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Li W, Li Y, Xu W, Chen Z, Gao Y, Liu Z, Li Q, Jiang M, Liu H, Luo B, Zhan Y, Dai L. Maternal PM 2.5 exposure and hypospadias risk in Chinese offspring: Insights from a nationwide surveillance-based study. JOURNAL OF HAZARDOUS MATERIALS 2024; 472:134503. [PMID: 38718509 DOI: 10.1016/j.jhazmat.2024.134503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 05/30/2024]
Abstract
Research on the association between maternal PM2.5 exposure and hypospadias risk in male offspring, particularly in highly polluted areas, has been limited and inconsistent. This study leveraged data from China's National Population-based Birth Defects Surveillance System spanning the years 2013 to 2019, and employed sophisticated machine learning models to estimate daily PM2.5 levels and other pollutants for mothers at a 1-km resolution and a 6-km buffer surrounding maternal residences. Multivariate logistic regression analyses were performed to evaluate the relationship between PM2.5 exposure and hypospadias risk. For sensitivity analyses, stratification analysis was conducted, and models for one-pollutant and two-pollutants, as well as distributed lag nonlinear models, were constructed. Of the 1194,431 boys studied, 1153 cases of hypospadias were identified. A 10 μg/m3 increase in maternal PM2.5 exposure during preconception and the first trimester was associated with an elevated risk of isolated hypospadias, with Odds Ratios (ORs) of 1.102 (95% CI: 1.023-1.188) and 1.089 (95% CI: 1.007-1.177) at the 1-km grid, and 1.122 (95% CI: 1.034-1.218) and 1.143 (95% CI: 1.048-1.246) within the 6-km buffer. Higher quartiles of PM2.5 exposure were associated with increased odds ratios compared to the lowest quartile. These findings highlight a significant association between PM2.5 exposure during the critical conception period and an elevated risk of isolated hypospadias in children, emphasizing the need for targeted interventions to reduce PM2.5 exposure among expectant mothers.
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Affiliation(s)
- Wenyan Li
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Yanhua Li
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wenli Xu
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Zhiyu Chen
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Yuyang Gao
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Zhen Liu
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Qi Li
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Ming Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hanmin Liu
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Biru Luo
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China; Department of Nursing Management, West China Second University, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Yu Zhan
- College of Carbon Neutrality Future Technology, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Li Dai
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, China.
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2
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Yesildemir O, Celik MN. The Effect of Various Environmental Pollutants on the Reproductive Health in Children: A Brief Review of the Literature. Curr Nutr Rep 2024:10.1007/s13668-024-00557-5. [PMID: 38935249 DOI: 10.1007/s13668-024-00557-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE OF REVIEW Environmental pollutants in air, water, soil, and food are a significant concern due to their potential adverse effects on fetuses, newborns, babies, and children. These chemicals, which pass to fetuses and babies through trans-placental transfer, breast milk, infant formula, dermal transfer, and non-nutritive ingestion, can cause health problems during childhood. This review aims to discuss how exposure to various environmental pollutants in early life stages can disrupt reproductive health in children. RECENT FINDINGS Environmental pollutants can affect Leydig cell proliferation and differentiation, decreasing testosterone production throughout life. This may result in cryptorchidism, hypospadias, impaired semen parameters, and reduced fertility. Although many studies on female reproductive health cannot be interpreted to support causal relationships, exposure to pollutants during critical windows may subsequently induce female reproductive diseases, including early or delayed puberty, polycystic ovary syndrome, endometriosis, and cancers. There is growing evidence that fetal and early-life exposure to environmental pollutants could affect reproductive health in childhood. Although diet is thought to be the primary route by which humans are exposed to various pollutants, there are no adopted nutritional interventions to reduce the harmful effects of pollutants on children's health. Therefore, understanding the impact of environmental contaminants on various health outcomes may inform the design of future human nutritional studies.
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Affiliation(s)
- Ozge Yesildemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Bursa Uludag University, 16059, Bursa, Türkiye.
| | - Mensure Nur Celik
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ondokuz Mayis University, 55200, Samsun, Türkiye
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3
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Payne SR, Anderson P, Spasojević N, Demilow TL, Teferi G, Dickerson D. Male urethral stricture disease. Why management guidelines are challenging in low-income countries. BJU Int 2022; 130:157-165. [PMID: 35726391 DOI: 10.1111/bju.15831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Urethral stricture disease is one of the commonest urological pathologies in adult men in low or low-middle income countries, providing a significant work burden for the small number of specialist surgeons who are able to provide appropriate treatment. The underlying causes of anterior urethral stricture relate to urethral fibrosis from sexually transmitted infection, with posterior urethral disruption secondary to pelvic trauma being an equally common cause of stricture disease in many countries in sub-Saharan Africa. Anterior urethral strictures are often long, and multifocal, and bulbo-prostatic disruptions are usually due to relatively low-velocity pelvic trauma. The management options available in resource poor settings are often severely limited by the individual's ability to pay for care, the availability of a specialist surgeon and, importantly, a shortage of functioning endoscopic equipment for less-invasive treatments. Consequently, reconstructive surgery is often regarded by the patient, and surgeon, as the most cost-effective and, therefore, primary means of treating a urethral stricture once urethral dilatation has failed. Regional anaesthetic techniques have limited the adoption of free graft augmentation as an alternative to pedicled flaps of locally available skin for reconstruction, whilst an inability to provide tension-free bulbo-prostatic anastomoses has negatively impacted the outcome from the treatment of pelvic fracture disruption injuries in much of sub-Saharan Africa. Urolink has, however, found that local surgeons can be taught sustainable skills required for successful complex urethroplasty when supported by longitudinal mentorship in the management of difficult clinical issues. Evidence-based practice is known to improve the standard of care in specific conditions in high-income countries, including the management of male urethral stricture disease. However, guidelines developed in high-income countries aren't necessarily appropriate for stricture management in less well-resourced healthcare environments, but could be adapted to help improve the delivery of stricture care for men in low- or low-middle income countries.
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Affiliation(s)
| | - Paul Anderson
- Urolink, British Association of Urological Surgeons, UK.,Dudley Group NHS Foundation Trust, Dudley, UK
| | | | - Tilaneh L Demilow
- Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia
| | - Getaneh Teferi
- Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia
| | - David Dickerson
- Urolink, British Association of Urological Surgeons, UK.,Weston Area Health NHS Trust, Weston-super-Mare, UK
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4
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Montano L, Maugeri A, Volpe MG, Micali S, Mirone V, Mantovani A, Navarra M, Piscopo M. Mediterranean Diet as a Shield against Male Infertility and Cancer Risk Induced by Environmental Pollutants: A Focus on Flavonoids. Int J Mol Sci 2022; 23:ijms23031568. [PMID: 35163492 PMCID: PMC8836239 DOI: 10.3390/ijms23031568] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open
Abstract
The role of environmental factors in influencing health status is well documented. Heavy metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls, dioxins, pesticides, ultrafine particles, produced by human activities put a strain on the body’s entire defense system. Therefore, together with public health measures, evidence-based individual resilience measures are necessary to mitigate cancer risk under environmental stress and to prevent reproductive dysfunction and non-communicable diseases; this is especially relevant for workers occupationally exposed to pollutants and/or populations residing in highly polluted areas. The Mediterranean diet is characterized by a high intake of fruits and vegetables rich in flavonoids, that can promote the elimination of pollutants in tissues and fluids and/or mitigate their effects through different mechanisms. In this review, we collected evidence from pre-clinical and clinical studies showing that the impairment of male fertility and gonadal development, as well as cancers of reproductive system, due to the exposure of organic and inorganic pollutants, may be counteracted by flavonoids.
