ABAMECTIN: Addendum First draft prepared by E. Bosshard, Federal Office of Public Health, Division of Food Science, Schwerzenbach, Switzerland Explanation Evaluation for acceptable daily intake Biochemical aspects Absorption, distribution and excretion Biotransformation Toxicological studies Acute toxicity Short-term toxicity Long-term toxicity and carcinogenicity Reproductive toxicity Embryotoxicity and teratogenicity Special studies Sensitivity of CF-1 mice Comments Toxicological evaluation References Explanation Abamectin comprises at least 80% avermectin B1a and not more than 20% avermectin B1b. Abamectin was first evaluated by the Joint Meeting in 1992, when it was allocated an ADI of 0-0.0001 mg/kg bw on the basis of the lowest NOAEL of 0.05 mg/kg bw per day for maternal toxicity observed in a study of teratogenicity in mice and a two-generation study of reproductive toxicity in rats. A safety factor of 500 was applied because of concern about the teratogenicity of the delta-8,9 isomer in CF-1 mice. The isomer is a photolytic degradation product which forms a variable part of the residue on crops. Abamectin was re-evaluated by the 1994 Joint Meeting in order to consider new information. This monograph addendum presents the data on abamectin submitted since 1992, comprising a study of the photo-oxidative stability of avermectin B1a, the main component of abamectin, and a study of the sensitivity of CD-1 mice to the toxicity of abamectin, and summarizes briefly the results of the studies described in the full monograph. Abamectin has a close structural relationship to ivermectin, a widely used therapeutic agent against onchocerciasis in humans, and the two compounds have similar toxic effects in various animal species. In 1992, the Joint FAO/WHO Expert Committee on Food Additives (JECFA) changed the ADI for ivermectin from 0-0.0002 to 0-0.001 mg/kg bw (WHO, 1990, 1993a). The present Meeting therefore also considered additional data on ivermectin, comprising the results of two studies in primates and a published report of a study in humans, which were reviewed and summarized by JECFA (Dalgard et al., 1986; Hendricks & Lankas, 1986 [summarized in WHO, 1991]; Pacqui et al., 1990 [summarized in WHO, 1993b]). Evaluation for acceptable daily intake 1. Biochemical aspects Under photolytic conditions in the laboratory and in the field, abamectin undergoes isomerization around the 8,9-double bond to produce small amounts of the delta-8,9 isomer. A study was conducted to investigate the stability of 0.15 EC formulations of avermectin B1a and the delta-8,9 isomer by exposing thin films of the compounds to simulated solar radiation for 1-23 h. Slightly higher degradation rates were seen for the delta-8,9 isomer than for avermectin B1a (Demchak & MacConnell, 1986). (a) Absorption, distribution and excretion Rats were given oral doses of 0.14 or 1.4 mg/kg bw per day of abamectin or 1.4 mg/kg bw per day of the delta-8,9 isomer. Over seven days, the percentages excreted in urine were 0.3-1% of the administered dose of abamectin and 0.4% of the dose of the isomer. The animals eliminated 69-82% of the dose of abamectin and 94% of the dose of isomer in faeces (Annex I, reference 67; Chiu & Lu, 1989). (b) Biotransformation In rats, goats and cattle, unchanged parent compound accounted for up to 50% of the total radioactive residues in tissues. The 24-hydroxymethyl derivative of abamectin was found in rats, goats and cattle treated with the compound and in rats treated with the delta-8,9 isomer, and the 3"-O-demethyl derivative was found in rats and cattle administered abamectin and in rats administered the isomer (Annex I, reference 