, Pathogenicity and Other Biological Proper-




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191.  DeMyer, W. :  Neurology 14, 806 (1964).
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193.  Perm, V.H.:   Science 141, 426 (1963).




194.  Courtney, K.D., and Valeric,  D.A.:   Teratology 1, 163 (1968).




195.  Joneja, M.,  and Ungthavorn, S.:   Teratology 2, 235 (1969).




196.  DeMyer, W.:   Arch. Anat. 48,  181 (1965).




197.  Lapointe, G.,  and Nosal, G.:   Biol. Neonate 36, 273 (1979).




198.  Robinson, G.C., Bromitt, J.R., and  Miller, J.R.:  Pediatrics 32, 115




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200.  Sheveleva, G.A., Kiriushchenkov, A.P., Sheina, N.I., and Silant'eva,




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225.  Johansson, S.L.:  Int. J. Cancer 127, 521 (1981).



226.  Mohr, U., Althoff, J., Ketkar, M.B., Conradt, P., and Morgareidge,



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227.  Takayama, S., and Kuwabara, N.:  Gann 73, 365 (1982).



228.  Yamagami, T., Handa, H., Takeuchi, J., Munemitsu, H., Aoki, M., and



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229.  Macklin, A.W., and Szot, R.J.:  Drug Chem. Toxicol. 3, 135 (1980).
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230.  Flaks, B.:  Pathol. Res. Pract. 163, 373 (1978).



231.  Boyland, E., Charles, R.T., and Cowing, N.F.C.:  Br. J. Cancer 15, 252



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232.  Boyland, E., Busby, E.R., Dukes, C.E., Grover, P.L., and Hanson, D.:



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233.  Schmahl, D., and Osswald, H.:  Arznemittel.-Forsch. 20, 1461 (1970).



234.  Schmahl, D.:  Recent Results Cancer Res. 52, 18 (1975).



235.  Weisburger,  E.K.:  Cancer 40, 1935 (1977).



236.  Truhaut, R., DeClercq, M., Loisillier, F., and Colin, S.:  Path. BioL.



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238.  Schmahl, D., and Osswald, H.:  Z.  Krebsforsch. 71, 198 (1968).



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240.  Stoner, G.D., Shimkin, M.B. , Kniazeff, A.J., Weisburger, J.H.,



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241.  Zeitlin, B.R.:  Lancet 1. 1066 (1972).
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242.  Bauer, A.R. Jr., Rank, R.K., Kerr, R., Straley, R.L., and Mason,

      J.D.:  Life Sci. 21, 63 (1977).

243.  Wurzner, H.-P., Lindstrom, E., Vuataz, L. , and Luginbuhl, H.:  Food

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244.  Palm, P.E., Arnold, E.P., Nick, M.S., Valentine, J.R., and Doerfler,

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245.  Hirakawa, T., Tanaka, M., and Takayama, S.:  Toxicol. Lett. 3, 55

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246.  Welsch, C., andMeites, J. :  Experientia 26, 1133 (1970).

247.  Verdeal, K., Erturk, E., and Rose, D.P.:  Eur. J. Cancer Clin. Oncol.
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248.  Lacassagne, A., Buu-Hoi, N.P., Giao, N.B., and Ferando, R.:  Bull.

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249.  Lupulescu, A.:  J.  Natl. Cancer Inst . 71, 1077 (1983).

250.  Bock, F.G.:  Banbury Rep. Ser. 3, 129 (1980).

251.  Gurkalo, V.K., and  Volfson, N.I.:  Arch. Geschwulstforsch. 52, 259

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252.  Welsch, C.W., Brown, C.K., Goodrich-Smith, M., Chiusano, J., and Moon,

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253.  Armuth, V, and Berenblum, I.:  Carcinogenesis 2, 977 (1981).

254.  Nomura, T.:  Cancer Rgs. 40, 1332 (1980).

255.  Govindwar, S.P., Kachole, M.S., and Pawar, S.S.:  Food Chem. Toxicol.

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256.  Ranadive, K.J., Gothoskar, S.V., and Tezabwala, B.U.:  Int. J. Cancer

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257.  Fujita, J., Tokuda, H., Sugawara, K., and Yoshida, 0.:  Toxicol. Lett.

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259.  Numerof, P., Gordon, M., and Kelly, J.M.:  J. Pharmacol. Exp. Ther.

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260.  Clemens, J.A., Shaar, C.J., Smastig, E.B., and Matsumoto, C. :  Horm.

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261.  Cazenave, J.-P., Reimers, H.-J., Perey, D.Y.E., and Mustard, J.F. :

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262.  Lacassagne, A., Buu-Hoi, N.P., and Ba-Giao, N. :  C.R. Acad. Sci.

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263.  Faddejeva, M.D., Belyaeva, T.N., Novikov, J.P., and Shalabi, H.G.:

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264.  Naiti, M., Nandi, R. , and Chaudhuri, K.:   FEBS Lett. 142, 280 (1982).

