The skin can biotransfo rm substances, often increasing their toxicity. Repetitive
exposure to coal tar induces the enzyme arylhydrocarbon hydroxylase (AHH) in the
epidermis. This and other enzymes convert PAHs into more carcinogenic forms. It is inter-
esting that people with psoriasis cannot induce AHH and do not seem to develop skin
cancer upon exposure to coal tar.
Examples of toxins absorbed through the skin include hexane, carbon tetrachloride,
and some insecticides. Toxins can also be absorbed by the eyes, although in that case it
is the eye as a target organ that is usually of concern. Various invertebrates have been shown
to take up toxins through their body surface, including arthropods and crustaceans such as
Daphnia. Molting has been shown to be a way to shed heavy metals. In addition, other
routes of exposure are used experimentally, such as injection subcutaneously, intramuscu-
larly, or into bo dy cavities.
Often, the amount of uptake is reduced because some of the toxic substanc e is bonded,
complexed, or limited by diffusion in the environmental source. The fraction that is avail-
able for uptake is called the bioavailability. For example, a fraction of some pesticides
can become so strongly bound to soil particles that they are practically unavailable. It may
be necessary to take multiple routes of exposure into account for some toxins. A worker
applying pesticides by spray may absorb by both inhalation and dermal contact.
18.4 DISTRIBUTION AND STORAGE
Once a toxin enters the bloodstream, it is distributed rapidly throughout the body. How-
ever, organs do not all receive equal distributions, nor do they store them with equal
efficiency. Moreover, the location where most of a toxin is stored is not necessarily the
primary site of toxic effect. For example, 90% of the lead in adul t humans is stored in
the bones, but its effects are on the kidney, nervous system, and blood cell production.
Individual organs and tissues will then take toxins according to the blood flow through
the organ (organ perfusion), their affinity for the toxin, and the presence of any transport
barriers. Most capillaries have large pores between the cells that form their wall. In some
tissues, however, there are few or no pores. The most notable case is the blood–brain
barrier. This prevents passage of polar compounds of medium molar mass. Its behavior
is similar to that of an intact plasma membrane in that it is permeable to nonpolar com-
pounds. Thus, mercuric chloride, which is mainly in ionic form, does not penetrate,
whereas methyl mercury does. Other tissues have barriers as well, including the peripheral
nerves, the placenta, the eyes, and the testes.
The major sites of storage for toxins are (1) bound to plasma proteins, (2) the liver and
kidneys, and (3) adipose tissue. Plasma proteins form complexes with many toxicants,
serving to solubilize and transport them. The effect of protein binding depend s o n how
the proteins compete with processes that detoxify or excrete them. If they give up the
toxicants readily, they may help to transport them to the detoxification site. If, on the
other hand, protein binding is relatively strong, it may sequester the toxins away from
detoxification.
Toxins are often concentrated in the liver or kidneys, possibly due to their role in
detoxifying and excreting them. They contain their own binding proteins. An example
is metallothionein, which figures in cadmium storage and in the transfer of cadm ium
from the liver to the kidney. Toxins absorbed in the stomach and intestines must pass
through the liver before reaching other parts of the body, thus giving that organ a chance
746 FATE AND T RANSPORT OF TOXINS