67; Chiu & Lu, 1989). The metabolic pathways of abamectin are shown in Figure 1. Figure 1. Main metabolic pathways of abamectin2. Toxicological studies (a) Acute toxicity The acute toxicity of abamectin is summarized in Table 1. In monkeys given a single oral dose of abamectin, the NOAEL was 1 mg/kg bw per day, with a plasma concentration of 38 ng/ml, and the LOAEL was 2 mg/kg bw per day, with a plasma concentration of 76 ng/ml (Gordon et al., 1985). The same NOAEL and LOAEL were observed with ivermectin in monkeys (WHO, 1991). Table 1. Acute toxicity of abamacetin and its delta-8,9 isomer Species Sex Route LD50 Component Purity (mg/kg bw) (%) Abamectin Mouse F Oral 13.6-23.8 B1a NR B1b 98.4 Pregnantb 11.8-19.0 B1a + B1b 94 Non-pregnantb 15.0-41.3 B1a + B1b 94 Rat M&F Oral approx. 11 B1a NR M&F Oral 8.7-12.8 B1a + B1b 91 Dog M&F Oral approx. 8 B1a NR B1a + B1b Monkey M&F Oral > 24 B1a + B1b Rat Dermal > 330 B1a +B1b 87±9.4 Rabbit Dermal > 1600 B1a + B1b 91.4 B1a + B1b 94 Delta-8,9 isomer Mouse M&F Oral > 80 (CF-1) NR, not reported a From Annex I, reference 67 b Five-day mortality (b) Short-term toxicity As shown in Table 2, abamectin induced acute effects on the central nervous system, manifested as tremors and mydriasis, particularly in dogs. CD-1 mice were less sensitive than rats and dogs. (c) Long-term toxicity and carcinogenicity Long-term studies of toxicity in mice and rats are summarized in Table 3. The effects in the long-term study of abamectin in rats showed a steep dose-response relationship. (d) Reproductive toxicity Studies of the reproductive toxicity of abamectin in rodents (Annex I, reference 67) reveal that pregnant CF-1 mice are particularly sensitive to effects on the central nervous system, as tremors were observed at a dose as low as 0.16 mg/kg bw per day in a study of maternal toxicity. No data on mice were available for the delta-8,9 isomer. In rats, the NOAELs and LOELs for maternal toxicity in most of the studies were higher than in CD-1 mice, ranging from > 0.4 to 1 mg/kg bw per day. In one study, however, an NOAEL of 0.12 mg/kg bw per day was found on the basis of reduced mating performance at a higher dose level. Studies of embryo- and fetotoxicity (Annex I, reference 67) have been performed only in rats. The NOAELs in the different studies were 0.1-0.3 mg/kg bw per day. The NOAELs and LOELs in most studies were lower for embryo- and fetotoxicity than for maternal toxicity, indicating that the developing organism is particularly sensitive. Increased pup mortality and reduced weight gain were consistent findings after postnatal exposure. The delta-8,9 isomer had no adverse effects in rats at the doses tested. (e) Embryotoxicity and teratogenicity Studies on the embryotoxicity and teratogenicity of abamectin and the delta-8,9 isomer in rodents are summarized in Table 5. Mice In pregnant CF-1 mice treated with abamectin, the NOAEL for maternal toxicity, manifested as tremors, weight loss and death, was 0.05 mg/kg bw per day, and the NOAEL for embryotoxicity and teratogenicity was 0.2 mg/kg bw per day. At higher doses (0.4 and 0.8 mg/kg bw per day), at which pronounced maternal toxicity occurs, an increased incidence of cleft palates was seen in comparison with concurrent control. The increase was not related to dose, and the incidences are within the range of those of historical controls (up to 3%) (Annex I, reference 67). Table 2. Short-term toxicity of abamectin Species Treatment Effect level Effects (mg/kg bw per day) NOAEL LOAEL Mouse 12 weeks, 0, 2, 5, 10, 20 ppm and 8 (40) 12 (60) Decreased body weight gain (CD-1) 3 weeks: 40, 60 ppm (diet) Rat 8 weeks: 0, 5, 10, 15, 20/25, 0.5 (10) 0.75 (15) Tremors, reduced body 40, 60 ppm (diet) weight gain Dog 12 weeks: 0, 0.25, 0.5, 1, 0.5 1 Mydriasis 4/2 mg/kg bw per day (diet) 18 weeks: 0, 0.25, 0.5, 2, 0.25 0.5 Tremors, ataxia, mydriasis, 8 mg/kg bw per day (gavage) hepatocellular vacuolation (avermectin B1a) and lipid accumulation, single death 53 weeks: 0, 0.25, 0.5, 0.25 0.5 Single instances of mydriasis, 1 mg/kg bw per day (diet) marginal effect From Annex 1, reference 67 Table 3. Long-term toxicity of abamectin Species Treatment Effect level Effects (mg/kg bw per day) NOAEL LOAEL Mouse 94 weeks: 0, 2, 4, 8 mg/kg bw 4 8 Tremors, increased (CD-I) per day (diet) mortality, reduced body weight gain; no tumorigenicity Rat 104 weeks: 0, 0.75, 1.5, 2/2.5/2 1.5 2/2.5 Tremors (after increase in mg/kg bw per day (diet) dose after 10 weeks), moribund condition; no tumorigenicity From Annex 1, reference 67 In study 7 in Table 5, the delta-8,9 isomer was maternally toxic in CF-1 mice, inducing tremors, decreased weight gain and death, at doses above 0.1 mg/kg bw per day. The NOAEL for embryotoxicity and teratogenicity was > 0.03 mg/kg bw per day. The NOAEL for maternotoxicity was based on the finding of one moribund animal among 25 treated animals at 0.5 mg/kg bw per day. A marked increase in the incidence of cleft palates, which exceeded the range seen in historical controls, was observed at this maternally toxic dose. An increased incidence of cleft palates was seen at the NOAEL for maternal toxicity, but the value was clearly within the range of that of historical controls. An increased incidence of exencephaly was found at 0.03 mg/kg bw per day, which slightly exceeded the historical control range (up to 1.6%), so that the increase can be regarded as a borderline effect (Annex I, reference 67). The results of this study indicate that teratogenic effects occur at maternally toxic doses. In a second study of the delta-8,9 isomer in mice (study 8), the NOAEL for maternal toxicity was 0.1 mg/kg bw per day and that for embryotoxicity and teratogenicity was 0.05 mg/kg bw per day. Increased incidences of cleft palate and exencephaly were observed over those in concurrent controls at doses of 0.1 mg/kg bw per day and higher. Most of the anomalies were found at 0.1 mg/kg bw per day in one litter, but the range observed in historical controls was often exceeded (Annex I, reference 67). It is remarkable, therefore, that no dose-response relationship was seen with respect to these malformations. Its absence renders interpretation of these results difficult, and the conclusion that teratogenicity occurred in the absence of maternotoxicity in this study seems to be questionable. In a third study in mice (study 9), the NOAEL for maternal and embrotoxicity and teratogenicity was > 0.06 mg/kg bw per day (Annex I, reference 67). Although increased incidences of cleft palate and exencephaly were seen in comparison with concurrent controls, there was no dose-response relationship, and the incidences were within the historical control range. Assessment of the maternal toxicity of the delta-8,9 isomer in these three studies was difficult because of the very steep dose-response curve and the uncertainty of the end-points used (decreased body weight and slight tremors). Table 4. Reproductive toxicity of abamectin and its delta-8,9 isomer Species Treatment Effect level Effects (mg/kg bw per day) NOAEL LOAEL Abamectin Mouse 0, 0.06, 0.16, 0.33 mg/kg bw per day 0.06 0.16 Maternal toxicity: tremors (CF-1) on days 6-15 of gestation (diet) Rat 14 weeks after exposure in utero: > 0.4 > 0.4 No effects 0, 0.1, 0.2, 0.4 mg/kg bw per day (gavage) (avermectin B1a) Two generations (F0, F1) 0, 0.5, 1, < 0.5 0.5 