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Affiliation(s)
- Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL), 84124 Salerno, Italy;
- PhD Program in Evolutionary Biology and Ecology, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Alessandro Maugeri
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
| | - Maria Grazia Volpe
- Institute of Food Sciences, National Research Council, CNR, 83100 Avellino, Italy;
| | - Salvatore Micali
- Urology Department, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Vincenzo Mirone
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80126 Naples, Italy;
| | - Alberto Mantovani
- Department of Food, Safety, Nutrition and Veterinary public health, Italian National Health Institute, 00161 Roma, Italy;
| | - Michele Navarra
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
- Correspondence:
| | - Marina Piscopo
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy;
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5
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Gaspari L, Tessier B, Paris F, Bergougnoux A, Hamamah S, Sultan C, Kalfa N. Endocrine-Disrupting Chemicals and Disorders of Penile Development in Humans. Sex Dev 2021; 15:213-228. [PMID: 34438394 DOI: 10.1159/000517157] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/10/2021] [Indexed: 01/09/2023] Open
Abstract
This paper reviews the current knowledge on the environmental effects on penile development in humans. The specific focus is on endocrine-disrupting chemicals (EDCs), a heterogeneous group of natural or manmade substances that interfere with endocrine function, and whether they can induce hypospadias and micropenis in male neonates. Epidemiological data and animal observations first raised suspicions about environmental effects, leading to the testis dysgenesis syndrome (TDS) hypothesis. More recent research has provided stronger indications that TDS may indeed be the result of the direct or indirect effects of EDCs. Drawing on epidemiological and toxicological studies, we also report on the effects of maternal diet and substances like pesticides, phthalates, bisphenol A, and polychlorinated biphenyls. Proximity to contamination hazards and occupational exposure are also suspected to contribute to the occurrence of hypospadias and micropenis. Lastly, the cumulative effects of EDCs and the possibility of transgenerational effects, with the penile development of subsequent generations being affected, raise concerns for long-term public health.
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Affiliation(s)
- Laura Gaspari
- Centre de Référence Maladies Rares du Développement Génital DEVGEN, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier, Université Montpellier, Montpellier, France.,Unité d'Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie, Hôpital Arnaud-de-Villeneuve, CHU Montpellier, Université Montpellier, Montpellier, France.,Développement Embryonnaire Fertilité Environnement, INSERM 1203, Université Montpellier, Montpellier, France
| | - Benoit Tessier
- Département de Chirurgie Viscérale et Urologique Pédiatrique, Hôpital Lapeyronie, CHU Montpellier, Université Montpellier, Montpellier, France.,Institut Debrest de Santé Publique IDESP, UMR INSERM, Université Montpellier, Montpellier, France
| | - Françoise Paris
- Centre de Référence Maladies Rares du Développement Génital DEVGEN, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier, Université Montpellier, Montpellier, France.,Unité d'Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie, Hôpital Arnaud-de-Villeneuve, CHU Montpellier, Université Montpellier, Montpellier, France.,Développement Embryonnaire Fertilité Environnement, INSERM 1203, Université Montpellier, Montpellier, France
| | - Anne Bergougnoux
- Centre de Référence Maladies Rares du Développement Génital DEVGEN, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier, Université Montpellier, Montpellier, France.,Laboratoire de Génétique Moléculaire, PhyMedExp, INSERM, CNRS UMR, CHU Montpellier, Université Montpellier, Montpellier, France
| | - Samir Hamamah
- Développement Embryonnaire Fertilité Environnement, INSERM 1203, Université Montpellier, Montpellier, France.,Département de Biologie de la Reproduction, Biologie de la Reproduction/DPI et CECOS, CHU Montpellier, Université Montpellier, Montpellier, France
| | - Charles Sultan
- Centre de Référence Maladies Rares du Développement Génital DEVGEN, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier, Université Montpellier, Montpellier, France
| | - Nicolas Kalfa
- Centre de Référence Maladies Rares du Développement Génital DEVGEN, Constitutif Sud, Hôpital Lapeyronie, CHU Montpellier, Université Montpellier, Montpellier, France.,Département de Chirurgie Viscérale et Urologique Pédiatrique, Hôpital Lapeyronie, CHU Montpellier, Université Montpellier, Montpellier, France.,Institut Debrest de Santé Publique IDESP, UMR INSERM, Université Montpellier, Montpellier, France
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6
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Endocrine disrupting chemicals in the pathogenesis of hypospadias; developmental and toxicological perspectives. Curr Res Toxicol 2021; 2:179-191. [PMID: 34345859 PMCID: PMC8320613 DOI: 10.1016/j.crtox.2021.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 12/11/2022] Open
Abstract
Penis development is regulated by a tight balance of androgens and estrogens. EDCs that impact androgen/estrogen balance during development cause hypospadias. Cross-disciplinary collaborations are needed to define a mechanistic link.
Hypospadias is a defect in penile urethral closure that occurs in approximately 1/150 live male births in developed nations, making it one of the most common congenital abnormalities worldwide. Alarmingly, the frequency of hypospadias has increased rapidly over recent decades and is continuing to rise. Recent research reviewed herein suggests that the rise in hypospadias rates can be directly linked to our increasing exposure to endocrine disrupting chemicals (EDCs), especially those that affect estrogen and androgen signalling. Understanding the mechanistic links between endocrine disruptors and hypospadias requires toxicologists and developmental biologists to define exposures and biological impacts on penis development. In this review we examine recent insights from toxicological, developmental and epidemiological studies on the hormonal control of normal penis development and describe the rationale and evidence for EDC exposures that impact these pathways to cause hypospadias. Continued collaboration across these fields is imperative to understand the full impact of endocrine disrupting chemicals on the increasing rates of hypospadias.
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Key Words
- Androgen
- BBP, benzyl butyl phthalate
- BPA, bisphenol A
- DBP, Σdibutyl phthalate
- DDT, dichlorodiphenyltrichloroethane
- DEHP, Σdi-2(ethylhexyl)-phthalate
- DHT, dihydrotestosterone
- EDC, endocrine disrupting chemicals
- EMT, epithelial to mesenchymal transition
- ER, estrogen receptor
- Endocrine disruptors
- Estrogen
- GT, genital tubercle
- Hypospadias
- NOAEL, no observed adverse effect level
- PBB, polybrominated biphenyl
- PBDE, polybrominated diphenyl ether
- PCB, polychlorinated biphenyl
- PCE, tetrachloroethylene
- Penis
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7
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Messina M, Mejia SB, Cassidy A, Duncan A, Kurzer M, Nagato C, Ronis M, Rowland I, Sievenpiper J, Barnes S. Neither soyfoods nor isoflavones warrant classification as endocrine disruptors: a technical review of the observational and clinical data. Crit Rev Food Sci Nutr 2021; 62:5824-5885. [PMID: 33775173 DOI: 10.1080/10408398.2021.1895054] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Soybeans are a rich source of isoflavones, which are classified as phytoestrogens. Despite numerous proposed benefits, isoflavones are often classified as endocrine disruptors, based primarily on animal studies. However, there are ample human data regarding the health effects of isoflavones. We conducted a technical review, systematically searching Medline, EMBASE, and the Cochrane Library (from inception through January 2021). We included clinical studies, observational studies, and systematic reviews and meta-analyses (SRMA) that examined the relationship between soy and/or isoflavone intake and endocrine-related endpoints. 417 reports (229 observational studies, 157 clinical studies and 32 SRMAs) met our eligibility criteria. The available evidence indicates that isoflavone intake does not adversely affect thyroid function. Adverse effects are also not seen on breast or endometrial tissue or estrogen levels in women, or testosterone or estrogen levels, or sperm or semen parameters in men. Although menstrual cycle length may be slightly increased, ovulation is not prevented. Limited insight could be gained about possible impacts of in utero isoflavone exposure, but the existing data are reassuring. Adverse effects of isoflavone intake were not identified in children, but limited research has been conducted. After extensive review, the evidence does not support classifying isoflavones as endocrine disruptors.
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Affiliation(s)
- Mark Messina
- Department of Nutrition, Loma Linda University, Loma Linda, California, USA
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Aedin Cassidy
- Nutrition and Preventive Medicine, Queen's University, Belfast, Northern Ireland, UK
| | - Alison Duncan
- College of Biological Sciences, University of Guelph, Guelph, Canada
| | - Mindy Kurzer
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - Chisato Nagato
- Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Martin Ronis
- Health Sciences Center, Louisiana State University Health Sciences Center, Baton Rouge, New Orleans, USA
| | - Ian Rowland
- Human Nutrition, University of Reading, Reading, England, UK
| | | | - Stephen Barnes
- Department of Pharmacology and Toxicology, University of Alabama, Alabama, USA
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8
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Rodprasert W, Toppari J, Virtanen HE. Endocrine Disrupting Chemicals and Reproductive Health in Boys and Men. Front Endocrinol (Lausanne) 2021; 12:706532. [PMID: 34690925 PMCID: PMC8530230 DOI: 10.3389/fendo.2021.706532] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/17/2021] [Indexed: 12/15/2022] Open
Abstract
Male reproductive health has declined as indicated by increasing rates of cryptorchidism, i.e., undescended testis, poor semen quality, low serum testosterone level, and testicular cancer. Exposure to endocrine disrupting chemicals (EDCs) has been proposed to have a role in this finding. In utero exposure to antiandrogenic EDCs, particularly at a sensitive period of fetal testicular development, the so-called 'masculinization programming window (MPW)', can disturb testicular development and function. Low androgen effect during the MPW can cause both short- and long-term reproductive disorders. A concurrent exposure to EDCs may also affect testicular function or damage testicular cells. Evidence from animal studies supports the role of endocrine disrupting chemicals in development of male reproductive disorders. However, evidence from epidemiological studies is relatively mixed. In this article, we review the current literature that evaluated relationship between prenatal EDC exposures and anogenital distance, cryptorchidism, and congenital penile abnormality called hypospadias. We review also studies on the association between early life and postnatal EDC exposure and semen quality, hypothalamic-pituitary-gonadal axis hormone levels and testicular cancer.
