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Lorcaserin is a 5-hydroxytryptamine 2C (serotonin) receptor agonist and a nongenotoxic rat carcinogen, which induced mammary tumors in male and female rats in a 2-yr bioassay. Female Sprague Dawley rats were treated by gavage daily with 0, 30, or 100 mg/kg lorcaserin, replicating bioassay dosing but for shorter duration, 12 or 24 wk. To characterize exposure and eliminate possible confounding by a potentially genotoxic degradation product, lorcaserin and N-nitroso-lorcaserin were quantified in dosing solutions, terminal plasma, mammary, and liver samples using ultra-high-performance liquid chromatography-electrospray tandem mass spectrometry. N-nitroso-lorcaserin was not detected, supporting lorcaserin classification as nongenotoxic carcinogen. Mammary DNA samples (n = 6/dose/timepoint) were used to synthesize PCR products from gene segments encompassing hotspot cancer driver mutations, namely regions of Apc, Braf, Egfr, Hras, Kras, Nfe2l2, Pik3ca, Setbp1, Stk11, and Tp53. Mutant fractions (MFs) in the amplicons were quantified by CarcSeq, an error-corrected next-generation sequencing approach. Considering all recovered mutants, no significant differences between lorcaserin dose groups were observed. However, significant dose-responsive increases in Pik3ca H1047R mutation were observed at both timepoints (ANOVA, P < 0.05), with greater numbers of mutants and mutants with greater MFs observed at 24 wk as compared with 12 wk. These observations suggest lorcaserin promotes outgrowth of spontaneously occurring Pik3ca H1047R mutant clones leading to mammary carcinogenesis. Importantly, this work reports approaches to analyze clonal expansion and demonstrates CarcSeq detection of the carcinogenic impact (selective Pik3ca H0147R mutant expansion) of a nongenotoxic carcinogen using a treatment duration as short as 3 months.

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Azo dyes used in textile products contain aromatic amines (AAs), which may be released into the environment after skin bacteria cleavage the azo bond. In Europe, 22 carcinogenic AAs are regulated. Unfortunately, no information is available in many non-European countries, including Brazil. This study aimed to determine the concentrations of 20 regulated AAs in clothes marketed in Brazil and Spain. Generally, higher levels of regulated AAs were found in samples sold in Brazil than in Spain, which is linked to the lack of regulation. Sixteen AAs showed concentrations above 5 mg/kg in samples commercialized in Brazil, while 11 exceeded that threshold in Spain. Regulated AAs with levels above 5 mg/kg were more found in synthetic clothes of pink color. Concentrations in clothing were also used to evaluate the dermal exposure to AAs in 3 vulnerable population groups. The highest exposure corresponded to 2,4-diaminoanisole for toddlers in Brazil and 4,4-oxydianiline for newborns in Spain. Non-cancer risks associated with exposure to 4,4-benzidine by Brazilian toddlers was 14.5 (above the threshold). On the other hand, 3,3-dichlorobenzidine was associated with potential cancer risks for newborns and toddlers in Brazil. Given this topic's importance, we recommend conducting continuous studies to determine the co-occurrence of carcinogenic substances.

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RESUMEN En abril de 2002, un grupo de investigadores suecos dio a conocer que algunos alimentos ricos en almidón y pobres en proteínas, sometidos a procesos con temperaturas mayores a 120 °C (fritura, horneado, asado y tostado) contenían el procancerígeno conocido como acrilamida, un "probable carcinógeno para los humanos" -mutágeno de categoría 2 y tóxico para la reproducción de categoría 3 según la Unión Europea-, comportándose como neurotóxico tras exposiciones agudas. La revisión tiene como objetivo mostrar una actualización de los avances en investigaciones sobre la toxicidad de la acrilamida como un aspecto preocupante en el tema alimentario, y exponer los mecanismos de la formación de este compuesto en los alimentos, sus efectos tóxicos, los métodos analíticos usados en su determinación, los niveles detectados en distintos alimentos y estudios recientes sobre su ingesta. Para ello se realizaron búsquedas en las bases de datos PubMed, SciELO, LILACS y ClinicalKey. Los estudios epidemiológicos llevan poco tiempo, y en su mayoría son inconsistentes respecto al cáncer en humanos, no obstante, se complementan con el empleo de biomarcadores, donde se obtienen resultados en cuanto a la toxicidad cancerígena y no cancerígena más fiables, con menor margen de error. Por el momento, la única recomendación para mitigar su exposición es la divulgación sobre los riesgos del consumo excesivo de alimentos fritos, demasiado tostados o procesados, y seguir una dieta equilibrada y saludable.

