Statistical Dose-Response Models with Hormetic Effects

Monotonically increasing or decreasing functions are often used to model the relationship between the response of an experimental unit and the dose of a given substance. Of late, there has been an increased interest in dose-response relationships that exhibit hormetic effects. These effects may be characterized by an increase in response at low doses instead of the expected decrease in response that is observed at higher doses. Herein, we study the statistical implications of hormesis in several ways. First, we present a broad class of parametric mathematical-statistical models, constructed from standard dose-response models, that allow the incorporation of hormetic effects in such a way that the presence of hormesis can be tested statistically. Second, we consider the impact of model misspecification on effective dose estimation, such as the ED50 and the limiting dose for stimulation, when the hormetic effect is present but ignored in the dose-response model by the researcher (model underspecification) and when an hormetic effect is not present but incorporated into the dose-response model (model overspecification). Our simulation study reveals that it is more damaging to the estimation of effective dose to ignore the hormetic effect through model underspecification than to include the hormetic effect in the model through model overspecification. Third, we develop a nonpara-metric regression technique useful as an exploratory procedure to indicate hormetic effects when present. Finally, both parametric and nonparametric methods are illustrated with an example.     

Hormetic Effect of Berberine Attenuates the Anticancer Activity of Chemotherapeutic Agents

Hormesis is a phenomenon of biphasic dose response characterized by exhibiting stimulatory or beneficial effects at low doses and inhibitory or toxic effects at high doses. Increasing numbers of chemicals of various types have been shown to induce apparent hormetic effect on cancer cells. However, the underlying significance and mechanisms remain to be elucidated. Berberine, one of the major active components of Rhizoma coptidis, has been manifested with notable anticancer activities. This study aims to investigate the hormetic effect of berberine and its influence on the anticancer activities of chemotherapeutic agents. Our results demonstrated that berberine at low dose range (1.25 ~ 5 μM) promoted cell proliferation to 112% ~170% of the untreated control in various cancer cells, while berberine at high dose rage (10 ~ 80 μM) inhibited cell proliferation. Further, we observed that co-treatment with low dose berberine could significantly attenuate the anticancer activity of chemotherapeutic agents, including fluorouracil (5-FU), camptothecin (CPT), and paclitaxel (TAX). The hormetic effect and thereby the attenuated anticancer activity of chemotherapeutic drugs by berberine may attributable to the activated protective stress response in cancer cells triggered by berberine, as evidenced by up-regulated MAPK/ERK1/2 and PI3K/AKT signaling pathways. These results provided important information to understand the potential side effects of hormesis, and suggested cautious application of natural compounds and relevant herbs in adjuvant treatment of cancer.     

Are ecosystems hormetic?

The phenomenon of hormesis has been observed mainly for the response of individual organisms to stress. A reasonable line of inquiry might explore the possibility of observing hormesis at other levels of ecological organization. This initial examination focuses on ecosystem hormesis. Explorations of hormetic responses of ecosystems to stress cannot be made independently of a fundamental concept of ecosystem. The scale‐dependence of ecosystem dynamics also influences whether an ecological disturbance is in reality a stressor. Ecosystem hormesis might be claimed if one or more components of an ecosystem exhibit hormesis. By this definition, ecosystem hormesis would be a trivial extension of hormesis observed for individual organisms. A non‐trivial extension of ecosystem hormesis would include the observation that integrated (i.e., holistic) measures of ecosystem structure or function displayed an hormetic response to an ecological stressor. Several such examples of ecosystem structural and functional hormesis are presented.     

Transcription‐blocking DNA damage in aging: a mechanism for hormesis

Recent evidence from studies on DNA repair systems that are implicated in accelerated aging syndromes, have revealed a mechanism through which low levels of persistent damage might exert beneficial effects for both cancer prevention and longevity assurance. Beneficial effects of adaptive responses to low doses of insults that in higher concentrations show adverse effects are generally referred to as hormesis. There are numerous examples of hormetic effects ranging from mild stresses of irradiation to heat stress, hypergravity, pro‐oxidants, or food restriction. Although the notion of hormesis is supported by many observations in various organisms, at least two major caveats have thus far prevented the application of hormesis for disease prevention in humans. First, the very nature of hormesis using toxins as a treatment regimen harbors the inherent danger of detrimental consequences. Second, the molecular mechanisms through which insults might exert beneficial effects have thus far remained elusive. Here, I discuss a mechanistic basis for hormesis and its implications for cancer prevention and healthy aging.     