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Affiliation(s)
- Wiwat Rodprasert
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Jorma Toppari
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Helena E. Virtanen
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- *Correspondence: Helena E. Virtanen,
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9
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Stewart MK, Mattiske DM, Pask AJ. Exogenous Oestrogen Impacts Cell Fate Decision in the Developing Gonads: A Potential Cause of Declining Human Reproductive Health. Int J Mol Sci 2020; 21:E8377. [PMID: 33171657 PMCID: PMC7664701 DOI: 10.3390/ijms21218377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022] Open
Abstract
The increasing incidence of testicular dysgenesis syndrome-related conditions and overall decline in human fertility has been linked to the prevalence of oestrogenic endocrine disrupting chemicals (EDCs) in the environment. Ectopic activation of oestrogen signalling by EDCs in the gonad can impact testis and ovary function and development. Oestrogen is the critical driver of ovarian differentiation in non-mammalian vertebrates, and in its absence a testis will form. In contrast, oestrogen is not required for mammalian ovarian differentiation, but it is essential for its maintenance, illustrating it is necessary for reinforcing ovarian fate. Interestingly, exposure of the bi-potential gonad to exogenous oestrogen can cause XY sex reversal in marsupials and this is mediated by the cytoplasmic retention of the testis-determining factor SOX9 (sex-determining region Y box transcription factor 9). Oestrogen can similarly suppress SOX9 and activate ovarian genes in both humans and mice, demonstrating it plays an essential role in all mammals in mediating gonad somatic cell fate. Here, we review the molecular control of gonad differentiation and explore the mechanisms through which exogenous oestrogen can influence somatic cell fate to disrupt gonad development and function. Understanding these mechanisms is essential for defining the effects of oestrogenic EDCs on the developing gonads and ultimately their impacts on human reproductive health.
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Affiliation(s)
- Melanie K. Stewart
- School of BioSciences, The University of Melbourne, Melbourne, VIC 3010, Australia; (D.M.M.); (A.J.P.)
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10
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Stewart MK, Mattiske DM, Pask AJ. Estrogen suppresses SOX9 and activates markers of female development in a human testis-derived cell line. BMC Mol Cell Biol 2020; 21:66. [PMID: 32933467 PMCID: PMC7493336 DOI: 10.1186/s12860-020-00307-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/25/2020] [Indexed: 11/20/2022] Open
Abstract
Background The increasing incidence of reproductive disorders in humans has been attributed to in utero exposure to estrogenic endocrine disruptors. In particular, exposure of the developing testis to exogenous estrogen can negatively impact male reproductive health. To determine how estrogens impact human gonad function, we treated the human testis-derived cell line NT2/D1 with estrogen and examined its impact on SOX9 and the expression of key markers of granulosa (ovarian) and Sertoli (testicular) cell development. Results Estrogen successfully activated its cognate receptor (estrogen receptor alpha; ESR1) in NT2/D1 cells. We observed a significant increase in cytoplasmic SOX9 following estrogen treatment. After 48 h of estrogen exposure, mRNA levels of the key Sertoli cell genes SOX9, SRY, AMH, FGF9 and PTGDS were significantly reduced. This was followed by a significant increase in mRNA levels for the key granulosa cell genes FOXL2 and WNT4 after 96 h of estrogen exposure. Conclusions These results are consistent with estrogen's effects on marsupial gonads and show that estrogen has a highly conserved impact on gonadal cell fate decisions that has existed in mammals for over 160 million years. This effect of estrogen presents as a potential mechanism contributing to the significant decrease in male fertility and reproductive health reported over recent decades. Given our widespread exposure to estrogenic endocrine disruptors, their effects on SOX9 and Sertoli cell determination could have considerable impact on the adult testis.
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Affiliation(s)
- Melanie K Stewart
- School of BioSciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Deidre M Mattiske
- School of BioSciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Andrew J Pask
- School of BioSciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
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11
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Spinder N, Prins JR, Bergman JEH, Smidt N, Kromhout H, Boezen HM, de Walle HEK. Congenital anomalies in the offspring of occupationally exposed mothers: a systematic review and meta-analysis of studies using expert assessment for occupational exposures. Hum Reprod 2020; 34:903-919. [PMID: 30927411 PMCID: PMC6505450 DOI: 10.1093/humrep/dez033] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/28/2019] [Accepted: 02/20/2019] [Indexed: 11/23/2022] Open
Abstract
STUDY QUESTION Is there an association between maternal occupational exposure to solvents, pesticides and metals as assessed by expert-based assessment and congenital anomalies in the offspring? SUMMARY ANSWER There is an association between maternal occupational exposure to solvents and congenital anomalies in the offspring, including neural tube defects, congenital heart defects and orofacial clefts. WHAT IS KNOWN ALREADY One important environmental risk factor for development of congenital anomalies is maternal occupational exposure to chemicals in the workplace prior to and during pregnancy. A number of studies have assessed the association with often conflicting results, possibly due to different occupational exposure assessing methods. STUDY DESIGN, SIZE, DURATION For this systematic review with meta-analysis, the search terms included maternal occupation, exposure, congenital anomalies and offspring. Electronic databases MEDLINE and EMBASE were searched for English studies up to October 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Two reviewers independently screened all citations identified by the search. Case-control studies and cohort studies were included if (I) they reported on the association between maternal occupational exposure to solvents, pesticides or metals and congenital anomalies, and (II) assessment of occupational exposure was performed by experts. Data on study characteristics, confounders and odds ratios (ORs) were extracted from the included studies for four subgroups of congenital anomalies. Methodological quality was assessed using the Newcastle-Ottawa Scale. In the meta-analysis, random effects models were used to pool estimates. MAIN RESULTS AND THE ROLE OF CHANCE In total, 2806 titles and abstracts and 176 full text papers were screened. Finally, 28 studies met the selection criteria, and 27 studies could be included in the meta-analysis. Our meta-analysis showed that maternal occupational exposure to solvents was associated with neural tube defects (OR: 1.51, 95%CI: 1.09–2.09) and congenital heart defects (OR: 1.31, 95%CI:1.06–1.63) in the offspring. Also maternal occupational exposure to glycol ethers, a subgroup of solvents, was associated with neural tube defects (OR: 1.93, 95%CI: 1.17–3.18) and orofacial clefts (OR: 1.95, 95%CI: 1.38–2.75) in the offspring. Only one study investigated the association between maternal occupational exposure to solvents and hypospadias and found an association (OR: 3.63, 95%CI: 1.94–7.17). Results of the included studies were consistent. In our meta-analysis, we found no associations between occupational exposure to pesticides or metals and congenital anomalies in the offspring. LIMITATIONS, REASONS FOR CAUTION A limited number of studies was included, which made it impossible to calculate pooled estimates for all congenital anomalies, analyse individual chemicals or calculate exposure–response relations. Bias could have been introduced because not all included studies corrected for potentially confounding factors. WIDER IMPLICATIONS OF THE FINDINGS Employers and female employees should be aware of the possible teratogenic effects of solvent exposure at the workplace. Therefore, is it important that clinicians and occupational health specialist provide women with preconception advice on occupational solvent exposure, to reduce the congenital anomaly risk. STUDY FUNDING/COMPETING INTEREST(S) NSp was paid by the Graduate School of Medical Sciences (MD/PhD program), UMCG, Groningen, the Netherlands. EUROCAT Northern Netherlands is funded by the Dutch Ministry of Health, Welfare and Sports. There are no competing interests. REGISTRATION NUMBER CRD42017053943.
