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Laccetta G, Di Chiara M, Cardillo A, De Nardo MC, Terrin G. The effects of industrial chemicals bonded to plastic materials in newborns: A systematic review. ENVIRONMENTAL RESEARCH 2023; 239:117298. [PMID: 37821060 DOI: 10.1016/j.envres.2023.117298] [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: 08/13/2023] [Revised: 09/21/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Phthalates are a family of industrial chemicals noncovalently bonded to plastic materials to enhance flexibility and durability. These compounds are extensively used in a variety of consumer products and even in many medical devices. Newborns present a higher susceptibility to phthalates. OBJECTIVE To assess the short- and long-term health consequences of exposure to phthalates during the neonatal period. METHODS Systematic review in accordance with the PRISMA statements. Eligible articles in English language were searched in MEDLINE, Scopus, ISI Web of Science, and Ovid databases using the following terms: "phthalate", "newborn", and "neonate". Unpublished data were searched in ClinicalTrials.gov website. All in vivo studies of any design published before May 16th, 2023 and fulfilling the following criteria were included: 1) investigations in which preterm and/or term newborns underwent one or more measurement of concentrations of phthalates on biological samples taken during the neonatal period; 2) studies in which quantitative measurement of phthalates was related to any kind of health outcome. Subgroup analysis was conducted by type of outcome. The quality assessment was performed according to the criteria from the "NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies". RESULTS 11,895 records were identified; finally, 5 articles were included for review. A mixture of phthalates was associated with improved performance on the NNNS summary scales of Attention, Handling, and Non-optimal reflexes before NICU discharge. At 2 months' corrected age, some phthalates were positively associated with problem-solving and gross motor abilities; increased levels of mono (2-ethylhexyl) phthalate, mono (2-ethyl-5-carboxypentyl) phthalate, and sum of di (2-ethylhexyl) phthalate (DEHP) metabolites (∑3DEHP and ∑4DEHP) were associated with worse fine motor performance. Furthermore, DEHP was associated with transient alteration of gut microbiota and increased IgM production after vaccine. A linear positive association between a mixture of phthalates and slope of the first growth spurt was even reported in preterm newborns. No relationship emerged between phthalates and bronchopulmonary dysplasia. Three studies out of 5 had fair quality. CONCLUSION Given some methodological issues and the paucity of related studies, further investigations of flawless quality aimed at clarifying the relationship between early exposure to phthalates and health outcomes are needed.
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Affiliation(s)
- Gianluigi Laccetta
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Maria Di Chiara
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Annalisa Cardillo
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Maria Chiara De Nardo
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Gianluca Terrin
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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Terada T, Kanou M, Hashimoto Y, Tanimoto M, Sugimoto M. Microfluidic Preparation of Nanoparticles Using Poly(ethylene Glycol)-distearoylphosphatidylethanolamine for Solubilizing Poorly Soluble Drugs. J Pharm Sci 2021; 111:1709-1718. [PMID: 34863973 DOI: 10.1016/j.xphs.2021.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 10/19/2022]
Abstract
Microfluidic systems have shown promise for the production of nanoparticles from mixtures of aqueous and organic solutions, including liposomes, oil-in-water nanoemulsions, and lipid nanoparticles. They offer important practical advantages, including low reagent consumption, parallelization, and automation, and are ideally suited to high-throughput optimization and scale-up. In this study, we developed a new method for the formulation of nanoparticles of poorly soluble drug compounds. The nanoparticles, prepared by microfluidic mixing using only poly(ethylene glycol)-distearoylphosphatidylethanolamine (PEG-DSPE), were highly stable and uniform in size. By mixing an organic solution of poorly soluble cyclosporine A and PEG-DSPE with water in the microfluidic device, amorphous cyclosporine A nanoparticles (CsA-NPs), with an encapsulation efficiency of approximately 90% and a particle size of 100-200 nm, were obtained. Analysis of the microfluidic process parameters revealed that particle size distribution was significantly controlled by the flow rate ratio. The obtained CsA-NPs were stable for up to 150 days at room temperature, and the pharmacokinetic profile was similar to that of the commercial formulation containing Cremophor EL, which has been reported to induce serious adverse effects after intravenous administration. These findings provide a useful technical platform for the safe solubilization of poorly soluble compounds and their subsequent pharmaceutical development.
