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STOMACH I N P RECLINICAL T OXICOLOGY Dr. K . K amala Pathology Advinus, B angalore

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Page 1: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

STOMACH IN PRECLINICAL TOXICOLOGY

Dr. K. Kamala

Pathology

Advinus, Bangalore

Page 2: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disclaimer

The ideas and thoughts expressed

in this presentation are purely that

of the presenter and do not

necessarily reflect the thinking of

the organization or represented by

the presenter.

Page 3: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Anatomy

Rat

Page 4: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Anatomy

Mouse

Page 5: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Trimming Guidelines

1: Forestomach (FS), gastric fundus (GF), antrum (A), pylorus (P).

2: Forestomach (FS), gastric fundus (GF)

3: Optional section - fundus

Page 6: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

1: Forestomach (FS), gastric fundus (GF), antrum (A), pylorus (P).

Trimming Guidelines

Page 7: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

2: Forestomach (FS), gastric fundus (GF)

Trimming Guidelines

Page 8: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

3: Optional section - fundus

Trimming Guidelines

Page 9: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Histology Comparisons

Rat Mouse

A

Page 10: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Histology Comparisons

Rabbit Dog

Page 11: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Commonly Affected Regions

ü In the decreasing order

ü Non glandular stomach in rats-frequency more

ü Glandular stomach in mice

ü Non glandular stomach in mice

ü Glandular stomach in rats

ü Dogs

ü Rabbits

Page 12: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Common Factors

Influencing Stomach Findings

üGavage/feeding studies

üFeed Quality/texture , contamination

üDuration of exposure

üSpecies difference

Page 13: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Gross Lesions

Non-glandular mucosa, white, focus

Glandular mucosa-raised focus

Glandular mucosa, Ulcer

Non glandular - Mass

Page 14: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Recording Gross Lesions

üFoci-depressed/white/raised

üDiscolouration

üMucosal thickening

üThinning of mucosa

üDistension

üTexture of contents

Page 15: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Gross & Micro Correlation

ØFoci

ØDiscoloration

ØDistended stomach

ØMucosal Thickening

ØAdhesions

ØMasses/nodular growth

Page 16: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Common Microscopic

Lesions- Short Term Studiesü Dilated/distended glands

ü Vacuolar changes/degeneration-non

glandular stomach-limiting ridge

ü Inflammation-glandular mucosa/submucosa

ü Submucosal leukocytic infiltration

ü Epithelial degeneration-eosinophilic

droplets in fundic mucosa—HE, PAS

ü Epithelial hyperplasia

ü Ectopic pancreas/keratin cyst

Page 17: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Common Induced Lesions-

Short Term Studies- Rat

üNon glandular-epithelial hyperplasia,

mucosal necrosis/erosion/ulceration

üGlandular-individual cell

necrosis/epithelial degeneration/mucosal

necrosis/ulceration

üMineralization

Page 18: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthDilated/Distended Glands - Rat

4x

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Disturbances of growth

20x

Dilated/Distended Glands - Rat

Page 20: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthEpithelial Cell Vacuolation-

Limiting Ridge- Rat

10x4x

Page 21: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthHyperkeratosis –

Non-glandular - Mouse

10x

Page 22: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthMucosal Necrosis/Ulcer –

Non-glandular - Mouse

10x

Page 23: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthMucosal Necrosis/Ulcer -

Non-glandular - Mouse

20x

Page 24: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthUlcer/Epithelial Hyperplasia-

Non-glandular - Rat

4x

Page 25: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthUlcer/Epithelial Hyperplasia-

Non-glandular - Rat

10x

Page 26: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Epithelial Hyperplasia/Ulcer- non

Glandular

ØHMG Co-A inhibitors

Ø Irritant potential of test substance

ØNot related to pharmacodynamic

properties of test substance

ØLong stasis of test substance

ØStress/starvation

ØBiochemical changes- BUN/Urea

ØHematology changes- altered

leukocyte count

Page 27: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthUlcer- Glandular Stomach–

Rat

10x

Page 28: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthUlcer-Glandular stomach –

Rat

20x

Page 29: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthMucosal Necrosis and

Pigmentation – Glandular - Rat

4x

Page 30: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Ulcer-glandular stomach

• Non seroidal anti-inflammatory drugs

• Stress

• High doses of ACE inhibitors

• Biochemical changes

• Hematology changes- associated

hemorrhage

Page 31: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Leukocytic Infiltration

Glandular Stomach - Rat

20x

Page 32: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthEpithelial degeneration

Glandular Stomach - Rat

20x

Page 33: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthEpithelial degeneration

Glandular Stomach - Rat

20x

Page 34: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Epithelial degeneration

Glandular Stomach - Rat

20x

Page 35: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

20x

Epithelial degeneration

Glandular Stomach - Rat

Page 36: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

100x

Epithelial degeneration

Glandular Stomach - Rat

Page 37: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

100x

Epithelial degeneration

Glandular Stomach - Rat

Page 38: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Epithelial Degeneration

üCommon in feeding studies

üAllergic gastritis

üEosinophilic gastritis

üEosinophilic droplets/ capillaries

ü Industrial chemicals

üNot observed with Pharmaceutical

compounds

üEnzyme preparations-fermentation

Page 39: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Epithelial Degeneration

Associated/primary changes

• Non glandular epithelial hyperplasia

• Lekocytic infiltration

• Edema in submucosa

• Foveolar epithelial hyperplasia

• Increased mucosal thickness- fundic

Page 40: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthEpithelial Hyperplasia

Glandular Stomach - Rat

10x

Page 41: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthEpithelial Hyperplasia

Glandular Stomach - Mouse

10x

Page 42: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Epithelial Hyperplasia-

Glandular stomach

ØCommon in aged mice

ØRats- discrete lesion and the incidence

rat is low, basophilic cells

ØMice-to differentiate for the

dilated/distended glands

ØTo differentiate adenoma/glandular

polyp

ØGastric acid inhibitors, H2 antagonists

Page 43: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthMineralization

Glandular Stomach - Rat

10x

Page 44: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthMineralization

Glandular Stomach - Rat

20x

Page 45: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Mineralization-

Glandular stomach

üMetastatic calcium salt deposits

üKidney injury and parathyroid

hyperplasia

üDystrophic

üAssociated changes

üConfirmation of metastatic mineral

deposits

üBasement membrane of blood vessels

üTyrosine kinase inhibitors(fibroblast

growth factor inhibitor)

Page 46: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthVasculitis/Perivasculitis -

Serosa - Rat

4x

Page 47: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthVasculitis/Perivasculitis -

Serosa - Rat

20x

Page 48: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthSquamous Cell Carcinoma -

Non-glandular - Mouse

4x

Page 49: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthSquamous Cell Carcinoma -

Non-glandular - Mouse

20x

Page 50: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthSquamous Cell Carcinoma –

Mouse

10x

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Disturbances of growthSquamous Cell Carcinoma –

Mouse

10x

Page 52: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthHistiocytic Sarcoma

Mouse

10x

Page 53: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthHistiocytic Sarcoma

Mouse

40x

Page 54: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthArtifact/Erosion -

Glandular Stomach - Rat

10x

Page 55: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Disturbances of growthArtifact-

Glandular Stomach - Rat

10x

Page 56: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM

Artifact-

Glandular Stomach - Rat

10x

Page 57: Kamala Kannan Stomach in Preclinical Toxicology · Kamala Kannan_Stomach in Preclinical Toxicology.pdf Author: p00017127 Created Date: 12/7/2014 11:17:06 PM