Lymphocyte Cytokinesis-block Micronucleus Research Articles

PIG-A gene mutation as a genotoxicity biomarker in polycyclic aromatic hydrocarbon-exposed barbecue workers

BackgroundThe PIG-A gene mutation assay is a valuable tool for measuring in vivo gene mutations in blood cells. The human PIG-A assay, used as a potential genotoxicity biomarker, is minimally invasive, sensitive, and cost-efficient; however, the relationship between carcinogen exposure and PIG-A mutations is not well understood.MethodsWe investigated the genotoxic effect of red blood cells using PIG-A assay and lymphocyte cytokinesis-block micronucleus test in barbecue restaurant workers (N = 70) exposed to polycyclic aromatic hydrocarbons (PAHs) and self-identified healthy control subjects (N = 56). Urinary PAH metabolites were measured to evaluate internal exposure levels.ResultsMultivariate Poisson regression showed that the PAH-exposed workers exhibited significantly higher PIG-A mutant frequency (MF) (8.04 ± 6.81 × 10− 6) than did the controls (5.56 ± 5.26 × 10− 6) (RR = 0.707, 95% CI: 0.615–0.812, P < 0.001). These results indicate that PAH exposure is a risk factor for elevated PIG-A MF. The frequencies of micronuclei (MN) and nuclear buds (NBUD) in the PAH-exposed workers (MN: 3.06 ± 2.07 ‰, NBUD: 1.38 ± 1.02 ‰) were also significantly higher than in the controls (MN: 1.46 ± 0.64 ‰, P < 0.001; NBUD: 0.70 ± 0.60 ‰, P < 0.001). Additionally, PIG-A MFs showed better associations with several urinary hydroxylated PAH metabolites (P2-OH-Flu = 0.032, r2-OH-Flu = 0. 268; P2-OH-Phe = 0.022, r2-OH-Phe = 0.286; P3-OH-Phe = 0.0312, r3-OH-Phe = 0.270; P4-OH-Phe = 0.018, r4-OH-Phe = 0.296), while the increase in MN, NPB, and NBUD frequencies was not associated with any OH-PAH metabolites; and high-PAH-exposed workers showed the highest PIG-A MFs. Furthermore, there was a significant association between PIG-A MF and PAH exposure levels (Chi-square test for trend, P = 0.006).ConclusionsOur results indicate that an increase in PIG-A MF in barbecue workers could reflect the response to PAH exposure, providing evidence of its potential as a genotoxicity biomarker in human risk assessment.

A new method to predict genotoxic effects based on serum molecular profile

It is critical to develop new methods to assess genotoxic effects in human biomonitoring since the conventional methods are usually laborious, time-consuming, and expensive. It is aimed to evaluate if the analysis of a drop of serum by Fourier Transform Infrared spectroscopy, allow to assess genotoxic effects in occupational exposure to cytostatic drugs in hospital professionals, as obtained by the lymphocyte cytokinesis-block micronucleus assay. It was considered peripheral blood from hospital professionals exposed to cytostatic drugs (n = 22) and from a non-exposed group (n = 36). It was observed that workers occupationally exposed presented a higher number of micronuclei (p < 0.05) in lymphocytes, in relation to the non-exposed group. The serum Fourier Transform Infrared spectra from exposed workers presented diverse different peaks (p < 0.01) in relation to the non-exposed group. The hierarchical cluster analysis of serum spectra separated serum samples of the exposed group from the non-exposed group with 61% sensitivity and 88% specificity. A support vector machine model of serum spectra enables to predict exposure with high accuracy (0.91), precision (0.89), sensitivity (0.86), F1 score (0.87) and AUC (0.96). Therefore, Fourier Transform Infrared spectroscopic analysis of a drop of serum enabled to predict in a rapid and simple mode the genotoxic effects of cytostatic drugs. The method presents therefore potential for high-dimension screening of exposure of genotoxic substances, due to its simplicity and rapid setup mode.

Determination of Lymphocyte Cytokinesis-Block Micronucleus Values in Apparently Healthy Children by means of Age and Sex.