Embryo- and fetotoxicity: 2/1.5 mg/kg bw per day (oral) Reduced pup weight; (avermectin B1a) increased pup mortality; developmental retardation (eye opening) 1 2/1.5 Maternal toxicity: tremors, deaths, decreased body weight gain, weight loss Two generations (F0, F1): 0.1 0.2 Embryo- and fetotoxicity: 0, 0.1, 0.2, 0.4 mg/kg bw per day spastic movements, reduced (oral) (avermectin B1a) weight gain, developmental retardation (eye opening) > 0.4 > 0.4 Maternal toxicity: no effects Two generations (F0, F1): Embryo- and fetotoxicity in F1 0, 0.15, 0.5, 1.5, 5 mg/l 0.3 (1.5 mg/l) 0.7 (5 mg/l) pups: tremors, increased (drinking-water) mortality, decreased weight > 0.7 > 0.7 Maternal toxicity Table 4 (contd) Species Treatment Effect level Effects (mg/kg bw per day) NOAEL LOAEL Two generations (F0, F1) 0.12 0.4 Embryo- and fetotoxicity: 0, 0.05, 0.12, 0.4 mg/kg bw increased mortality, reduced per day (oral) weight 0.12 (?) 0.4 Maternal toxicity: reduced body weight gain during lactation in F0 and F1 not related to dose Delta-8,9 isomer Rat Two generations (F0, F1) > 0.4 > 0.4 No treatment-related 0, 0.06, 0.12, 0.4 mg/kg bw effects per day (gavage) From Annex I, reference 67 Table 5. Embryotoxicity and teratogenicity of abamectin and its delta-8,9 isomer Study Species No. Dose Maternal toxicity Malformations no. (mg/kg bw (no. of animals) (% fetuses) per day) Abamectin Avermectin B1a 1 Mouse 20 0 Cleft palate (0.4) (CF-1) 0.1 Tremors, death (1) 0.2 0.4 Tremors, death (3) Cleft palate (2.4) 0.8 Tremors, death (2) Cleft palate (2.5) Avermectin B1b 2 Mouse 12 0 (CF-1) 0.025 0.05 Cleft palate, exencephaly (1) 0.075 Tremors, weight loss, death (2) 0.1 Abamectin 3 Rat 25 0 None Externala (0.3) 0.4 None 0.8 None Externala (0.7) 1.6 None Externala (0.6) Abamectin 4 Rabbit 10 0 0.5 1 2 3 All animals: stupor, loss of body Not investigated weight, reduced food and water consumption; one moribund Table 5 (contd) Study Species No. Dose Maternal toxicity Malformations no. (mg/kg bw (no. of animals) (% fetuses) per day) Abamectin 5 Rabbit 18 0 Externala (2.1) 0.5 One death 1 One death 2 Reduced food and water Externala (7.4) consumption, weight loss Delta-8,9 isomer 6 Mouse 7-11 0 (CF-1) 1.5 Deaths Only group with litters; cleft 3 Deaths palate (29) 6.25 Deaths 12.5 Deaths 25 Deaths 50 Deaths 7 Mouse 12 0 Exencephaly (0.7) (CF-1) 0.05 Decreased body weight gain, fewer implantsb 0.1 ? Cleft palate (11), exencephaly (1.7) 0.5 Tremors, loss of body weight, Cleft palate (1), exencephaly (4) single deaths 1 Tremors, decrease or loss of body Cleft palate (8), exencephaly (2) weight; fewer implants, single deaths 8 Mouse 25 0 (CF-1) 0.015 None Cleft palate (0.5) 0.03 None Exencephaly (1.3) 0.06 None Exencephaly (1.3) Table 5 (contd) Study Species No. Dose Maternal toxicity Malformations no. (mg/kg bw (no. of animals) (% fetuses) per day) 9 Mouse 25 0 Exencephaly (0.4) (CF-1) 0.015 Cleft palate (0.4), exencephaly (0.4) 0.03 Cleft palate (0.4), exencephaly (2) 0.1 Cleft palate (2) 0.5 Moribund (1) Cleft palate (10), exencephaly (0.4) 10 Rat 25 0 No effect No effect 0.25 No effect No effect 0.5 No effect No effect 1 No effect No effect From Annex I, reference 67. The historical control incidences of malformations in CF-1 mice (in % fetuses) were 0.3 (max. 3) for cleft palate and 0.3 (max. 1.6) for exencephaly. In Charles River rats, the incidences in historical controls were 0.03 (max. 0.3) for cleft palate and 0.004 (max. 0.3) for gastroschisis. a Cleft palate, exencephaly, gastroschisis, omphaloceles, clubbed forefeet b Statistically nonsignificant and non-dose-related increases in the rates of resorptions and of dead fetuses in all treated groups; fewer