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In Silico Approaches in Genetic Toxicology - Progress and Future - Masamitsu Honma, Ph.D. Division of Genetics and Mutagenesis, National Institute of Health Sciences, Tokyo, JAPAN
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Page 1: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

In Silico Approaches in Genetic Toxicology -Progress and Future-

Masamitsu Honma, Ph.D.Division of Genetics and Mutagenesis,National Institute of Health Sciences,

Tokyo, JAPAN

Page 2: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Mutagenicity?

Non-Mutagenic(Ames –ve)

Mutagenic(Ames +ve)

NH2

FF

CH3

NH2

OH

O Non-Mutagenic(Ames –ve)

N

N

N

NOO

Carcinogen

Non-carcinogen

Page 3: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

CH3

ClO

NH

CH3

O

H3C O

HN

Cl

CH3

O

H3CO

OS

O

O

Cl

H3C

OH

Cl

S

OH

O O

CH3

CH3

O

CH3

O

CH 3

H 2C

O

F

Br

N

BrS

N

H3C

O NH

Cl

HO

HO

HN

O

Cl

Mutagenicity?

Mutagenic(Ames +ve)

Non-Mutagenic(Ames –ve)

Mutagenic(Ames +ve)

Non-Mutagenic(Ames –ve)

Mutagenic(Ames +ve)

Non-Mutagenic(Ames –ve)

Mutagenic(Ames +ve)

Mutagenic(Ames +ve)

Non-Mutagenic(Ames –ve)

Mutagenic(Ames +ve)

Non-Mutagenic(Ames –ve)

H3C

Cl

HO

CH3O

Cl

Mutagenic(Ames +ve)

Non-Mutagenic(Ames –ve)

Page 4: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

What is In Silico and QSAR?

• In silico toxicology is a type of toxicity assessment that uses computational methods to predict the toxicity of chemicals.

• A QSAR (Quantitative Structure-Activity Relationship ) is a mathematical relationship between a biological activity of a chemical and its structures and characteristics.

• QSAR/ in silico toxicology attempts to find consistent relationship between toxicity and molecular properties, so that these “rules” can be used to evaluate the toxicity of new compounds.

HO

HN

O

Cl

Page 5: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Why Ames Assay?

• The electrophilic theory of chemical carcinogenesis was developed by James and Elizabeth Miller in the 1970s.

• Bruce Ames developed the Ames assay in 1972. It has a high positive predictivity for DNA-reactive chemical carcinogens based on the electrophilic theory. The Ames assay is an in vitro model of chemical carcinogenicity.

• Other reasons to develop QSAR models -----• Highly reproducible results among laboratories• Large number of data set • Binary results (positive or negative)

Page 7: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Rule-Based QSAR

Information

Knowledge

Rule

Value

VolumeDataDataDataData

Page 8: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Statistical-Based QSAR

TopologicalGeometricElectronicPhysicochemical------

Calculation of molecular descriptor

Activity = F (descriptors)

Molecular descriptor Activity

Statistical analysis Internal and

external validation

Results

Artificial neural netk-nearest neighborsRandom forestDecision tree Support vector machine---------

Machine Learning

Page 9: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

• Alerts can be mined automatically from a training set of chemicals with known toxicity labels.

• The training data usually consists of positive and negative examples.

• Different machine learning approaches can be used.

• Extremely data dependent.

Rule-Based vs. Statistical-Based

Statistical-BasedRule-Based

• Rules are suggested by experts.

• Mechanism is known or suggested.

• Validation sets are available for every rule.

• Longer development cycle.

• Can not extrapolate prediction new chemotypes.

Page 10: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

QSAR Approach for Toxicological Assessment

High throughput screening for huge number of chemicals without cost and labor

Test for unavailable chemicals (e.g., impurity, intermediates, flavoring chemicals)

Strongly contribute to animal welfare

Great advantage

But------- The QSAR results are correct and reliable?