The cytokinesis-block micronucleus (MN) assay on blood lymphocytes is one of the most important tests implemented in cytogenetics for the measurement of genotoxicity. For the purpose of biological dosing, it is crucial to know the spontaneous frequency of MN and its normal values in general population, especially in children, which are used for the population databases. In this study, MN levels were investigated in cytokinesis-blocked lymphocytes of 150 apparently healthy children aged 1 to 15. Our aim was to assess the variability of MN values according to age and sex. The mean MN frequency among boys was 3.69 ± 1.747‰ and 4.12 ± 1.867‰ in girls where there was no significant difference in relation to age and sex. However, when we separated age groups as 0–2 years, 3–5 years, 6–10 years, and 11–15 years, one-way ANOVA test showed significant association. Significance was obvious in the 0–2 years age group with the 3–5 years age group and 6–10 years age group. When we grouped our study population as 0–2 years and 3–15 years, the mean MN frequency among the 0–2 years age group was 2.85 ± 1.599‰ and 4.07 ± 1.867‰ in the 3–15 years age group which was also statistically significant. This difference may be attributed to age-related increase of close contact with environmental hazardous agents. In conclusion, normal values of MN obtained in this study will add valuable information in regard to update the current childhood population data and will act as a reference for further genotoxicity studies.

“Normal values” for the lymphocyte cytokinesis-block micronucleus cytome parameters: Repeatability and reproducibility in a healthy reference population

The micronucleus test in peripheral blood lymphocytes is the most widely validated technique to evaluate the DNA damage and chromosomal instability in human populations. The test is largely applied in monitoring environmental and occupational exposure to genotoxic agents. It was also proposed as a biomarker of risk/susceptibility for cancer and other degenerative diseases. The availability of “normal values” in healthy populations is a main requisite for the assay application in human biomonitoring. Age and gender-related ranges of micronucleated binucleated cells (MNBN) baseline values were established in a group of 103 healthy platelet donors (50 males and 53 females) not recently exposed to genotoxic agents and characterized for demographic, lifestyle and dietary factors. Repeatability of the test by the same scorer was evaluated. Reproducibility was estimated through analysis of repeated blood samples. High correlation between the results of the three blood samplings in two separate scoring sessions of MNBN/1000BN (R2 values were 0.83, 0.74 and 0.68; P < 0.0001) and PI values (R2 values were 0.69, 0.62 and 0.65; P < 0.0001) was detected. High consistency among the values obtained in three different samplings in the same individual was observed (Intraclass Correlation Coefficient (ICC) = 0.905, (95% CI = 0.868–0.933, P < 0.0001) The range of “normal” values predicted on the basis of the results of the present study appears to be sufficiently narrow to warrant application of the assay in the comparison of data obtained from groups of exposed or susceptible subjects, supporting its use in preventive programs. The large inter-individual variability predicted by the model used in the present study hampers a clinical application of the assay at individual level. The method applied in the present study represents a generally applicable model to derive “normal values” in any population, as an essential step before starting a biomonitoring study.

Validity of the Lymphocyte Cytokinesis-Block Micronucleus Assay (L-CBMN) as biomarker for human exposure to chemicals with different modes of action: A synthesis of systematic reviews