implants per female at 0.05 and 1 mg/kg bw per day Rats In rats treated with abamectin, the NOAEL for both maternal toxicity, indicated by tremors and weight loss, and for embryotoxicity and teratogenicity was > 1.6 mg/kg bw per day. At 0.8 and 1.6 mg/kg bw per day, the incidence of external malformations was greater than that in concurrent controls (Annex I, reference 67); the increase was not dose-related. The range of incidences of each malformation in historical controls indicates that the increases seen in animals treated with abamectin were not related to treatment. In rats treated with the delta-8,9 isomer, no maternal or embryotoxicity or teratogenicity was seen at doses ranging from 0 to 1 mg/kg bw per day (Annex 1, reference 67). (g) Special studies Sensitivity of CF-1 mice Multidrug resistance has been associated with over-expression of permeability glycoprotein (P-glycoprotein), which is a component of the plasma membrane in various cell types and species (Beck, 1997; Gottesman & Pastan, 1993). Cells that express high levels of P-glycoprotein have decreased rates of drug uptake, decreased steady-state levels of drugs and decreased drug retention (Beck et al., 1983). Schinkel et al. (1994) used mice that had been genetically engineered for disruption of the gene that encodes P-glycoprotein and showed that ivermectin is a substrate for this protein. In a short-term study of oral toxicity, comparisons were made of the sensitivity of CF-1 and CD-1 mice to abamectin and their levels of P-glycoprotein, in order to determine whether low levels of the protein could explain the particularly high sensitivity of CD-1 mice to abamectin. Abamectin was administered orally in sesame oil to groups of 49 male and 50 female CF-1 mice and five male and five female CD-1 mice at 0.8 mg/kg bw per day for five days. A control group received only the vehicle. The LD50 for abamectin given orally is about 10 mg/kg bw for CF-1 mice and higher for CD-1 mice. Signs of severe neurotoxicity appeared in 12 female and five male CF-1 mice 3-4 h after the first dose; no clinical signs of toxicity were seen in any of the other CF-1 mice or in any of the CD-1 or control mice. Immunohistochemical investigation of the cerebellum, cerebral cortex and jejunum showed that the abamectin-sensitive CF-1 mice had low levels of P-glycoprotein and the abamectin-insensitive CF-1 mice had higher levels, which were similar to those seen in CD-1 mice (Lankas et al., 1994). These results indicate that about 17% of CF-1 mice are highly sensitive to abamectin and that there is a strong correlation between the P-glycoprotein level and sensitivity to abamectin. Comments In a study of photo-oxidative stability, the half-life of the delta-8,9 isomer was 4.5 and that of avermectin B1a was 6.5 h. Because of the close structural relationship between abamectin and ivermectin, a widely used therapeutic agent against human onchocerciasis and other parasitic diseases, and the very similar toxic effects of the two compounds in various animal species, additional data on ivermectin were considered, comprising the results of two studies in primates and a published report of a study in humans. A study in which expression of the P-glycoprotein (a permeability protein associated with multiple drug resistance) was correlated with sensitivity to avermectins in different mouse strains was also considered. A two-week study of the oral toxicity of ivermectin conducted in immature rhesus monkeys at doses of 0, 0.3, 0.6 and 1.2 mg/kg bw per day showed no adverse effects on body weight, clinical signs, ophthalmoscopic end-points, haematological, or clinical chemical parameters, or