Interspecies Variability of Plant Hormesis by the Antiauxin PCIB in a Laboratory Bioassay

Chemical hormesis constitutes an alternative possible use of herbicidal agents for crop enhancement that is, however, compromised by the apparent variability of this low-dose stimulation phenomenon. Studies demonstrating the variability are rare and, therefore, this study investigated the interspecies variability of growth stimulation induced by the auxin-inhibitor PCIB [2-(p-chlorophenoxy)-2-methylpropionic acid] to determine if hormesis is generalizable enough and sufficiently stable between species/cultivars for practical use or which implications may have to be taken into account. In 85 complete dose–response bioassays with 23 cultivars of five species, the variability of PCIB effects was evaluated. The expression of PCIB hormesis proved to depend on the species/cultivar tested, ranging from a cultivar-dependent hormetic efficacy and an occasional lack of hormesis, to a complete lack of hormetic effectiveness in certain species/cultivars. Therefore, frequency estimations, as well as the pattern of dose-dependent variability of dose–response quantities, may inevitably depend on the biological model(s) used and, thus, apply only to the specific conditions for characterization. Comparing the frequency distribution of effective doses demonstrated a risk of a previously hormetic dose causing a loss of hormesis or inhibitory effects in another species/cultivar. Therefore, selecting a dose that will induce hormesis in every species/cultivar is unrealistic. This may limit the window for practical applications to stimulants with negligible varietal differences, to cultivar selective treatments, and/or to cultivars that enable a beneficial long-term use. Hence, efficient crop enhancement by chemical hormesis needs not only a good stimulant, but also a species/cultivar able to convert a specific low-dose treatment into an economic benefit.     

Early Life Hormetic Treatments Decrease Irradiation-Induced Oxidative Damage,Increase Longevity,and Enhance Sexual Performance during Old Age in the Caribbean Fruit Fly

Early life events can have dramatic consequences on performance later in life. Exposure to stressors at a young age affects development, the rate of aging, risk of disease, and overall lifespan. In spite of this, mild stress exposure early in life can have beneficial effects on performance later in life. These positive effects of mild stress are referred to as physiological conditioning hormesis. In our current study we used anoxia conditioning hormesis as a pretreatment to reduce oxidative stress and improve organismal performance, lifespan, and healthspan of Caribbean fruit flies. We used gamma irradiation to induce mild oxidative damage in a low-dose experiment, and massive oxidative damage in a separate high-dose experiment, in pharate adult fruit flies just prior to adult emergence. Irradiation-induced oxidative stress leads to reduced adult emergence, flight ability, mating performance, and lifespan. We used a hormetic approach, one hour of exposure to anoxia plus irradiation in anoxia, to lower post-irradiation oxidative damage. We have previously shown that this anoxic-conditioning treatment elevates total antioxidant capacity and lowers post-irradiation oxidative damage to lipids and proteins. In this study, conditioned flies had lower mortality rates and longer lifespan compared to those irradiated without hormetic conditioning. As a metric of healthspan, we tracked mating both at a young age (10 d) and old age (30 d). We found that anoxia-conditioned male flies were more competitive at young ages when compared to unconditioned irradiation stressed male flies, and that the positive effects of anoxic conditioning hormesis on mating success were even more pronounced in older males. Our data shows that physiological conditioning hormesis at a young age, not only improves immediate metrics of organismal performance (emergence, flight, mating), but the beneficial effects also carry into old age by reducing late life oxidative damage and improving lifespan and healthspan.     

Detecting and Estimating Hormesis Using a Model-Based Approach

Hormesis is defined as a dose-response relationship that is stimulatory at low doses, but is inhibitory at higher doses. In a given experiment, it is not unusual to observe enhanced responses at low doses, however, such enhanced responses may not imply hormesis, but the random fluctuation of the data. Statistical tests can be developed to detect hormesis when enhanced responses at low concentrations are observed. We propose the use of a model-based approach to detect the presence of, and estimate the extent of, hormesis. This approach includes two steps: detection and estimation. In the detection step, we compare the full and the reduced models. The full model describes the dose-response relationship incorporating the hormetic effect; the reduced model describes the dose-response relationship without the hormetic effect. The full model is an extension of the reduced model and has an extra parameter that measures the amount of increase in response at low doses. A test of statistical significance of this extra parameter can essentially be a test for detecting hormesis. In the estimation step, we obtain the area under the best-fitted dose-response curve falling within the hormetic zone. Considering both the number of concentrations within the hormetic zone and the magnitude of the stimulatory response, we propose using the ratio of the area under the hormetic zone (AUC_H) and the area under the best-fitted curve from zero to zero equivalent point (AUC_ZEP) as an estimate of magnitude of the hormetic effect. Two numerical examples are used to illustrate the use of this model-based approach.     

