described in the December 2006 Toxicological Sciences, Calabrese
and his colleagues analyzed data showing how cell proliferation
in 13 different yeast strains responded to various doses of 2,189
potential anticancer drugs.
Almost 80 percent of the drugs exhibited a NOAEL, the team
found. Among these, the group further looked for reports of biological effects triggered by doses even lower than that level. The
authors had expected that 25 percent of these drugs, just by chance,
would exhibit activity above that seen with no exposure. In fact,
60 percent did.
The effects observed at those low doses were modest, perhaps
60 percent higher or lower than those that occur in the absence
of any exposure, Calabrese notes. He acknowledges that such
changes might not always have clinical significance.
These findings and earlier analyses by his group, Calabrese says,
show that measurable biological effects at low doses appear to be
more the norm than an anomaly.
Indeed, even pollutants that don’t have a NOAEL may have
nonlinear effects at low doses, notes Bernard Weiss of the University of Rochester (N.Y.) School of Medicine and Dentistry.
For example, the drop in a child’s IQ for each 1 microgram per
deciliter of lead in the blood is much higher at concentrations
below 10 μg/dl than at concentrations above that value (SN:
5/5/01, p. 277).
So, Weiss concludes, toxicity estimates based on high-dose
measurements greatly underestimate low-dose harm.
HOW DOES IT WORK? Scientists have recently begun to discover mechanisms to explain hormesis and other nonlinear dose
responses. For instance, Rodgers has been looking at what genes
are preferentially turned on or off in the mice exposed to Chernobyl radiation. Compared with unexposed mice, those caged in
the Ukraine forest had 600 to 1,200 genes whose activity had
been altered.
“We expected to see an increase in the expression of genes
involved in DNA repair,” Rodgers says. “What we found instead was
an increase in the expression of genes that respond to oxidative
stress—such as free radicals.”
Another explanation of hormesis was suggested in 2000 by
researchers working with human-cancer cells exposed to epigal-locatechin gallate (EGCG), the principal cancer-fighting ingredient in green tea. The team showed that although high-dose exposures of EGCG inhibited cell growth, low doses stimulated cell
proliferation. D. James Morré of Purdue University in West
Lafayette, Ind., says that his team several years ago found a unique
enzyme on cell surfaces that appeared to be “a molecular target for
chemical hormesis.”
The group subsequently determined that this enzyme can bind
to various substances, in addition to EGCG, and alter their cellular
effects. Those responses disappeared when the enzyme was inactive.
Some scientists have suggested additional processes that play a
role in hormesis. In an upcoming issue of the International Journal of Low Radiation, Bobby R. Scott of the Lovelace Respiratory
Research Institute in Albuquerque, N.M., and his colleagues report
that low doses of radiation induce mild oxidative stress in cells, activating a high-efficiency form of DNA repair and stimulating the
immune system. This stress also “activates a special apoptosis [cell
suicide] process”—one that culls genetically unstable cells, he says.
Scott suggests that these same processes probably work to counteract chemical poisons.
IMPLICATIONS Although most toxicologists today agree that
hormesis occurs—a big change from a decade ago—some argue that
Calabrese and his team greatly overstate its frequency. A major
portion of this controversy hinges on differences in the use of the
term hormesis.
“I totally believe that [nonlinear] low-dose responses occur frequently,” says Kristina A. Thayer of the National Institute of Envi-
ronmental Health Sciences in Research Triangle Park, N.C. “In
fact, I have no problem accepting that most of the time they might
be stimulatory.”
However, she says that Calabrese equates stimulatory low-dose
effects with benefits when there’s no reason to expect that they
would necessarily be beneficial. Her research with the plastic-softening agent bisphenol A, a hormone-mimicking agent, illustrates
a detrimental effect of low-dose stimulation similar to what
Andrade found for DEHP.
Among toxic agents that show positive biologic effects at low
doses, Calabrese sees the possibility for better drug design. For
example, he says, current treatments for dementia provide tiny
doses of drugs that at high doses would be toxic. For instance, he
says, “every Alzheimer’s drug on the market today acts via hormetic
[low-dose] activities.”
Even though a hormetic treatment may show only a small effect,
Calabrese proposes that several treatments might be put together
to achieve a therapeutic benefit.
Scott suggests a related therapeutic
application of hormesis that uses small
doses of radiation to trigger immuno-logical and cell-death processes. However, cancer cells are “reluctant” to
undergo programmed death, Scott
notes. Because certain compounds—
such as resveratrol, a polyphenol in
grapes (SN: 11/4/06, 293)—sensitize
cancer cells to radiation, Scott envisions
pretreating people with such com-
— JONATHAN BORAK, pounds and following this up with a
YALE SCHOOL OF hormetic dose of radiation. “For lung
MEDICINE cancer,” he says, “perhaps just low-dose
diagnostic X rays would do.”
Beyond new medical applications,
information gleaned from research into low-dose exposures might
help fine-tune regulation of chemicals. Scientists may find that
many pollutants aren’t as toxic at low doses as has been assumed,
Calabrese says.
“You can imagine why industry loves hormesis,” Weiss says. It
suggests pollution may not need to be cleaned up as thoroughly
as regulations have been asking for.
Calabrese counters, however, that if traces of certain pollutants
are not as dangerous as earlier estimates had suggested, why not
investigate whether some regulations are unduly strict?
Indeed, proving that some low-dose exposures are “of no regulatory concern could make a qualitative difference in regulations,”
observes economist Lester B. Lave of Carnegie Mellon University
in Pittsburgh. However, he adds that to justify changing guidelines for regulations, far more research would be needed.
For instance, there has been much discussion suggesting that
low doses of chemicals—even pollutants—might rev up immunity
in a beneficial way. However, because many people have compromised immune systems, Lave says that before raising the acceptable environmental limits of a pollutant, “I’d want to know if we
see a [beneficial] hormetic response in those people, or babies
with undeveloped immune systems, or the elderly.” Moreover, he
says, effects at low doses tend to be subtle, so “I’d want to see them
documented in humans, not just animals”—and to know at precisely what dose they turn detrimental.
Jonathan Borak, a toxicologist at the Yale School of Medicine in
New Haven, Conn., agrees that it’s too early for hormesis or other
nonlinear low dose–effects data to be “practically relevant” for
altering regulatory or health policy.
Although “I believe hormesis is real, it is fundamentally difficult—
and expensive—to demonstrate,” Borak says. Looking for relatively
small low-dose effects could quadruple the cost of toxicology studies, he estimates, underscoring “practical and economic reasons why
today almost nobody looks for them.” ■
“I believe
hormesis is
real, [but] is
fundamentally
difficult—and
expensive—to
demonstrate.”