Abstract
This book is presented as an aid to the professionals working on the development of pharmaceutical or chemical products for human use to assist in the interpretation of pathology data generated in toxicology studies. The book is a product of the successful course, “Pathology for nonpathologists” that is annually presented as a collaboration between the American College of Toxicology and the Society of Toxicologic Pathology.
Below is a chapter-by-chapter review:
Chapter 1; Introduction to Toxicologic Pathology: This chapter addresses the characteristics of the pathologists involved in these studies, how they are trained, what kind of work they do, and continues with presentation of how tissues are processed to prepare them for evaluation by pathologists. It gives some information about common artifacts and then goes on to present procedures that are necessary to clarify changes by using non-routine stains and techniques to identify pathologic processes. There are abundant and well explained images as well as a wealth of references.
Chapter 2; The Pathology Report, Peer Review and Pathology Working Group: This chapter is not much different from a chapter that would be in any toxicologic pathology publication, although more explanations are given on the subjects that it covers. It also covers assurance of the quality of the pathologist-generated data. It is effective and well-illustrated with numerous references.
Chapter 3; Deals with Routine and Special Techniques in Toxicologic Pathology: This chapter is a continuation of Chapter 1; however, it moves on to more experimental techniques including computed tomography, Magnetic Resonance Imaging, and others. Many of these techniques are used for specific purposes and are not routine. There are useful images, but a few more explanations may help the reader without training in these techniques to better understand their significance.
Chapter 4; The Liver and Gallbladder: This chapter presents a thorough examination of this important organ system. There are very good images to help the person understand the functioning of the liver. The authors discuss the interaction between liver morphology and the clinical pathology parameters that are routinely used to examine the condition of the liver functions. The images in this chapter are excellent diagrams, but it would be more informative if actual images of histology slides with the specific conditions were presented as well.
Chapter 5; Pathology of the Gastrointestinal Tract and Exocrine Pancreas: This chapter is well presented with illustrative images having explanations of the presence of the changes illustrated. There are many references, as is the case for most of the chapters in this book.
Chapter 6; Pathology of the Urinary System: This important chapter start with a good explanation of the physiology and anatomy of the organ system. This chapter is complemented by presenting multiple images of routine studies. It also illustrates some of the pathology that can be observed both spontaneous and drug-induced lesions. The authors also delve into some interesting case studies.
Chapter 7; Pathology of the Nervous System: The authors start by acknowledging that the nervous system is the most challenging organ to assess in toxicity studies. This chapter is thoroughly illustrated with images and briefly discusses various stains. It also has multiple excellent examples of lesions.
Chapter 8; Cardiovascular System: This chapter is brief in the introduction of the organ system, without discussing the vasculature. It has some useful images on the sampling of the heart. The chapter ends with brief case studies and has an ample reference list.
Chapter 9; Pathology of the Respiratory System: The initial approach is a very complete examination of the anatomy and function of the system; it is thoroughly illustrated with images and drawings and is well written and referenced.
Chapter 10; Pathology of the Lymphoid System: This is a thorough and easy to follow chapter, with well-chosen references. The images are easy to understand.
Chapter 11; Pathology of the Male and Female Reproductive System and Mammary Gland; This is the largest chapter of the book and rightfully so. It presents many images illustrating the morphology of spermatogenesis and the other mechanisms of development and injury to this system. The illustrations are excellent and well referenced.
Chapter 12; Pathology of the Integumentary System: It focuses briefly on morphology and moves on to discuss the complications of conducting dermatological research. There are a few illustrations of changes in the skin with several etiologies. The authors devote much of the chapter to allergic reactions and how these studies are conducted.
Chapter 13; Pathology of the Endocrine System: The chapter starts with an overview of the system and then presents specific issues found in different endocrine glands.
Chapter 14; Pathology of Bone, Skeletal Muscle and Tooth: This chapter is succinct and packed with good information. There are good illustrations. The section dealing with the tooth is better discussed than is generally found in most pathology books. This chapter was excellent in detailing the specifics on these topics.
Chapter 15; Pathology of the Eye: This is a discussion on the ocular lesions produced by different compounds with good illustrations mostly based on excellent microscopic images.
Chapter 16; Pathology of the Ear: The chapter is a good primer on this organ that is seldom sectioned in routine toxicology studies. It contains excellent illustrations of the normal inner ear, and a valuable listing of the toxicants that damage the inner ear.
Chapter 17; Principles of Toxicologic Clinical Pathology: This chapter is also seldomly included in pathology books. This is a welcome change and makes this book more complete. Although this chapter would not supplant a dedicated clinical pathology book, it facilitates the review of the clinical pathology background as well as compound-related changes in toxicology studies.
Chapter 18; Carcinogenicity: This is another welcome addition to a pathology book, where carcinogenesis is frequently limited to the identification of the organ of origin. The analysis of the estimation of carcinogenic potential of pharmaceuticals is a major conclusion of toxicology studies, where the pathology opinion is pivotal. This chapter will give the reader a valuable introduction to this process.
Chapter 19; Pathology of Juvenile Animals: This is yet another welcome contribution, which allows one to look at the different systems to differentiate growth changes vs. compound effect changes. Most pathology books do not cover these juvenile changes and the inclusion in this book adds to the value of this publication.
Chapter 20; Non-mammalian Laboratory Species: Fish, Frogs and Beyond: The use of non-mammalian species in drug development studies is limited by the need to address their relevancy and accuracy. There is interest in decreasing the use of mammals in research; to achieve this, either in vitro studies or studies in alternative species will be implemented. This chapter addresses these issues and will help the reader understand what types of testing may be doable in these alternative species.
In conclusion: This book, with modest objectives, more than accomplishes its mission. It is generally well written, well-illustrated and well referenced. I found the book to be a “go to” book not just for non-pathologists, but for pathologists and other professionals as well. It is valuable for those who did not train specifically in pathology and would also serve as an excellent reference book for all those who generate and evaluate data in toxicology studies.