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Wenzel AG, Bloom MS, Butts CD, Wineland RJ, Brock JW, Cruze L, Unal ER, Kucklick JR, Somerville SE, Newman RB. Influence of race on prenatal phthalate exposure and anogenital measurements among boys and girls. ENVIRONMENT INTERNATIONAL 2018; 110:61-70. [PMID: 29097052 DOI: 10.1016/j.envint.2017.10.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/13/2017] [Accepted: 10/13/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Select phthalates have antiandrogenic activity, which raises concern for adverse developmental outcomes given widespread exposure of pregnant women. Investigators have reported associations between maternal urinary phthalates and altered anogenital distance (AGD), a marker of in utero androgen activity, among offspring. However, data assessing the impact of race on these associations is sparse. OBJECTIVES To evaluate associations between prenatal phthalate exposure and AGD in a racially diverse newborn population. METHODS We prospectively collected second trimester urine from 187 African American and 193 white mothers, and used liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) to measure eight phthalate metabolites and calculate molar sums. We measured anopenile (APD) and anoscrotal (ASD) distances of 171 boys and anoclitoral (ACD) and anofourchette (AFD) distances of 128 girls at delivery. We collected sociodemographic and clinical data from questionnaires and delivery records. RESULTS We identified a statistically significant inverse association for mono-2-ethylhexyl phthalate (MEHP) and APD in boys (B=-1.57mm, p=0.02), which was stronger for African Americans (B=-2.07mm, p=0.04) than for whites (B=-1.23mm, p=0.22), although the racial interaction was not statistically significant (p=0.56). We found a longer ASD for higher molar sums of dibutyl phthalate (∑DBP; B=0.99mm, p=0.04), with stronger associations for whites (B=1.30mm, p=0.04) than for African Americans (B=0.39mm, p=0.59), again without a statistically significant racial interaction (p=0.34). Among girls, we found inverse associations for tertiles of MEHP with AFD and ACD, and statistically significant race-based interactions, in which ACD was longer for whites and shorter for African Americans, following exposure to monoethyl phthalate (MEP; p=0.01) and ∑DBP (p=0.08). CONCLUSIONS Our findings suggest race and sex play important roles in phthalate-associated reproductive developmental toxicity, with important implications for designing future investigations and health interventions.
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Affiliation(s)
- Abby G Wenzel
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA; National Institute of Standards and Technology, Hollings Marine Laboratory, Charleston, SC, USA
| | - Michael S Bloom
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, USA.
| | - Celeste D Butts
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Rebecca J Wineland
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - John W Brock
- Department of Chemistry, University of North Carolina Asheville, Asheville, NC, USA
| | - Lori Cruze
- Department of Biology, Wofford College, Spartanburg, SC, USA
| | - Elizabeth R Unal
- Department of Obstetrics and Gynecology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - John R Kucklick
- National Institute of Standards and Technology, Hollings Marine Laboratory, Charleston, SC, USA
| | - Stephen E Somerville
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Roger B Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
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Dorman DC, Chiu W, Hales BF, Hauser R, Johnson KJ, Mantus E, Martel S, Robinson KA, Rooney AA, Rudel R, Sathyanarayana S, Schantz SL, Waters KM. Systematic reviews and meta-analyses of human and animal evidence of prenatal diethylhexyl phthalate exposure and changes in male anogenital distance. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2018; 21:207-226. [PMID: 30199328 PMCID: PMC6786271 DOI: 10.1080/10937404.2018.1505354] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Male reproductive alterations found in animals and humans following in utero phthalate exposure include decreased anogenital distance (AGD) and other reproductive-tract malformations. The aim of this investigation was to conduct systematic reviews of human and animal evidence of the effect of in utero exposure to diethylhexyl phthalate (DEHP) on anogenital distance (AGD) in males. PubMed, Embase, and Toxline were searched for relevant human and experimental animal studies on August 15, 2016. Search results were screened for relevance, and studies that met the inclusion criteria were evaluated for quality and data extracted for analysis. Confidence in the human and animal bodies of evidence was assessed and hazard conclusions reached by integrating evidence streams. The search yielded 6 relevant human studies and 19 animal studies. Meta-analysis of 5 human observational prospective cohort studies showed that increased maternal urinary concentrations of DEHP metabolites were associated with decreased AGD in boys (-4.07 [CI, -6.49 to -1.66] % decrease per log10 rise in DEHP metabolites). Meta-analysis and meta-regression of the 19 experimental animal studies found reduced AGD with DEHP treatment, with a dose-response gradient, and with heterogeneity explained by species and strain. There is a moderate level of evidence from human investigations and a high level of data from animal studies that in utero exposure to DEHP decreases AGD. Based upon the available human and animal evidence, and consideration of mechanistic data, DEHP is presumed to be a reproductive hazard to humans on the basis of effects on AGD.
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Affiliation(s)
- David C. Dorman
- Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Weihsueh Chiu
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, USA
| | - Barbara F. Hales
- Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Russ Hauser
- Department of Environmental Health and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kamin J. Johnson
- Predictive Safety Center, The Dow Chemical Company, Midland, MI, USA
| | - Ellen Mantus
- Board on Environmental Studies and Toxicology at the National Academies of Sciences, Engineering, and Medicine, Washington, DC, USA
| | - Susan Martel
- Board on Environmental Studies and Toxicology at the National Academies of Sciences, Engineering, and Medicine, Washington, DC, USA
| | - Karen A. Robinson
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Andrew A. Rooney
- Office of Health Assessment and Translation, Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | | | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Susan L. Schantz
- Department of Comparative Biosciences, College of Veterinary Medicine and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Katrina M. Waters
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
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Bornman MS, Chevrier J, Rauch S, Crause M, Obida M, Sathyanarayana S, Barr DB, Eskenazi B. Dichlorodiphenyltrichloroethane exposure and anogenital distance in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE) birth cohort study, South Africa. Andrology 2017; 4:608-15. [PMID: 27457477 DOI: 10.1111/andr.12235] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 12/16/2022]
Abstract
Dichlorodiphenyltrichloroethane (DDT) is used for malaria control by 10 countries, nine of which are in Africa. Technical DDT contains various isomers with 65-80% insecticidal p,p'-DDT and 15-21% o,p'-DDT, an estrogenic chemical, while the persistent metabolite of p,p'-DDT, dichlorodiphenyldichloroethylene (p,p'-DDE), is an antiandrogen. In utero antiandrogenic exposure reduces anogenital distance in animal models and the anal position index in a single study. This study examined the associations between mother's serum DDT and DDE levels at delivery and anogenital distance in their children at birth and age 1 year. Data were collected as part of the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), a birth cohort study located in rural South Africa. DDT and DDE concentrations were measured in blood samples collected from 752 mothers at delivery. Anogenital distance measurements, taken at birth (n = 671) and age 1 year (n = 674), included anofourchette and anoclitoral distances in girls, and anoscrotal and anopenile lengths in boys. We also measured anococcygeal and coccyx-fourchette distances in girls, while in boys, we measured anococcygeal and coccyx-scrotal distances as well as penile length and penile width. The anal position index is calculated for both sexes as anoscrotal/coccyx-scrotal in boys and anofourchette/coccyx-fourchette in girls. We found no associations between p,p'-DDT/-DDE or o,p'-DDT and anogenital distance measurements at birth in either boys or girls. At 1 year, o,p'-DDE was negatively associated with anofourchette in girls (β =-1.32 mm, 95% confidence interval (CI) = -2.27, -0.38) and positively associated with penile width in boys (β = 0.30 mm, 95% CI = 0.00, 0.60). The results do not suggest an overt antiandrogenic or estrogenic effect on anogenital distance after long-term DDT exposure. These weak associations may be due to chance.