Page 11: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

QSAR Used for Assessing Mutagenicity of Impurities in Pharmaceuticals (ICH-M7)

MHLW/PMDA, Japan Masamitsu Honma Rapporteur / Topic LeaderKenichi Masumura Deputy Topic LeaderJunichi Fukuchi ExpertKeiji Hirabayashi Expert

EC, EuropeRoland Froetschl Topic LeaderDiana van Riet-Nales Deputy Topic Leader

FDA, USAAisar Atrakchi Topic LeaderStephen Miller Deputy Topic LeaderTimothy McGovern Expert

Health Canada, CanadaAlisa Vespa Topic Leader

Swissmedic, SwitzerlandElisabeth Klenke Topic Leader

CFDA, ChinaTao Sun Topic Leader

JPMA, JapanTsuneo Hashizume Topic LeaderNaoto Fukutsu Deputy Topic LeaderKazusei Komatsu Expert

EFPIA, EuropeSteven Spanhaak Topic LeaderLutz Mueller Deputy Topic LeaderKevin McKiernan Expert

PhRMA, USAWarren Ku Topic LeaderDavid DeAntonis Deputy Topic LeaderJoseph DeGeorge Expert

WSMI Esther Vock Topic Leader

HSA, SingaporeLooi Yee Hoo Observer

ICH-M7 (R1) EWG MembersRegulatory Industry

Page 12: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Base

+

toluene

Pd catalyst/ Ligand 1) conc H2SO4

LiOt-Bu THF

1) NaBH4 / MgCl2 /MeOH

F3C

XCN

NH2

F3C

NH

CN F3C

NH

O

NH2

F3C

NH

O

NH

O

O

2) aqHCl

F3C

NH

HN O

O

F3C

N

HN O

O

OO

Sodium carbonate Tetrahydrofuran

Cl

O

O

F3C

N

N

O

O

O O

F3C CF3

Br

F3C CF3

Methylene chlorideNaOH/TBAB

1)

2) Ethanol/water

2) Ethanol/water

1)

Step 1 Step 2

Step 3 Step 4 Step 5

Step 6

Cl

O

O

X=Cl, Br

3) Ethanol/water

2) toluene/heptane(1) (2)

(3) (4)

(5)

Synthetic Route of Drug Substances(Byproducts)

Degradation from Drug Substances(Degradants)

Impurities Mutagenic or non-mutagenic?

Page 13: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Major Points of ICH-M7 Guideline for Assessment of Genotoxic Impurities

The focus of this guideline is on DNA reactive substances which can be detected by the Ames assay

Evaluation of mutagenicity of impurities using the QSAR

Application of a Threshold of Toxicological Concern (TTC) to control genotoxic impurities

Page 14: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

(Q) SAR Analysis in ICH-M7

Two (Q)SAR prediction methodologies that complement each other should be applied. One methodology should be expert rule based and the second methodology should be statistical based.

The absence of structural alerts from two complementary (Q)SAR methodologies (expert rule-based and statistical) is sufficient to conclude that the impurity is of no mutagenic concern, and no further testing is recommended.

Page 15: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Hillebrecht A et al., Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations., Chem Res Toxicol, 24, 843–853, 2011)

Performance of Four QSAR Models for Predicting Ames Mutagenicity

Data Source

Hansen (Industrial chemicals)2,647 compounds(67% positive)

Roche (Pharmaceuticals)2,335 compounds(13% positive)

QSAR Tool

DEREKToxtree

McaseLSMA

DEREKToxtree

McaseLSMA

Sensitivity (%)

80.985.2

74.667.8

43.442.9

30.617.4

Specificity (%)

59.153.1

74.063.8

91.677.5

85.893.9

Concordance (%)

73.774.6

74.466.4

85.573.1

78.983.6

QSAR Type

Rule

Statistical

Rule

Statistical

Page 16: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

How to Improve QSAR Prediction ?

New QSAR Algorithm/ Model• AI, Deep-learning ?

