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The utility of decision-making tools for the risk governance of nanotechnology is at the core of this paper. Those working in nanotechnology risk management have been prolific in creating such tools, many derived from European FP7 and H2020-funded projects. What is less clear is how such tools might assist the overarching ambition of creating a fair system of risk governance. In this paper, we reflect upon the role that tools might and should play in any system of risk governance. With many tools designed for the risk governance of this emerging technology falling into disuse, this paper provides an overview of extant tools and addresses their potential shortcomings. We also posit the need for a data readiness tool. With the EUs NMP13 family of research consortia about to report to the Commission on ways forward in terms of risk governance of this domain, this is a timely intervention on an important element of any risk governance system.

Nanosafety assessment has experienced an intense era of research during the past decades driven by a vivid interest of regulators, industry, and society. Toxicological assays based on in vitro cellular models have undergone an evolution from experimentation using nanoparticulate systems on singular epithelial cell models to employing advanced complex models more realistically mimicking the respective body barriers for analyzing their capacity to alter the immune state of exposed individuals. During this phase, a number of lessons were learned. We have thus arrived at a state where the next chapters have to be opened, pursuing the following objectives: (1) to elucidate underlying mechanisms, (2) to address effects on vulnerable groups, (3) to test material mixtures, and (4) to use realistic doses on (5) sophisticated models. Moreover, data reproducibility has become a significant demand. In this context, we studied the emerging concept of adverse outcome pathways (AOPs) from the perspective of immune activation and modulation resulting in pro-inflammatory versus tolerogenic responses. When considering the interaction of nanomaterials with biological systems, protein corona formation represents the relevant molecular initiating event (e.g., by potential alterations of nanomaterial-adsorbed proteins). Using this as an example, we illustrate how integrated experimental-computational workflows combining in vitro assays with in silico models aid in data enrichment and upon comprehensive ontology-annotated (meta)data upload to online repositories assure FAIRness (Findability, Accessibility, Interoperability, Reusability). Such digital twinning may, in future, assist in early-stage decision-making during therapeutic development, and hence, promote safe-by-design innovation in nanomedicine. Moreover, it may, in combination with in silico-based exposure-relevant dose-finding, serve for risk monitoring in particularly loaded areas, for example, workplaces, taking into account pre-existing health conditions. This article is categorized under: Toxicology and Regulatory Issues in NanomedicineToxicology of Nanomaterials.

Two training programs were developed and training materials were assembled for teaching early career researchers on deeper understanding of nanorisk governance. The here provided teaching materials are part of the deliverables of NANORIGO project, grant agreement no. 814530, call H2020-NMBP-TO-IND-2018. The training programs and the related materials are described in the document 0_D5.2 Report CS1. 0_D5.2 Report CS1: This document reports about the activities and results of the NANORIGO Case Study 1 CS1 (task T5.1) “Case study on training”, which aims (i) at testing whether the NANORIGO nanorisk governance framework (NRGF) can improve training towards safe working practices and particularly in nanorisk governance, and (ii) at demonstrating the usefulness of the NRGF for preparing the training by trainers. In this context the document comprises two training programs for early career researchers on deeper understanding and practical application of the NRGF, including working safely with nanomaterials (NM) with respect to hazard and exposure as well as to accountability and responsibility. 1_The TiO2 case - a perspective on the history and how it developed: Introduction into the TiO2 case about classification and the EFSA conclusion that E 171 can no longer be considered as safe when used as a food additive, its history, public involvement and how MNBP-13 projects see their contribution to the topic. 2_The TiO2 Case - background and instructions for group work: Introduction in the TiO2 case and group work instructions for two groups: Group 1: ”Carcinogenic Classification/Labeling Request, 2016, Inhalation Route, French ANSES”; Group2: “TiO2‘s (Food additive E171) Genotoxicity cannot be ruled out, EFSA” 3_The TiO2 case - background and instructions for role play: Introduction in the TiO2 case, summarized results of the most relevant different studies concerning TiO2 as food additive and instructions for the role play 4_TiO2 as food additive - documents in a nutshell: The most relevant statements and abstract from EFSA report - Safety assessment of titanium dioxide (E171) as a food additive 5_EFSA report - Safety assessment of titanium dioxide (E171) as a food additive: Safety assessment of titanium dioxide (E171) as a food additive from 25 March 2021, doi: 10.2903/j.efsa.2021.6585 6_ANSES CLH report Proposal for Harmonised Classification and Labelling: CLH report; Proposal for Harmonised Classification and Labelling; Based on Regulation (EC) No 1272/2008 (CLP Regulation), Annex VI, Part 2; Substance Name: Titanium dioxide; EC Number: 236-675-5; CAS Number: 13463-67-7; May 2016