ABSTRACT In April 2002, a group of Swedish researchers revealed that some foods rich in starch and poor in protein, subjected to processes with temperatures above 120 °C (frying, baking, roasting and toasting) contained the procancerogen known as acrylamide, a "probable carcinogen for human"-mutagen of category 2 and toxic to category 3 reproduction according to European Union-behaving as neurotoxic after acute exposures. The review aims to show an update of the advances in research on the toxicity of acrylamide as a worrying aspect in the food issue, and to expose the mechanisms of formation of this compound in food, its toxic effects, the analytical methods used in its determination, the levels detected in different foods, and recent studies on its intake. For that, searches were conducted in PubMed, SciELO, LILACS and ClinicalKey. Epidemiological studies take a short time, and are mostly inconsistent with respect to cancer in human. However, they are complemented using biomarkers where results are obtained in terms of the most reliable carcinogenic and non-carcinogenic toxicity, with less margins of error. For now, the only recommendation to mitigate exposition is to divulge the risk of excessive consumption of fried, very roasted or processed foods, and to follow an equilibrated and healthy diet.

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BACKGROUND: Breast Cancer (BC) is the most common cancer in women worldwide and, although 70% of patients are responsive to selective Estrogen Receptor (ER) modulators such as Tamoxifen (Tam), patients' survival is comprised by resistance to endocrine therapy. Brazilian flora, especially the Amazon biome, is one of the richest global sources of native species with potentially bioactive compounds. Arrabidaea chica is a plant native to the Amazon that has been used in the treatment of different diseases. However, its action on BC remains unclear. METHODS: Herein the biological effects of the chloroform extract of A. chica (CEAC) were evaluated on BC cells and in in vivo model. After confirmation of CEAC antioxidant capacity, cells were treated with CEAC and Tam, alone and with CEAC+Tam. The cell viability was evaluated by MTT and hormone receptor transcripts levels were assessed (ESR1, ESR2 and AR). Finally, anticarcinogenicity of CEAC was recorded in Drosophila melanogaster through Epithelial Tumor Test (ETT). RESULTS: The study confirmed the antioxidant activity of CEAC. CEAC was selective for MCF-7, downregulating ESR2 and AR transcripts and upregulating ESR2 expression. The modulatory effects of CEAC on ERs did not differ between cells treated with Tam and with CEAC+Tam. Interestingly, previous treatment with CEAC, followed by treatment with Tam promoted a significant decrease in cell viability. The extract also presented anticarcinogenic effect in in vivo assay. CONCLUSION: The bioassays on breast tumor cells demonstrated the antiproliferative activity of the extract, which modulated the expression of hormone receptors and sensitized luminal tumor cells to Tam. These results suggest that CEAC could be a complementary treatment for BC.

