A mechanistic redefinition of adverse effects - a key step in the toxicity testing paradigm shift

The efforts of the committee that produced the report on Toxicity Testing in the 21st Century reflected the need to look at the issue of assessing risks to humans from exposure to various chemicals through a lens of 21st century biology. The problem - determining if there is a risk of specific exposures - is as old as humanity; every generation brings its own perspective and tools for examining the problem and coming to answers and solutions. Bringing this generation's tools to bear requires us to see the problem of chemical risk assessment in a different light, both in terms of testing of toxicity pathways in vitro and in the interpretation of the tests for estimating whether exposures will be safe. One key issue will be to assess when pathway perturbations are believed to be excessive, i.e., when they are deemed adverse. Redefinition of adversity based on in vitro testing will require a new perception of dose response functions as probabilities of failures, with multiple underlying processes acting sequentially and in parallel leading to failure at a cellular and an organism level. These dose response relationships for adversity will also require a computational systems biology approach for examining toxicity pathway dynamics and stress pathway overload. While the overall approach of defining adversity for in vitro endpoints and using this definition of adversity for risk assessment can be painted in broad brush strokes, as we have done here for DNA-reactive compounds, it will take implementation with a series of prototypes to show the process in practice.