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Like many PFAS, toxicity studies with HFPO-DA indicate the liver is the primary target of toxicity in rodents following oral exposure. Due to the structural diversity of PFAS, the mode of action (MOA) can differ between PFAS for the same target tissue. There is significant evidence for involvement of peroxisome proliferator-activated receptor alpha (PPAR\u03b1) activation based on molecular and histopathological responses in the liver following HFPO-DA exposure, but other MOAs have also been hypothesized based on limited evidence. The MOA underlying the liver effects in mice exposed to HFPO-DA was assessed in the context of the Key Events (KEs) outlined in the MOA framework for PPAR\u03b1 activator-induced rodent hepatocarcinogenesis. The first 3 KEs (ie, PPAR\u03b1 activation, alteration of cell growth pathways, and perturbation of cell growth\/survival) are supported by several lines of evidence from both in vitro and in vivo data available for HFPO-DA. In contrast, alternate MOAs, including cytotoxicity, PPAR\u03b3 and mitochondrial dysfunction are generally not supported by the scientific literature. HFPO-DA-mediated liver effects in mice are not expected in humans as only KE 1, PPAR\u03b1 activation, is shared across species. PPAR\u03b1-mediated gene expression in humans produces only a subset (ie, lipid modulating effects) of the responses observed in rodents. As such, the adverse effects observed in rodent livers should not be used as the basis of toxicity values for HFPO-DA for purposes of human health risk assessment.<\/jats:p>","DOI":"10.1093\/toxsci\/kfad004","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T17:42:12Z","timestamp":1673458932000},"page":"15-29","source":"Crossref","is-referenced-by-count":23,"title":["Assessment of the mode of action underlying development of liver lesions in mice following oral exposure to HFPO-DA and relevance to humans"],"prefix":"10.1093","volume":"192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8931-617X","authenticated-orcid":false,"given":"Melissa M","family":"Heintz","sequence":"first","affiliation":[{"name":"ToxStrategies, LLC , Asheville, North Carolina 28801, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie C","family":"Haws","sequence":"additional","affiliation":[{"name":"ToxStrategies, LLC , Austin, Texas 78759, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E","family":"Klaunig","sequence":"additional","affiliation":[{"name":"School of Public Health, Indiana University , Bloomington, Indiana 47405, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Cullen","sequence":"additional","affiliation":[{"name":"North Carolina State University College of Veterinary Medicine , Raleigh, North Carolina 27606, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad M","family":"Thompson","sequence":"additional","affiliation":[{"name":"ToxStrategies, LLC , Katy, Texas 77494, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"2023032007565093300_","doi-asserted-by":"crossref","first-page":"105226","DOI":"10.1016\/j.yrtph.2022.105226","article-title":"Grouping of PFAS for human health risk assessment: Findings from an independent panel of experts","volume":"134","author":"Anderson","year":"2022","journal-title":"Regul. 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