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Affiliation(s)
- M S Bornman
- School of Health Systems and Public Health, University of Pretoria Centre for Sustainable Malaria Control (UP CSMC), University of Pretoria, Pretoria, South Africa
| | - J Chevrier
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - S Rauch
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - M Crause
- School of Health Systems and Public Health, University of Pretoria Centre for Sustainable Malaria Control (UP CSMC), University of Pretoria, Pretoria, South Africa
| | - M Obida
- School of Health Systems and Public Health, University of Pretoria Centre for Sustainable Malaria Control (UP CSMC), University of Pretoria, Pretoria, South Africa
| | - S Sathyanarayana
- Department of Pediatrics, Seattle Children's Research Institute, University of Washington, Seattle, WA, USA
| | - D B Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - B Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
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Huang CF, Wang IJ. Changes in Urinary Phthalate Metabolite Levels Before and After the Phthalate Contamination Event and Identification of Exposure Sources in a Cohort of Taiwanese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080935. [PMID: 28825610 PMCID: PMC5580637 DOI: 10.3390/ijerph14080935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 08/13/2017] [Accepted: 08/15/2017] [Indexed: 11/16/2022]
Abstract
In 2011, the Taiwan Food and Drug Administration inadvertently discovered that, for decades, manufacturers had replaced expensive natural emulsifiers in food products with diethylhexyl phthalate (DEHP). We wanted to compare urinary phthalate metabolite levels of children before and after the DEHP food contamination event and identify source(s) of phthalate exposure in addition to the illegal food additives. In the present study, morning urine samples were collected from a cohort of 453 children in 2010 in Taipei. After the DEHP food contamination event, there were 200 cohort children left at follow-up in 2013. The geometric means (GMs) of urinary mono(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP) levels before and after the event were 9.39 and 13.34 µg/g of creatinine, respectively, with no significant difference (p = 0.093). After the DEHP food contamination event, we found that urinary phthalate metabolite levels were significantly higher in people who frequently consumed microwave-heated food and used fragrance-containing products (p < 0.05). In addition, children who did not frequently wash hands before eating had significantly higher urinary phthalate metabolite levels than those who did (p < 0.05). These results demonstrate that urinary phthalate metabolite levels did not decrease after the DEHP food contamination event, thus, other sources must contribute to phthalate exposure in daily life. Public awareness of approaches to reducing phthalate exposure is necessary.
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Affiliation(s)
- Chian-Feng Huang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 10055, Taiwan.
- Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan 33058, Taiwan.
| | - I-Jen Wang
- Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taipei 11267, Taiwan.
- Institute of Environmental & Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei 100044, Taiwan.
- Department of Health Risk Management, China Medical University, Taichung 110001, Taiwan.
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de Mello Santos T, da Silveira LTR, Rinaldi JC, Scarano WR, Domeniconi RF. Alterations in prostate morphogenesis in male rat offspring after maternal exposure to Di- n -butyl-phthalate (DBP). Reprod Toxicol 2017; 69:254-264. [DOI: 10.1016/j.reprotox.2017.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 03/06/2017] [Accepted: 03/20/2017] [Indexed: 01/09/2023]
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Bui TT, Alves A, Palm-Cousins A, Voorspoels S, Covaci A, Cousins IT. Estimating uptake of phthalate ester metabolites into the human nail plate using pharmacokinetic modelling. ENVIRONMENT INTERNATIONAL 2017; 100:148-155. [PMID: 28089278 DOI: 10.1016/j.envint.2017.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/06/2017] [Accepted: 01/06/2017] [Indexed: 06/06/2023]
Abstract
There is a lack of knowledge regarding uptake of phthalate esters (PEs) and other chemicals into the human nail plate and thus, clarity concerning the suitability of human nails as a valid alternative matrix for monitoring long-term exposure. In particular, the relative importance of internal uptake of phthalate metabolites (from e.g. blood) compared to external uptake pathways is unknown. This study provides first insights into the partitioning of phthalate-metabolites between blood and nail using pharmacokinetic (PK) modelling and biomonitoring data from a Norwegian cohort. A previously published PK model (Lorber PK model) was used in combination with measured urine data to predict serum concentrations of DEHP and DnBP/DiBP metabolites at steady state. Then, partitioning between blood and nail was assessed assuming equilibrium conditions and treating the nail plate as a tissue, assuming a fixed lipid and water content. Although calculated as a worst-case scenario at equilibrium, the predicted nail concentrations of metabolites were lower than the biomonitoring data by factors of 44 to 1300 depending on the metabolite. It is therefore concluded that internal uptake of phthalate metabolites from blood into nail is a negligible pathway and does not explain the observed nail concentrations. Instead, external uptake pathways are more likely to dominate, possibly through deposition of phthalates onto the skin/nail and subsequent metabolism. Modelling gaseous diffusive uptake of PEs from air to nail revealed that this pathway is unlikely to be important. Experimental quantification of internal and external uptake pathways of phthalates and their metabolites into the human nail plate is needed to verify these modelling results. However, based on this model, human nails are not a good indicator of internal human exposure for the phthalate esters studied.
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Affiliation(s)
- Thuy T Bui
- IVL Swedish Environmental Research Institute, SE-100 31 Stockholm, Sweden; Department of Environmental Science and Analytical Chemistry (ACES), Stockholm University, SE-106 91 Stockholm, Sweden.
| | - Andreia Alves
- VITO NV Flemish Institute for Technological Research, Boeretang 200, 2400 Mol, Belgium; Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Universiteitplein 1, B-2610 Wilrijk, Belgium
| | - Anna Palm-Cousins
- IVL Swedish Environmental Research Institute, SE-100 31 Stockholm, Sweden
| | - Stefan Voorspoels
- VITO NV Flemish Institute for Technological Research, Boeretang 200, 2400 Mol, Belgium
| | - Adrian Covaci
- Toxicological Center, Department of Pharmaceutical Sciences, University of Antwerp, Universiteitplein 1, B-2610 Wilrijk, Belgium
| | - Ian T Cousins
- Department of Environmental Science and Analytical Chemistry (ACES), Stockholm University, SE-106 91 Stockholm, Sweden
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Li X, Nie X, Chen J, Wang Y. Preparation of epoxidized cardanol butyl ether as a novel renewable plasticizer and its application for poly(vinyl chloride). POLYM INT 2016. [DOI: 10.1002/pi.5280] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Xiaoying Li
- Institute of Chemical Industry of Forestry Products, CAF; Nanjing 210042 PR China
| | - Xiaoan Nie
- Institute of Chemical Industry of Forestry Products, CAF; Nanjing 210042 PR China
- Institute of New Technology of Forestry, CAF; Beijing 10091 PR China
| | - Jie Chen
- Institute of Chemical Industry of Forestry Products, CAF; Nanjing 210042 PR China
| | - Yigang Wang
- Institute of Chemical Industry of Forestry Products, CAF; Nanjing 210042 PR China
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Schooling CM, Houghton LC, Terry MB. Potential Intervention Targets in Utero and Early Life for Prevention of Hormone Related Cancers. Pediatrics 2016; 138:S22-S33. [PMID: 27940974 DOI: 10.1542/peds.2015-4268e] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 11/24/2022] Open
Abstract
Hormone-related cancers have long been thought to be sensitive to exposures during key periods of sexual development, as shown by the vulnerability to such cancers of women exposed to diethylstilbestrol in utero. In addition to evidence from human studies, animal studies using new techniques, such as gene knockout models, suggest that an increasing number of cancers may be hormonally related, including liver, lung, and bladder cancer. Greater understanding of sexual development has also revealed the "mini-puberty" of early infancy as a key period when some sex hormones reach levels similar to those at puberty. Factors driving sex hormones in utero and early infancy have not been systematically identified as potential targets of intervention for cancer prevention. On the basis of sex hormone pathways, we identify common potentially modifiable drivers of sex hormones, including but not limited to factors such as obesity, alcohol, and possibly nitric oxide. We review the evidence for effects of modifiable drivers of sex hormones during the prenatal period and early infancy, including measured hormones as well as proxies, such as the second-to-fourth digit length ratio. We summarize the gaps in the evidence needed to identify new potential targets of early life intervention for lifelong cancer prevention.