Recently fourteen systematic reviews applying the same selection and evaluation criteria analyzed the induction of micronuclei in lymphocytes as biomarker for DNA damage induced by human exposure to a given chemical or chemical mixture. The results obtained in the individual reviews were summarized to evaluate the validity of the Cytokinesis-Block-Micronucleus assay in lymphocytes (L-CBMN) and propose recommendations for its use in occupational and environmental exposure studies. All systematic reviews found consistent increases of MN frequencies in exposed subjects versus controls in all genotoxic compounds or group of chemicals investigated, in the following decreasing order: As/Cr/Ni, vinyl chloride, formaldehyde, Hg/Pb/Cd, “miscellaneous”, pesticides, cytostatics/antineoplastics, anaesthetic gasses, dust/asbestos/other fibers, polycyclic aromatic hydrocarbons, ethylene oxide, butadiene, styrene and petroleum/derivatives. Two reviews compared the results with the recommended exposure limits. For styrene, MN was found not to be induced under the recommended threshold limit. For vinyl chloride the safe exposure limit based on the L-CBMN data is lower than the current one. The L-CBMN thus appears to be a valid biomarker to assess DNA damage in populations exposed to genotoxic chemicals. Many shortcomings have been reported in assessment of confounding factors, such as lifestyle patterns, in particular diet and the major one the exposure assessment. All these factors together with methodological variables may contribute to the large variability in MN frequencies, also in controls. Information on frequency and origin of MN in more than one tissue (e.g. lymphocytes and buccal cells) in parallel, may provide better understanding of the mechanisms involved. Use of automated MN scoring systems to increase numbers of cells scored and facilitate screening more individuals would increase data reliability and provide information on the link between mutagenicity and carcinogenicity, if the studies are done prospectively. Efforts should be made to unravel the genotoxic effects induced when chronic and/or mixed exposures are involved.

The potential for complete automated scoring of the cytokinesis block micronucleus cytome assay using imaging flow cytometry

The lymphocyte Cytokinesis-Block Micronucleus (CBMN) assay was originally developed for the measurement of micronuclei (MN) exclusively in binucleated (BN) cells, which represent the population of cells that can express MN because they completed nuclear division. Recently the assay has evolved into a comprehensive cytome method to include biomarkers that measure chromosomal instability and cytotoxicity by quantification of nuclear buds (NBUDs), nucleoplasmic bridges (NPBs) and apoptotic/necrotic cells. Furthermore, enumeration of mono- and polynucleated cells allows for computation of the nuclear division index (NDI) to assess mitotic activity. Typically performed by manual microscopy, the CBMN cytome assay is laborious and subject to scorer bias and fatigue, leading to inter- and intra-scorer variability. Automated microscopy and conventional flow cytometry methods have been developed to automate scoring of the traditional and cytome versions of the assay. However, these methods have several limitations including the requirement to create high-quality microscope slides, lack of staining consistency and sub-optimal nuclear/cytoplasmic visualization. In the case of flow cytometry, stripping of the cytoplasmic membrane makes it impossible to measure MN in BN cells, calculate the NDI or to quantify apoptotic or necrotic cells. Moreover, the absence of cellular visualization using conventional flow cytometry, makes it impossible to quantify NBUDs and NPBs. In this review, we propose that imaging flow cytometry (IFC), which combines high resolution microscopy with flow cytometry, may overcome these limitations. We demonstrate that by using IFC, images from cells in suspension can be captured, removing the need for microscope slides and allowing visualization of intact cytoplasmic membranes and DNA content. Thus, mono-, bi- and polynucleated cells with and without MN can be rapidly and automatically identified and quantified. Finally, we present high-resolution cell images containing NBUDs and NPBs, illustrating that IFC possesses the potential for completely automated scoring of all components of the CBMN cytome assay.

In vivo chemical genotoxin exposure and DNA damage in humans: An overview based on the lymphocyte cytokinesis block micronucleus assay

In vivo chemical genotoxin exposure and DNA damage in humans: An overview based on the lymphocyte cytokinesis block micronucleus assay

Systematic review of the use of the lymphocyte cytokinesis-block micronucleus assay to measure DNA damage induced by exposure to polycyclic aromatic hydrocarbons.

The effect of exposure to polycyclic aromatic hydrocarbons (PAHs) to induce micronuclei (MN) measured using the lymphocytes cytokinesis-block micronucleus (CBMN) assay were evaluated in 34 studies according to the exposure: 20 studies in coke oven workers, 7 studies in different occupational exposures as alluminium industry workers, rubber factory workers, road construction workers, airport workers and diesel exposed workers, 6 studies on environmentaly exposed groups as police, volunteers and children. Reviewed papers indicate that the CBMN assay is a sensitive biomarker of PAHs exposure in polluted air. Reviewed studies confirmed previous conclusions, that the frequency of MN measured using the lymphocyte CBMN is not significantly affected by smoking, females are more sensitive to PAHs than males, the frequency of MN is increased with age.