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Inhalation of xenobiotics during manufacture process in chrome plating bath produce hazards to workers' health. Chromium (Cr) is a metal widely used by industry, and its hexavalent (VI) form has been classified as mutagenic and carcinogenic. This study aimed to evaluate the occupational risk of exposure to metals in chrome plating workers. Biological monitoring was performed through quantification of Cr, Pb, As, Ni, and V in blood by ICP-MS in 50 male chrome-plating workers from the exposed group and 50 male non-exposed workers. The inflammatory parameters assessed were ß-2 integrin, intercellular adhesion molecule-1 (ICAM-1), and L-selectin expression in lymphocytes. The genotoxicity was evaluated with comet and micronucleus (MN) assays and as a biomarker of oxidative damage the lipid peroxidation (MDA) and protein carbonyl (PCO). The results demonstrated that Cr levels in blood and urine were increased in the exposed group compared to the non-exposed group. Although the biomarkers of exposure proved to be within the levels considered safe in exposed individuals, chrome plating workers presented significantly increase in the percentage of lymphocytes expressing ß-2 integrin, ICAM-1, and L-selectin as well as DNA damage (comet assay) and plasmatic MDA and PCO levels. Therefore, it is possible also assign the injuries caused to lipids, proteins, and DNA assessed due to the increased presence of other metals such as Pb, As, Ni, and V in exposed subjects. These results suggest that exposure to xenobiotics present in the occupational environment in chrome plating industry could play a crucial role toward the inflammation, genetic, and oxidative damage.

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Aflatoxins are mycotoxins produced as secondary fungal metabolites. Among them, aflatoxin B1 (AFB1) stands out due to its genotoxic and mutagenic potential, being a potent initiator of carcinogenesis. In this review, the outcomes from the published literature in the past 10 years on the effects of AFB1 pathophysiological mechanisms on embryological and fetal development are discussed. In several animal species, including humans, AFB1 has a teratogenic effect, resulting in bone malformations, visceral anomalies, lesions in several organs, and behavioral and reproductive changes, in addition to low birth weight. The mutagenic capacity of AFB1 in prenatal life is greater than in adults, indicating that when exposure occurs in the womb, the risk of the development of neoplasms is higher. Studies conducted in humans indicate that the exposure to this mycotoxin during pregnancy is associated with low birth weight, decreased head circumference, and DNA hypermethylation. However, as the actual impacts on humans are still unclear, the importance of this issue cannot be overemphasized and studies on the matter are essential.

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Knowledge of the toxic potential of polycyclic aromatic hydrocarbons (PAHs) has increased over time. Much of this knowledge is about the 16 United States - Environmental Protection Agency (US - EPA) priority PAHs; however, there are other US - EPA non-priority PAHs in the environment, whose toxic potential is underestimated. We conducted a systematic review of in vitro, in vivo, and in silico studies to assess the genotoxicity, mutagenicity, and carcinogenicity of 13 US - EPA non-priority parental PAHs present in the environment. Electronic databases, such as Science Direct, PubMed, Scopus, Google Scholar, and Web of Science, were used to search for research with selected terms without time restrictions. After analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, 249 articles, published between 1946 and 2020, were selected and the quality assessment of these studies was performed. The results showed that 5-methylchrysene (5-MC), 7,12-dimethylbenz[a]anthracene (7,12-DMBA), cyclopenta[cd]pyrene (CPP), and dibenzo[al]pyrene (Db[al]P) were the most studied PAHs. Moreover, 5-MC, 7,12-DMBA, benz[j]aceanthrylene (B[j]A), CPP, anthanthrene (ANT), dibenzo[ae]pyrene (Db[ae]P), and Db[al]P have been reported to cause mutagenic effects and have been being associated with a risk of carcinogenicity. Retene (RET) and benzo[c]fluorene (B[c]F), the least studied compounds, showed evidence of a strong influence on the mutagenicity and carcinogenicity endpoints. Overall, this systematic review provided evidence of the genotoxic, mutagenic, and carcinogenic endpoints of US - EPA non-priority PAHs. However, further studies are needed to improve the future protocols of environmental analysis and risk assessment in severely exposed populations.