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Affiliation(s)
- Takeshi Terada
- Pharmaceutical Research Department, Mitsubishi Tanabe Pharma Corporation, 3-16-89, Kashima, Yodogawa-ku, Osaka-shi, Osaka, 532-8505, Japan..
| | - Masahito Kanou
- Pharmaceutical Research Department, Mitsubishi Tanabe Pharma Corporation, 3-16-89, Kashima, Yodogawa-ku, Osaka-shi, Osaka, 532-8505, Japan
| | - Yousuke Hashimoto
- Pharmaceutical Research Department, Mitsubishi Tanabe Pharma Corporation, 3-16-89, Kashima, Yodogawa-ku, Osaka-shi, Osaka, 532-8505, Japan
| | - Masahiko Tanimoto
- Pharmaceutical Research Department, Mitsubishi Tanabe Pharma Corporation, 3-16-89, Kashima, Yodogawa-ku, Osaka-shi, Osaka, 532-8505, Japan
| | - Masaaki Sugimoto
- Pharmaceutical Research Department, Mitsubishi Tanabe Pharma Corporation, 3-16-89, Kashima, Yodogawa-ku, Osaka-shi, Osaka, 532-8505, Japan
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Cai J, Shi G, Zhang Y, Zheng Y, Yang J, Liu Q, Gong Y, Yu D, Zhang Z. Taxifolin ameliorates DEHP-induced cardiomyocyte hypertrophy via attenuating mitochondrial dysfunction and glycometabolism disorder in chicken. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 255:113155. [PMID: 31539850 DOI: 10.1016/j.envpol.2019.113155] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 08/31/2019] [Accepted: 08/31/2019] [Indexed: 06/10/2023]
Abstract
Di-(2-ethylhexyl) phthalate (DEHP) is a prevalent environmental contaminant that severely impacts the health of human and animals. Taxifolin (TAX), a plant flavonoid isolated from yew, exerts protective effects on cardiac diseases. Nevertheless, whether DEHP could induce cardiomyocyte hypertrophy and its mechanism remains unclear. This study aimed to highlight the specific molecular mechanisms of DEHP-induced cardiomyocyte hypertrophy and the protective potential of TAX against it. Chicken primary cardiomyocytes were treated with DEHP (500 μM) and/or TAX (0.5 μM) for 24 h. The levels of glucose and adenosine triphosphate (ATP) were detected, and cardiac hypertrophy-related genes were validated by real-time quantitative PCR (qRT-PCR) and Western blot (WB) in vitro. The results showed that DEHP-induced cardiac hypertrophy was ameliorated by TAX, as indicated by the increased cardiomyocyte area and expression of atrial natriuretic peptide (ANP), natriuretic peptides A-like (BNP) and β-myosin heavy cardiac muscle (β-MHC). Furthermore, DEHP induced cardiac hypertrophy via the interleukin 6 (IL-6)/Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) pathway in vitro. In addition, DEHP disrupted mitochondrial function and glycometabolism by activating the insulin-like growth factor 1 (IGF1)/phosphatidylinositol 3-kinase (PI3K) pathway and the peroxisome proliferator activated receptors (PPARs)/PPARG coactivator 1 alpha (PGC-1α) pathway to induce cardiac hypertrophy in vitro. Intriguingly, those DEHP-induced changes were obviously alleviated by TAX treatment. Taken together, cardiac hypertrophy was induced by DEHP via activating the IL-6/JAK/STAT3 signaling pathway, triggering glycometabolism disorder and mitochondrial dysfunction in vitro, can be ameliorated by TAX. Our findings may provide a feasible molecular mechanism for the treatment of cardiomyocyte hypertrophy induced by DEHP.
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Affiliation(s)
- Jingzeng Cai
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China
| | - Guangliang Shi
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China; Key Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, PR China
| | - Yuan Zhang
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China
| | - Yingying Zheng
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China
| | - Jie Yang
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China
| | - Qi Liu
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China
| | - Yafan Gong
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China
| | - Dahai Yu
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China
| | - Ziwei Zhang
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, PR China; Key Laboratory of the Provincial Education Department of Heilongjiang for Common Animal Disease Prevention and Treatment, PR China; State Key Laboratory of Animal Nutrition, Beijing 100193, PR China.
