A critical view of the mechanism(s) of toxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin. Implications for human safety assessment.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) has been an important issue in occupational and environmental health for nearly two decades. During this period scientists have studied its possible impacts on exposed human populations. At the same time enormous efforts were made to elucidate the mechanism of TCDD action in various biological models. This paper provides a critical view of the advances made towards understanding the mechanism of TCDD action. Major topics discussed include the Ah-receptor hypothesis, TCDD as a thyroid hormone agonist, TCDD and vitamin A deficiency, TCDD's effect on receptor regulation, and its effect on intermediary metabolism including related hormonal responses. Although the exact mechanism of TCDD action is not yet known, more information is available on the toxicity of this compound than perhaps on that of any other substance. This wealth of information allows important conclusions regarding the assessment of acute, as well as of chronic, toxicities of TCDD for humans. There is no documented case of human death as a result of exposure to TCDD. It appears that humans are acutely less sensitive to TCDD than some animal species. The cause of TCDD-induced lethality in rats is a progressive lethal hypoglycemia due to inhibition of gluconeogenesis. Regulation of this metabolic pathway is quite different amongst species, although primates share great similarities. The assumption that the cause of TCDD-induced death in primates, in analogy to rats, is inhibition of gluconeogenesis would suggest that the acute toxicity of TCDD in humans would be in the range seen in rhesus monkeys (70-300 micrograms/kg). These values are about midway between the most (guinea pig) and least (hamster) sensitive species. TCDD is not a genotoxic agent and not an initiator, but promoter of tumor formation. There is considerable evidence that promotion of cancer, like any other chronic end point of toxicity, is a threshold-type biological process. Therefore, a linear extrapolation of the dose-response is an unnecessarily conservative approach in the safety assessment of TCDD. This paper, based on several studies with different end points of toxicity, supports the notion that 10 pg/kg/day of TCDD represent a safe lifetime exposure level for humans with regard to promotion of cancer, porphyria and chloracne.