pathological manifestations. Thus, the NOAEL in this study was > 1.2 mg/kg bw per day. In a second two-week study with ivermectin, in which neonatal rhesus monkeys were administered doses of 0, 0.04 or 0.1 mg/kg bw per day by nasogastric intubation, the NOAEL was 0.1 mg/kg bw per day. The doses administered were 10-30 times the dose that would be received by the nursing infant of a lactating mother who had been treated with ivermectin for onchocerciasis. New data were submitted which showed that the high sensitivity of the CF-1 mouse to the toxicity of avermectins on the nervous system is associated with a deficiency in the expression of P-glycoprotein in both the epithelium of the small intestine and the capillary endothelial cells of the blood-brain barrier. The deficiency is associated with a marked increase in the concentration of ivermectin in the brain and plasma after administration of the compound. CD-1 mice and those of the CF-1 strain that have higher levels of P-glycoprotein are less sensitive to the toxicity of abamectin on the central nervous system than the approximately 17% of CF-1 mice deficient in this protein. The oral LD50 for CF-1 P-glycoprotein-deficient mice was about one order of magnitude lower than that of CD-1 mice and of CF-1 mice with higher levels of P-glycoprotein. This heterogeneity in the CF-1 mouse strain may explain the apparent absence of a dose-response relationship with respect to maternal toxicity in the studies of teratogenicity. These data cannot, however, be used to demonstrate a correlation between P-glycoprotein deficiency and teratogenicity, although, given the apparent absence of a dose-response relationship, such a correlation might be inferred. Extensive information available on the use of ivermectin in animal and human health was reviewed at the fortieth meeting of the Joint FAO/WHO Expert Committee on Food Additives (JECFA) in 1992. That Committee concluded that 'despite the extremely wide use of ivermectin, there is no evidence of significant incidences of adverse effects on reproductive performance in treated animals and the very limited data on reproductive toxicity in humans indicate that ivermectin does not increase the incidence of birth defects.' The Meeting confirmed that the lowest NOAEL was 0.05 mg/kg bw per day for maternal toxicity in the studies of teratogenicity in mice for abamectin and for the delta-8,9 isomer. The Joint Meeting in 1992 considered that slight decreases in body-weight gain early in the lactation period in one generation of rats in a study of reproductive toxicity provided supporting evidence. The present Meeting concluded that the NOAEL in the study on reproductive toxicity in rats was 0.12 mg/kg bw per day on the basis of toxicity to pups at the higher dose level. The Meeting concluded that the CF-1 mouse strain is heterogeneous with respect to sensitivity to abamectin and, therefore, may be an inappropriate model for studying the toxicity (including teratogenicity) of avermectins. The Meeting therefore decided to base the ADI on the NOAEL of 0.12 mg/kg bw per day for pup toxicity in the study of reproductive toxicity in rats. A safety factor of 500 was applied because the concern about the teratogenicity of the delta-8,9 isomer could not be assuaged by the additional data. Toxicological evaluation Levels that cause no toxic effect Rat: 0.12 mg/kg bw per day (two-generation study of reproductive toxicity) Estimate of acceptable daily intake for humans 0-0.0002 mg/kg bw Studies that would provide information useful for continued evaluation of the compound 1. Data on P-glycoprotein in other species, including humans 2. Establishment and validation