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Abstract
Alternative plasticizers to di(2-ethylhexyl) phthalate (DEHP) for blood bags have been sought for many years. Cyclohexane-1,2-dicarboxylic acid, diisononylester (Hexamoll(®) DINCH(®)) is an alternative that has been evaluated in preliminary studies for compatibility and efficacy to preserve whole blood. While Hexamoll(®) DINCH(®) has an extensive database for mammalian toxicity via oral administration, data were needed to evaluate toxicity from intravenous (IV) administration to support the use of the plasticizer Hexamoll(®) DINCH(®) in blood bags. A series of studies was performed by slow IV injection or IV infusion of Hexamoll(®) DINCH(®), a highly viscous, hydrophobic substance, suspended in Intralipid(®) 20% (20% intravenous fat emulsion). Rats were injected once, followed by 14 days of recovery; injected daily for 5 days followed by 5 days of recovery, or infused for 29 days (4h/day) followed by 14 days of recovery. Dose levels were 0, 62, 125, and 250-300mg/kg body weight/day. These dose levels represent the limits of suspension and far exceed any anticipated exposures from migration out of plasticized blood bags. Animals were observed for signs of toxicity; body weight and feed consumption were measured; blood collected for clinical chemistry and hematology; and tissues collected and processed for histopathology. Special emphasis was placed on evaluating endpoints and tissues that are commonly associated with plasticizer exposure in rodents. Urine was collected during the 4-week study to quantify urinary metabolites of Hexamoll(®) DINCH(®). The results of the studies indicate that no substance-related toxicity occurred: no effects on behavior, no effects on organ weight, no effect on serum chemistry including thyroid hormones; and no effect on major organs, especially no testicular toxicity and no indication for peroxisome proliferation in the liver. The only effects seen were petechia and granulomas related to dissipation of suspended Hexamoll(®) DINCH(®) in the aqueous environment of the blood. However, the results of metabolite analyses demonstrate that Hexamoll(®) DINCH(®) was bioavailable. Therefore, based on the lack of Hexamoll(®) DINCH(®)-related systemic toxicity with the exception of the physical limitations, the no-observed-adverse-effect level for parenterally administered Hexamoll(®) DINCH(®) is considered to be 300mg/kg bw/day.
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Baccile N, Babonneau F, Thomas B, Coradin T. Introducing ecodesign in silica sol–gel materials. ACTA ACUST UNITED AC 2009. [DOI: 10.1039/b911123a] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Rosicarelli B, Stefanini S. DEHP effects on histology and cell proliferation in lung of newborn rats. Histochem Cell Biol 2008; 131:491-500. [DOI: 10.1007/s00418-008-0550-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2008] [Indexed: 11/28/2022]
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Brain JD, Blanchard JD, Heyder J, Wolfthal SF, Beck BD. Relative Toxicity of Di(2-Ethylhexyl) Sebacate and Related Compounds in an in Vivo Hamster Bioassay. Inhal Toxicol 2008. [DOI: 10.3109/08958379609002573] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hill SS, Shaw BR, Wu AH. The clinical effects of plasticizers, antioxidants, and other contaminants in medical polyvinylchloride tubing during respiratory and non-respiratory exposure. Clin Chim Acta 2001; 304:1-8. [PMID: 11165193 DOI: 10.1016/s0009-8981(00)00411-3] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In 1999, a Blue Ribbon Panel convened to examine the health effects of two commonly used plasticizers present in medical devices and toys. Of particular interest were the plasticizers used in medical tubing. Hospitalized patients can be exposed to a high dose of these chemicals while receiving respiratory therapy or during hemodialysis, and are more likely to be vulnerable to potentially ill effects than healthy individuals. After extensive review of existing research, the Panel concluded that there was not enough evidence of harmful health effects to remove di-(2-ethylhexyl) phthalate (DEHP) and other plasticizers from use in medical tubing. The Panel recognized the importance of plasticizers in enabling tubing such as PVC for respiratory support or in dialysis to be flexible enough for use in a variety of clinical applications that might not be possible with rigid (plasticizer-free) tubing. Nevertheless, we reviewed the literature regarding the health effects for five of the most common compounds, plasticizers and antioxidants found in medical tubing, and suggest that further clinical studies be conducted. We concur with the Panel's recommendation that alternative materials be developed and studied.