Training data set• New• Many• Reliable

Page 17: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Database (name ) Information LinkBenchmark Data Set for In Silico Prediction of Ames Mutagenicity (Hansen et. al., 2009)

Ames mutagenicity database for 6,500 compounds

http://doc.ml.tu-berlin.de/toxbenchmark/

Carcinogenic Potency Database (CPDB) 1,547 chemicals http://toxnet.nlm.nih.gov/cpdb/cpdb.html

GAP – Genetic Activity Profile Database by US EPA and IARC (Latest update in 2000)

Data on approx. 300 chemicals from volumes 1-50 of the IARC Monographs and on 115

http://cfpub.epa.gov/si/si_public_record_Report.cfm?dirEntryId=44472&CFID=726518&CFTOKEN=15601022

Existing Chemicals Examination (EXCHEM) database (Japan) Ames mutagenicity for more than 360 HPV chemicals

http://dra4.nihs.go.jp/mhlw_data/jsp/SearchPageENG.jsp

Istituto superiore di Sanità database (ISSCAN) More than 1,150 chemical compounds tested with the long-term carcinogenicity bioassay on rodents, mutagenicity data.

http://www.iss.it/meca/index.php?lang=1&anno=2013&tipo=25

National Toxicology Program (NTP) database 2,163 chemicals in genetic toxicity studies ftp://157.98.192.110/ntp-cebs/datatype

Toxicity Reference Database (ToxRefDB) Studies on 330 chemicals, many of which are active ingredients of pesticides

http://actor.epa.gov/toxrefdb/faces/SearchByEndpoint.jsp

TOXNET database : Carcinogenesis Research Information System database (CCRIS) and the Genetic Toxicology Databank (GENE-TOX)

CCRIS: over 9,000 chemical records with animal carcinogenicity, mutagenicity, tumor promotion, and tumor inhibition test results. GENE-TOX: on over 3,000 chemicals, from expert peer review of the open scientific literature.

http://toxnet.nlm.nih.gov/

Ames Mutagenicity Data Sources in Major Public Domain

Page 18: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Chemicals newly manufacturing produced or imported more than 100kg/year must be assessed its mutagenicity by Ames assay.

Industrial Safety and Health Law “An-eihou” in Japan

The permission of the use of the Ames data to improve QSAR models by Chemical Hazards Control Division, Industrial Safety and Health Department, Labor Standards Bureau in MHLW

0

5,000

10,000

15,000

20,000

25,000

30,000

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

Manufacture

import

Page 19: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Proposal of International Collaborative Studies to Improve

Ames/QSAR models (QSAR2014, Milan, Italy, June 2014)

Page 20: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

1. Lhasa Limited (UK)

2. MultiCASE Inc (USA)

3. Leadscope Inc (USA)

4. Prous Institute (Spain)

5. Bourgas University (Bulgaria)

6. Istituto Superiore di Sanita (Italy)

7. Istituto di Ricerche Farmacologiche Mario Negiri (Italy)

8. Swedish Toxicology Science Research Center (Sweden)

9. FUJITSU KYUSHU SYSTEMS (Japan)

10. IdeaConsult Ltd. (Bulgaria)

11. Molecular Networks GmbH and Altamira LLC (USA)

12. Sumilation Plus (USA)

DEREK Nexus, SARAH

CASE Ultra rule-, statistical-based

Leadscope rule-, statistical-based

Symmetry

OASIS TIMES

Toxtree

SARpy + VEGA + CAESER (consensus model)

AZAMES

ADMEWORKS

AMBIT

ChemiTunes

Mut_Risk-0

QSAR Venders QSAR Model

Participants in Ames/QSAR Project

Page 21: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Ames Mutagenicity of Challenging Chemicals

Class A : Strongly positive, in which the chemical generally induces more than 1,000 colonies/mg in at least one Ames strains in the presence or absence of rat S9.

Class B : Positive, in which the chemical induces colonies more than 2-fold of the negative control at least one Ames strains in the presence or absence of rat S9, but not in class A.

Class C : Negative, which is neither class A nor B.