COVID-19, predominantly a mild disease, is associated with more severe clinical manifestation upon pulmonary involvement. Virion-laden aerosols and droplets target different anatomical sites for deposition. Compared to droplets, aerosols more readily advance into the peripheral lung. We performed in silico modeling to confirm the secondary pulmonary lobules as the primary site of disease initiation. By taking different anatomical aerosol origins into consideration and reflecting aerosols from exhalation maneuvers breathing and vocalization, the physicochemical properties of generated respiratory aerosol particles were defined upon conversion to droplet nuclei by evaporation at ambient air. To provide detailed, spatially-resolved information on particle deposition in the thoracic region of the lung, a top-down refinement approach was employed. Our study presents evidence for hot spots of aerosol deposition in lung generations beyond the terminal bronchiole, with a maximum in the secondary pulmonary lobules and a high preference to the lower lobes of both lungs. In vivo, initial chest CT anomalies, the ground glass opacities, resulting from partial alveolar filling and interstitial thickening in the secondary pulmonary lobules, are likewise localized in these lung generations, with the highest frequency in both lower lobes and in the early stage of disease. Hence, our results suggest a disease initiation right there upon inhalation of virion-laden respiratory aerosols, linking the aerosol transmission route to pathogenesis associated with higher disease burden and identifying aerosol transmission as a new independent risk factor for developing a pulmonary phase with a severe outcome.

The immune system is professional in recognizing and responding to non-self, including nanomaterials. Immune responses by professional and nonprofessional immune cells are thus nearly inevitable upon exposure of cells and organisms to such materials. The state of research into taking the immune system into account in nanosafety studies is reviewed and three aspects in which further improvements are desirable are identified: 1) Due to technical limitations, more stringent testing for endotoxin contamination should be made. 2) Since under overdose conditions immunity shows unphysiological responses, all doses used should be justified by being equivalent to tissue-delivered doses. 3) When markers of acute inflammation or cell stress are observed, functional assays are necessary to distinguish between homeostatic fluctuation and genuine defensive or tolerogenic responses. Since immune activation can also indicate that the immune system considers a stimulus to be harmless and induces tolerance, activation markers by themselves do not necessarily imply a danger to the body. Guidelines such as these are necessary to approach the point where specific nanomaterials are classified as safe based on reliable testing strategies.

Nanotechnology is a fast growing field and already a multi-billion dollar market with numerous products available for consumers. TiO2 and SiO2 are by mass the most produced nanomaterials and, thus, of particular interest regarding their biological effects upon inhalation – especially in combination with other inhalable biomolecules such as allergens. We investigated the protein-binding capacity of these two nanomaterials and present detailed uptake profiles of protein-conjugated TiO2 or SiO2 nanoparticles (NPs) in A549 lung epithelial and THP-1 macrophage-like cells. TiO2 and SiO2 NPs (both with a hydrodynamic diameter of about 150 nm) are able to bind bovine serum albumin (BSA), green fluorescent protein (GFP) and the major birch pollen allergen Bet v 1 in substantial amounts that suggest protein monolayers around the particles. GFP-conjugated TiO2 and SiO2 NPs were taken up in A549 and THP-1 cells in a time-dependent manner as demonstrated by confocal laser scanning microscopy, flow cytometry and life cell imaging. By the aid of fluorescent proteins (GFP or fluorescently labeled Bet v 1) we found that both, the NPs and the conjugated proteins entered the cells. Using A549/THP-1 co-cultures, we showed that the majority of SiO2 NPs is taken up by THP-1 cells; however, also A549 cells take up significant amounts of particles when co-cultured with THP-1 macrophage-like cells. The here discussed data provide valuable insights into protein (allergen) delivery by NPs at the lung epithelial barrier.

The incidence of severe COVID-19 in children is low, and underlying mechanisms for lower SARS-CoV-2 susceptibility and self-limiting disease severity are poorly understood. Severe clinical manifestations in adults require SARS-CoV-2 inoculation in the lower respiratory tract, establishing a pulmonary disease phase. This may be either accomplished by direct inoculation of the thoracic region upon exposure to virion-laden aerosols, or by infection of the upper respiratory system and aspiration of virion-laden aerosols originating right there into the lower respiratory tract. The particularities of epithelial barriers as the anatomical site of first viral deposition specifically determine the initial characteristics of an innate immune response, emerging respiratory tissue damage and dysfunctionality, and hence, severity of clinical symptoms. We, thus, investigated by in silico modeling whether the combined effect of juvenile lung morphometry, children’s ventilatory pattern and the peculiarities of the virion-laden aerosols’ properties, render children more resilient to aerosol deposition in the lower respiratory tract. Our study presents evidence for major age-dependent differences of the regional virion-laden aerosol deposition. We identified deposition hotspots in the alveolar–interstitial region of the young adult. Our data reveal that children are void of corresponding hotspots. The inoculum quantum in the alveolar–interstitial region hotspots is found to be considerably related to age. Our results suggest that children are intrinsically protected against SARS-CoV-2 inoculation in the lower respiratory tract, which may help to explain the lower risk of severe clinical manifestations associated with a pulmonary phase.