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Affiliation(s)
- N Spinder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J R Prins
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J E H Bergman
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - N Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H Kromhout
- Division of Environmental Epidemiology, Institute for Risk Assessment Science, Utrecht University, Utrecht, The Netherlands
| | - H M Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H E K de Walle
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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12
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Dent MP, Li H, Carmichael PL, Martin FL. Employing Dietary Comparators to Perform Risk Assessments for Anti-Androgens Without Using Animal Data. Toxicol Sci 2020; 167:375-384. [PMID: 30247711 PMCID: PMC6358230 DOI: 10.1093/toxsci/kfy245] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This study investigated the use of androgen receptor (AR) reporter gene assay data in a non-animal exposure-led risk assessment in which in vitro anti-androgenic activity and exposure data were put into context using a naturally occurring comparator substance with a history of dietary consumption. First, several dietary components were screened to identify which selectively interfered with AR signaling in vitro, using the AR CALUX® test. The IC50 values from these dose-response data together with measured or predicted human exposure levels were used to calculate exposure: activity ratios (EARs) for the dietary components and a number of other well-known anti-androgenic substances. Both diindolylmethane (DIM) and resveratrol are specifically acting dietary anti-androgens. The EARs for several anti-androgens were therefore expressed relative to the EAR of DIM, and how this 'dietary comparator ratio' (DCR) approach may be used to make safety decisions was assessed using an exposure-led case study for an anti-androgenic botanical ingredient. This highlights a pragmatic approach which allows novel chemical exposures to be put into context against dietary exposures to natural anti-androgenic substances. The DCR approach may have utility for other modes of action where appropriate comparators can be identified.
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Affiliation(s)
- Matthew P Dent
- Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Bedfordshire MK44 1LQ, UK
| | - Hequn Li
- Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Bedfordshire MK44 1LQ, UK
| | - Paul L Carmichael
- Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Bedfordshire MK44 1LQ, UK
| | - Francis L Martin
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
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13
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Govers LC, Phillips TR, Mattiske DM, Rashoo N, Black JR, Sinclair A, Baskin LS, Risbridger GP, Pask AJ. A critical role for estrogen signaling in penis development. FASEB J 2019; 33:10383-10392. [PMID: 31225966 PMCID: PMC6704459 DOI: 10.1096/fj.201802586rr] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 05/28/2019] [Indexed: 11/11/2022]
Abstract
Hypospadias, a developmental defect of the penis, is one of the most common congenital malformations in humans. Its incidence has rapidly increased over recent decades, and this has been largely attributed to our increased exposure to endocrine-disrupting chemicals. Penis development is primarily an androgen-driven process; however, estrogen and xenoestrogens are known to affect penis development in both humans and mice. Here, we investigated the role of estrogen in the developing penis. Using a novel penis culture system, we showed that exogenous estrogen directly targets the developing penis in utero to cause hypospadias. In addition, we also uncovered an unexpected endogenous role for estrogen in normal postnatal penis development and showed that a loss of estrogen signaling results in a mild hypospadias phenotype, the most common manifestation of this disease in humans. Our findings demonstrated that both androgen and estrogen signaling are intrinsically required for normal urethral closure. These findings confirmed that penis development is not an entirely androgen-driven process but one in which endogenous estrogen signaling also plays a critical role.-Govers, L. C., Phillips, T. R., Mattiske, D. M., Rashoo, N., Black, J. R., Sinclair, A., Baskin, L. S., Risbridger, G. P., Pask, A. J. A critical role for estrogen signaling in penis development.
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Affiliation(s)
- Luke C. Govers
- School of BioSciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tiffany R. Phillips
- School of BioSciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Deidre M. Mattiske
- School of BioSciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nineveh Rashoo
- School of BioSciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jay R. Black
- School of Earth Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adriane Sinclair
- Division of Pediatric Urology, University of California–San Francisco Benioff Children’s Hospital, San Francisco, California, USA
| | - Laurence S. Baskin
- Division of Pediatric Urology, University of California–San Francisco Benioff Children’s Hospital, San Francisco, California, USA
| | - Gail P. Risbridger
- Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia
| | - Andrew J. Pask
- School of BioSciences, The University of Melbourne, Melbourne, Victoria, Australia
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14
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Raghavan R, Romano ME, Karagas MR, Penna FJ. Pharmacologic and Environmental Endocrine Disruptors in the Pathogenesis of Hypospadias: a Review. Curr Environ Health Rep 2019; 5:499-511. [PMID: 30578470 DOI: 10.1007/s40572-018-0214-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE OF REVIEW Endocrine disrupting chemicals (EDCs) potentially have a role in causing hypospadias malformation through modifiable in-utero exposure. Considering the emerging literature on the role of potential endocrine disrupting substances on the occurrence of hypospadias and the potential to inform public health efforts to prevent the occurrence of these malformations, we have summarized the current literature, identified areas of consensus, and highlighted areas that warrant further investigation. RECENT FINDINGS Pharmaceuticals, such as diethylstilbestrol, progestin fertility treatments, corticosteroids, and valproic acid, have all been associated with hypospadias risk. Data on exposure to dichlorodiphenyltrichloroethane and hexachlorobenzene pesticides, as well as non-persistent pollutants, particularly phthalates, is less consistent but still compelling. Improving exposure assessment, standardizing sample timing to relevant developmental windows, using clear case identification and classification schemes, and elucidating dose-response relationships with EDCs will help to provide clearer evidence. Promising directions for future research include identification of subgroups with genetic hypospadias risk factors, measurement of intermediate outcomes, and study of EDC mixtures that will more accurately represent the total fetal environment.
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Affiliation(s)
- Rajiv Raghavan
- Division of Pediatric Urology, Children's Hospital at Dartmouth, Dartmouth
- Geisel School of Medicine, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Megan E Romano
- Department of Epidemiology, Dartmouth
- Geisel School of Medicine, Lebanon, NH, USA
| | - Margaret R Karagas
- Department of Epidemiology, Dartmouth
- Geisel School of Medicine, Lebanon, NH, USA
| | - Frank J Penna
- Division of Pediatric Urology, Children's Hospital at Dartmouth, Dartmouth
- Geisel School of Medicine, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
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15
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Han X, Shao W, Yue Z, Xing L, Shen L, Long C, Zhang D, He D, Lin T, Wei G. [Di (2-ethylhexyl) phthalate-induced hypospadias in SD rats is related with Mafb expression: a transcriptome profiling-based study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:456-463. [PMID: 31068290 DOI: 10.12122/j.issn.1673-4254.2019.04.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the transcriptome profile of genital tubercles (GTs) in male SD rats and explore the mechanism of hypospadias induced by Di (2-ethylhexyl) phthalate (DEHP). METHODS Forty time-pregnant SD rats were randomly divided into 4 equal groups, namely GD16 group and GD19 group (in which the male GTs were collected on gestation day[GD]16 and GD19 for RNA-seq, respectively), control group and DEHP exposure group (with administration of oil and 750 mg/kg DEHP by gavage from GD12 to GD19, respectively).In the control and DEHP exposure groups, the GTs were collected from the male fetuses on GD19.5, and scanning electron microscopy and HE staining were used to observe the morphological changes.The differentially expressed genes (DEGs) in the GTs were screened using lllumina HiSeq 2000 followed by GO and KEGG enrichment analyses to characterize the transcriptome profile.Immunofluorescence assay was performed to verify the DEGs (Mafb) identified by RNA-seq results.Immunofluorescence assay and Western blotting were used to examine the expression levels of Mafb in the penile tissue. RESULTS A total of 1360 DEGs were detected in the GTs between GD16 group and GD19 group by RNA-seq.Among these genes, 797 were up-regulated and 563 were down-regulated.These DEGs were mainly enriched in the cell adhesion plaque signaling pathway, axon guidance signaling pathway, and extracellular matrix receptor signaling pathway.Compared with that in GD16 group, Mafb was significantly up-regulated in GD19 group, which was consistent with the sequencing results.Mafb and β-catenin were significantly down-regulated in DEHP-exposed group compared with the control group (P < 0.01). CONCLUSIONS Mafb expression increases progressively with the development of GTs in male SD rats.DEHP exposure causes significant down-regulation of Mafb and β-catenin, suggesting that β-catenin signaling pathway that affects Mafb is related to DEHP-induced hypospadias in SD rats.