Molecular mechanisms by which in vivo exposure to exogenous chemical genotoxic agents can lead to micronucleus formation in lymphocytes in vivo and ex vivo in humans

The purpose of this review is to summarise current knowledge on the molecular mechanisms by which in vivo exposure to exogenous chemical genotoxins in humans induces micronuclei (MNi) and other nuclear anomalies in lymphocytes in vivo and ex vivo after nuclear division in vitro. MNi originate from acentric chromosome fragments and/or whole chromosomes that are unable to engage with the mitotic spindle and/or fail to segregate properly to the daughter nuclei during anaphase. The lagging fragments or whole chromosomes are surrounded by membrane and become MNi. Acentric fragments are caused by failure of repair or mis-repair of DNA strand breaks which may be induced by chemicals that (i) damage the phosphodiester backbone of DNA, and/or (ii) inhibit the DNA damage response mechanisms or repair of DNA strand breaks and/or (iii) cause DNA replication stress due to DNA adduct or cross-link formation. MNi originating from lagging whole chromosomes may be induced by chemicals that cause defects in centromeres or the mitotic machinery. Mis-repair of chemically-induced DNA breaks may also cause formation of dicentric chromosomes and nucleoplasmic bridges (NPBs) between daughter nuclei in mitosis. NPBs may break and initiate recurring breakage-fusion-bridge cycles and chromosomal instability. The review also explores knowledge on (i) the routes by which lymphocytes in the human body may be exposed to genotoxic chemicals, (ii) kinetics of MNi expression in lymphocytes in vivo and ex vivo in the lymphocyte cytokinesis-block micronucleus (L-CBMN) assay and (iii) current evidence on the efficiency of the L-CBMN assay in detecting in vivo exposure to chemical genotoxins and its concordance with MNi expression in epithelial tissues. The review also identifies important knowledge gaps (e.g. effect of nanomaterials; interactions with nutritional deficiencies etc.) regarding mechanisms by which in vivo chemical genotoxin exposure may cause MNi formation in lymphocytes in vivo and ex vivo in lymphocytes.

The use of the lymphocyte cytokinesis-block micronucleus assay for monitoring pesticide-exposed populations.

Pesticides are widely used around the world, and hundreds of millions of people are exposed annually in occupational and environmental settings. Numerous studies have demonstrated relationships between pesticide exposure and increased risk of cancers, neurodegenerative and neurodevelopmental disorders, respiratory diseases and diabetes. Assessment of genotoxicity of pesticides and biomonitoring their effect in exposed populations is critical for a better regulation and protection, but it can be complicated because pesticides are often used as complex mixtures. The cytokinesis-block micronucleus assay in human lymphocytes (L-CBMN) is a validated method of assessment of DNA damage induced by clastogenic and aneuploidogenic mechanisms. The goal of this review is to provide an updated summary of publications on biomonitoring studies using this assay in people exposed to pesticides in different settings, and to identify gaps in knowledge, and future directions. A literature search was conducted through MedLine/PubMed and TOXLINE electronic databases up to December 2015. A total of 55 full-text articles, related to 49 studies, excluding reviews, were selected for in depth analysis, divided by the settings where exposures occurred, such as chemical plant workers, pesticide sprayers, floriculturists, agricultural workers and non-occupationally exposed groups. Majority of studies (36 out of 49) reported positive findings with L-CBMN assay. However, most of the studies of professional applicators that used single pesticide or few compounds in the framework of specific programs did not show significant increases in MN frequency. A decreased level of pesticide-induced genotoxicity was associated with the proper use of personal protection. In contrast, subjects working in greenhouses or during intensive spraying season and having acute exposure, showed consistent increases in MN frequency. Overall, this analysis confirmed that L-CBMN is an excellent tool for pesticide biomonitoring, and can validate the effects of educational and intervention programs on reducing exposure and genetic damage.