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Affiliation(s)
- C Mary Schooling
- CUNY School of Public Health and Hunter College, New York, New York; .,School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China; and
| | - Lauren C Houghton
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Sheikh IA, Abu-Elmagd M, Turki RF, Damanhouri GA, Beg MA, Al-Qahtani M. Endocrine disruption: In silico perspectives of interactions of di-(2-ethylhexyl)phthalate and its five major metabolites with progesterone receptor. BMC STRUCTURAL BIOLOGY 2016; 16:16. [PMID: 27719669 PMCID: PMC5056466 DOI: 10.1186/s12900-016-0066-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Di-(2-ethylhexyl)phthalate (DEHP) is a common endocrine disrupting compound (EDC) present in the environment as a result of industrial activity and leaching from polyvinyl products. DEHP is used as a plasticizer in medical devices and many commercial and household items. Exposure occurs through inhalation, ingestion, and skin contact. DEHP is metabolized to a primary metabolite mono-(2-ethylhexyl)phthalate (MEHP) in the body, which is further metabolized to four major secondary metabolites, mono(2-ethyl-5-hydroxyhexyl)phthalate (5-OH-MEHP), mono(2-ethyl-5-oxyhexyl)phthalate (5-oxo-MEHP), mono(2-ethyl-5-carboxypentyl)phthalate (5-cx-MEPP) and mono[2-(carboxymethyl)hexyl]phthalate (2-cx-MMHP). DEHP and its metabolites are associated with developmental abnormalities and reproductive dysfunction within the human population. Progesterone receptor (PR) signaling is involved in important reproductive functions and is a potential target for endocrine disrupting activities of DEHP and its metabolites. This study used in silico approaches for structural binding analyses of DEHP and its five indicated major metabolites with PR. Methods Protein Data bank was searched to retrieve the crystal structure of human PR (Id: 1SQN). PubChem database was used to obtain the structures of DEHP and its five metabolites. Docking was performed using Glide (Schrodinger) Induced Fit Docking module. Results DEHP and its metabolites interacted with 19-25 residues of PR with the majority of the interacting residues overlapping (82-95 % commonality) with the native bound ligand norethindrone (NET). DEHP and each of its five metabolites formed a hydrogen bonding interaction with residue Gln-725 of PR. The binding affinity was highest for NET followed by DEHP, 5-OH-MEHP, 5-oxo-MEHP, MEHP, 5-cx-MEPP, and 2-cx-MMHP. Conclusion The high binding affinity of DEHP and its five major metabolites with PR as well as a high rate of overlap between PR interacting residues among DEHP and its metabolites and the native ligand, NET, suggested their disrupting potential in normal PR signaling, resulting in adverse reproductive effects.
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Affiliation(s)
- Ishfaq A Sheikh
- King Fahd Medical Research Center, King Abdulaziz University, PO Box 80216, Jeddah, 21589, Kingdom of Saudi Arabia
| | - Muhammad Abu-Elmagd
- Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Rola F Turki
- KACST Innovation Center in Personalized Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Ghazi A Damanhouri
- King Fahd Medical Research Center, King Abdulaziz University, PO Box 80216, Jeddah, 21589, Kingdom of Saudi Arabia
| | - Mohd A Beg
- King Fahd Medical Research Center, King Abdulaziz University, PO Box 80216, Jeddah, 21589, Kingdom of Saudi Arabia.
| | - Mohammed Al-Qahtani
- Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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Lassen TH, Frederiksen H, Kyhl HB, Swan SH, Main KM, Andersson AM, Lind DV, Husby S, Wohlfahrt-Veje C, Skakkebæk NE, Jensen TK. Prenatal Triclosan Exposure and Anthropometric Measures Including Anogenital Distance in Danish Infants. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1261-8. [PMID: 26908126 PMCID: PMC4977040 DOI: 10.1289/ehp.1409637] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 09/24/2015] [Accepted: 02/12/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Triclosan (TCS) is widely used as an antibacterial agent in consumer products such as hand soap and toothpaste, and human exposure is widespread. TCS is suspected of having endocrine-disrupting properties, but few human studies have examined the developmental effects of prenatal TCS exposure. OBJECTIVES We prospectively examined associations between prenatal TCS exposure and anthropometric measures at birth and anogenital distance (AGD) at 3 months of age. METHODS Pregnant women from the Odense Child Cohort (n = 514) provided urine samples at approximately gestational week 28 (median 28.7 weeks, range 26.4-34.0), and urinary TCS concentration was measured by isotope dilution TurboFlow-liquid chromatography-tandem mass spectrometry. Multiple linear regression analysis was used to examine associations between prenatal TCS exposure and measures of size at birth (birth weight, length, head and abdominal circumference) and AGD at 3 months of age (median 3.3 months, range 2.3-6.7 months), controlling for potential confounders. RESULTS Newborn boys in the highest quartile of prenatal TCS exposure had a 0.7-cm [95% confidence interval (CI): -1.2, -0.1, p = 0.01] smaller head circumference than boys in the lowest quartile. Additionally in boys, inverse associations of borderline statistical significance were observed between prenatal TCS exposure and abdominal circumference at birth and AGD at 3 months of age (p-values < 0.10). Prenatal TCS exposure was not significantly associated with any of the outcomes in girls. However, AGD was measured in fewer girls, and we observed no significant interactions between a child's sex and prenatal TCS exposure in anthropometric measures at birth. CONCLUSION Prenatal TCS exposure was associated with reduced head and abdominal circumference at birth and with reduced AGD at 3 months of age in boys, although the last two findings were statistically nonsignificant. These findings require replication but are compatible with an anti-androgenic effect of prenatal TCS exposure on fetal growth in boys. CITATION Lassen TH, Frederiksen H, Kyhl HB, Swan SH, Main KM, Andersson AM, Lind DV, Husby S, Wohlfahrt-Veje C, Skakkebæk NE, Jensen TK. 2016. Prenatal triclosan exposure and anthropometric measures including anogenital distance in Danish infants. Environ Health Perspect 124:1261-1268; http://dx.doi.org/10.1289/ehp.1409637.
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Affiliation(s)
- Tina Harmer Lassen
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henriette Boye Kyhl
- Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
- Odense Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Shanna H. Swan
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Katharina M. Main
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dorte Vesterholm Lind
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Steffen Husby
- Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark
| | - Christine Wohlfahrt-Veje
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Niels E. Skakkebæk
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tina Kold Jensen
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Address correspondence to T.K. Jensen, Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Winsløwsparken 17, 5000 Odense, Denmark. Telephone: 4565503077. E-mail:
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Outcome reporting bias in observational epidemiology studies on phthalates. Ann Epidemiol 2016; 26:597-599.e4. [DOI: 10.1016/j.annepidem.2016.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/28/2016] [Accepted: 07/01/2016] [Indexed: 12/19/2022]
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Abstract
Exposure to environmental chemicals has adverse effects on the health and survival of humans. Emerging evidence supports the idea that exposure to endocrine-disrupting compounds (EDCs) can perturb an individual’s physiological set point and as a result increase his/her propensity toward several diseases. The purpose of this review is to provide an update on di-(2-ethylhexyl) phthalate, the primary plasticizer found in plastic medical devices used in neonatal intensive care units, its effects on the fetus and newborn, epidemiological studies, pharmacokinetics, toxicity and epigenetic implications. We searched the PubMed databases to identify relevant studies. Phthalates are known EDCs that primarily are used to improve the flexibility of polyvinyl chloride plastic products and are called plasticizers in lay terms. Neonates and infants are particularly vulnerable to the effects of phthalates, beginning with maternal exposure and placental transfer during gestation and during infancy following birth. In line with the developmental origins of adult disease, a focus on the effects of environmental chemicals in utero or early childhood on the genesis of adult diseases through epigenome modulation is timely and important. The epigenetic effects of phthalates have not been fully elucidated, but accumulating evidence suggests that they may be associated with adverse health effects, some of which may be heritable. Phthalate exposure during pregnancy and the perinatal period is particularly worrisome in health-care settings. Although the clinical significance of phthalate exposure has been difficult to assess with epidemiologic studies, the evidence that physiological changes occur due to exposure to phthalates is growing and points toward the need for more investigation at a molecular, specifically epigenetic level.