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Affiliation(s)
- Xiang Han
- Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering, Chongqing 400014, China
| | - Wang Shao
- Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering, Chongqing 400014, China
| | - Zhou Yue
- Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering, Chongqing 400014, China
| | - Liu Xing
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Lianju Shen
- Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering, Chongqing 400014, China
| | - Chunlan Long
- Chongqing Key Laboratory of Child Urogenital Development and Tissue Engineering, Chongqing 400014, China
| | - Deying Zhang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Dawei He
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Tao Lin
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Guanghui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
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16
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White JT, Kovar E, Chambers TM, Sheth KR, Peckham-Gregory EC, O'Neill M, Langlois PH, Jorgez CJ, Lupo PJ, Seth A. Hypospadias Risk from Maternal Residential Exposure to Heavy Metal Hazardous Air Pollutants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E930. [PMID: 30875870 PMCID: PMC6466330 DOI: 10.3390/ijerph16060930] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 12/21/2022]
Abstract
Objective: Investigate whether residential prenatal exposure to heavy metal hazardous air pollutants (HMHAPs) is associated with an increased risk of hypospadias. Methods: Data on non-syndromic hypospadias cases (n = 8981) and control patients delivered in Texas were obtained from the Texas Birth Defects Registry and matched 1:10 by birth year. Average exposure concentrations of HMHAPs were obtained from the 2005 U.S. Environmental Protection Agency National-Scale Air Toxics Assessment and categorized into quintiles. Odds ratios and 95% confidence intervals were estimated. STROBE reporting guidelines were followed. Results: We observed associations between hypospadias and prenatal HMHAP exposure. Manganese demonstrated significant increased risk of hypospadias at the medium, medium-high and high exposure quintiles; lead in the medium-high and high exposure quintiles. Cadmium, mercury and nickel demonstrated a significant inverted "U-shaped" association for exposures with significant associations in the medium and medium-high quintiles but not in the medium-low and high quintiles. Arsenic and chromium demonstrated a significant bivalent association for risk of hypospadias in a lower quintile as well as a higher quintile with non-significant intermediate quintiles. Conclusions: Using data from one of the world's largest active surveillance birth defects registries, we identified significant associations between hypospadias and HMHAP exposures. These results should be used in counseling for maternal demographic risk factors as well as avoidance of heavy metals and their sources.
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Affiliation(s)
- Jeffrey T White
- Pediatric Urology, Norton Children's Hospital, Louisville, KY 40207, USA.
- Department of Urology, University of Louisville School of Medicine, Louisville, KY 40202, USA.
| | - Erin Kovar
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Tiffany M Chambers
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Kunj R Sheth
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
- Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital, Houston, TX 77030, USA.
| | - Erin C Peckham-Gregory
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
- Department of Pediatrics, Texas Children's Hospital, Houston, TX 77030, USA.
| | - Marisol O'Neill
- Department Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX 78751, USA.
| | - Carolina J Jorgez
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
- Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital, Houston, TX 77030, USA.
| | - Philip J Lupo
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
- Department of Pediatrics, Texas Children's Hospital, Houston, TX 77030, USA.
| | - Abhishek Seth
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
- Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital, Houston, TX 77030, USA.
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17
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Sheth KR, Kovar E, White JT, Chambers TM, Peckham-Gregory EC, O'Neill M, Langlois PH, Seth A, Scheurer ME, Lupo PJ, Jorgez CJ. Hypospadias risk is increased with maternal residential exposure to hormonally active hazardous air pollutants. Birth Defects Res 2019; 111:345-352. [PMID: 30694020 DOI: 10.1002/bdr2.1461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/19/2018] [Accepted: 12/28/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND With the increasing birth prevalence of hypospadias, there is growing concern for pollutant exposure interfering with normal penile development. We assess the association between hypospadias and hormonally active hazardous air pollutants (HAHAPs) through a nationwide database of hazardous air pollutants and the Texas Birth Defects Registry (TBDR). METHODS Using the TBDR, we identified 8,981 nonsyndromic isolated hypospadias cases from 1999 to 2008. Birth certificate controls were matched for birth year at a 10:1 ratio to cases. Estimated HAHAP concentrations from the 2005 U.S. EPA National-Scale Air Toxics Assessment were used to assign exposure based on maternal residence at birth. Exposure levels were categorized as quintiles based on the distribution in controls. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for each increasing exposure category of selected HAHAPs. RESULTS Of the 10 HAHAPs studied, seven were significantly associated with hypospadias risk. The HAHAP that was most strongly associated with hypospadias was phenol, which was associated with risk in all groups except the high exposure group. Cumulative HAHAP exposure demonstrated a modest increase in hypospadias risk (OR 1.15, 95% CI: 1.07-1.24, p < 0.001) in the medium and medium-high quintiles. CONCLUSIONS While maternal exposure to some HAHAPs was significantly associated with the risk of hypospadias in male offspring, the effects were modest, and no dose-response effects were observed. Future work should employ biomarkers of exposure to better delineate the relationship.
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Affiliation(s)
- Kunj R Sheth
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas.,Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital, Houston, Texas.,Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas
| | - Erin Kovar
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jeffrey T White
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas.,Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital, Houston, Texas.,Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas
| | - Tiffany M Chambers
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Erin C Peckham-Gregory
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Texas Children's Hospital, Houston, Texas
| | - Marisol O'Neill
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas.,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas
| | - Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - Abhishek Seth
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas.,Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital, Houston, Texas.,Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas
| | - Michael E Scheurer
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Texas Children's Hospital, Houston, Texas
| | - Philip J Lupo
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Texas Children's Hospital, Houston, Texas
| | - Carolina J Jorgez
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas.,Division of Pediatric Urology, Department of Surgery, Texas Children's Hospital, Houston, Texas.,Center for Reproductive Medicine, Baylor College of Medicine, Houston, Texas
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18
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Kalliora C, Mamoulakis C, Vasilopoulos E, Stamatiades GA, Kalafati L, Barouni R, Karakousi T, Abdollahi M, Tsatsakis A. Association of pesticide exposure with human congenital abnormalities. Toxicol Appl Pharmacol 2018; 346:58-75. [PMID: 29596925 PMCID: PMC6029725 DOI: 10.1016/j.taap.2018.03.025] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/04/2018] [Accepted: 03/22/2018] [Indexed: 01/10/2023]
Abstract
Human pesticide exposure can occur both occupationally and environmentally during manufacture and after the application of indoor and outdoor pesticides, as well as through consumption via residues in food and water. There is evidence from experimental studies that numerous pesticides, either in isolation or in combination, act as endocrine disruptors, neurodevelopmental toxicants, immunotoxicants, and carcinogens. We reviewed the international literature on this subject for the years between 1990 and 2017. The studies were considered in this review through MEDLINE and WHO resources. Out of the n = 1817 studies identified, n = 94 were reviewed because they fulfilled criteria of validity and addressed associations of interest. Epidemiological studies have provided limited evidence linking pre- and post-natal exposure to pesticides with cancers in childhood, neurological deficits, fetal death, intrauterine growth restriction, preterm birth, and congenital abnormalities (CAs). In this review, the potential association between pesticide exposure and the appearance of some human CAs (including among others musculoskeletal abnormalities; neural tube defects; urogenital and cardiovascular abnormalities) was investigated. A trend towards a positive association between environmental or occupational exposure to some pesticides and some CAs was detected, but this association remains to be substantiated. Main limitations of the review include inadequate exposure assessment and limited sample size. Adequately powered studies with precise exposure assessments such as biomonitoring, are warranted to clarify with certainty the potential association between pesticide exposure and human CAs.
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Affiliation(s)
- Charikleia Kalliora
- Medical School, University of Crete, Heraklion, Crete, Greece; Department of Pharmacology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Crete, Greece.
| | | | - George A Stamatiades
- Division of Endocrinology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Roza Barouni
- Department of Biology, University of Athens, Greece
| | | | - Mohammad Abdollahi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran, Iran
| | - Aristidis Tsatsakis
- Department of Toxicology & Forensic Science, Medical School, University of Crete, Voutes Campus, Heraklion 71003, Greece
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19
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Le Cornet C, Fervers B, Pukkala E, Tynes T, Feychting M, Hansen J, Togawa K, Nordby KC, Oksbjerg Dalton S, Uuksulainen S, Wiebert P, Woldbæk T, Skakkebæk NE, Olsson A, Schüz J. Parental Occupational Exposure to Organic Solvents and Testicular Germ Cell Tumors in their Offspring: NORD-TEST Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:067023. [PMID: 28893722 PMCID: PMC5743448 DOI: 10.1289/ehp864] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/16/2016] [Accepted: 12/22/2016] [Indexed: 05/28/2023]
Abstract
BACKGROUND Testicular germ cell tumors (TGCT) were suggested to have a prenatal environmentally related origin. The potential endocrine disrupting properties of certain solvents may interfere with the male genital development in utero. OBJECTIVES We aimed to assess the association between maternal and paternal occupational exposures to organic solvents during the prenatal period and TGCT risk in their offspring. METHODS This registry-based case control study included TGCT cases aged 14–49 y (n=8,112) diagnosed from 1978 to 2012 in Finland, Norway, and Sweden. Controls (n=26,264) were randomly selected from the central population registries and were individually matched to cases on year and country of birth. Occupational histories of parents prior to the child’s birth were extracted from the national censuses. Job codes were converted into solvent exposure using the Nordic job-Nordic Occupational Cancer Study Job-Exposure Matrix. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Overall, no association was found between prenatal maternal exposure to solvents and TGCT risk. In subset analyses using only mothers for whom occupational information was available in the year of or in the year prior to the child’s birth, there was an association with maternal exposure to aromatic hydrocarbon solvents (ARHC) (OR=1.53; CI: 1.08, 2.17), driven by exposure to toluene (OR=1.67; CI: 1.02, 2.73). No association was seen for any paternal occupational exposure to solvents with the exception of exposure to perchloroethylene in Finland (OR=2.42; CI: 1.32, 4.41). CONCLUSIONS This study suggests a modest increase in TGCT risk associated with maternal prenatal exposure to ARHC. https://doi.org/10.1289/EHP864.
