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Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

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Page 1: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Raman Govindarajan, MD, PhD.

Regional Director

Medical and Scientific Affairs

Johnson and Johnson Asia Pacific

Toxicology Fundamentals

Page 2: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

A Day in Toxicology

• The Fundamentals of Toxicology

• Preclinical Safety Assessment of Cosmetics & Toiletries

How? Case Studies

Page 3: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• What is Toxicology?

The traditional definition of toxicology:

" the science of toxin ”.

Page 4: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• What is Toxicology?

A more descriptive definition of toxicology:

"the study of the adverse effects of chemicals or physical agents on living organisms".

Page 5: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Which one of the following is a toxin?

1. Alcohol

2. Aspirin

3. Water

4. Table salt

Page 6: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Toxicity depends on the DOSE

Page 7: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

“All substances are poisons; there is none which is not a poison. The right dose differentiates a poison and a remedy.”

-- Paracelsus

Page 8: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• Toxicity depends on the dose– High oxygen level cause “oxygen intoxication”

Page 9: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• Toxicity depends on the dose– High oxygen level cause “oxygen intoxication”– Too much water (several gallons) can cause

osmotic imbalance and brain damage

Page 10: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• Toxicity depends on the dose– High oxygen level cause “oxygen intoxication”– Too much water (several gallons) can cause

osmotic imbalance and brain damage– 1 beer vs. a six pack of beer

Page 11: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• Toxicity depends on the dose– High oxygen level cause “oxygen intoxication”– Too much water (several gallons) can cause

osmotic imbalance and brain damage– 1 beer vs. a six pack of beer– 1 sleeping pill vs. a bottle of sleeping pills

Page 12: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• Toxicity depends on the dose– High oxygen level cause “oxygen intoxication”– Too much water (several gallons) can cause

osmotic imbalance and brain damage– 1 beer vs. a six pack of beer– 1 sleeping pill vs. a bottle of sleeping pills– 1 aspirin vs. a bottle of aspirins

Page 13: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals
Page 14: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What is LD 50 ?

1. Fifty Lead molecules

2. A famous singer in 1950’s

3. A Latin dance introduced in 1950’s

4. A means to measure toxicity

Page 15: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

How is Toxicity measured by?

Page 16: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Toxicity is measured by LD50:

Lethal Dose that kills

50% of the population

Page 17: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Toxicity is measured by:

• LD50: Lethal Dose that kills 50% of the population

• Dosage measured in weight of toxin per body weight

Page 18: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Dose-response curves are used to derive dose estimates of chemical substances. A common dose estimate for acute

toxicity is the LD50 (Lethal Dose 50%).

Page 19: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Examples of LD50:

Chemical LD50 (ppm)

Nicotine 1

DDT 100

Table Salt 3000

Trichloroethylene 5000

Page 20: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What is ED 10 ?

1. The 10th version of ET movie

2. Brief for the 10th Edward in the family

3. The 10th Executive Director in a company

4. Indication of the effectiveness of a substance

Page 21: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Effective Doses (EDs) are used to indicate the effectiveness of a substance. Normally, effective dose refers to a beneficial effect (relief of pain). It might also stand for a harmful effect (paralysis). Thus the specific endpoint must be indicated.

Page 22: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Effective Dose

Page 23: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What does EC stands for?– 1. Title for a TV show starring a talking horse– 2. Effective concentration– 3. Exposure concentration – 4. New musical show in Broadway

Page 24: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• EC10

This is the commonly used abbreviation for the exposure concentration of a toxicant causing a defined effect on 10% of a test population

Page 25: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Absorption is the process whereby a substance moves from outside the body into the body.

Page 26: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Page 27: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Definition

Page 28: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What is Toxicokinetics?

Toxicokinetics is the study of "how a substance gets into the body and what happens to it in the body".Essentially, it is the study of “the kinetics of all toxic substances”.

Page 29: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Toxicity/Preclinical Safety Review

• Single Dose Study

• Multiple Dose Study: Subacute, Subchronic, Chronic

• Mutagenicity/Carcinogenicity Study

Page 30: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Acute toxicity results from a single exposure to a poisonous substance.

Route of administration:

Oral, IV, IP, Dermal, Subcutaneous

Page 31: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Acute toxicity results from a single exposure to a poisonous substance– Usually has an immediate life-threatening

effect

Page 32: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Acute toxicity results from a single exposure to a poisonous substance– Usually has an immediate life-threatening

effect– Usually easily diagnosed

Page 33: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Acute toxicity results from a single exposure to a poisonous substance– Usually has an immediate life-threatening

effect– Usually easily diagnosed– Most of the time there are antidotes that can

reduce the toxicity of the chemical

Page 34: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Multiple Dose Tests:

Subacute: days to 2 wks

Subchronic: 4 - 13 wks

Chronic: 6 - 12 months in rodents

7 - 10 years in non-rodents

Study design depending on the objective of the study

Page 35: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Chronic toxicity results from prolonged exposure to a poisonous substance over a long period of time

Page 36: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Chronic toxicity results from prolonged exposure to a poisonous substance over a long period of time– No immediate effect but could be life-

threatening in the long term

Page 37: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Chronic toxicity results from prolonged exposure to a poisonous substance over a long period of time– No immediate effect but could be life-

threatening in the long term– Usually hard to diagnose and treat

Page 38: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Chronic toxicity results from prolonged exposure to a poisonous substance over a long period of time– No immediate effect but could be life-

threatening in the long term– Usually hard to diagnose and treat– Hard to distinguish effects from other

influences

Page 39: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What is mutagenic?

