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Among embryotoxic effects described for the three molecules, the alteration on craniofacial morphogenesis is a common feature in humans and animal models, including rodent embryos developed in vitro. The aim of the present work is to evaluate the developmental effects of low Eth serum concentration (17\u00a0mM, corresponding to the legal limit to drive in UK, USA, Canada, and many other countries) in mixture with increasing realistic concentrations of the antifungal drug FLUCO (62.5\u2013500\u00a0\u00b5M) or with increasing realistic concentrations of the antiepileptic drug VPA (31.25\u2013250\u00a0\u00b5M). Groups exposed to Eth alone (17\u2013127.5\u00a0mM), FLUCO alone (62.5\u2013500\u00a0\u00b5M) or VPA alone (31.25\u2013750\u00a0\u00b5M) were also included. The chosen alternative animal model was the post-implantation rat whole embryo culture (WEC). E9.5 embryos were exposed in vitro to the test molecules during the whole test period (48\u00a0h, corresponding to the developmental stages characteristics of any vertebrate, for human embryos post-fertilization days 23\u201331). Data were statistically analyzed and processed for modelling applying the benchmark dose (BMD) and relative potency factor (RPF) approaches. Concentration-related effects on facial outcomes were observed in all experimental groups, with a significant enhancement in the groups co-exposed with Eth in comparison to the single exposures. Data obtained by the present work suggest an additional alert for the assumption of even low levels of alcohol in pregnant women during FLUCO or VPA therapy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00204-022-03410-2","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T17:04:57Z","timestamp":1668618297000},"page":"619-629","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Moderate alcohol consumption during pregnancy increases potency of two different drugs (the antifungal fluconazole and the antiepileptic valproate) in inducing craniofacial defects: prediction by the in vitro rat whole embryo culture"],"prefix":"10.1007","volume":"97","author":[{"given":"Francesca","family":"Metruccio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Battistoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-4673","authenticated-orcid":false,"given":"Francesca","family":"Di Renzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Moretto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Menegola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"key":"3410_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2017.05.006","author":"A Bal-Price","year":"2017","unstructured":"Bal-Price A, (Bette) Meek ME (2017) Adverse outcome pathways: application to enhance mechanistic understanding of neurotoxicity. 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All animal experimental protocols were approved by the Ministry of Health, Department of Veterinary Public Health, Nutrition and Food Safety Committee (authorization number 948\/2017).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}