Organic Chemicals
John L. O'Donoghue VMD, PhD, DABT, in Neurobiology of Disease, 2007
IV. Pathogenesis: Etiological Agents and Factors Affecting Mode of Action
Organic chemicals can produce many effects on the nervous system [8,9]. Table 3 includes a list of nervous system functions affected by a variety of organic chemicals. Underlying these functional changes are cellular and subcellular changes that mediate the clinical and pathological appearance of the neurotoxicity.
Table 3. Examples of Nervous System Functions Affected by Organic Chemicals
Function | Effect | Chemical |
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Global |
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Cranial nerve |
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Somatosensory |
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Motor |
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Autonomic |
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Note: DMAP, dimethylaminopropionitrile; MPTP, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine; TOCP, tri-o-tolyl phosphate.
The pathogenesis of neurotoxicity induced by exposure to organic chemicals depends on the specific chemical involved, the dose rate, and the developmental status of the exposed individual. Within classes or groupings of similar chemicals, the pathogenesis may vary significantly depending on the number and spacing of substituent groups. For example, among dicarbonyls, commonly referred to as diketones, the gamma spacing between the carbonyls, such as in 2,5-hexanedione, is critical for development of peripheral neuropathy. If the carbonyls are one carbon closer together, as in 2,4-pentandione, foci of necrosis are seen in the brainstem. If the carbonyls are one carbon further apart, as in 2,6-hexanedione, no neurotoxicity is observed. Similarly, 2-mercaptopropionic acid and 3-mercaptopropionic acid, although similar in structure, produce different forms of neurotoxicity. Table 4 provides a simple grouping of various chemical structures and compares and contrasts examples of neurotoxic effects of the chemicals within that group.
Table 4. Chemical Structure and Neurotoxicity in Studies with Humans or Experimental Animals
General Chemical Structure | Examples of Neurotoxic Effects | Examples of Specific Chemical |
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Organometals |
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Nitriles |
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Organophosphorus compounds |
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Organosulfur compounds |
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Aliphatic chemicals containing oxygen |
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Aliphatic chemicals containing halogens |
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Simple aromatic hydrocarbons | Encephalopathy | Toluene |
Halogenated aromatics |
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Although chemical structure is an important determinant of what type of neurotoxicity occurs, the exposure or dose rate can also change the pathogenesis of neurotoxicity. Acrylamide is an example of a substance studied for years as a prototype for chemicals causing peripheral neuropathy. However, the clinical and morphological appearance of acrylamide-induced neurotoxicity in humans and laboratory animals varies depending on the dose rate. In laboratory animals given acrylamide at a high dose rate (≥30 mg/kg/day), ataxia and weakness predominate in the clinical picture and cerebellar Purkinje's cells and nerve terminals degenerate in the CNS and PNS. However, at a lower dose rate (10 mg/kg/day), nerve terminals still degenerate and peripheral nerves show evidence of degeneration, but Purkinje cell lesions are no longer seen.
The stage of development of the organism (human or experimental animal) can have a profound effect on the pathogenesis of neurotoxicity. One of the best examples is from exposure to ethanol [10]. In adults, ethanol consumption causes inebriation that, except in individuals who heavily consume ethanol, results in mild reversible effects. However, as noted previously, ethanol is a serious public health problem. The pathogenesis of fetal neurotoxicity due to ethanol is complex because it differs depending on the developmental stage of the fetus and cell type involved. In addition, it may involve the toxicity of ethanol or its metabolites. The nervous system is most susceptible to ethanol intoxication during synaptogenesis, when neurite elaboration occurs, synapses form, and interneuronal signaling begins. For humans this occurs in the last trimester and into the first few years of life. The most readily observable effect of ethanol exposure in the developing fetal brain is neuronal cell death, which occurs by necrosis and apoptosis. The metabolism of alcohol forms reactive oxygen species and depletes antioxidants, two activities that can cause cell necrosis. Widespread cell death occurs when ethanol produces activation of BAX-dependent caspase-3, which is sufficient to trigger apoptosis within 6 hours of exposure in animal models [11]. Cell death affects a number of processes because the loss of neurons reduces production, migration, and differentiation of neuronal cell lines that underlie diminished or lost structures and functions later in life. Ethanol exposure also triggers premature maturation of precursor cells to astrocytes, an event that interferes with the migration of neuronal cells to their normal location in the brain. Ethanol further interferes with growth factors such as insulin-like growth factor, which is necessary for neuronal cell maintenance. Developing neurotransmitter systems, including the serotonin system and N-methyl-d-aspartate receptor function, are altered by exposure to ethanol. All of these interactions between ethanol and the developing fetal nervous system depend on life-stage changes that occur in immature neurons and glial cells; these neurons and cells are not seen in these cell populations in mature animals. Ethanol presents one of the clearest situations in which the neurotoxicity observed in the adult and the developing brain differs greatly.
As exemplified by the effects of ethanol on the developing nervous system, multiple cell types may be involved in the pathogenesis of organic-chemical-induced neurotoxicity. This aspect of neurotoxicity is often overlooked; because of their complexity, reductionist thinking has often been necessary in studying these neurotoxicities. In addition to affecting multiple cell types, organic chemicals may have to affect different cell types in a certain sequence for neurotoxicity to become evident. MPTP is an example of a heterocyclic compound that has induced a parkinsonian-like neurotoxicity in drug abusers who inadvertently used an illicit drug contaminated with it [12]. The clinical disease induced by MPTP has many of the characteristics of idiopathic Parkinson's disease. Nigrostriatal degeneration induced by MPTP is the consequence of a complex series of events that leads to accumulation of 1-methyl-4-phenylpyridinium (MPP+) in dopaminergic neurons. MPTP's lipophilicity makes it capable of passing through the blood-brain barrier; nevertheless, MPTP alone is not neurotoxic, and critical neurotoxic metabolites of MPTP formed in other tissues are blocked by the blood-brain barrier. The neurotoxicity of MPTP depends on its metabolic activation, which occurs by its oxidation to 1-methyl-4-phenyl-2,3-dihydropyridium and then to MPP+, primarily in astrocytes that catalyze the first critical metabolic step by the enzyme monoamine oxidase type B. The MPP+ formed in astrocytes is subsequently released into the extracellular space, from where it is taken up and accumulated intracellularly to toxic concentrations in neuromelanin containing dopaminergic neurons. Once taken up by neurons, MPP+ accumulates in mitochondria, where it inhibits the flow of electrons through the respiratory chain. This causes the death of nigrostriatal cells and the depletion of dopamine in the extrapyramidal system, resulting in parkinsonian signs and symptoms. The toxicity of MPTP would not occur except for the critical interplay between the astrocyte metabolism and the dopaminergic system uptake and accumulation of MPP+.
The final pathways by which many, if not all, organic chemicals produce neurotoxicity in adults and in the developing nervous system involve essentially the same processes (e.g., necrosis, apoptosis, interference with intracellular movement, and interference with oxidative metabolism). What makes the neurotoxicities distinctive are the triggers that induce these processes and the regional differences in anatomy, physiology, and pharmacokinetics that allow the triggers to be expressed in different cell populations in the CNS and PNS.