Use of the lymphocyte cytokinesis-block micronucleus assay in occupational biomonitoring of genome damage caused by in vivo exposure to chemical genotoxins: Past, present and future.

This article concerns the use of the lymphocyte cytokinesis-block micronucleus (CBMN) assay in biomonitoring of occupational and environmental exposures to genotoxic agents. Furthermore, we evaluated the use of this method in different exposure scenarios, in comparison to other DNA damage biomarkers and its regional distribution. So far ca. 400 studies have been published and the number increased substantially in the last years. The most frequently investigated groups are hospital personnel, followed by workers in the chemical industry and agricultural workers. The lymphocyte CBMN assay is more frequently used in occupational studies than MN assays with epithelial cells and other methods, such as chromosomal aberration analyses, Comet assay and DNA-adduct measurements. The use of probes which enable the discrimination between MN containing chromosome fragments and whole chromosomes allows the identification of the molecular mechanisms of MN formation. Most studies were performed in Europe and Asia (ca. 65% and 25%, respectively). Important future developments will be the evaluation of the biological consequences of formation of additional nuclear endpoints (e.g. nucleoplasmic bridges), the improvement of the understanding of the health consequences of their formation, and the use of automated scoring devices. Future applications of the CBMN assay should address new emerging problems, e.g. the potential genotoxic damage induced by the use of nanoparticles and mobile phones. The control of occupational exposures to chemical genotoxins is currently based on chemical measurements which do not reflect interactions of individual factors and the inclusion of the lymphocyte CBMN assay in routine surveillance of workers could contribute substantially to the prevention of adverse health effects.

Occupational exposure to cytostatic/antineoplastic drugs and cytogenetic damage measured using the lymphocyte cytokinesis-block micronucleus assay: A systematic review of the literature and meta-analysis.

Many studies have reported the occurrence of work-environment contamination by antineoplastic drugs (ANPD), with significant incorporation of trace amounts of these hazardous drugs in hospital personnel. Given the ability of most ANPD to actively bind DNA, thus inducing genotoxic effects, it is of pivotal importance to assess the degree of genotoxic damage (i.e., residual genotoxic risk) in occupationally exposed subjects. The lymphocyte cytokinesis-block micronucleus (L-CBMN) assay is largely used for biological effect monitoring in subjects occupationally exposed to ANPD. In this study, we identified and analyzed the studies published reporting the use of the L-CBMN assay as biomarker of genotoxic risk in health care workers exposed to ANPD with the aim of performing meta-analysis and providing a meta-estimate of the genotoxic effect of exposure. We retrieved 24 studies, published from 1988 to 2015, measuring MN in peripheral blood lymphocytes in health care workers occupationally exposed to ANPD. In 15 out of the 24 studies (62.5%), increased MN frequencies were recognized in exposed subjects as compared to controls. The meta-analysis of MN frequency of the combined studies confirmed an association between occupational exposure to ANPD and cytogenetic effects with an overall meta-estimate of 1.67 [95% CI: 1.41-1.98]. In 16 out of the 24 studies (66.6%) at least one other genotoxicity biomarker, besides L-CBMN assay, was employed for biological effect monitoring. In several studies the effect of exposure to ANPD was evaluated also in terms of MN in exfoliated buccal cells. Other studies focused on genotoxicity endpoints, such as sister chromatid exchanges (3 studies), chromosome aberrations (6 studies), or primary DNA damage investigated by comet assay (7 studies). Overall, there was good agreement between other genotoxicity tests employed and L-CBMN assay outcomes.

A systematic review of the association between occupational exposure to formaldehyde and effects on chromosomal DNA damage measured using the cytokinesis-block micronucleus assay in lymphocytes.