265.  Szuts, T., Olsson, S., Lindquist,  N.G., and Ullberg, S.:  Toxicology

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266.  Stehlik, G., Kainzbauer, J., Tausch, H.,  and Richter, 0.:  J.

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267.  Oppelt, W.W., Zange, M., Ross, W.E., and  Remmer , H.:  Xenobiotica 5,

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268.  Turner, D.M., Armitage,  A.K., Briant, R.H., and Dollery, C.T.:

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269.  Litterst, C.L., Mimnaugh, E.G., Reagan, R.L., and Gram, T.E.:  Drug

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270.  Hill, P., and Wynder, E.L.:  Cancer Lett. 6, 251 (1979).

271.  Nguyen, T.L., Gruenke, L.D., and Castagnoli, N. Jr.:  J. Med. Chem. 22,

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274.  Callahan, M.M., Robertson, R.S., Arnaud, M.J., Branfman, A.R., and

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275.  Tank, B.K.,  Grant, D.M., and Kalow, W.:  Drug Metab, Dispos. 11, 218

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276.  Ferrero, J.L., and Neims, A.H.:  Life Sci. 33, 1173 (1983).

277.  Arnaud, M.J.:  Biochem.  Med. 16, 67 (1976).
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278.  Szczawinska, K.,  Ginelli, E., Bartosek, I., Gambazza, C., and

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279.  Castle, M.C., and Mead,  J.A.R.:  Biochem. Pharmacol. 27, 37 (1978).

280.  Owellen, R.J., Hartke, C.A., and Hains, F.O.:  Cancer Res. 37, 2597

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284.  Ross, R.K.,  Paganini-Hill, A., Krailo, M.D., Gerkins, V.R., Henderson,

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285.  Newball, H.H., and Byar, D.P.:  Urology 2, 525 (1973).

286.  Weisburger,  J.H., Cohen, L.A., and Wynder, E.L.:  On the Etiology and

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287.  Miller, A.B.:  Coffee and Cancer.  In "Carcinogens and Mutagens in the


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290.  Cole, P.:  Lancet 1, 1335 (1971).


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295.  Armstrong, B., Garrod, A., and Doll, R.:  Br. J. Cancer 33, 127 (1976).


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             SOURCE BOOKS AND MAJOR REVIEWS FOR SECTION 5.3.2.3






  1.  Bull, L.B., Culvenor, C.C.J., and Dick, A.T.:  "The Pyrrolizidine


      Alkaloids."  John Wiley and Sons, New York, 1968, 293 pp.


  2.  McLean, E.K.:  Pharmacological Reviews 22. 429-483 (1970).


  3.  International Agency for Research on Cancer:  "Some Naturally Occurring


      Substances," LARC Monographs on the Evaluation of Carcinogenic Risk of


      Chemicals to Man, Vol. 10.  Int. Agency Res. Cancer, Lyon, France,


      1976, pp. 265-342.
                                     338

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 4.  International Agency for Research on Cancer:  "Some Pharmaceutical

     Drugs," IARC Monographs on the Evaluation of Carcinogenic Risk of

     Chemicals to Man, Vol. 24.  Int. Agency Res. Cancer, Lyon, France,

     1980, pp. 211-241.

 5.  International Agency for Research on Cancer:  "Some Antineoplastic and

     Immunosuppressive Agents," IARC Monographs on the Evaluation of

     Carcinogenic Risk of Chemicals to Man, Vol. 26.  Int. Agency Res.

     Cancer, Lyon, France, 1981, pp. 349-384.

 6.  Schoental, R.:   Carcinogens in Plants and Microorganisms.  In "Chemical

     Carcinogens" (C.E. Searle, ed.), ACS Monograph 173, American Chemical
                          i- ^
     Society, Washington, D.C., 1976, pp. 626-689.

 7.  Culvenor, C.C.J., and Jago, M.V.:  Carcinogenic Plant Products and

     DNA.  In "Chemical Carcinogens and DNA" (P.L. Grover, ed.), CRC Press,

     Boca Raton,  Florida, 1979, pp. 161-186.

 8.  Miller, A.B.:  Coffee and Cancer.  In "Carcinogens and Mutagens in the

     Environment" (H.F. Stich, ed.), Vol. Ill, CRC Press, Boca Raton,

     Florida, 1983,  pp. 13-20.

 9.  Timson, J.:   Mutat.  Res. 47, 1-52 (1977).

10.  Thayer, P.S., and Palm, P.E. :   CRC Grit. Rev. Toxicol. _3_, 345-369

     (1975).

11.  Oser, B.L.,  and Ford, R.A.:  Drug Chem. Toxicol. 4. 311-329 (1981).

12.  Hakim, S.A.E.:   Maharashtra Med. J. 17, 109-130 (1970).
                                   339

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