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Affiliation(s)
- Charlotte Le Cornet
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC) , Lyon, France
- Division of Cancer Epidemiology, Deutsches Krebsforschungszentrum (DKFZ) , Heidelberg, Germany
| | - Béatrice Fervers
- Département Cancer et Environnement, Centre Léon Bérard , Lyon, France
- Université Claude Bernard-Lyon1 , 43 Blvd. du 11 Novembre 1918 , Villeurbanne, France
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research , Helsinki, Finland
- Faculty of Social Sciences, University of Tampere , Finland
| | - Tore Tynes
- Cancer Registry of Norway, Majorstuen, Oslo, Norway
- National Institute of Occupational Health , Oslo, Norway
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet , Stockholm, Sweden
| | - Johnni Hansen
- Danish Cancer Society Research Center , Copenhagen, Denmark
| | - Kayo Togawa
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC) , Lyon, France
| | | | | | | | - Pernilla Wiebert
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet , Stockholm, Sweden
| | - Torill Woldbæk
- National Institute of Occupational Health , Oslo, Norway
| | - Niels E Skakkebæk
- International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark
| | - Ann Olsson
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC) , Lyon, France
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet , Stockholm, Sweden
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC) , Lyon, France
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20
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Bonde JP, Flachs EM, Rimborg S, Glazer CH, Giwercman A, Ramlau-Hansen CH, Hougaard KS, Høyer BB, Hærvig KK, Petersen SB, Rylander L, Specht IO, Toft G, Bräuner EV. The epidemiologic evidence linking prenatal and postnatal exposure to endocrine disrupting chemicals with male reproductive disorders: a systematic review and meta-analysis. Hum Reprod Update 2016; 23:104-125. [PMID: 27655588 PMCID: PMC5155570 DOI: 10.1093/humupd/dmw036] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/22/2016] [Accepted: 08/31/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND More than 20 years ago, it was hypothesized that exposure to prenatal and early
postnatal environmental xenobiotics with the potential to disrupt endogenous
hormone signaling might be on the causal path to cryptorchidism, hypospadias, low
sperm count and testicular cancer. Several consensus statements and narrative
reviews in recent years have divided the scientific community and have elicited a
call for systematic transparent reviews. We aimed to fill this gap in knowledge in
the field of male reproductive disorders. OBJECTIVE AND RATIONALE The aim of this study was to systematically synthesize published data on the risk
of cryptorchidism, hypospadias, low sperm counts and testicular cancer following
in utero or infant exposure to chemicals that have been
included on the European Commission's list of Category 1 endocrine
disrupting chemicals defined as having documented adverse effects due to endocrine
disruption in at least one intact organism. SEARCH METHODS A systematic literature search for original peer reviewed papers was performed in
the databases PubMed and Embase to identify epidemiological studies reporting
associations between the outcomes of interest and exposures documented by
biochemical analyses of biospecimens including maternal blood or urine, placenta
or fat tissue as well as amnion fluid, cord blood or breast milk; this was
followed by meta-analysis of quantitative data. OUTCOMES The literature search resulted in 1314 references among which we identified 33
papers(28 study populations) fulfilling the eligibility criteria. These provided
85 risk estimates of links between persistent organic pollutants and rapidly
metabolized compounds (phthalates and Bisphenol A) and male reproductive
disorders. The overall odds ratio (OR) across all exposures and outcomes was 1.11
(95% CI 0.91–1.35). When assessing four specific chemical subgroups
with sufficient data for meta-analysis for all outcomes, we found that exposure to
one of the four compounds, p,p′-DDE, was related to an elevated risk: OR
1.35 (95% CI 1.04–1.74). The data did not indicate that this
increased risk was driven by any specific disorder. WIDER IMPLICATIONS The current epidemiological evidence is compatible with a small increased risk of
male reproductive disorders following prenatal and postnatal exposure to some
persistent environmental chemicals classified as endocrine disruptors but the
evidence is limited. Future epidemiological studies may change the weight of the
evidence in either direction. No evidence of distortion due to publication bias
was found, but exposure–response relationships are not evident. There are
insufficient data on rapidly metabolized endocrine disruptors and on specific
exposure–outcome relations. A particular data gap is evident with respect
to delayed effects on semen quality and testicular cancer. Although high quality
epidemiological studies are still sparse, future systematic and transparent
reviews may provide pieces of evidence contributing to the narrative and weight of
the evidence assessments in the field.
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Affiliation(s)
- Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark .,Institute of Public Health, University of Copenhagen, DK-1016 Copenhagen K, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Susie Rimborg
- The Royal Library/ University of Copenhagen Library, DK-2200 Copenhagen N, Denmark
| | - Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Lund, Sweden
| | | | - Karin Sørig Hougaard
- National Research Centre for the Working Environment, DK-2100 Copenhagen Ø, Denmark
| | - Birgit Bjerre Høyer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark.,Department of Clinical Epidemiology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Katia Keglberg Hærvig
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Sesilje Bondo Petersen
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Lars Rylander
- Department of Occupational and Environmental Medicine, University of Lund, SE-221 85 Lund, Sweden
| | - Ina Olmer Specht
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Gunnar Toft
- Department of Clinical Epidemiology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark.,Research Center for Prevention and Health (RCPH), University of Copenhagen, DK-2600 Glostrup, Denmark
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21
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Abstract
Introduction Endocrine disruptors or environmental agents, disrupt the endocrine system, leading to various adverse effects in humans and animals. Although the phenomenon has been noted historically in the cases of diethylstilbestrol (DES) and dichlorodiphenyltrichloroethane (DDT), the term “endocrine disruptor” is relatively new. Endocrine disruptors can have a variety of hormonal activities such as estrogenicity or anti-androgenicity. The focus of this review concerns on the induction of hypospadias by exogenous estrogenic endocrine disruptors. This has been a particular clinical concern secondary to reported increased incidence of hypospadias. Herein, the recent literature is reviewed as to whether endocrine disruptors cause hypospadias. Methods A literature search was performed for studies involving both humans and animals. Studies within the past 5 years were reviewed and categorized into basic science, clinical science, epidemiologic, or review studies. Results Forty-three scientific articles were identified. Relevant sentinel articles were also reviewed. Additional pertinent studies were extracted from the reference of the articles that obtained from initial search results. Each article was reviewed and results presented. Overall, there were no studies which definitely stated that endocrine disruptors caused hypospadias. However, there were multiple studies which implicated endocrine disruptors as one component of a multifactorial model for hypospadias. Conclusions Endocrine disruption may be one of the many critical steps in aberrant development that manifests as hypospadias.
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Affiliation(s)
- Sisir Botta
- Department of Urology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Gerald R Cunha
- Department of Urology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Laurence S Baskin
- Department of Urology, University of California San Francisco, San Francisco, CA 94143, USA
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22
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Bouty A, Ayers KL, Pask A, Heloury Y, Sinclair AH. The Genetic and Environmental Factors Underlying Hypospadias. Sex Dev 2015; 9:239-259. [PMID: 26613581 DOI: 10.1159/000441988] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 12/22/2022] Open
Abstract
Hypospadias results from a failure of urethral closure in the male phallus and affects 1 in 200-300 boys. It is thought to be due to a combination of genetic and environmental factors. The development of the penis progresses in 2 stages: an initial hormone-independent phase and a secondary hormone-dependent phase. Here, we review the molecular pathways that contribute to each of these stages, drawing on studies from both human and mouse models. Hypospadias can occur when normal development of the phallus is disrupted, and we provide evidence that mutations in genes underlying this developmental process are causative. Finally, we discuss the environmental factors that may contribute to hypospadias and their potential immediate and transgenerational epigenetic impacts.