1. Something to do with music

2. Something to do with DNA

3. Something to do with mutes

Page 40: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• Mutagenesis

The process whereby a substance damages

DNA and produces alterations in or loss

of genes or chromosomes.

Page 41: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Mutagenicity Tests– Ames Test

– Mammalian Chromosomal Aberration

– Micronucleus Test (in vivo)

Page 42: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What is carcinogenic ?

1. A place that makes cars

2. Something to do with gambling

3. Something that can cause tumors

4. A place that repairs cars

Page 43: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• Carcinogen A carcinogen is any substance which

causes cancer

Page 44: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Carcinogenicity Studies• Traditional 2-year Bioassay– different routes of administration, use rats and mice – two year duration, expensive, labor-intensive– interspecies extrapolation problem, especially mice

Page 45: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Carcinogenicity Studies• Traditional Testing– different routes of administration, use rats and mice

– two year duration, expensive, labor-intensive

– interspecies extrapolation problem, especially mice

• Transgenic Animal Testing – P53, Neonatal, TgAc, XPA, XPA/P53 and RasH2 models

– shorter testing period, less expensive, less labor-intensive

– have genes relevant to humans

– predictability? -- not enough data

Page 46: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What is a reproductive toxin?

Page 47: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Basic

Reproductive toxicity is defined as adverse effects on the male and female reproductive systems that result from exposure to chemical substances.

Page 48: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Which of the following causes reproductive toxicity?

1. Alcohol2. Vitamin A

3. Tobacco smoke (primary)

4. Aspirin

Page 49: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Special Toxicity Studies

• Eye Irritation • Skin Irritation • Contact Sensitization • Comedogenicity• Genital/Mucus Membrane Irritation

Page 50: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Irritation:

Any substance causing inflammation following immediate, prolonged, or repeated contact with skin or mucous membrane.

Page 51: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• The most common cause of Occupational Skin Disease is irritation of the skin from contact with substances at work.

Page 52: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Strong irritants (e.g. acids, alkaline or solvents) cause skin inflammation after a short period of skin contact.

Dermatitis from cement

Page 53: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Weak irritants (such as water, detergents, coolants) cause inflammation after repeated exposures over a longer time.

Page 54: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Dermal Irritation Tests

– Primary Irritation Test • Single Dose

– Cumulative Irritation Test• Multiple Dose

Page 55: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• In intracutaneous irritation tests using albino rabbits, the raised blebs caused by injecting extracts of test materials are either resolved without causing any visible changes or produce inflammation marked by redness and swelling in the 24 to 72 hours following injection.

Page 56: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Sensitization or hypersensitivity reactions usually occur as a result

of repeated or prolonged contact

with a substance that interacts

with the body's immune system.

Page 57: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Which of the following is considered

to be a sensitizer?

1. Latex Gloves

2. DNCB (1-chloro-2, 4-dinitrobenzene)

3. Kathon®CG

4. All of the above

Page 58: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

After wearing natural latex gloves daily for several weeks or months, a person may develop a rash

Page 59: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Biomaterials and devices that cause sensitization reactions do so by means of their extractable chemical caused cell-mediated immunity.

Page 60: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Commonly Used Sensitization Tests

• Guinea Pig Maximization Test

(Magnuson-Kligman Test)

• Modified Buhler’s Test

• Local Lymph Node Assay

Page 61: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Positive response to DNCB in a guinea pig, seen in the maximization test

Page 62: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What does following compounds have in common?

1. Polycyclic aromatic hyrocarbons

2. Quinolones

3. Tetracyclines

4. PABA

Page 63: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Ingredients absorb in the solar spectrum (280 - 400 nm)

• Photomutagenicity • Phototoxicity• Photosensitization • Photocarcinogenicity

Page 64: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Studies to support Product Claims

• Ocular Irritation (Draize or TEP)

• Genital/Mucus Membrane Irritation

• Comedogenicity

• HET CAM – eye irritation test

Page 65: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

What is comedone?

Page 66: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Comedone:

A follicle that has been plugged with a combination of hardened oil (sebaceous material) and dead skin cells.

Page 67: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Which of the following can causes a comedogenic reaction?

1. Cocoa Butter

2. Lanolin

3. Amydimethyl PABA

4. All of the above

Page 68: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

1. Cocoa Butter - a skin softener and lubricator. It is considered comedogenic and may cause allergic reactions.

2. Lanolin - a sheep’s wool derivative, it is highly comedogenic.

3. Amyldimethyl PABA - causes skin irritation.

4. All of the above

Page 69: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

• Skin Absorption Data

• Toxicokinetic and Pharmacokinetic Data

Other important information:

Page 70: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Photosensitization :Hypersensitivity to light.

An abnormally heightened response, especially of the skin, to sunlight or ultraviolet radiation, caused by certain disorders or chemicals and characterized by a toxic or allergic reaction

Page 71: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Safety Testing

• Knowledge of Toxicity is primarily obtained in 3 ways:– by studies using cells (in vitro)– by experimental studies using animals– by the study and observation of people during

normal use of a substance

Page 72: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Four basic steps in the risk assessment process:

Page 73: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Page 74: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology quiz

What is “toxicologist”?

1. A person who always kills my project

2. A person who is intoxicated

3. A person who can not make it to medical school

4. Our partner in R&D

Page 75: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

Formulator and Toxicologist works together

faster time to market !

Page 76: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

New Formulation

Page 77: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

New Formulation

Toxicology Testing

Page 78: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

New Formulation

Toxicology Testing To Market

Page 79: Raman Govindarajan, MD, PhD. Regional Director Medical and Scientific Affairs Johnson and Johnson Asia Pacific Toxicology Fundamentals

Toxicology: Fundamentals

New Formulation

Toxicology Testing To Market