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63
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Jensen TK, Frederiksen H, Kyhl HB, Lassen TH, Swan SH, Bornehag CG, Skakkebaek NE, Main KM, Lind DV, Husby S, Andersson AM. Prenatal Exposure to Phthalates and Anogenital Distance in Male Infants from a Low-Exposed Danish Cohort (2010-2012). ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1107-13. [PMID: 26672060 PMCID: PMC4937858 DOI: 10.1289/ehp.1509870] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 11/30/2015] [Indexed: 05/02/2023]
Abstract
BACKGROUND Phthalates comprise a large class of chemicals used in a variety of consumer products. Several have anti-androgenic properties, and in rodents prenatal exposure has been associated with reduced anogenital distance (AGD)-the distance from the anus to the genitals in male offspring. Few human studies have been conducted, but associations between the anti-androgenic phthalates and male AGD have been reported. OBJECTIVE We aimed to study the association between phthalate exposure in late pregnancy in Danish women pregnant in 2010-2012 and AGD in their male infants at 3 months of age (n = 273). METHODS In the Odense child cohort study, urinary concentrations of 12 phthalate metabolites of diethyl, di-n-butyl, diisobutyl, di(2-ethylhexyl), butylbenzyl, and diisononyl phthalate (DEP, DnBP, DiBP, DEHP, BBzP, and DiNP, respectively) were measured among 245 mothers of boys at approximately gestational week 28 (range, 20.4-30.4) and adjusted for osmolality. AGD, penile width, and weight were measured 3 months after the expected date of birth. Associations between prenatal phthalate and AGD and penile width were estimated using multivariable linear regression adjusting for age and weight-for-age standard deviation score. RESULTS Phthalate levels were lower in this population than in a recent Swedish study in which phthalates were measured in the first trimester. No consistent associations were seen between any prenatal phthalate and AGD or penile width. Most associations were negative for exposures above the first quartile, and for ln-transformed exposures modeled as continuous variables, but there were no consistent dose-response patterns, and associations were not statistically significant (p > 0.05). CONCLUSION We found no significant trends towards shorter AGD in boys with higher phthalates exposures in this low exposed Danish population. CITATION Jensen TK, Frederiksen H, Kyhl HB, Lassen TH, Swan SH, Bornehag CG, Skakkebaek NE, Main KM, Lind DV, Husby S, Andersson AM. 2016. Prenatal exposure to phthalates and anogenital distance in male infants from a low-exposed Danish cohort (2010-2012). Environ Health Perspect 124:1107-1113; http://dx.doi.org/10.1289/ehp.1509870.
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Affiliation(s)
- Tina Kold Jensen
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Odense University Hospital, Hans Christian Andersen Children’s Hospital, Odense, Denmark
- Address correspondence to T.K. Jensen, Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Winsløwsparken 17, 5000 Odense, Denmark. Telephone: 4565503077. E-mail:
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henriette Boye Kyhl
- Odense University Hospital, Hans Christian Andersen Children’s Hospital, Odense, Denmark
| | - Tina Harmer Lassen
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Shanna H. Swan
- Department of Preventive Medicine, Mount Sinai School of Medicine, New York, New York, USA
| | | | - Niels E. Skakkebaek
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katharina M. Main
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dorte Vesterholm Lind
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Steffen Husby
- Odense University Hospital, Hans Christian Andersen Children’s Hospital, Odense, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Mendiola J, Oñate-Celdrán J, Samper-Mateo P, Arense-Gonzalo JJ, Torres-Roca M, Sánchez-Rodríguez C, García-Escudero D, Fontana-Compiano LO, Eisenberg ML, Swan SH, Torres-Cantero AM. Comparability and reproducibility of adult male anogenital distance measurements for two different methods. Andrology 2016; 4:626-31. [DOI: 10.1111/andr.12202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 03/20/2016] [Accepted: 03/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- J. Mendiola
- Division of Preventive Medicine and Public Health; Department of Health and Social Sciences; University of Murcia School of Medicine; Murcia (Murcia) Spain
| | - J. Oñate-Celdrán
- Department of Urology; ‘Reina Sofia’ University General Hospital; Murcia (Murcia) Spain
| | - P. Samper-Mateo
- Department of Urology; ‘Reina Sofia’ University General Hospital; Murcia (Murcia) Spain
| | - J. J. Arense-Gonzalo
- Division of Preventive Medicine and Public Health; Department of Health and Social Sciences; University of Murcia School of Medicine; Murcia (Murcia) Spain
| | - M. Torres-Roca
- Department of Urology; ‘Reina Sofia’ University General Hospital; Murcia (Murcia) Spain
| | - C. Sánchez-Rodríguez
- Department of Urology; ‘Reina Sofia’ University General Hospital; Murcia (Murcia) Spain
| | - D. García-Escudero
- Department of Urology; ‘Reina Sofia’ University General Hospital; Murcia (Murcia) Spain
| | | | - M. L. Eisenberg
- Department of Urology and Obstetrics/Gynecology; Stanford University School of Medicine; Stanford CA USA
| | - S. H. Swan
- Department of Preventive Medicine; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - A. M. Torres-Cantero
- Division of Preventive Medicine and Public Health; Department of Health and Social Sciences; University of Murcia School of Medicine; Murcia (Murcia) Spain
- Department of Preventive Medicine; ‘Reina Sofia’ University General Hospital; Murcia (Murcia) Spain
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65
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Arbuckle TE, Fisher M, MacPherson S, Lang C, Provencher G, LeBlanc A, Hauser R, Feeley M, Ayotte P, Neisa A, Ramsay T, Tawagi G. Maternal and early life exposure to phthalates: The Plastics and Personal-care Products use in Pregnancy (P4) study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 551-552:344-56. [PMID: 26878646 DOI: 10.1016/j.scitotenv.2016.02.022] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 01/15/2016] [Accepted: 02/03/2016] [Indexed: 05/24/2023]
Abstract
Phthalates are a group of chemicals found in a number of consumer products; some of these phthalates have been shown to possess estrogenic activity and display anti-androgenic effects. While a number of biomonitoring studies of phthalates in pregnant women and infants have been published, there is a paucity of data based on both multiple sampling periods and in different matrices. Phthalate metabolites were measured in 80 pregnant women and their infants in Ottawa Canada (2009-2010) in urine, meconium and breast milk collected at various time periods pre- and post-parturition. At least 50% of the women had at least one urine sample greater than the limit of detection (LOD) for the various phthalate metabolites, with the exception of mono-n-octyl phthalate (MnOP), mono-isononyl phthalate (MiNP) and mono(carboxy-isooctyl) phthalate (MCiOP). Four major clusters of maternal urinary metabolites were identified. Among infants (n=61), the following metabolites were rarely (< 10%) detected: mono-cyclohexyl phthalate (MCHP), mono-isononyl phthalate (MiNP), mono-methyl phthalate (MMP), and mono-n-octyl phthalate (MnOP). While mono-benzyl phthalate (MBzP), mono-3-carboxypropyl phthalate (MCPP), MEHHP, and MEOHP were frequently detected in maternal urines at any time point, these metabolites were rarely detected in breast milk. Maternal urinary concentrations of MEP and the DEHP metabolites were higher in samples collected during pregnancy than postnatally. No statistically significant differences were observed in infant's urinary phthalate concentrations between breast-fed and bottle-fed infants. Significant correlations were observed between maternal urinary MEHHP (r=0.35), MEOHP (r=0.35) and MEP (r=0.37) collected at <20weeks gestation with levels in meconium and between MBzP (r=0.78) and MEP (r=0.56) in maternal and infant urine collected 2-3months after birth. These results suggest at least some maternal-fetal-infant transfer of phthalates and that meconium may be a useful matrix for measuring in utero exposure to phthalates.
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Affiliation(s)
- Tye E Arbuckle
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada.