Epidemiological Assessment of Hormesis in Studies with Low-Level Exposure

Despite its resurgence within toxicology and, specifically, risk assessment, the concept of hormesis remains peripheral to current epidemiological practice. In this paper we examine some reasons for this, focusing on applications within occupational and environmental epidemiology. Unclear in the existing literature is whether hormesis pertains to a single biological mechanism or response, or the aggregate effect of all correlates of exposure. Although J-shaped and U-shaped relationships between risk factors and disease endpoints have been identified epidemiologically, it is unclear whether such patterns reflect biological hormesis or a combination of factors resulting in a hormetic-looking relationship. Given the potential importance of assessing hormetic responses in epidemiological studies, we identify and discuss key limitations of epidemiology in validly detecting and interpreting hormesis. For example, most observational occupational and environmental studies lack the ability to determine the dose received by each individual, and therefore poor surrogates of exposure are frequently used, potentially introducing considerable systematic and random error. Further, because exposure is not randomly assigned to humans, the potential for confounding is great. Finally, using a simple simulation to assess the impact of ignoring hormesis in the analysis of epidemiological data containing mild hormesis, we demonstrate a resulting “hormetic bias,” in which relative risks at exposure levels above the hormetic region are systematically overestimated.     

Stress-response hormesis and aging: "that which does not kill us makes us stronger"

Hormesis refers to the beneficial effects of a treatment that at a higher intensity is harmful. In one form of hormesis, sublethal exposure to stressors induces a response that results in stress resistance. The principle of stress-response hormesis is increasingly finding application in studies of aging, where hormetic increases in life span have been seen in several animal models.     

Slowing down aging from within: mechanistic aspects of anti-aging hormetic effects of mild heat stress on human cells

Since aging is primarily the result of a failure of maintenance and repair mechanisms, various approaches are being developed in order to stimulate these pathways and modulate the process of aging. One such approach, termed hormesis, involves challenging cells and organisms by mild stress that often results in anti-aging and life prolonging effects. In a series of experimental studies, we have reported that repeated mild heat stress (RMHS) has anti-aging hormetic effects on growth and various cellular and biochemical characteristics of human skin fibroblasts undergoing aging in vitro. These beneficial effects of repeated challenge include the maintenance of stress protein profile, reduction in the accumulation of oxidatively and glycoxidatively damaged proteins, stimulation of the proteasomal activities for the degradation of abnormal proteins, improved cellular resistance to other stresses, and enhanced levels of cellular antioxidant ability. In order to elucidate the molecular mechanisms of hormetic effects of RMHS, we are now undertaking studies on signal transduction pathways, energy production and utilisation kinetics, and the proteomic analysis of patterns of proteins synthesised and their posttranslational modifications in various types of human cells undergoing cellular aging in vitro. Human applications of hormesis include early intervention and modulation of the aging process to prevent or delay the onset of age-related conditions, such as sarcopenia, Alzheimer's disease, Parkinson's disease, cataracts and osteoporosis.     

Evidence for hormesis in mutagenicity dose-response relationships

This study assessed the occurrence of hormetic dose responses from three previously published data sets [1-3] with 825 chemicals in three Ames assay tester strains (i.e., TA97, TA98, TA100) with and without the S9 fraction, using a five dose protocol and semi-log dose spacing. Ninety-five (95) (11.5%) chemicals satisfied the multiple a priori entry criteria, with a total of 107 assays. Of the assays satisfying the entry criteria, 61 involved TA100, a strain that detects base-pair substitution mutations. 29.5% (18/61) satisfied the statistical evaluative criteria for hormesis, exceeding that predicted by chance by 4.0-fold (p<0.001). The remaining 46 assays involved TA97 and TA98, strains that detect frameshift mutations. Of these 46 assays, the overall responses for the lowest two doses closely approximated the control response (e.g., 101.77% of the control for TA98; 99.20% for TA97). Only 2.2% (1/46) of the assays satisfied the evaluative criteria for hormesis. In conclusion, these data support a hormetic model for TA100, whereas the responses for TA97 and TA98 are consistent with a threshold dose-response model.     