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The nonclinical branch of regulatory pharmacology has traditionally relied on the sensitivity and specificity of regulatorily recommended bioassays. Nonetheless, any predictive testing (eg, safety pharmacology) with less than 100% sensitivity or 100% specificity is prone to deliver false positive or negative results (namely, outcomes discordant to the clinical gold standard). It was recently suggested that the statistics-based and regulatory pertinent "predictive values approach" (PVA) might help to reach a more predictive use of preclinical testing data. To resolve the associated probability of carcinogenicity to humans, the PVA was applied to 37 pharmaceuticals bearing inadequate epidemiological evidence of carcinogenicity, but identifiable as unequivocal mutagens. According to current knowledge, a 98.9% (or more) probability of carcinogenicity to humans was reckoned for those 37 genotoxic drugs. Accordingly, these pharmaceutical drugs might be either scientifically or regulatorily regarded as "carcinogenic to humans." In the USA, European Union, or Canada as examples, the great majority of these 37 pharmaceuticals are authorized for medical use in humans. From the results of the present appraisal, the following is suggested (1) for the pharmaceuticals listed in this report, to include significant carcinogenicity warnings in their prescribing information; (2) to conduct pharmacoepidemiology studies or risk-benefit analyses (if warranted), and (3) based on the respective risk-benefit analyses, to re-evaluate the authorization of hydralazine and phenoxybenzamine as antihypertensives, oxcarbazepine as an anticonvulsant, and phenazopyridine as a urinary tract antimicrobial or analgesic. For the four latter drugs (eg, phenoxybenzamine), a 99.5% probability of carcinogenicity to humans was estimated.

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Glycidyl methacrylate (GMA; CAS no. 106-91-2) is a chemical monomer used in the manufacture of dental resins, can coatings and polymers. GMA has demonstrated toxicity to the ocular, digestive, respiratory and dermal systems. Human exposure occurs mainly in the workplace, but it can also happen through food. Although there were no available data on carcinogenicity of GMA, carcinogenic potential in the nasal cavity is highly expected. Further studies are needed to assess GMA exposure in humans. This study provides an alert of GMA human exposure and its genotoxic and carcinogenic potential.

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Resumo O agrotóxico malathion vem sendo amplamente utilizado no mundo em programas de controle de arboviroses e em 2015 foi classificado pela Agência Internacional para Pesquisas em Câncer (IARC) como provável agente carcinogênico para seres humanos. Este trabalho objetivou a sistematização das evidências dos efeitos carcinogênicos e mutagênicos associados à exposição do malathion e seus análogos, malaoxon e isomalathion. A busca foi realizada nas bases de dados TOXLINE, PUBMED e SCOPUS por artigos originais publicados de 1983 a 2015. Do total de 273 artigos elegíveis, foram selecionados 73. Os resultados dos estudos in vitro e in vivo evidenciaram danos genéticos e cromossômicos provocados pelo malathion; os estudos epidemiológicos evidenciaram associações significativamente positivas para cânceres de tireóide, de mama, e ovariano em mulheres na menopausa. Estas evidências do efeito carcinogênico do malathion devem ser considerados diante de sua utilização em programas de controle de arboviroses.

Abstract Malathion has been widely used worldwide in arbovirus control programs. In 2015, it was classified by the International Agency for Research on Cancer (IARC) as a probable carcinogen to humans. This work aimed to systematize the evidence of the carcinogenic and mutagenic effects associated with the exposure of malathion and its analogs, malaoxon and isomalathion. The search was carried out in Toxline, PubMed and Scopus databases for original papers published from 1983 to 2015. In all, 73 papers were selected from a total of 273 eligible papers. The results of in vitro and in vivo studies showed mainly genetic and chromosomal damages caused by malathion. The epidemiological studies evidenced significant positive associations for thyroid, breast, and ovarian cancers in menopausal women. This evidence of the carcinogenic effect of malathion should be considered before its use in arbovirus control programs.

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Regarding carcinogenicity testing, the long-term rodent bioassay (RCB) has been the test required by most regulatory agencies across the world. Nonetheless, due to the lack of knowledge about its specificity, it has been argued that the RCB is unspecific or even invalid. Because of the substantial limitations of epidemiology to identify chemicals probably not carcinogenic to humans (PNCH), it has been very difficult to address the specificity of the RCB. Nevertheless, because mechanistic/pharmacological data are currently recognized as a valid stream of evidence for the identification of chemical hazards, the road is now open to gain insight into the specificity of the RCB. Based on sound mechanistic/pharmacological data that support the classification of chemicals as PNCH, 100 PNCH substances were gathered in this investigation. Contrary to what was previously forecast, in this study, the RCB exhibited a functional specificity that ranged from 83% to 91%, depending on the settings of the testing (2-species vs. rats only, and the nominal maximum tolerated dose). Other contributions of this work were: (a) enabling the comparison, in terms of specificity, between the RCB and the alternative methods that could replace it (eg, Tg.AC mouse, rasH2 mouse); (b) disclosing what the specificity is for alternative methods that were developed using the RCB as the reference standard; and (c) expanding the previous narrow (only seven substances) set of chemicals identified as not likely to be carcinogenic to humans by hazard identification programs.