| | - Mandy Fisher
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Susan MacPherson
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Carly Lang
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Gilles Provencher
- Centre de toxicologie du Québec (CTQ), Institut national de santé publique du Québec (INSPQ), Québec, QC, Canada
| | - Alain LeBlanc
- Centre de toxicologie du Québec (CTQ), Institut national de santé publique du Québec (INSPQ), Québec, QC, Canada
| | - Russ Hauser
- Department of Environmental Health and Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Mark Feeley
- Bureau of Chemical Safety, Health Products and Food Branch, Health Canada, Ottawa, ON, Canada
| | - Pierre Ayotte
- Centre de toxicologie du Québec (CTQ), Institut national de santé publique du Québec (INSPQ), Québec, QC, Canada; Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU Québec, Québec, QC, Canada
| | - Angelica Neisa
- Population Studies Division, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Tim Ramsay
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
| | - George Tawagi
- Department of Obstetrics and Perinatal Medicine, The Ottawa Hospital, Ottawa, ON, Canada
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Pham N, Iyer S, Hackett E, Lock BH, Sandy M, Zeise L, Solomon G, Marty M. Using ToxCast to Explore Chemical Activities and Hazard Traits: A Case Study WithOrtho-Phthalates. Toxicol Sci 2016; 151:286-301. [DOI: 10.1093/toxsci/kfw049] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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67
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Bui TT, Giovanoulis G, Cousins AP, Magnér J, Cousins IT, de Wit CA. Human exposure, hazard and risk of alternative plasticizers to phthalate esters. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 541:451-467. [PMID: 26410720 DOI: 10.1016/j.scitotenv.2015.09.036] [Citation(s) in RCA: 241] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/07/2015] [Accepted: 09/07/2015] [Indexed: 05/22/2023]
Abstract
Alternative plasticizers to phthalate esters have been used for over a decade, but data regarding emissions, human exposure and health effects are limited. Here we review 20 alternative plasticizers in current use and their human exposure, hazard and risk. Physicochemical properties are collated for these diverse alternatives and log KOW values range over 15 orders of magnitude and log KAW and log KOA values over about 9 orders of magnitude. Most substances are hydrophobic with low volatility and are produced in high volumes for use in multiple applications. There is an increasing trend in the total use of alternative plasticizers in Sweden compared to common phthalate esters in the last 10 years, especially for DINCH. Evaluative indoor fate modeling reveals that most alternatives are distributed to vertical surfaces (e.g. walls or ceilings). Only TXIB and GTA are predicted to be predominantly distributed to indoor air. Human exposure data are lacking and clear evidence for human exposure only exists for DEHT and DINCH, which show increasing trends in body burdens. Human intake rates are collected and compared with limit values with resulting risk ratios below 1 except for infant's exposure to ESBO. PBT properties of the alternatives indicate mostly no reasons for concern, except that TEHPA is estimated to be persistent and TCP toxic. A caveat is that non-standard toxicological endpoint results are not available and, similar to phthalate esters, the alternatives are likely "pseudo-persistent". Key data gaps for more comprehensive risk assessment are identified and include: analytical methods to measure metabolites in biological fluids and tissues, toxicological information regarding non-standard endpoints such as endocrine disruption and a further refined exposure assessment in order to consider high risk groups such as infants, toddlers and children.
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Affiliation(s)
- Thuy T Bui
- IVL Swedish Environmental Research Institute, SE-100 31 Stockholm, Sweden; Department of Environmental Science and Analytical Chemistry (ACES), Stockholm University, SE-106 91 Stockholm, Sweden.
| | - Georgios Giovanoulis
- IVL Swedish Environmental Research Institute, SE-100 31 Stockholm, Sweden; Department of Environmental Science and Analytical Chemistry (ACES), Stockholm University, SE-106 91 Stockholm, Sweden
| | - Anna Palm Cousins
- IVL Swedish Environmental Research Institute, SE-100 31 Stockholm, Sweden
| | - Jörgen Magnér
- IVL Swedish Environmental Research Institute, SE-100 31 Stockholm, Sweden
| | - Ian T Cousins
- Department of Environmental Science and Analytical Chemistry (ACES), Stockholm University, SE-106 91 Stockholm, Sweden
| | - Cynthia A de Wit
- Department of Environmental Science and Analytical Chemistry (ACES), Stockholm University, SE-106 91 Stockholm, Sweden
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68
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Harris S, Wegner S, Hong SW, Faustman EM. Phthalate metabolism and kinetics in an in vitro model of testis development. Toxicol In Vitro 2015; 32:123-31. [PMID: 26689326 DOI: 10.1016/j.tiv.2015.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/19/2015] [Accepted: 12/07/2015] [Indexed: 01/08/2023]
Abstract
We have developed an in vitro model of testis development (3D-TCS) using rat testicular cells overlaid with extracellular matrix. One barrier preventing utilization of in vitro models in toxicity testing is the absence of metabolic capability. Another challenge is lack of kinetic data for compounds in vitro. We characterized metabolic capabilities and investigated the kinetics of phthalate male reproductive toxicants in the 3D-TCS. Cells were treated with three phthalate diesters for 2, 8 and 24 h. Parent compounds and metabolites were measured in cell culture media and cell lysate via mass spectrometry. Levels of monoester metabolites were used as an indication of metabolism of phthalates via lipase activity. Metabolites were detected in all treated cell media and cell lysate samples, with levels ranging from <0.5-14.7% of initial mass of parent compound. Phthalates partitioned between media and lysate in a manner consistent with each compound's degree of lipophilicity. UDGPT activity was detected in DBP and DEP treated samples. 3D-TCS microarray data indicated gene expression for lipases and CYPP450s. Results indicate that the 3D-TCS is a metabolically active co-culture and that physiochemical properties can provide information about the kinetics of compounds in the 3D-TCS, improving our ability to interpret results from the model.
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Affiliation(s)
- Sean Harris
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Susanna Wegner
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Sung Woo Hong
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States; Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA 98105, United States
| | - Elaine M Faustman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States; Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, WA 98105, United States.
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69
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Marie C, Vendittelli F, Sauvant-Rochat MP. Obstetrical outcomes and biomarkers to assess exposure to phthalates: A review. ENVIRONMENT INTERNATIONAL 2015; 83:116-36. [PMID: 26118330 DOI: 10.1016/j.envint.2015.06.003] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 06/01/2015] [Accepted: 06/02/2015] [Indexed: 05/23/2023]
Abstract
Studies of the effects on pregnancy outcomes of in utero exposure to phthalates, contaminants that are widely present in the environment, have yielded conflicting results. In addition, the mode of assessment of exposure varies between studies. The aim of this review was therefore to establish a current state of knowledge of the phthalates and metabolites involved in unfavorable pregnancy outcomes. Extant data were analyzed to determine which biomarker is the best suited to assess the relation between in utero exposure to phthalates and pregnancy outcomes. This review of the literature was conducted using the database of PubMed. A search was made of studies investigating exposure to phthalates and the following birth outcomes: preterm birth (gestational age <37 weeks), change in gestational age, change in body size at birth (birth weight, length, head circumference), anti-androgenic function, decreased anogenital distance, cryptorchidism, hypospadias and congenital malformation. The methodological approach adopted in each study was examined, in particular the methods used for exposure assessment (biomarkers and/or questionnaire). Thirty-five studies were included. Premature birth and decreased anogenital distance were the most commonly reported outcomes resulting from a moderate level of exposure to phthalates. The principal metabolites detected and involved were primary metabolites of di-2(ethylhexyl)-phthalate (DEHP) and di-n-butyl-phthalate (DnBP). No clear conclusion could be drawn with regard to gestational age at birth, body size at birth and congenital malformations. In epidemiological studies, maternal urine is the most suitable matrix to assess the association between in utero exposure to phthalates and pregnancy outcomes: in contrast to other matrices (cord blood, amniotic fluid, meconium and milk), sampling is easy, non-invasive and, can be repeated to assess exposure throughout pregnancy. Oxidative metabolites are the most relevant biomarkers since they are not prone to external contamination. Further epidemiological studies are required during pregnancy to i) determine the role of phthalates other than DEHP [currently replaced by various substitution products, in particular diisononyl-phthalate (DiNP)]; ii) establish the effect of phthalates on other outcomes (body size adjusted for gestational age, and congenital malformations); iii) determine the pathophysiological pathways; and iv) identify the most suitable time for biomarker determination of in utero exposure to phthalates.
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Affiliation(s)
- Cécile Marie
- Centre Hospitalier Universitaire de Clermont-Ferrand, 58 Rue Montalembert, 63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), 28 place Henri-Dunant BP 38, 63001 Clermont-Ferrand, France.
| | - Françoise Vendittelli
- Centre Hospitalier Universitaire de Clermont-Ferrand, 58 Rue Montalembert, 63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), 28 place Henri-Dunant BP 38, 63001 Clermont-Ferrand, France; AUDIPOG (Association des Utilisateurs de Dossiers informatisés en Pédiatrie, Obstétrique et Gynécologie) RTH Laennec Medical University, 7 rue Guillaume Paradin, 69372 Lyon Cedex 08, France
| | - Marie-Pierre Sauvant-Rochat
- Clermont Université, Université d'Auvergne, EA 4681, PEPRADE (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), 28 place Henri-Dunant BP 38, 63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Faculté de Pharmacie, Département Santé Publique et Environnement, 28 place Henri-Dunant BP 38, 63001 Clermont-Ferrand, France
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70
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Abstract
Prenatal stress is known to alter hypothalamic-pituitary-adrenal axis activity, and more recent evidence suggests that it may also affect androgen activity. In animal models, prenatal stress disrupts the normal surge of testosterone in the developing male, whereas in females, associations differ by species. In humans, studies show that (1) associations between prenatal stress and child outcomes are often sex-dependent, (2) prenatal stress predicts several disorders with notable sex differences in prevalence, and (3) prenatal exposure to stressful life events may be associated with masculinized reproductive tract development and play behavior in girls. In this minireview, we examine the existing literature on prenatal stress and androgenic activity and present new, preliminary data indicating that prenatal stress may also modify associations between prenatal exposure to diethylhexyl phthalate, (a synthetic, antiandrogenic chemical) and reproductive development in infant boys. Taken together, these data support the hypothesis that prenatal exposure to both chemical and nonchemical stressors may alter sex steroid pathways in the maternal-placental-fetal unit and ultimately alter hormone-dependent developmental endpoints.