Hormesis provides a generalized quantitative estimate of biological plasticity

Phenotypic plasticity represents an environmentally-based change in an organism’s observable properties. Since biological plasticity is a fundamental adaptive feature, it has been extensively assessed with respect to its quantitative features and genetic foundations, especially within an ecological evolutionary framework. Toxicological investigations on the dose-response continuum (i.e., very broad dose range) that include documented evidence of the hormetic dose response zone (i.e., responses to doses below the toxicological threshold) can be employed to provide a quantitative estimate of phenotypic plasticity. The low dose hormetic stimulation is an adaptive response that reflects an environmentally-induced altered phenotype and provides a quantitative estimate of biological plasticity. Analysis of nearly 8,000 dose responses within the hormesis database indicates that quantitative features of phenotypic plasticity are highly generalizable, being independent of biological model, endpoint measured and chemical/physical stress inducing agent. The magnitude of phenotype changes indicative of plasticity is modest with maximum responses typically being approximately 30–60% greater than control values. The present findings provide the first quantitative estimates of biological plasticity and its capacity for generalization. Summary This article provides the first quantitative estimate of biological plasticity that may be generalized across plant, microbial, animal systems, and across all levels of biological organization. The quantitative features of plasticity are described by the hormesis dose response model. These findings have important biological, biomedical and evolutionary implications.     

New considerations on hormetic response against oxidative stress

In order to survive living organisms have developed multiple mechanisms to deal with tough environmental conditions. Hormesis is defined as a process in which exposure to a low dose of a chemical agent or environmental factor that is damaging at higher doses induces an adaptive beneficial effect on the cell or organism. In this paper, we examine several ideas that might be taken into consideration before using hormesis as a therapeutic tool to improve health and life span, and hopefully will open the discussion for new and interesting debates regard hormesis. The first one is to understand that the same stressor or inductor can activate different pathways in a parallel or dual response, which might lead to diverse outcomes. Another idea is related to the mechanisms involved in activating Nrf2, which might be different and have diverse hormetic effects.Last, we discuss mild oxidative stress in association to low-grade chronic inflammation as a stimulating avenue to be explored and the unexpected effects proposed by the obesity paradox theory. All the previous might help to clarify the reasons why centenarians are able to reach the extreme limits of human life span, which could probably be related to the way they deal with homeostasis maintenance, providing an opportunity for hormesis to intervene significantly.Keyword: Aging, Hormesis, Inflammation, Nrf2, Obesity, Oxidative stress     

A Proposed Working Definition for the Novel Concept of Neurobehavioral Hormesis

It is proposed that a novel concept, neurobehavioral hormesis, be considered for integration into the field of toxicology. Hormesis results in a non-linear dose response where low dose exposures to toxicants cause beneficial effects, and detrimental effects at higher doses. Hormesis has not been systematically incorporated into traditional risk assessment methodologies, yet there is recent evidence that this pattern of results is relatively prevalent. In this paper, hormesis is applied to neurobehavioral toxicology, and an operational definition is proposed for application to putative examples of neurobehavioral hormesis. The two primary criteria used for the operational definition are: (1) performance is enhanced with low dose exposure and denigrated at higher doses, and (2) the change in behavior persists following a recovery period. In recent research from our laboratory it was reported that rats exposed to JP-8 jet fuel vapor demonstrated such a pattern of neurobehavioral performance on tests of learning and memory. Specifically, animals with long-term exposure to low concentrations of jet fuel demonstrated enhanced performance on specific operant tasks as compared both to controls and to animals exposed to higher concentrations. The effect was most apparent during complex versus simple operant tests, and was observed months following the last exposure to jet fuel. The effects meet both criteria for the proposed working definition of neurobehavioral hormesis, and thus provide evidence of the validity for considering neurobehavioral hormesis in published and future research, and suggests a more systematic investigation of existing literature may be warranted. Also, it provides additional support for the overall proposal to include hormetic effects in formal risk assessment paradigms.     

Zinc interference with Cd‐induced hormetic effect in differentiated Caco‐2 cells: Evidence for inhibition downstream ERK activation

Cadmium (Cd) is a toxic metal that enters the food chain. Following oral ingestion, the intestinal epithelium represents an effective protective barrier against Cd toxicity, but it is also a target tissue that may accumulate and trap high levels of the ingested metal. Using human enterocytic‐like Caco‐2 cells, we have previously shown that Cd may induce a concentration and time‐dependent increase in 3‐(4,5‐dimethyl‐2‐thiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide assay (MTT)‐reducing activity in differentiated cultures with correlation to ERK1/2 activation. The present study shows that (a) Zn prevents the Cd‐induced hormesis effect on MTT reduction in a concentration‐dependent manner, without inhibiting Cd‐induced ERK1/2 activation; (b) Zn also induces similar hormetic stimulation of MTT‐reducing activity but without ERK1/2 activation. The effect of both metals was sensitive to inhibitors of translation during protein synthesis. There is evidence for the involvement of reactive oxygen species (ROS) in Cd‐induced ERK1/2 activation. In contrast, the Zn effect on the MTT‐reducing activity would not be triggered by ROS but it would be sensitive to the redox state of the cell. Steps downstream ERK1/2 activation by Cd does not involve eIF4E which is rather downregulated by Cd. In conclusion, Cd and Zn both can modify translation processes during protein synthesis via different signaling cascades with crosstalk, and cross‐inhibition may occur. This phenomenon is observed over a small range of metal concentrations and is characterized by a hormesis‐like response. Considering that the hormetic effect on dehydrogenase activity could reflect an adaptive response to the metals whether cross‐inhibition is beneficial is an open question.     