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The long-term rodent bioassay (RCB) has been the gold-standard for the pre-marketing prediction of chemical and drug carcinogenicity to humans. Nonetheless, the validity of this toxicity test has remained elusive for several decades. In the quest to uncover the performance of the RCB, its sensitivity (SEN) was charted as the first step. This appraisal was based on (a) chemicals with sufficient epidemiological evidence of carcinogenicity, and (b) other substances with limited epidemiological evidence, or remarkable classifications of carcinogenicity based on mechanistic or pharmacological data. In the present study, chemicals evaluated for their carcinogenicity to humans in IARC Monographs volumes 1-123, U.S. EPA IRIS Assessments, and U.S. NTP RoC were considered. This investigation gathered additional evidence supporting that, in hazard identification, the RCB is unwarranted for mutagenic or direct-acting genotoxicants. However, for purposes of risk assessment or management, the RCB might be justified whenever there is a lack of reliable and/or comprehensive epidemiological data. The RCB exhibited a significantly different SEN for threshold-based human carcinogens compared to non-threshold-based ones. With threshold-based chemicals, to increase the SEN of the testing from 80% (rat-RCB) to 90%, the 2-species RCB might be warranted. Nevertheless, the resolve would depend on the viewpoint, and on the future analysis of the overall performance of the RCB. In terms of SEN, and cancer hazard identification, the comparison between the RCB and alternative methods (e.g. rasH2 mouse, Tg.AC mouse) is now enabled.

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The Report on Carcinogens (RoC), from the National Toxicology Program of the USA, is one of the world-leading programs for the identification and acknowledgment of substances that represent a hazard of cancer to humans. RoC covers several essential topics concerning environmental, occupational, and pharmaceutical agents that are known to be, or reasonably anticipated to be carcinogenic to humans. To promote the highest exploitation by its potential users, several RoC aspects and features were put together into one article. For doing so, a comprehensive description is provided regarding RoC history, scope, general features, listing criteria, contents, handbook, and website. Secondary and tertiary aims for this work were (a) to point out some improvement opportunities for the RoC, and (b) to discuss pending issues in regulatory science and cancer hazard assessments. In this regard, for agents classified as probably, likely, reasonably anticipated, possibly or suspected to be a human carcinogen, there is a lack of quantitative knowledge concerning the likelihood of those agents actually being carcinogenic to humans. Elucidating these probabilities is necessary, because the duration of current regulations and the arrival of new acts may depend on it. On the other hand, there is a dramatic imbalance in priorities toward carcinogens, compared with non-carcinogens, in current cancer hazard identification programs. That vision may ignore that the availability on the market of chemicals classified as probably not carcinogenic to humans can also be important for the employment, alimentation, economy, quality of life of consumers, and human health.

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Fibropapillomatosis (FP) poses a significant threat to the conservation of green sea turtles (Chelonia mydas). Polycyclic aromatic hydrocarbons-PAHs are considered mutagenic, carcinogenic and toxic, and can act as cofactor of this disease. In order to evaluate possible differences between green sea turtles with and without FP, we monitored 15 PAHs in liver samples of 44 specimens (24 with FP) captured in Brazil. We detected eight PAHs and quantified phenanthrene in all green sea turtles with FP. Specimens without FP presented lower values than the tumored ones (1.48 ng g-1 and 17.35 ng g-1, respectively; p < 0.0001). There were no significant differences between tumored and non-tumored specimens, among studied areas, or Southwest Atlantic Fibropapillomatosis Score. Even though we found higher concentrations in the liver samples of green sea turtles with FP, further studies are necessary to confirm if these pollutants are involved in the pathogenesis of the disease.