Page 22: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Category

Class A

Class B

Class C

Total

Phase I(2014-2015)

183 (4.7%)

383 (9.8%)

3,336 (85.5%)

3,902

Phase II(2015-2016)

253 (6.6%)

309 (8.1%)

3,267 (85.3%)

3,829

Phase III(2016-2017)

236 (5.4%)

393(8.9%)

3,780 (85.7%)

4,409

Total(2014-2017)

672 (5.5%)

1,085 (8.9%)

10,383 (85.6%)

12,140

Ames/QSAR Project (Phase I-III) Challenged Chemicals

Page 23: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

0

20

40

60

80

100

0

20

40

60

80

100

0

20

40

60

80

100

100-Specificity (%)

Sens

itivi

ty (%

) Validation I(A vs. C)

Validation II(A vs. C)

ROC Graphs for Challenged QSAR Models’ Validation

0

20

40

60

80

100

0 20 40 60 80 1000

20

40

60

80

100

0 20 40 60 80 1000

20

40

60

80

100

0 20 40 60 80 100

Validation III(A vs. C)

Validation I(AB vs. C)

Validation II(AB vs. C)

Validation III(AB vs. C)

Concordance: 68.0-87.3%

Page 24: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

CH3

N

H2N

Cl

Cl

O

Cl Cl

H

H3C

NH

O

O

O

CH3

OH

O

NH2

O

O

NH2OH

HO

H2N

HO

OH

NH2

CH

3

CH

3

CH

3

HC

CH3N

CH3

P

NH3CCH3

N

CH3

CH3

Cl

Cl

O

F F

F

FN

F

F

FCH3

P

Cl

Cl

H3CS

S NH

N

HNH

O

F F

F

NH

H

O

O

OCH3

OHO

CH3

O

OCH3

SO

O

Cl

H3C O

O

NH2 HCl

N

N

Cl

Cl

O

F

Cl

CH3

S

O

O Cl

CH3

CH3

Br

O

CH2

CH3H3C

CH3

False NegativesClass A chemicals, but negative call by almost QSAR tools

HH3C N

H

HH

O

OH3C

OF

F

FF

CH

F

FF

CH3

H3C

O

Cl

N

O

O

O O Br

Br

F

N

O

O

N N

O

FCl

O

O

N

F

F

O

O

F

O

N

O

ON

F

Page 25: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

False PositiveClass C chemicals, but positive call by almost QSAR tools

O

N

O O

O

OO

O

H2N

O– N

+

O

O

O

N

N

NN

Cl

N +

OO–

Cl

H3C O

N+

O

O–

NH

O

N+

O

O–

O

N+

O

O–

O

N+

O

O–

O–

N+ O

O

O

N+

O–

O

HO

NN

HO

N+

O–

ON+

O–

O

O

NH

NH2

O

OH NOO

N

CH3

O O

NO

O

O

OCH3

H3C

N

NO O

N

N

CH3

N N

O

O

N

O

N

NH2

ClO

O

O

N

S

NO

O

O

N O

NO O

O

O

O

N

NO

OO

O O

O

O

N

NOO

O

O

O

O

OThey may be mutagens?

Page 26: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Inter-Laboratory Reproducibility of Ames Mutagenicity

Databases Intersections ConcordanceGTP/NCI; TA 100 20 chemicals 85%

GTP/NTP; TA 100 39 chemicals 79%

GTP/NCI; TA 98 18 chemicals 88%

GTP/NTP; TA 98 21 chemicals 92%

Databases Intersections Concordance

GTP/NCI; TA 100 15 chemicals 80%

GTP/NTP; TA 100 14 chemicals (21%)*

GTP/NCI; TA 98 13 chemicals 90%

GTP/NTP; TA 98 23 chemicals 65%

GTP: Report of the U.S. Environmental Protection Agency Gene-Tox ProgramNCI: Short-Term Testing Program in the National Cancer Institute (NCI), National Institutes of Health, US Department of Health and Human ServicesNTP: NTP Program - P&G Inventory

-S9

+S9

82%

Analyzed Dr. Mekenyan in Bourgas "Prof. As. Zlatarov" University

*excluded for calculation

Page 27: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

What means Ames positive?