Formaldehyde (FAL) is classified as a Class I carcinogen by the WHO International Agency for Research on Cancer. Therefore, there is a need to validate appropriate methods for detecting its genotoxic effects in vivo in humans. One of the most commonly used methods to measure the genotoxic effects of exposure to environmental chemicals is the lymphocyte cytokinesis-block micronucleus (L-CBMN assay). We performed a systematic review and statistical analysis of the results from all of the published studies in which the L-CBMN assay was used to measure the genotoxic effects of human exposure to FAL. The results of this systematic review indicated that the majority (62%) of the 21 investigations in the 17 published studies we examined showed significant increases in lymphocyte micronucleus (MN) frequency (a biomarker of chromosome breakage or loss), in exposed subjects relative to controls. We used a novel quality score tool to determine if the investigations adequately addressed known variables that affect MN frequency in lymphocytes and found that MN frequency was not explained by quality because there was no significant correlation between quality score and fold-change in MN frequency (R=0.008, P=0.97). The results of all of the studies (positive or negative), when combined together, indicated a highly significant doubling in lymphocyte MN frequency in those exposed to FAL relative to controls (P<0.0001). These observations, together with a significant positive correlation between L-CBMN assay MN frequency and FAL air concentration (R=0.529, P=0.017) indicate the suitability of this method to measure in vivo genotoxicity of FAL. Furthermore, fold-increase in lymphocyte MN frequency in the exposed subjects relative to controls was strongly positively correlated with the duration of FAL exposure (R=0.779, P<0.0001) suggesting the need to better understand the potential for cumulative genomic instability induced by chronic exposures to FAL.

DNA and chromosomal damage in medical workers exposed to anaesthetic gases assessed by the lymphocyte cytokinesis-block micronucleus (CBMN) assay. A critical review.

The lymphocyte cytokinesis-block micronucleus (CBMN) assay has been applied in hundreds of in vivo biomonitoring studies of humans exposed either environmentally or occupationally to genotoxic chemicals. However, there is an emerging need to re-evaluate the use of MN and other biomarkers within the lymphocyte CBMN cytome assay as quantitative indicators of exposure to main classes of chemical genotoxins. The main aim of the present report is to systematically review published studies investigating the use of the lymphocyte CBMN assay to determine DNA damage in subjects exposed to anaesthetic gases. We also compared performance of the CBMN assay with other DNA damage assays employed and identified strengths and weaknesses of the published studies. We have retrieved 11 studies, published between 1996 and 2013, reporting MN associated with occupational exposures (operating room personnel). The individual job categories were often described (anaesthesiologists, technicians, radiologists) among cases, as well as duration of exposure. All studies reported the compounds present at the workplace and, in some instances, the exposure levels were measured. Controls were usually recruited among personnel at the hospital not exposed to anaesthetics or they were healthy unexposed subjects from general population. The number of investigated subjects, due to the character of the occupation, was relatively smaller than those investigated in other occupational monitoring settings. Overall, the majority of the studies were age- and gender- matched (or investigated only males or females) while less attention was given to lifestyle confounders. Appropriate measurement of exposure, available in approximately half of the studies only, was compromised by the lack of the personal dosimetry-based determinations. In all studies, higher MN frequencies were observed in exposed individuals. The meta-analysis of mean MN frequency of combined studies confirmed this tendency (log mean ratio=0.56 [0.34-0.77]; P=3.51×10-7). Similar differences between the exposed and controls were also observed for other biomarkers.

Application of the lymphocyte Cytokinesis-Block Micronucleus Assay to populations exposed to petroleum and its derivatives: Results from a systematic review and meta-analysis.