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The application of in silico methods is increasing on toxicological risk prediction for human and environmental health. This work aimed to evaluate the performance of three in silico freeware models (OSIRIS v.2.0, LAZAR, and Toxtree) on the prediction of carcinogenicity and mutagenicity of thirty-eight volatile organic compounds (VOC) related to chemical risk assessment for occupational exposure. Theoretical data were compared with assessments available in international databases. Confusion matrices and ROC curves were used to evaluate the sensitivity, specificity, and accuracy of each model. All three models (OSIRIS, LAZAR and Toxtree) were able to identify VOC with a potential carcinogenicity or mutagenicity risk for humans, however presenting differences concerning the specificity, sensitivity, and accuracy. The best predictive performances were found for OSIRIS and LAZAR for carcinogenicity and OSIRIS for mutagenicity, as these softwares presented a combination of negative predictive power and lower risk of false positives (high specificity) for those endpoints. The heterogeneity of results found with different softwares reinforce the importance of using a combination of in silico models to occupational toxicological risk assessment.

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Introdução: o óleo de copaíba é o composto extraído do tronco da copaibeira (Copaifera sp.) que tem sido utilizado na medicina popular desde a chegada dos portugueses ao Brasil. Objetivo: o objetivo deste estudo foi avaliar possíveis efeitos carcinogênicos e/ ou anticarcinogênicos do óleo de copaíba (Copaifera officinalis L.), por meio do teste para detecção de clones de tumores epiteliais (warts) em Drosophila melanogaster. Metodologia: foram preparadas três soluções de óleo de copaíba, nas proporções de 0,5%, 1% e 2%. Nessas soluções foram cultivadas Drosophilas melanogaster expostas simultaneamente à doxorrubicina na concentração de 0,4 mM, agente conhecidamente cancerígeno, também utilizado como controle positivo na presente pesquisa. Para controle negativo foi utilizado Tween 80 (1%). O tratamento foi realizado com todas as larvas descendentes do cruzamento de fêmeas wts/ TM3 com machos mwh/mwh. Resultados: o óleo de copaíba apresentou atividade carcinogênica quando utilizado isoladamente na concentração 2%, visto que houve aumento estatisticamente significativo (p ≤ 0,05) na frequência de tumores em comparação com o controle negativo. Além disso, evidenciou-se potencialização do efeito carcinogênico da doxorrubicina nas concentrações 0,5% e 1%, uma vez que houve um aumento estatisticamente significativo (p ≤ 0,05) na frequência de tumores nessas concentrações, quando associadas à DXR, em comparação com o controle positivo. Conclusão: os resultados evidenciaram o efeito carcinogênico isolado do óleo de copaíba, bem como seu efeito potencializador quando associado à doxorrubicina.

Introduction: the copaiba oil is a compound extracted from the trunk of the copaiba tree (Copaifera sp.) that has been used in popular medicine since the arrival of the Portuguese in Brazil. Purpose: this study aimed to evaluate the possible carcinogenic and/ or anticarcinogenic effects of the copaiba oil (Copaifera officinalis L.) through the test for detection of epithelial tumor clones (warts) in Drosophila melanogaster. Methodology: three solutions of copaiba oil were prepared in the proportions 0,5%, 1% and 2%. In these solutions were cultivated Drosophilas melanogaster previously exposed to doxorubicin at a 0.4 mM concentration, admittedly carcinogenic agent, which was also used for positive control in the present research. For negative control Tween 80 (1%) was used. The treatment was performed on all larvae descendant of the crossing of females wts/TM3 with males mwh/mwh. Results: the results showed that the copaiba oil presented carcinogenic activity when used in isolation at the concentration of 2%, seeing that there was a statistically significant increase (p ≤ 0,05) in tumor frequency in comparison to the negative control. Moreover, there was a potentiation of doxorubicin's carcinogenic effect at concentrations 0,5% and 1%, since there was a statistically significant increase (p ≤ 0,05) of tumor frequency in these concentrations, when associated to DXR, in comparison to the positive control. Conclusion: the results evidenced the isolated carcinogenic effect of copaiba oil, as well as its potentiating effect when associated with doxorubicin