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Affiliation(s)
- Emily S Barrett
- Department of Obstetrics and Gynecology (E.S.B.), University of Rochester School of Medicine and Dentistry, Rochester, New York 14642; and Department of Preventive Medicine (S.H.S.), Icahn School of Medicine at Mt Sinai, New York, New York 10029
| | - Shanna H Swan
- Department of Obstetrics and Gynecology (E.S.B.), University of Rochester School of Medicine and Dentistry, Rochester, New York 14642; and Department of Preventive Medicine (S.H.S.), Icahn School of Medicine at Mt Sinai, New York, New York 10029
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Mendiola J, Melgarejo M, Moñino-García M, Cutillas-Tolín A, Noguera-Velasco JA, Torres-Cantero AM. Is anogenital distance associated with semen quality in male partners of subfertile couples? Andrology 2015; 3:672-6. [DOI: 10.1111/andr.12059] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/03/2015] [Accepted: 05/05/2015] [Indexed: 11/29/2022]
Affiliation(s)
- J. Mendiola
- Division of Preventive Medicine and Public Health; Department of Health and Social Sciences; University of Murcia School of Medicine; IMIB-Arrixaca.; Espinardo (Murcia) Spain
| | - M. Melgarejo
- Division of Preventive Medicine and Public Health; Department of Health and Social Sciences; University of Murcia School of Medicine; IMIB-Arrixaca.; Espinardo (Murcia) Spain
- Department of Laboratory Medicine; “Virgen de la Arrixaca” University Hospital; El Palmar (Murcia) Spain
| | - M. Moñino-García
- Division of Preventive Medicine and Public Health; Department of Health and Social Sciences; University of Murcia School of Medicine; IMIB-Arrixaca.; Espinardo (Murcia) Spain
| | - A. Cutillas-Tolín
- Division of Preventive Medicine and Public Health; Department of Health and Social Sciences; University of Murcia School of Medicine; IMIB-Arrixaca.; Espinardo (Murcia) Spain
| | - J. A. Noguera-Velasco
- Department of Laboratory Medicine; “Virgen de la Arrixaca” University Hospital; El Palmar (Murcia) Spain
| | - A. M. Torres-Cantero
- Division of Preventive Medicine and Public Health; Department of Health and Social Sciences; University of Murcia School of Medicine; IMIB-Arrixaca.; Espinardo (Murcia) Spain
- Department of Preventive Medicine; “Reina Sofia” University General Hospital; Murcia (Murcia) Spain
- Regional Campus of International Excellence ‘Campus Mare Nostrum’; University of Murcia; Murcia (Murcia) Spain
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72
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Axelsson J, Rylander L, Rignell-Hydbom A, Lindh CH, Jönsson BAG, Giwercman A. Prenatal phthalate exposure and reproductive function in young men. ENVIRONMENTAL RESEARCH 2015; 138:264-70. [PMID: 25743932 DOI: 10.1016/j.envres.2015.02.024] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/20/2015] [Accepted: 02/21/2015] [Indexed: 05/21/2023]
Abstract
BACKGROUND Prenatal exposure to phthalates is suggested to negatively impact male reproductive function, but human data are lacking. OBJECTIVES To study associations between prenatal exposure to diethylhexyl phthalate (DEHP) and diisononyl phthalate (DiNP), and reproductive parameters of adolescent men. METHODS Using linear regression models adjusted for potential confounders, we studied associations between levels of DEHP- and DiNP metabolites in maternal sera from mean 12 weeks of pregnancy, and testicular size, semen quality and reproductive hormones in 112 adolescent sons, recruited from the general population. RESULTS Men in the highest exposure tertile of one DiNP metabolite [mono-(carboxy-iso-octyl) phthalate], compared with men in the lowest tertile had: 4.3mL (95% CI: 0.89, 7.6mL; p<0.001) lower total testicular volume; 30% (95% CI: 3.6, 63%; p=0.02) higher levels of follicle-stimulating hormone; and 0.87mL (95% CI: 0.28, 1.5mL; p=0.004) lower semen volume. Men in the highest exposure tertile of one DEHP metabolite [mono-(2-ethyl-5-hydroxylhexyl) phthalate] had 0.70mL (95% CI: 0.090, 1.3mL; p=0.03) lower semen volume than men in the lowest exposure tertile. The levels of two DiNP metabolites [mono-(hydroxy-iso-nonyl) phthalate and mono-(oxo-iso-nonyl) phthalate] were linearly associated with luteinizing hormone (p<0.01). CONCLUSION Prenatal levels of some metabolites of DEHP and DiNP seemed negatively associated with reproductive function of adolescent men.
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Affiliation(s)
- Jonatan Axelsson
- Molecular Reproductive Medicine, Skåne University Hospital Malmö, Lund University, 205 02 Malmö, Sweden.
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, 221 85 Lund, Sweden
| | - Anna Rignell-Hydbom
- Division of Occupational and Environmental Medicine, Lund University, 221 85 Lund, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, 221 85 Lund, Sweden
| | - Bo A G Jönsson
- Division of Occupational and Environmental Medicine, Lund University, 221 85 Lund, Sweden
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Skåne University Hospital Malmö, Lund University, 205 02 Malmö, Sweden
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73
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Swan SH, Sathyanarayana S, Barrett ES, Janssen S, Liu F, Nguyen RHN, Redmon JB. First trimester phthalate exposure and anogenital distance in newborns. Hum Reprod 2015; 30:963-72. [PMID: 25697839 DOI: 10.1093/humrep/deu363] [Citation(s) in RCA: 262] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is first trimester phthalate exposure associated with anogenital distance (AGD), a biomarker of prenatal androgen exposure, in newborns? SUMMARY ANSWER Concentrations of diethylhexyl phthalate (DEHP) metabolites in first trimester maternal urine samples are inversely associated with AGD in male, but not female, newborns. WHAT IS KNOWN ALREADY AGD is a sexually dimorphic measure reflecting prenatal androgen exposure. Prenatal phthalate exposure has been associated with shorter male AGD in multiple animal studies. Prior human studies, which have been limited by small sample size and imprecise timing of exposure and/or outcome, have reported conflicting results. STUDY DESIGN, SIZE, DURATION The Infant Development and the Environment Study (TIDES) is a prospective cohort study of pregnant women recruited in prenatal clinics in San Francisco, CA, Minneapolis, MN, Rochester, NY and Seattle, WA in 2010-2012. Participants delivered 787 infants; 753 with complete data are included in this analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS Any woman over 18 years old who was able to read and write English (or Spanish in CA), who was <13 weeks pregnant, whose pregnancy was not medically threatened and who planned to deliver in a study hospital was eligible to participate. Analyses include all infants whose mothers provided a first trimester urine sample and who were examined at or shortly after birth. Specific gravity (SpG) adjusted concentrations of phthalate metabolites in first trimester urine samples were examined in relation to genital measurements. In boys (N = 366), we obtained two measures of anogenital distance (AGD) (anoscrotal distance, or AGDAS and anopenile distance, AGDAP) as well as penile width (PW). In girls (N = 373), we measured anofourchette distance (AGDAF) and anoclitoral distance (AGDAC). We used multivariable regression models that adjusted for the infant's age at exam, gestational age, weight-for-length Z-score, time of day of urine collection, maternal age and study center. MAIN RESULTS AND THE ROLE OF CHANCE Three metabolites of DEHP were significantly and inversely associated with both measures of boys' AGD. Associations (β, 95% confidence interval (CI)) between AGDAS and (log10) SpG-adjusted phthalate concentrations were: -1.12 (-2.16, -0.07) for mono-2-ethylhexyl phthalate (MEHP), -1.43, (-2.49, -0.38) for mono-2-ethyl-5-oxohexyl phthalate (MEOHP), and -1.28 (-2.29, -0.27) for mono-2-ethyl-5-hydroxyhexyl (MEHHP). Associations were of similar magnitude for AGDAP. Associations were weaker and not statistically significant for PW. No other phthalate metabolites were associated with any genital measurement in boys. No phthalate metabolites were associated with either AGD measure in girls. LIMITATIONS, REASONS FOR CAUTION Exposure assessment was based on a single first trimester urine sample, which may have introduced exposure misclassification. In addition, significant between-center differences suggest that this measurement is difficult to standardize. WIDER IMPLICATIONS OF THE FINDINGS Our findings are consistent with multiple rodent studies and most human studies which were far smaller. The data we report here suggest that even at current low levels, environmental exposure to DEHP can adversely affect male genital development resulting in reproductive tract changes that may impact reproductive health later in life. These findings have important implications for public policy since most pregnant women are exposed to this ubiquitous chemical. STUDY FUNDING/COMPETING INTERESTS Funding for TIDES was provided by the following grants from the National Institute of Environmental Health Sciences: R01ES016863-04 and R01 ES016863-02S4. The authors report no conflict of interest.