The lymphocyte cytokinesis-block micronucleus (CBMN) assay is applied in many different in vivo biomonitoring studies of human exposure to genotoxic chemicals. Among extensively chemicals investigated, we identified petroleum and its derivatives, in particular benzene and the most common mixture of benzene, toluene, and xylene. Although conflicting results have been reported on the effects of benzene exposure, the number of positive findings in independent studies suggests that occupational exposure to benzene causes DNA damage in peripheral blood lymphocytes. To assess current evidence on this hypothesis, we conducted a meta-analysis. Our aim was to evaluate the effect of benzene exposure on genetic damage, quantified using the CBMN assay on individuals occupationally exposed to petroleum and its derivatives. Statistical analyses were conducted using the rmeta package from the free Software Environment for Statistical Computing R. Combined study results indicated that benzene exposure is associated with an increased level of genetic damage in peripheral blood lymphocytes, as reflected by an increased MN frequency. The summary mean difference in MN frequency between exposed and unexposed individuals was 1.64 (95% CI: 0.80-2.47). Overall, this finding points to MN frequency as a sensitive biomarker which could be used to evaluate genetic damage induced by occupational - industrial or environmental - exposure to benzene. This review also identified some important knowledge gaps as well as the need of large, well-designed studies. In particular, it is fundamental to accurately characterize the investigated population, including dietary habits and genetic variability which could modulate MN frequency in both exposed individuals and unexposed controls. In conclusion, according to present findings the use of the CBMN assay in biomonitoring studies could provide objective evidence to guide prioritization of preventive interventions in subjects occupationally exposed to petroleum derivatives, and in particular benzene.

Correlation between the genotoxicity endpoints measured by two different genotoxicity assays: comet assay and CBMN assay

Correlation between the genotoxicity endpoints measured by two different genotoxicity assays: comet assay and CBMN assay

Automatic versus manual lymphocyte fixation: impact on dose estimation using the cytokinesis-block micronucleus assay.

The lymphocyte cytokinesis-block micronucleus (CBMN) assay is a biodosemeter for the exposure to ionizing radiation. We examined the feasibility to implement a fully automated cell harvesting system for binucleate lymphocyte (BN) fixation. We compared fully automated versus manual BN fixation and evaluated its relevance on the accuracy of dose estimates using the CBMN. First, dose-response curves based on X-ray irradiated blood samples of ten healthy donors (0-4Gy, dose rate 1.0Gy/min) were established. BN was either prepared manually or fully automatically using the Hanabi cell harvester system PII. Slides were finally scored following an automatic or semi-automatic approach using the Metafer4 platform. The variance was calculated per dose and separately for each of the four fixation and scoring combinations. Thereafter, a serial of 16 blood samples of unknown exposure doses (0-3.9Gy X-ray) was analyzed. Employing the four fixation and scoring combinations, we compared the number of dose estimates lying outside the ±0.5Gy interval and the mean absolute difference (MAD) and examined sensitivity, specificity and accuracy of doses merged into binary dose categories of clinical significance. Irrespective of the fixation procedure, we observed at doses ≤1.0Gy about 2-4 times higher median variances for the automated scoring procedure over the semi-automated approach (p≤0.03). The lowest median variance was observed for automatic fixation+semi-automated scoring (135) which was even 2 times lower relative to manual fixation+semi-automated scoring (276, p=0.04). These differences became negligible after doses >1.0Gy. For the automatic fixation procedure, we also observed a tendency toward borderline significant higher numbers of dose estimates falling into the ±0.5Gy interval (25%, p=0.08) and lower MAD values (50%, p=0.09), which was predominantly caused by the accuracy of dose assessment >1.0Gy. Regarding the discrimination of binary dose categories of clinical significance, we observed a good agreement of both fixation procedures. The implementation of the automatic cell harvesting system considerably reduces the workload and results in dose estimates with a tendency of being slightly more accurate as they are after a manual fixation.

Commentary: Critical questions, misconceptions and a road map for improving the use of the lymphocyte cytokinesis-block micronucleus assay for in vivo biomonitoring of human exposure to genotoxic chemicals—A HUMN project perspective

