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Dietary Supplements: A Framework for Evaluating Safety (2005)
Institute of Medicine (IOM)

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. "7 Categories of Scientific Evidence--In Vitro Data." Dietary Supplements: A Framework for Evaluating Safety. Washington, DC: The National Academies Press, 2005.

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Dietary Supplements: A Framework for Evaluating Safety
  • How serious is the adverse effect that might be predicted? Mutagenicity in many assays, DNA damage in human cells, cell transformation, and production of DNA adducts in vitro are evidence of higher levels of concern, especially for potential carcinogenesis. Evidence of enzyme induction without DNA damage or mutagenesis is of lesser concern.

  • Does the evidence provide mechanistic or mode of action information which lends biological plausibility to effects observed in humans or animals?

  • Is the mechanism or mode of action consistent with the type of effect, caused by similar substances, such as plants in the same family?

  • Is there information suggesting that the concentrations used in vitro are relevant or irrelevant? Concern should increase if the active ingredient and/or metabolite of concern reach relevant concentrations in blood or tissue (see Chapter 3).

  • Is there consistency in more than one assay?

The answers to these questions determine the appropriate level of concern, as described in Table 7-1. Information such as that in the right column warrants higher levels of concern about public safety and risk of consumption. In vitro information such as that described in the left column warrants lower levels of concern, while information described in the middle column warrants concern, but additional information may be required to warrant conclusion that a risk exists.

ANNEX 7-1 USE OF GENETIC TOXICOLOGY INFORMATION

Genetic toxicology is the study of the ability of substances to cause selective damage to the DNA of living organisms (or RNA in the case of RNA viruses). In addition to providing the raw materials for evolution, genetic alterations are associated with a large proportion of human diseases, including cancer. Chromosomal aberrations, such as deletions, inversions, and translocations, have been associated with leukemia, lymphoma, and some solid tumors.

The term genotoxic is applied to substances (or physical agents like ultraviolet light or X-rays) that have an intrinsic ability to damage DNA (not simply due to gross toxicity that may secondarily result in damage to DNA). Different genotoxicants interact with DNA in different ways, cause different types of DNA alterations, and can be detected using different assay systems (Preston and Hoffmann, 2001).

For example, substances that cause heritable changes in DNA sequence are called mutagens. A mutation may result from an alteration in a single DNA base or addition or deletion of one or more DNA bases (point muta-

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Front Matter (R1-R20)
Executive Summary (1-18)
1 Introduction and Background (19-42)
2 Approaches Used by Others and Existing Safety Frameworks (43-84)
3 The Framework (85-125)
4 Categories of Scientific Evidence--Human Information and Data (126-155)
5 Categories of Scientific Evidence--Animal Data (156-174)
6 Categories of Scientific Evidence--Information About Related Substances (175-216)
7 Categories of Scientific Evidence--In Vitro Data (217-234)
8 Interactions (235-246)
9 Vulnerable Groups and Prevalance of Use (247-252)
10 Scientific Principles for Integrating and Evaluating the Available Data (253-268)
11 Applying the Framework: Case Studies Using the Prototype Safety Monographs (269-291)
12 Factors Influencing Use of the Safety Framework (292-296)
13 Findings and Recommendations (297-306)
Appendix A: Existing Frameworks or Systems for Evaluating the Safety of Other Substances (307-315)
Appendix B: Scope of Work and Comments to Initial July 2002 Framework (316-321)
Appendix C: Plant Family Information (322-355)
Appendix D: Chaparral: Prototype Monograph Summary (356-362)
Appendix E: Glucosamine: Prototype Monograph Summary (363-366)
Appendix F: Melatonin: Prototype Monograph Summary (367-371)
Appendix G: Chromium Picolinate: Prototype Monograph Summary (372-375)
Appendix H: Saw Palmetto: Prototype Monograph Summary (376-379)
Appendix I: Shark Cartilage: Prototype Monograph Summary (380-384)
Appendix J: Prototype Focused Monograph: Review of Liver-Related Risks for Chaparral (385-449)
Appendix K: Protoype Focused Monograph: Review of Anti-Androgenic Risks of Saw Palmetto Ingestion by Women (450-477)
Appendix L: Acknowledgements (478-480)
Appendix M: Biographical Sketches of Commitee Members (481-488)
Index (489-506)