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Affiliation(s)
- S H Swan
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle, WA, USA Seattle Children's Research Institute, Seattle, WA, USA
| | - E S Barrett
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - S Janssen
- Department of Occupational Medicine, University of California San Francisco, San Francisco, CA, USA
| | - F Liu
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R H N Nguyen
- Department of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
| | - J B Redmon
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
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Parra MD, Mendiola J, Jørgensen N, Swan SH, Torres-Cantero AM. Anogenital distance and reproductive parameters in young men. Andrologia 2015; 48:3-10. [DOI: 10.1111/and.12403] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 12/25/2022] Open
Affiliation(s)
- M. D. Parra
- Department of Health and Social Sciences; Division of Preventive Medicine and Public Health; University of Murcia School of Medicine; Murcia Spain
| | - J. Mendiola
- Department of Health and Social Sciences; Division of Preventive Medicine and Public Health; University of Murcia School of Medicine; Murcia Spain
| | - N. Jørgensen
- University Department of Growth and Reproduction; University of Copenhagen; Rigshospitalet; Copenhagen Denmark
| | - S. H. Swan
- Department of Preventive Medicine; Icahn School of Medicine at Mount Sinai; New York New York USA
| | - A. M. Torres-Cantero
- Department of Health and Social Sciences; Division of Preventive Medicine and Public Health; University of Murcia School of Medicine; Murcia Spain
- Department of Preventive Medicine; Reina Sofía University General Hospital; Murcia Spain
- Regional Campus of International Excellence ‘Campus Mare Nostrum’; University of Murcia; Murcia Spain
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75
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Stability of proposed biomarkers of prenatal androgen exposure over the menstrual cycle. J Dev Orig Health Dis 2015; 6:149-57. [PMID: 25584807 DOI: 10.1017/s2040174414000646] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The prenatal hormonal milieu is widely believed to shape health later in life; however, there are considerable methodological challenges associated with measuring the in utero hormonal environment. Two potential biomarkers of prenatal androgen exposure that can be measured postnatally have been proposed: anogenital distance (AGD) and the ratio of the second to fourth digits of the hand (2D:4D). Although both measures are widely used research tools, their use in adult women may be complicated by the dramatic fluctuations in reproductive hormones across the menstrual cycle. To determine whether there is cyclical variation in these biomarkers, we conducted a longitudinal study of 12 naturally cycling, nulliparous adult women. Trained examiners assessed two measures of AGD [anus to clitoris (AGD-AC) and anus to fourchette (AGD-AF)] and 2D:4D in both hands for the duration of three menstrual cycles, taking measurements during the follicular, peri-ovulatory and luteal phases of each cycle. Despite the small sample size, longer (more masculine) AGD was associated with lower (more masculine) digit ratios, as predicted by the literature. Using multi-level linear regression models, we found that AGD and 2D:4D measurements did not differ significantly across cycle phases. AGD-AF and digit ratios in both hands were associated with age at menarche, suggesting a possible common developmental trajectory. These results demonstrate that AGD and 2D:4D are stable across the menstrual cycle. In addition, research is needed to determine how reliably these measures reflect the in utero hormonal milieu.
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Bornehag CG, Carlstedt F, Jönsson BAG, Lindh CH, Jensen TK, Bodin A, Jonsson C, Janson S, Swan SH. Prenatal phthalate exposures and anogenital distance in Swedish boys. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:101-7. [PMID: 25353625 PMCID: PMC4286276 DOI: 10.1289/ehp.1408163] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 10/10/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Phthalates are used as plasticizers in soft polyvinyl chloride (PVC) and in a large number of consumer products. Because of reported health risks, diisononyl phthalate (DiNP) has been introduced as a replacement for di(2-ethylhexyl) phthalate (DEHP) in soft PVC. This raises concerns because animal data suggest that DiNP may have antiandrogenic properties similar to those of DEHP. The anogenital distance (AGD)--the distance from the anus to the genitals--has been used to assess reproductive toxicity. OBJECTIVE The objective of this study was to examine the associations between prenatal phthalate exposure and AGD in Swedish infants. METHODS AGD was measured in 196 boys at 21 months of age, and first-trimester urine was analyzed for 10 phthalate metabolites of DEP (diethyl phthalate), DBP (dibutyl phthalate), DEHP, BBzP (benzylbutyl phthalate), as well as DiNP and creatinine. Data on covariates were collected by questionnaires. RESULTS The most significant associations were found between the shorter of two AGD measures (anoscrotal distance; AGDas) and DiNP metabolites and strongest for oh-MMeOP [mono-(4-methyl-7-hydroxyloctyl) phthalate] and oxo-MMeOP [mono-(2-ethyl-5-oxohexyl) phthalate]. However, the AGDas reduction was small (4%) in relation to more than an interquartile range increase in DiNP exposure. CONCLUSIONS These findings call into question the safety of substituting DiNP for DEHP in soft PVC, particularly because a shorter male AGD has been shown to relate to male genital birth defects in children and impaired reproductive function in adult males and the fact that human levels of DiNP are increasing globally.
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Su PH, Chang CK, Lin CY, Chen HY, Liao PC, Hsiung CA, Chiang HC, Wang SL. Prenatal exposure to phthalate ester and pubertal development in a birth cohort in central Taiwan: a 12-year follow-up study. ENVIRONMENTAL RESEARCH 2015; 136:324-30. [PMID: 25460653 DOI: 10.1016/j.envres.2014.10.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/26/2014] [Accepted: 10/30/2014] [Indexed: 05/19/2023]
Abstract
Phthalate esters are widely used plasticizers that are present in many daily used products. Although some of their reproductive effects have been reported, pubertal development effects from prenatal exposure to phthalates awaits further investigations. A population based birth cohort was established (N=437 at baseline) with maternal exposure to phthalates assessed in urine collected at the third trimester of pregnancy in 2001 and 2002. Their 133 children with prenatal phthalates exposure were followed up for the outcomes of pubertal development by sequential physical examinations at eight and 11 years old in 2009 and 2012. Urinary concentrations of major phthalate metabolites (i.e., mono-2-ethylhexyl phthalate [MEHP], mono-(2-ethyl-5-hydroxyhexyl) phthalate [MEHHP], mono-(2-ethyl-5-oxohexyl) phthalate [MEOHP], mono-butyl phthalate [MBP], mono-benzyl phthalate [MBzP], monomethyl phthalate [MMP], and mono-ethyl phthalate [MEP]) were determined using liquid chromatography linked to tandem mass spectrometry. The reproductive development measurements included bone age (for both genders), testicle size (for boys), uterus size, and ovarian volume (for girls). We reported results of 133 children with complete data by applying generalized estimating equations for the repeated continuous outcomes. After controlling for Tanner stage, we detected a significant association between reduced uterus size and increasing phthalate exposure in the 2(nd) tertile relative to the 1st tertile of creatinine-corrected MEHP (B=-0.40; 95% C.I.: -0.73, -0.07, relative to the 1st tertile) and total DEHP (B=-0.39, 95% C.I.:-0.66, -0.01 for the 2nd tertile and B=0.34, 95% C.I.: -0.67, -0.01 for the 3rd tertile, relative to the 1st tertile) with a linear trend among girls. MBzP was also found negatively associated with bone age/chronological age ratio (B=-0.07, 95% CI: -0.13, -0.01 for the 3rd tertile, relative to the 1st tertile) with a linear trend for girls. We found no evidence of an association between phthalate exposure and ovarian volume or testicle size. This analysis suggests phthalate exposure may affect specific pubertal development characteristics in human beings. Further studies with larger sample sizes and longer follow-up period are warranted.