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Fipronil (FP) is an insecticide that belongs to the phenylpyrazole chemical family and is used to control pests by blocking GABA receptor at the entrance channel of the chlorine neurons. The aim of this study was to evaluate the mutagenic, recombinogenic and carcinogenic potential of FP. The mutagenic and recombinogenic effects were evaluated using the somatic mutation and recombination test (SMART) on wing cells of Drosophila melanogaster. Third instar larvae from standard (ST) and high bioactivation (HB) crosses were treated with different concentrations of FP (0.3, 0.7, 1.5 or 3.0 × 10-5 mM). The results showed mutagenic effects at all concentrations tested in the HB cross; and all concentrations tested in the ST cross, except at concentration of 0.7 × 10-5 mM. The carcinogenic effect of FP was assayed through the test for detection of epithelial tumor (warts) in D. melanogaster. Third instar larvae from wts/TM3 virgin females mated to mwh/mwh males were treated with different concentrations of FP (0.3, 0.7, 1.5 or 3.0 × 10-5 mM). All these concentrations induced a statistically significant increase in tumor frequency. In conclusion, FP proved to be mutagenic, recombinogenic and carcinogenic in somatic cells of D. melanogaster.

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In the European Union, traditional herbal medicines that are regarded as "acceptably safe, albeit not having a recognized level of efficacy" fit into a special category of drugs ("traditional herbal medicine products") for which requirements of non-clinical and clinical studies are less rigorous. A regulation proposal published by the Brazilian National Health Surveillance (Anvisa) defines a similar drug category ("traditional phytotherapeutic products") for registration purposes. Regarding herbal medicines, both agencies seem to be lenient regarding proof of efficacy, and consider long-standing folk use as evidence of safety and a waiver of a thorough toxicological evaluation. Nonetheless, several herbal products and constituents with a long history of folk usage are suspected carcinogenic and/or hepatotoxic. Herbal products have also been shown to inhibit and/or induce drug-metabolizing enzymes. Since herbal medicines are often used in conjunction with conventional drugs, kinetic and clinical interactions are a cause for concern. A demonstration of the safety of herbal medicines for registration purposes should include at least in vitro and in vivo genotoxicity assays, long-term rodent carcinogenicity tests (for drugs intended to be continuously used for > 3 months or intermittently for > 6 months), reproductive and developmental toxicity studies (for drugs used by women of childbearing age), and investigation of the effects on drug-metabolizing enzymes.

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Background: Inflammation is a common phenomenon present in gastric mucosa of patients infected with H. pylori. Activation of the RAGE/multiligand axis is thought to be a relevant factor in cancer-mediated inflammation. RAGE is a membrane receptor, belonging to the immunoglobulin family, and the over-expression of RAGE has been associated with increased invasiveness and metastasis generation in different types of cancer, including gastric cancer. Furthermore recent experiences show that the use of its soluble form (sRAGE) or silencing of the gene coding for this receptor could provide therapeutic benefits in cancer. Aim: To evaluate the immunohistochemical expression of RAGE, MUC-1, β-Catenin free and phosphorylated, Cyclin-D1 and GSK3 in gastric biopsy specimens infected with H. pylori. Material and Methods: Immunohistochemical analysis was carried out in gastric biopsies from 138 patients: 55 with inflammatory injury (no atrophic gastritis), 42 with pre-cancerous conditions (atrophy or intestinal metaplasia) and 41 with dysplastic lesions or in situ adenocarcinoma. Results: There was a high rate of positive RAGE expression in the three groups of biopsies. Biopsies with dysplasia or in situ carcinoma had a significantly higher percentage of RAGE expression than the other groups of biopsies. Conclusions: The increased RAGE expression reported in both dysplasia and incipient cancer support the role of the multiligand/RAGE axis in gastric carcinogenesis.

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