The lymphocyte cytokinesis-block micronucleus (CBMN) assay has been applied in hundreds of in vivo biomonitoring studies of humans exposed to genotoxic chemicals because it allows the measurement of both structural and numerical chromosome aberrations. The CBMN cytome assay version which, apart from measuring micronuclei (MN) already present in cells in vivo or expressed ex vivo, also includes measurement of nucleoplasmic bridges (NPB), nuclear buds (NBUD), necrosis and apoptosis, is also increasingly being used in such studies. Because of the numerous published studies there is now a need to re-evaluate the use of MN and other biomarkers within the lymphocyte CBMN cytome assay as quantitative indicators of exposure to chemical genotoxins and the genetic hazard this may cause. This review has identified some important misconceptions as well as knowledge gaps that need to be addressed to make further progress in the proper application of this promising technique and enable its full potential to be realised. The HUMN project consortium recommends a three pronged approach to further improve the knowledge base and application of the lymphocyte CBMN cytome assay to measure DNA damage in humans exposed to chemical genotoxins: (i) a series of systematic reviews, one for each class of chemical genotoxins, of studies which have investigated the association of in vivo exposure in humans with MN, NPB and NBUD induction in lymphocytes; (ii) a comprehensive analysis of the literature to obtain new insights on the potential mechanisms by which different classes of chemicals may induce MN, NPB and NBUD in vitro and in vivo and (iii) investigation of the potential advantages of using the lymphocyte CBMN cytome assay in conjunction with other promising complementary DNA damage diagnostics to obtain an even more complete assessment of the DNA damage profile induced by in vivo exposure to chemical genotoxins in humans.

Does the recommended lymphocyte cytokinesis-block micronucleus assay for human biomonitoring actually detect DNA damage induced by occupational and environmental exposure to genotoxic chemicals?

This commentary challenges the paradigm that the cytokinesis-block micronucleus assay (CBMN assay) with cultured human lymphocytes, as it is performed currently, is a sensitive and useful tool for detecting genotoxic effects in populations exposed occupationally or environmentally to genotoxic chemicals. Based on the principle of the assay and the available data, increased micronucleus (MN) frequencies in binucleated cells (BNC) are mainly due to MN produced in vitro during the cultivation period (i.e. MN produced in vivo do not substantially contribute to the MN frequency measured in BNC). The sensitivity of the assay for the detection of induced MN in BNC after an in vivo exposure to a genotoxic chemical is limited because cytochalasin B (Cyt-B) is added relatively late during the culture period and, therefore, the BNC that are scored do not always represent cells that have completed one cell cycle only. Furthermore, this delay means that damaged cells can be eliminated by apoptosis and/or that DNA damage induced in vivo can be repaired prior to the production of a MN in the presence of Cyt-B. A comparison with the in vitro CBMN assay used for genotoxicity testing leads to the conclusion that it is highly unlikely that DNA damage induced in vivo is the cause for increased MN frequencies in BNC after occupational or environmental exposure to genotoxic chemicals. This commentary casts doubt on the usefulness of the CBMN assay as an indicator of genotoxicity in human biomonitoring and questions the relevance of many published data for hazard identification and risk assessment. Thus, it seems worthwhile to reconsider the use of the CBMN assay as presently conducted for the detection of genotoxic exposure in human biomonitoring.

Folate deficiency is associated with the formation of complex nuclear anomalies in the cytokinesis‐block micronucleus cytome assay

Chromosomal instability (CIN) is an important hallmark to oncogenesis and can be diagnosed morphologically by the presence of nuclear anomalies such as micronuclei (MN), nucleoplasmic bridges (NPBs), and nuclear buds (NBuds). We have identified additional nuclear anomalies formed under folate-deficient conditions, defined as "fused" nuclei (FUS), "circular" nuclei (CIR), and "horse-shoe" nuclei (HS) and investigated their suitability for inclusion as additional CIN biomarkers in the lymphocyte cytokinesis-block micronucleus cytome (CBMN-Cyt) assay. Although the morphological appearance of FUS, CIR, and HS suggested an origin from multiple NPB in the fusion region between the two nuclei, the very low frequency of dicentric chromosomes in metaphase spreads from these cultures did not support this model. Fluorescence in situ hybridization (FISH) analysis of cytokinesis-blocked binucleated (BN) cells with peptide nucleic acid probes for telomeres and centromeres (PNA-FISH) revealed a high proportion of fusion regions contained both centromeric and telomeric DNA. This suggests that folate deficiency may disrupt the process of sister chromatid separation and chromosome segregation during mitosis. It was concluded that the FUS, CIR, and HS morphologies represent promising biomarkers of CIN that are sensitive to folate deficiency, and further validation and investigation of the mechanisms responsible for their formation is warranted.