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Affiliation(s)
- Aurore Bouty
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Melbourne, Vic., Australia.,Department of Surgery, Royal Children's Hospital, University of Melbourne, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Katie L Ayers
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Andrew Pask
- Department of Zoology, University of Melbourne, Melbourne, Vic., Australia
| | - Yves Heloury
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Melbourne, Vic., Australia.,Department of Surgery, Royal Children's Hospital, University of Melbourne, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Andrew H Sinclair
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
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23
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Background fish feminization effects in European remote sites. Sci Rep 2015; 5:11292. [PMID: 26061088 PMCID: PMC4462152 DOI: 10.1038/srep11292] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 05/18/2015] [Indexed: 11/08/2022] Open
Abstract
Human activity has spread trace amounts of chemically stable endocrine-disrupting pollutants throughout the biosphere. These compounds have generated a background level of estrogenic activity that needs to be assessed. Fish are adequate sentinels for feminization effects as male specimens are more sensitive than humans to exogenous estrogenic compounds. High mountain lakes, the most distant environments of continental areas, only receive semi-volatile compounds from atmospheric deposition. We analyzed the expression levels of estrogen-regulated genes in male fish from these mountain lakes in Europe. Incipient feminization involving expression of estrogen receptor and zona radiata genes revealed a widespread diffuse estrogenic impact. This effect was correlated with the concentrations of some organochlorine compounds in fish and was consistent with the persistent occurrence of these tropospheric pollutants in the most remote planet regions. These results should be of general concern given the increasing endocrine disruption effects in human populations.
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24
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Svechnikov K, Stukenborg JB, Savchuck I, Söder O. Similar causes of various reproductive disorders in early life. Asian J Androl 2014; 16:50-9. [PMID: 24369133 PMCID: PMC3901882 DOI: 10.4103/1008-682x.122199] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
During the past few decades, scientific evidence has been accumulated concerning the possible adverse effects of the exposure to environmental chemicals on the well-being of wildlife and human populations. One large and growing group of such compounds of anthropogenic or natural origin is referred to as endocrine-disrupting chemicals (EDCs), due to their deleterious action on the endocrine system. This concern was first focused on the control of reproductive function particularly in males, but has later been expanded to include all possible endocrine functions. The present review describes the underlying physiology behind the cascade of developmental events that occur during sexual differentiation of males and the specific role of androgen in the masculinization process and proper organogenesis of the external male genitalia. The impact of the genetic background, environmental exposures and lifestyle factors in the etiology of hypospadias, cryptorchidism and testicular cancer are reviewed and the possible role of EDCs in the development of these reproductive disorders is discussed critically. Finally, the possible direct and programming effects of exposures in utero to widely use therapeutic compounds, environmental estrogens and other chemicals on the incidence of reproductive abnormalities and poor semen quality in humans are also highlighted.
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Affiliation(s)
| | | | | | - Olle Söder
- Department of Women's and Children's Health, Paediatric Endocrinology Unit, Karolinska Institutet and University Hospital, Stockholm, Sweden
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25
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Jeng HA. Exposure to endocrine disrupting chemicals and male reproductive health. Front Public Health 2014; 2:55. [PMID: 24926476 PMCID: PMC4046332 DOI: 10.3389/fpubh.2014.00055] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 05/12/2014] [Indexed: 11/18/2022] Open
Abstract
Endocrine disrupting chemicals (EDCs) can interfere with normal hormonal balance and may exert adverse consequences on humans. The male reproductive system may be susceptible to the effects of such environmental toxicants. This review discusses the recent progress in scientific data mainly from epidemiology studies on the associations between EDCs and male reproductive health and our understanding of possible mechanisms associated with the effects of EDCs on male reproductive health. Finally, the review provides recommendations on future research to enhance our understanding of EDCs and male reproductive health. The review highlights the need for (1) well-defined longitudinal epidemiology studies, with appropriately designed exposure assessment to determine potential causal relationships; (2) chemical and biochemical approaches aimed at a better understanding of the mechanism of action of xenoestrogens with regard to low-dose effects, and assessment of identify genetic susceptibility factors associated with the risk of adverse effects following exposure to EDCs.
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Affiliation(s)
- Hueiwang Anna Jeng
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University , Norfolk, VA , USA
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26
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Heavy metal levels in adolescent and maternal blood: association with risk of hypospadias. ISRN PEDIATRICS 2014; 2014:714234. [PMID: 24729887 PMCID: PMC3960776 DOI: 10.1155/2014/714234] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 01/20/2014] [Indexed: 11/18/2022]
Abstract
Background. Hypospadias is a part of testicular digenesis syndrome (TDS) which includes infertility, cryptorchidism, and spermatogenesis. Heavy metals act as endocrine disrupting compounds. Heavy metals such as cadmium, chromium, arsenic, and lead have been associated with male infertility, cryptorchidism, spermatogenesis, cancer, reproductive disorder, and neurological disorder. However, it remains an important issue to corroborate or refute the hypothesis that the role of heavy metals in male reproductive tract disorders. Hence, the present study was designed to investigate the possible association of heavy metal and risk of hypospadias by estimating the blood heavy metal levels. Methods. In this case control study, 50 hypospadias boys diagnosed and confirmed by a pediatric urologist and 50 randomly selected age-matched (1-5 years) healthy control boys not suffering from any clinically detectible illness and their mothers have been included and heavy metal levels in the blood of these subjects have been estimated by Atomic Absorption Spectrophotometer (AAS). Result. Significantly high levels of cadmium and lead have been observed in hypospadias cases; however, all heavy metal levels were present in higher concentration. Conclusion. Higher blood levels of cadmium and lead may be associated with the increased risk of hypospadias.
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27
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Carmichael SL, Yang W, Roberts EM, Kegley SE, Wolff C, Guo L, Lammer EJ, English P, Shaw GM. Hypospadias and residential proximity to pesticide applications. Pediatrics 2013; 132:e1216-26. [PMID: 24167181 PMCID: PMC3813401 DOI: 10.1542/peds.2013-1429] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Experimental evidence suggests pesticides may be associated with hypospadias. OBJECTIVE Examine the association of hypospadias with residential proximity to commercial agricultural pesticide applications. METHODS The study population included male infants born from 1991 to 2004 to mothers residing in 8 California counties. Cases (n = 690) were ascertained by the California Birth Defects Monitoring Program; controls were selected randomly from the birth population (n = 2195). We determined early pregnancy exposure to pesticide applications within a 500-m radius of mother's residential address, using detailed data on applications and land use. Associations with exposures to physicochemical groups of pesticides and specific chemicals were assessed using logistic regression adjusted for maternal race or ethnicity and age and infant birth year. RESULTS Forty-one percent of cases and controls were classified as exposed to 57 chemical groups and 292 chemicals. Despite >500 statistical comparisons, there were few elevated odds ratios with confidence intervals that excluded 1 for chemical groups or specific chemicals. Those that did were for monochlorophenoxy acid or ester herbicides; the insecticides aldicarb, dimethoate, phorate, and petroleum oils; and adjuvant polyoxyethylene sorbitol among all cases; 2,6-dinitroaniline herbicides, the herbicide oxyfluorfen, and the fungicide copper sulfate among mild cases; and chloroacetanilide herbicides, polyalkyloxy compounds used as adjuvants, the insecticides aldicarb and acephate, and the adjuvant nonyl-phenoxy-poly(ethylene oxy)ethanol among moderate and severe cases. Odds ratios ranged from 1.9 to 2.9. CONCLUSIONS Most pesticides were not associated with elevated hypospadias risk. For the few that were associated, results should be interpreted with caution until replicated in other study populations.