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Affiliation(s)
- Pen-Hua Su
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung City, Taiwan; School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - Chin-Kuo Chang
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Ching-Yi Lin
- Department of Obstetrics and Gynecology, School of Medicine, Chung Shan Medical University, Taichung City, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Hsiao-Yen Chen
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli County, Taiwan
| | - Pao-Chi Liao
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Chao A Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, County, Taiwan
| | - Hung-Che Chiang
- National Environmental Health Center, National Health Research Institutes, Miaoli County, Taiwan
| | - Shu-Li Wang
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli County, Taiwan; Department of Public Health, National Defence Medical Center, Taipei City, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung City, Taiwan.
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78
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Phthalates and critically ill neonates: device-related exposures and non-endocrine toxic risks. J Perinatol 2014; 34:892-7. [PMID: 25357096 DOI: 10.1038/jp.2014.157] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/15/2014] [Accepted: 07/18/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess the types and magnitudes of non-endocrine toxic risks to neonates associated with medical device-related exposures to di(2-ethylhexyl)phthalate (DEHP). STUDY DESIGN Dose-response thresholds for DEHP toxicities were determined from published data, as were the magnitudes of DEHP exposures resulting from neonatal contact with polyvinyl chloride (PVC) devices. Standard methods of risk assessment were used to determine safe levels of DEHP exposure in neonates, and hazard quotients were calculated for devices individually and in aggregate. RESULT Daily intake of DEHP for critically ill preterm infants can reach 16 mg/kg per day, which is on the order of 4000 and 160,000 times higher than desired to avoid reproductive and hepatic toxicities, respectively. The non-endocrine toxicities of DEHP are similar to complications experienced by preterm neonates. CONCLUSION DEHP exposures in neonatal intensive care are much higher than estimated safe limits, and might contribute to common early and chronic complications of prematurity. Concerns about phthalates should be expanded beyond endocrine disruption.
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Habert R, Livera G, Rouiller-Fabre V. Man is not a big rat: concerns with traditional human risk assessment of phthalates based on their anti-androgenic effects observed in the rat foetus. Basic Clin Androl 2014; 24:14. [PMID: 25780587 PMCID: PMC4349750 DOI: 10.1186/2051-4190-24-14] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 08/15/2014] [Indexed: 11/10/2022] Open
Abstract
Phthalates provide one of the most documented example evidencing how much we must be cautious when using the traditional paradigm based on extrapolation of experimental data from rodent studies for human health risk assessment of endocrine disruptors (EDs). Since foetal testis is known as one of the most sensitive targets of EDs, phthalate risk assessment is routinely based on the capacity of such compounds to decrease testosterone production by the testis or to impair masculinization in the rat during foetal life. In this paper, the well-established inhibiting effects of phthalates of the foetal Leydig cells function in the rat are briefly reviewed. Then, data obtained in humans and other species are carefully analysed. Already in January 2009, using the organotypic culture system named Fetal Testis Assay (FeTA) that we developed, we reported that phthalates might not affect testosterone production in human foetal testes. Several recent experimental studies using xenografts confirm the absence of detectable anti-androgenic effect of phthalates in the human foetal testes. Epidemiological studies led to contradictory results. Altogether, these findings suggest that phthalates effects on foetal Leydig cells are largely species-specific. Consequently, the phthalate threshold doses that disturb foetal steroidogenesis in rat testes and that are presently used to define the acceptable daily intake levels for human health protection must be questioned. This does not mean that phthalates are safe because these compounds have many deleterious effects upon germ cell development that may be common to the different studied species including human. More generally, the identification of common molecular, cellular or/and phenotypic targets in rat and human testes should precede the choice of the toxicological endpoint in rat to accurately assess the safety threshold of any ED in humans.
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Affiliation(s)
- René Habert
- Sorbonne Paris Cité, Laboratory of Development of the Gonads, Unit of Stem Cells and Radiation, University Paris Diderot, BP 6, 92265 Fontenay-aux-Roses, France ; CEA, DSV, iRCM, SCSR, LDG, 92265 Fontenay-aux-Roses, France ; INSERM, Unité 967, F-92265 Fontenay aux Roses, France ; Stem Cells and Radiation Unit, LDG / SCSR / iRCM / DSV, Centre CEA, BP6, F-92265 Fontenay aux Roses, France
| | - Gabriel Livera
- Sorbonne Paris Cité, Laboratory of Development of the Gonads, Unit of Stem Cells and Radiation, University Paris Diderot, BP 6, 92265 Fontenay-aux-Roses, France ; CEA, DSV, iRCM, SCSR, LDG, 92265 Fontenay-aux-Roses, France ; INSERM, Unité 967, F-92265 Fontenay aux Roses, France
| | - Virginie Rouiller-Fabre
- Sorbonne Paris Cité, Laboratory of Development of the Gonads, Unit of Stem Cells and Radiation, University Paris Diderot, BP 6, 92265 Fontenay-aux-Roses, France ; CEA, DSV, iRCM, SCSR, LDG, 92265 Fontenay-aux-Roses, France ; INSERM, Unité 967, F-92265 Fontenay aux Roses, France
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Liu C, Xu X, Huo X. Anogenital distance and its application in environmental health research. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2014; 21:5457-64. [PMID: 24474565 DOI: 10.1007/s11356-014-2570-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 01/16/2014] [Indexed: 02/05/2023]
Abstract
Anogenital distance (AGD), a useful anthropometric measurement for genital development in both animals and humans, was originally found by reproductive toxicologists in rodent experiments. As an easy-to-measure and sensitive marker, AGD has become a bioassay of fetal androgen action and a well-established reproductive toxicity endpoint in animals. It is generally accepted that AGD is sexually dimorphic in many mammals, with males having longer AGD than females. Exposure to proposed endocrine disruptors may result in reduced AGD; thus, it has been used to measure health effects of compounds with endocrine-altering properties or endocrine-disrupting chemicals (EDCs) in environmental toxicology. Moreover, AGD is an important clinical measure to address endocrine-sensitive endpoints in the first year of life and to assess the adverse impact of in utero exposure to environmental EDCs. Recently, AGD has been identified as one of the endpoints in the US Environmental Protection Agency guidelines for reproductive toxicity studies in humans, but use of AGD in human studies is still rare, and the results remain mixed and inconclusive due to many reasons. In order to achieve a breakthrough, researchers are endeavoring to standardize the measurement of AGD, normalize age-specific population data in different ethnic groups, and conduct more in-depth human researches in this field.
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Affiliation(s)
- Chunhua Liu
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, 22 Xinling Rd., Shantou, 515041, China
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Gallinger ZR, Nguyen GC. Presence of phthalates in gastrointestinal medications: Is there a hidden danger? World J Gastroenterol 2013; 19:7042-7047. [PMID: 24222946 PMCID: PMC3819538 DOI: 10.3748/wjg.v19.i41.7042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 08/26/2013] [Accepted: 09/17/2013] [Indexed: 02/06/2023] Open
Abstract
Pharmaceutical companies that produce gastrointestinal (GI) medications often utilize phthalates for their ability to localize medication release. Commonly prescribed GI medications that may utilize phthalates are 5-Aminosalicylates, proton pump inhibitors, and pancreatic enzymes. Our understanding of the cumulative health effects of phthalates from medications remains unclear, and there is increasing evidence that phthalates are not harmless. Experimental studies in animals have shown that phthalates, specifically dibutyl phthalate and Di-(2-ethyl-hexyl) phthalate, have the potential to alter and/or inhibit reproductive biology and in utero development. Despite the lack of definitive human data, many cohort and cross-sectional studies demonstrate concerning associations between phthalates and poor health status, specifically developmental problems. Longitudinal studies and studies with larger sample sizes are required to determine whether phthalates actually cause negative health consequences. It is also important that physicians regularly review and discuss with patients the medicinal ingredients in their medications and supplements, specifically in pregnant woman with inflammatory bowel disease.
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