of a more sensitive method to assess neurotoxic effects of avermectins in rodents 3. Acute toxicity of the delta-8,9 isomer in CF-1 and CD-1 mice, with measurements of P-glycoprotein and blood and brain levels of the compound 4. Study of the teratogenicity in CD-1 and CF-1 mice of abamectin and the delta-8,9 isomer with concurrent measurements of P-glycoprotein, in order to correlate its presence or absence with maternal toxicity and teratogenicity References Beck, W.T. (1987) The cell biology of multiple drug resistance. Biochem. Pharmacol., 36, 2879-2887. Beck, W.T., Cirtain, M.C. & Lefko, J.L. (1983) Energy-dependent reduced drug binding as a mechanism of vinca alkaloid resistance in human leukemic lymphoblasts. Mol. Pharmacol., 24, 485-492. Chiu, S.-H. & Lu, A.Y.U. (1989) Metabolism and tissue residues. In: Campbell, W.C., ed., Ivermectin and Abamectin, New York, Springer Verlag, pp. 131-143. Dalgard, D.W., Mistretta, L.H., Bromberg, N.M. & Vargas, K.J. (1986) Sixteen day oral toxicity study of MK-0933 in immature rhesus monkeys. Study no. TT-85-9033. Unpublished report prepared by Merck Research Laboratories, Three Bridges, NJ, USA. Submitted to WHO by Merck Research Laboratories, Three Bridges, NJ, USA. Demchak, R.J. & MacConnell, J.G. (1986) Comparison of avermectin B1a and its 8,9-Z isomer on petri dishes. Unpublished report dated 27 May 1986, prepared by Merck Research Laboratories, Three Bridges, NJ, USA. Submitted to WHO by Merck Research Laboratories, Three Bridges, NJ, USA. Gordon, L.R., Kornbrust, D.J., Douwning, G.V., Nickell, B.E., Buck, J. & Rafferty, C.E. (1985) Oral toxicity and plasma level study in monkeys with ivermectin (MK 0933) and abamectin (MK 0936). Study no. T 85-013-0. Unpublished report prepared by Merck, Sharpe & Dohme Research Laboratories, West Point, PA, USA. Submitted to WHO by Merck Research Laboratories, Three Bridges, NJ, USA. Gottesman, M.M. & Pastan, I. (1993) Biochemistry of multidrug resistance mediated by the multidrug transporter. Ann. Rev. Biochem., 62, 385-427. Lankas, G.R., Cartwright, M.E. & Umbenhauer, D. (1994) Abamectin (#177) Final report for TT #94-2775: Exploratory 5-day oral toxicity study comparing abamectin sensitivity and P-glycoprotein levels in CF-1 and CD-1 mice. Unpublished report dated 12 September 1994, prepared by Merck, Sharpe & Dohme Research Laboratories, West Point, PA, USA. Submitted to WHO by Merck Research Laboratories, Three Bridges, NJ, USA. Pacqué, M., Muñoz, B., Poetschke, G., Foose, J., Greene, B.M. & Taylor, H.R. (1990) Pregnancy outcome after inadvertant ivermectin treatment during community-based distribution. Lancet, 336, 1486-1489. Schinkel, A.H., Smit, J.J.M., van Tellingen, O., Beijen, J.H., Wagenaar, E., van Deemter, L., Mol, C.A.A.M., van der Valk, M.A., Robanus-Maandag, E.C., te Riele, H.P.J., Berns, A.J.M. & Borst, P. (1994) Disruption of the mouse mdr1a P-glycoprotein gene leads to a deficiency in the blood-brain barrier and to increased sensitivity to drugs. Cell, 77, 491-502. WHO (1990) Evaluation of Certain Veterinary Drug Residues in Food (Thirty-sixth report of the Joint FAO/WHO Expert Committee on Food Additives) (WHO Technical Report Series, No. 799), Geneva. WHO (1991) Toxicological Evaluation of Certain Veterinary Drug Residues in Food (WHO Food Additives Series, No. 27), Geneva. WHO (1993a) Evaluation of Certain Veterinary Drug Residues in Food (Fortieth report of the Joint FAO/WHO Expert Committee on Food Additives) (WHO Technical Report Series, No. 832), Geneva. WHO (1993b) Toxicological Evaluation of Certain Veterinary Drug Residues in Food (WHO Food Additives Series, No. 31), Geneva.
See Also: Toxicological Abbreviations