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Affiliation(s)
- Suzan L. Carmichael
- Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Wei Yang
- Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | | | | | | | - Liang Guo
- Public Health Institute, Oakland, California
| | - Edward J. Lammer
- Children's Hospital Oakland Research Institute, Oakland, California; and
| | - Paul English
- California Department of Public Health, Richmond, California
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28
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A nested case-control study of intrauterine exposure to persistent organochlorine pollutants and the risk of hypospadias. PLoS One 2012; 7:e44767. [PMID: 23028613 PMCID: PMC3459969 DOI: 10.1371/journal.pone.0044767] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 08/07/2012] [Indexed: 11/19/2022] Open
Abstract
Background Environmental exposures to endocrine disrupting chemicals have been suggested as a risk factor for male genital abnormalities such as hypospadias. The aim of this case-control study was to investigate the association between fetal exposure to persistent organochlorine pollutants (POP) and the risk for hypospadias. Methodology/Principal Findings The Southern Sweden Maternity Cohort (SSMC) contains serum samples collected in early pregnancy among women in Southern Sweden. Linkages with the Medical Birth Register, the Malformation Register and the In-patient Register resulted in 390 SSMC mothers who had given birth to a boy with hypospadias in year 1986–2002 (mean 1995). For 237 of these (cases) sufficient amounts of serum for the chemical analyses were available. For each case, a control boy from the SSMC was randomly selected, matched for maternal age, birth year, parity and maternal smoking. PCB-153, p,p’-DDE and hexachlorbenzene (HCB) were used as biomarkers for POP exposure. The exposures were categorized into quartiles based on the distributions among the controls. There were no statistically significant trends between the a priori categorisation of the exposure variables and the risk for hypospadias. However, when the upper HCB quartile (>26 ng/ml) was compared to the other quartiles an odds ratio of 1.65 (95% CI 1.02 to 2.69) was obtained. p,p′-DDE levels above median (>1.0 ng/ml) compared to levels below 0.1 ng/ml gave an OR of 1.69 (95% CI 0.97 to 2.93). Conclusions The present study suggests that fetal exposure to HCB and p,p’-DDE may be a risk factor for hypospadias.
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29
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Carmichael SL, Ma C, Feldkamp ML, Munger RG, Olney RS, Botto LD, Shaw GM, Correa A. Nutritional factors and hypospadias risks. Paediatr Perinat Epidemiol 2012; 26:353-60. [PMID: 22686387 PMCID: PMC3376012 DOI: 10.1111/j.1365-3016.2012.01272.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND We examined whether hypospadias was associated with several aspects of the diet, including intake of animal products, intake of several nutrients and food groups related to a vegetarian diet and oestrogen metabolism, and diet quality. METHODS The study included deliveries from 1997 to 2005 that were part of the National Birth Defects Prevention Study. Diet was assessed by food frequency questionnaire during maternal telephone interviews, and two diet quality indices were developed based on existing indices. Analyses included 1250 cases with second- or third-degree hypospadias (urethra opened at the penile shaft, scrotum or perineum) and 3118 male, liveborn, non-malformed controls. All odds ratios (OR) and 95% confidence intervals [CI] were estimated from logistic regression models that included several potential confounders, including energy intake. RESULTS Intake of animal products was not associated with hypospadias; for example, the adjusted OR for any vs. no intake of meat was 1.0 [95% CI 0.6, 1.6]. Frequency of intake of meat or other animal products was also not associated with hypospadias, nor was intake of iron or several nutrients that are potentially related to oestrogen metabolism. Diet quality was also not associated with hypospadias; the OR for diet quality in the highest vs. lowest quartile for the two diet quality indices were 1.0 [95% CI 0.6, 1.6] and 0.9 [95% CI 0.7, 1.1]. CONCLUSION This large study does not support an association of a vegetarian diet or worse diet quality with hypospadias.
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Affiliation(s)
- Suzan L. Carmichael
- Department of Pediatrics, Stanford University, Stanford, CA,Corresponding author: Dr. Suzan L. Carmichael, Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, 1265 Welch Road, Rm. X111, Stanford, CA 94305-5415, telephone 650.736.0735, fax 650.721.5751,
| | - Chen Ma
- Department of Pediatrics, Stanford University, Stanford, CA
| | - Marcia L. Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT,Utah Birth Defect Network, Utah Department of Health, Salt Lake City, UT
| | - Ronald G. Munger
- Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT
| | - Richard S. Olney
- National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA
| | - Lorenzo D. Botto
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT,Utah Birth Defect Network, Utah Department of Health, Salt Lake City, UT
| | - Gary M. Shaw
- Department of Pediatrics, Stanford University, Stanford, CA
| | - Adolfo Correa
- National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA
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30
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Carmichael SL, Shaw GM, Lammer EJ. Environmental and genetic contributors to hypospadias: a review of the epidemiologic evidence. BIRTH DEFECTS RESEARCH. PART A, CLINICAL AND MOLECULAR TERATOLOGY 2012; 94:499-510. [PMID: 22678668 PMCID: PMC3393839 DOI: 10.1002/bdra.23021] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 03/22/2012] [Accepted: 03/28/2012] [Indexed: 12/28/2022]
Abstract
This review evaluates current knowledge related to trends in the prevalence of hypospadias, the association of hypospadias with endocrine-disrupting exposures, and the potential contribution of genetic susceptibility to its etiology. The review focuses on epidemiologic evidence. Increasing prevalence of hypospadias has been observed, but such increases tend to be localized to specific regions or time periods. Thus, generalized statements that hypospadias is increasing are unsupported. Owing to the limitations of study designs and inconsistent results, firm conclusions cannot be made regarding the association of endocrine-disrupting exposures with hypospadias. Studies with more rigorous study designs (e.g., larger and more detailed phenotypes) and exposure assessment that encompasses more breadth and depth (e.g., specific endocrine-related chemicals) will be critical to make better inferences about these important environmental exposures. Many candidate genes for hypospadias have been identified, but few of them have been examined to an extent that enables solid conclusions. Further study is needed that includes larger sample sizes, comparison groups that are more representative of the populations from which the cases were derived, phenotype-specific analyses, and more extensive exploration of variants. In conclusion, examining the associations of environmental and genetic factors with hypospadias remain important areas of inquiry, although our actual understanding of their contribution to hypospadias risk in humans is currently limited.
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Affiliation(s)
- Suzan L Carmichael
- Department of Pediatrics, Division of Neonatology, Stanford University School of Medicine, California, USA.
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31
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Deibert CM, Hensle TW. The psychosexual aspects of hypospadias repair: A review. Arab J Urol 2011; 9:279-82. [PMID: 26579312 PMCID: PMC4150566 DOI: 10.1016/j.aju.2011.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 10/16/2011] [Accepted: 10/16/2011] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE To review the psychosexual effects on men after hypospadias repair. METHODS We reviewed all English-language publications in the MEDLINE database from the US National Library of Medicine with the search terms 'hypospadias adult', 'psychosexual hypospadias', 'psychosocial hypospadias', and 'social hypospadias'. Each term returned 1036, 35, 19 and 68 results, respectively, which were reviewed. RESULTS While improvements in surgical techniques have improved function, the abnormality and repair still causes a disruption in perceived quality of life for many men. After repair, many men suffer from a negative view of their genitals and some degree of sexual inhibition. However, they still maintain a satisfactory sex life. CONCLUSIONS Psychosexual effects of hypospadias repair they endure in adulthood, although affected men maintain satisfaction with their sexual life.
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Affiliation(s)
- Christopher M Deibert
- Columbia University, College of Physicians and Surgeons, 161 Fort Washington Ave, 11th Floor, New York, NY 10032, USA
| | - Terry W Hensle
- Columbia University, College of Physicians and Surgeons, Teaneck, NJ, USA
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32
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Cook MB, Trabert B, McGlynn KA. Organochlorine compounds and testicular dysgenesis syndrome: human data. INTERNATIONAL JOURNAL OF ANDROLOGY 2011; 34:e68-84; discussion e84-5. [PMID: 21668838 PMCID: PMC3145030 DOI: 10.1111/j.1365-2605.2011.01171.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cryptorchidism, hypospadias, subfertility and testicular germ-cell tumour have been suggested to comprise a testicular dysgenesis syndrome (TDS) based on the premise that each may derive from perturbations of embryonal programming and gonadal development during foetal life. Endocrine-disrupting chemicals have been hypothesized to be associated with these disorders, given the importance of sex steroid hormones in urogenital development and homeostasis. Organochlorines are one such set of compounds which are defined as containing between one and ten covalently bonded chlorine atoms. These compounds are persistent pollutants with long half-lives, accumulate in adipose tissue when ingested, bioaccumulate and biomagnify, and have complex and variable toxicological profiles. Examples of organochlorines include dichloro-diphenyl-trichloroethane and its metabolites, polychlorinated biphenyls, and chlordane. In this comprehensive review of human epidemiologic studies which have tested for associations between organochlorines and facets of TDS, we find evidence for associations between the exposures p,p'-DDE, cis-nonachlor and trans-nonachlor with testicular germ-cell tumour. The sum of the evidence from human epidemiological studies does not indicate any association between specific organochlorines studied and cryptorchidism, hypospadias or fertility. Many other endocrine-disrupting chemicals, including additional organochlorines, have yet to be assessed in relation to disorders associated with TDS, yet study of such chemicals has strong scientific merit given the relevance of such hypotheses to urogenital development.
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Affiliation(s)
- M B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20852-7234, USA.
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