While the traditional animal-testing toxicology paradigm was developed in the early 1900s, scientists are now beginning to appreciate the many limitations of animal tests as well as embrace alternative perspectives—and methods—within the field of toxicology.

Researchers with the Physicians Committee have been working hard to
support the development of nonanimal test methods for the study of a
serious occupational hazard. While the traditional animal-testing
toxicology paradigm was developed in the early 1900s, scientists are
now beginning to appreciate the many limitations of animal tests as
well as embrace alternative perspectives—and methods—within the
field of toxicology. For better or worse (we think worse), animal
test methods have long been used to approximate human health
hazards, but for chemical respiratory allergies, animal methods
can’t even begin to approximate the physiological process that
occurs in humans. Science’s overreliance on the “endpoint” paradigm
in toxicology has prevented us from being able to adequately protect
workers from a major occupational hazard prevalent in many
industries, like woodworking, adhesives and paints, and cosmetic
dyes.
Due to complex species differences in both the respiratory tract and
the immune system of test animals and humans, traditional
toxicologists have not been able observe this endpoint in test
animals. One reason for this is that chemicals interact with
different portions of the respiratory tract depending on the physics
of inhalation—rats and mice, along with guinea pigs and rabbits,
have radically different respiratory tracts, in which airflow is
mostly horizontal, while human respiration relies primarily on
vertical airflow. This causes chemicals to accumulate in entirely
different parts of the respiratory tract in animals. And the
situation for respiratory allergy is further compounded by the
myriad of human-specific immune processes involved in chemical
allergy responses.
Fortunately, the next generation of toxicologists is looking at
chemical hazards differently and collaborating with clinicians and
chemists to understand how hazardous chemicals act in the human body
to cause adverse outcomes like allergy, also known as sensitization.
A few years ago, a collaboration led by the Physicians Committee
outlined the steps in the Adverse Outcome Pathway (AOP) of chemical
respiratory sensitization as a first step toward establishing what
we already know, and what we have yet to learn, to evaluate test
methods.
We need to develop reliable test methods in order to accurately
identify which chemicals warrant extra protections, like personal
protective equipment and environmental exposure limits for workers
and consumers. But before we can answer whether test methods
identify respiratory sensitizers, we have to have high confidence in
a defined reference set of chemical sensitizers. It’s a catch-22: We
can’t know what methods work because we don’t have high confidence
in a reference set, and we can’t use any methods in development to
define a reference set because they haven’t been evaluated. And,
although skin sensitizers are better understood because of clinical
testing, respiratory sensitizers are too toxic to test on
volunteers.
Luckily, at the Physicians Committee, we’re always up for a
challenge when it comes to establishing and advancing human-relevant
approaches, so we organized a diverse team of experts including
everyone from computational chemists, chemical biologists,
pathophysiologists, to respiratory therapists to work together to
establish a reference list of chemicals shown to cause respiratory
sensitization in humans. And through this collaboration, that’s
precisely what we did.
Working from a list of chemicals suspected to have respiratory
sensitization potential based on their chemical structure, instead
of “screening” each one through a lab test, we mined the literature
for the gold standard of human health—clinical data. While we don’t
test respiratory sensitizers in people proactively, monitoring
environmental exposures to reactive chemicals in the workplace has
been an essential method in many areas of occupational health and
toxicology. When a patient shows up with symptoms of chemical
respiratory sensitization, those incidents are sometimes published
in occupational health literature as case reports. And included in
those reports are exposure histories, as well as data from
inhalation and allergy testing.
Through a diligent effort to catalog and read through all the case
reports we could find for each chemical, and with attention to what
we know about respiratory sensitization through the AOP, we were
able to identify twenty-eight different chemicals that have been
documented as causing respiratory sensitization in humans. We can
now move forward with evaluating the many different computational
and in vitro test methods in development and forge a path toward
protecting human health with the first test methods validated based
on a chemical reference set driven by clinical data. The Physicians
Committee will continue to work with test method developers and
regulators to establish a testing strategy to identify additional
chemical respiratory sensitizers based solely on nonanimal test
methods, but for now, we’re off to a tremendous start.