Class A : Strongly positive, in which the chemical generally induces more than 1,000 colonies/mg in at least one Ames strains in the presence or absence of rat S9.

Class B : Positive, in which the chemical induces colonies more than 2-fold of the negative control at least one Ames strains in the presence or absence of rat S9, but not in class A.

Class C : Negative, which is neither class A nor B.

may contain false-positive.

may contain false-negative.

Page 28: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

0

50

100

150

200

250

300

0 1.2 4.9 20 78 313 1250 5000

0

50

100

150

200

250

300

0 313 625 1250 2500 5000

TA100 (+S9) 1st trial

TA100 (+S9) 2nd trial

Is this Ames Positive?-Example A-

ConfidentialNegative

Negative

Results

PLAUSIBLE

Alert matched: 352Aromatic amine oramide

PHARM_ECOLI NegativePHARM_SALM Inconclusive

CASE Ultra

QSAR

Derek NX

Page 29: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

4'-(chloroacetyl) acaetanilde

(Cas# 140-49-8)

O N

O

Cl

Is this Ames Positive?-Example C-

TA1537(-S9)

TA1537(+S9)

Lab. A Lab. B Lab. C Lab. D

Dunkel et al., Environ Mutagen, 7, Suppl. 5, 1-248 (1985)

Positive

Results

PHARM_ECOLI NegativePHARM_SALM Negative

QSAR

Derek NX INACTIVE

CASE Ultra

Page 30: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Integrated approach for Genotoxicity Assessment

QSAR is not only a tool for the prediction. It can support to judge the results of actual Ames test.

Molecular Mechanism Mutagenic Potential

HO

HN

O

Cl

Cross-Talk

Re-modeling

Re-build Data Base

Feed-Back

QSAR beyond Ames

Page 31: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

Summary

The ICH-M7 guideline is the first international guideline addressing the use of QSARs for evaluating human health effect.

A large number of highly reliable data sets are essential to allow the development and improvement of QSAR models.

The Ames/QSAR international collaborative study is successfully ongoing. Its outcome gives a lot of benefits to QSAR vendors, QSAR users, and regulatory.

The integrated approach with QSAR results increases the sensitivity and specificity of the Ames assay for predicting rodent carcinogens. It can support to judge the Ames results with molecular mechanism.

Page 32: In Silico Approaches in Genetic Toxicology -Progress and ... · Hillebrecht A et al.,Comparative Evaluation of in Silico Systems for Ames Test Mutagenicity Prediction: Scope and Limitations.,

AcknowledgementNational Institute of Health Sciences (Japan)

Airi KitazawaMasami YamadaTakeshi MoritaMakoto Hayashi

Lhasa Limited (UK)

MultiCASE Inc (USA)

Leadscope Inc (USA)

Prous Institute (Spain)

Bourgas University (Bulgaria)

Istituto Superiore di Sanita (Italy)

Istituto di Ricerche Farmacologiche Mario Negiri (Italy)

Swedish Toxicology Sciences Research Center (Sweden)

FUJITSU KYUSHU SYSTEMS (Japan)

IdeaConsult Ltd. (Bulgaria)

Molecular Networks GmbH and Altamira LLC (USA)

Sumilation Plus (USA)

Alex Cayley

Roustem Saiakhov

Glenn Matt

Christine DeMeo

Ovanes Mekenyan

Cecillia Bossa

Emilio Benfenati

Ulf Norinder

Hitomi Koga

Nina Jelazkova

Chihae Yang

Bob Clark

Chemical Hazards Control Division, Labor Standards Bureau in MHLW (Japan)

Kazuyo OofuchiShinji TsunodaHideaki HirakawaShinji KouzukiTatsuya Anai

Pharmaceutical Medical Devices Agency (Japan) Jun-ichi FukuchiKeiji Hirabayashi


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