Hormesis and ecological risk assessment: Fact or fantasy?

Hormesis is a widespread phenomenon across occurring many taxa and chemicals, and, at the single species level, issues regarding the application of hormesis to human health and ecological risk assessment are similar. However, interpreting the significance of hormesis for even a single species in an ecological risk assessment can be complicated by competition with other species, predation effects, etc. In addition, ecological risk assessments may involve communities of hundreds or thousands of species as well as a range of ecological processes. Applying hormetic adjustments to threshold effect levels for chemicals derived from sensitivity distributions for a large number of species is impractical. For ecological risks, chemical stressors are frequently of lessor concern than physical stressors (e.g., habitat alteration) or biological stressors (e.g., introduced species), but the relevance of hormesis to non‐chemical stressors is unclear. Although ecological theories such as the intermediate disturbance hypothesis offer some intriguing similarities between chemical hormesis and hormetic‐like responses resulting from physical disturbances, mechanistic explanations are lacking. While further exploration of the relevance of hormesis to ecological risk assessment is desirable, it is unlikely that hormesis is a critical factor in most ecological risk assessments, given the magnitude of other uncertainties inherent in the process.     

U.S. EPA Reference Dose/Reference Concentration Methodology: Update on a Review of the Process

The U.S. Environmental Protection Agency (USEPA) has been reviewing several approaches to testing and risk assessment related to implementation of the Food Quality Protection Act (FQPA) and the Amendments to the Safe Drinking Water Act (SDWA), both signed into law in 1996. Based on recommendations from a review of issues related to children's health protection under these laws, the USEPA established the RfD Technical Panel to evaluate in depth the current reference dose (RfD) and reference concentration (RfC) process in general, and in particular with respect to how well children and other potentially sensitive subpopulations are protected. The RfD Technical Panel also was asked to consider scientific issues that have become of greater concern in RfD and RfC derivation (e.g., neurotoxicity, immunotoxicity), and to raise issues that should be explored or developed further for application in the RfD/RfC process. This paper provides the current status of the activities of the RfD Technical Panel. The Technical Panel has recommended that acute, short- term, and intermediate reference values should be set for chemicals, where possible, and that these values should be incorporated into the USEPA's Integrated Risk Information System (IRIS) Database. A review of current testing procedures is underway, including the endpoints assessed, life stages covered by exposure and outcome evaluation, and information that can be derived from current protocols on various durations of exposure. Data gaps identified for risk assessment include the types of pharmacokinetic data that should be collected, especially for developmental toxicity studies, the impact of aging on toxic responses occurring after early exposure as well as concomitant with exposure in old age, and information available on latency to response. The implications of the RfD Technical Panel's recommendations for various uncertainty factors are also being explored.     

Application of Hormetic UV-C for Delayed Ripening and Reduction of Rhizopus Soft Rot in Tomatoes: the Effect of Tomatine on Storage Rot Development

The application of ultraviolet-light C (UV-C, 254 nm) hormesis on tomato fruits to stimulate beneficial responses is a new method of inducing host resistance to Rhizopus soft rot, with maximum protection at 72 h following artificial inoculation with Rhizopus stolonifer and delay fruit ripening. In the tomato-Rhizopus soft rot pathosystem, UV-C induced resistance of tomatoes to soft rot was reversed by fluorescent light, and not by storage under dark condition. The present study was aimed at finding a possible fungal toxic mechanism that was involved in the control of Rhizopus soft rot. The development of carotenoids, loss of chlorophyll and ethylene production were significantly retarded during storage after treatment with hormetic doses of UV-C. The delayed ripening of UV-C treated fruits was attributed in part to the high level of putrescine and spermine polyamines. In a time-control study, it was found that the resistance of UV-C-treated tomatoes artificially inoculated with R. stolonifer correlated with a high concentration of tomatine which accumulated up to 72 h after UV-C treatment. However, there was a higher tomatine content in UV-C-treated fruits compared to untreated fruits where it was transitory at 96 h after treatment in the time-course study.