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Affiliation(s)
- S S Hill
- Department of Chemistry, 55 North Eagleville Road, University of Connecticut, Storrs, CT 06269-4060, USA
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Karle VA, Short BL, Martin GR, Bulas DI, Getson PR, Luban NL, O'Brien AM, Rubin RJ. Extracorporeal membrane oxygenation exposes infants to the plasticizer, di(2-ethylhexyl)phthalate. Crit Care Med 1997; 25:696-703. [PMID: 9142038 DOI: 10.1097/00003246-199704000-00023] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To determine the exposure to, and evaluate the potential toxicity from, the plasticizer, di(2-ethylhexyl)phthalate (DEHP) during extracorporeal membrane oxygenation (ECMO) therapy. DESIGN Protocol 1 consisted of a prospective comparison of three ECMO circuit designs in vitro. Protocol 2 consisted of a prospective, comparative clinical study evaluating DEHP plasma concentrations in ECMO vs. non-ECMO patients with respiratory failure. SETTING Neonatal intensive care unit at The Children's National Medical Center, Washington, DC. PATIENTS In protocol 2, 28 consecutive term infants were referred for ECMO therapy. Eighteen infants required ECMO; ten control patients received conventional ventilation and improved without ECMO. INTERVENTIONS In protocol 1, three ECMO circuit designs were primed in vitro with normal saline, albumin, and human blood, which was maintained at 37 degrees C and recirculated at 400 mL/min for 48 hrs. Plasma samples were obtained at time 0, 1 hr, and every 6 hrs. In protocol 2, ventilatory and cardiovascular management of the patients in the study was conducted by the attending physician. Patients were placed on ECMO when they met the institutional criteria for ECMO therapy. Daily plasma concentrations for DEHP were collected until 3 days after decannulation from bypass in the ECMO group. Control patients were sampled daily until extubation. Evidence of cardiac, liver, or lung toxicity was evaluated by Chest Radiographic Scores, liver function studies, and echocardiograms obtained on day 1, day 3, and the day of decannulation in the ECMO group, or at the time of extubation in the control group. Sedation, blood product transfusions as indicated, antibiotics, and hyperalimentation were administered to all patients. MEASUREMENTS AND MAIN RESULTS All DEHP plasma concentrations were measured by gas chromatography. In protocol 1, three circuits were studied: circuit A (small surface area); circuit B (larger surface area); and circuit C (surface area of A but with heparin-bonded tubing in the circuit). DEHP leached from circuit A at 0.32 +/- 0.12 microgram/ mL/hr, compared with 0.57 +/- 0.14 microgram/mL/hr from circuit B (p < .05). This amount of DEHP extrapolates in the ECMO patient to a potential exposure of 20 to 70 times that exposure from other medical devices or procedures, such as transfusions, dialysis, or short-term cardiopulmonary bypass. Circuit C showed almost no leaching from the circuit; DEHP concentrations decreased at a rate of 0.2 +/- 0.04 microgram/mL/ hr. In protocol 2, DEHP was undetected in the control patients. DEHP concentrations in ECMO patients were greater in the early course of ECMO. However, most patients cleared this compound from the plasma before decannulation. In contrast to the in vitro results in protocol 1, the average highest concentration at any time on bypass was 8.3 +/- 5.7 micrograms/mL or 2 mg/kg. CONCLUSIONS DEHP leaches from ECMO circuits, with potential exposure concentrations related to the surface area of the tubing in the ECMO circuit. Heparin bonding of the tubing eliminates this risk. Although significant concentrations of DEHP leach from the nonheparin-bonded circuits over time, our in vivo studies showed that the DEHP plasma concentrations were less than the previously reported values and do not correlate with any observable short-term toxicity. This compound may be either efficiently metabolized by the newborn, or redistributed into various tissues. Although signs of toxicity were not found in this study, long-term complications from chronic exposure to DEHP have not been determined.
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Affiliation(s)
- V A Karle
- Department of Pediatrics, George Washington University, School of Medicine, Washington, DC, USA
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Huber WW, Grasl-Kraupp B, Schulte-Hermann R. Hepatocarcinogenic potential of di(2-ethylhexyl)phthalate in rodents and its implications on human risk. Crit Rev Toxicol 1996; 26:365-481. [PMID: 8817083 DOI: 10.3109/10408449609048302] [Citation(s) in RCA: 227] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The plasticizer di(2-ethylhexyl) phthalate (DEHP), to which humans are extensively exposed, was found to be hepatocarcinogenic in rats and mice. DEHP is potentially set free from objects made of synthetic materials (e.g., those used in medicine). Chronically, the greatest amounts are transferred to persons undergoing hemodialysis (up to 3.1 mg/kg b.w. per day) who would thus be considered the individuals most endangered by tumorigenesis. Although toxicokinetics seem to play a certain unclear role in the course of DEHP-related toxicity, toxicodynamic factors appear more decisive. DEHP is a representative of "peroxisome proliferators" (PP), a distinct group of substances that, in rodents, do not only induce peroxisomes but also specific enzymes in other organelles, organ growth, and DNA synthesis. The cluster of the characteristic effects of PP is generally, although perhaps not quite appropriately summarized as "peroxisome proliferation," and is strongest in the liver. The lowest observed effect level (LOEL) and the no observed effect level (NOEL) of peroxisome proliferation in the rat, as determined by the induction of specific enzymes (peroxisomal beta-oxidation, carnitine-acetyl-transferase, cytochrome P-452), DNA synthesis, and hepatomegaly, may be assumed as 50 and 25 mg/kg b.w. per day, respectively. DEHP and other carcinogenic PP are neither genotoxic nor tumor initiators, but they appear to be tumor promoters, also implicating a threshold level for the carcinogenic effect. Although a causal relationship between a particular effect of peroxisome proliferation and hepatocarcinogenesis is as yet unknown, peroxisome proliferation as a whole phenomenon appears to be associated with the potential of tumor induction, as shown by comparison of the relative strength of individual PP and by comparison of species and organ specificities. Likewise, LOEL and NOEL of rodent carcinogenesis, that is, 300 and 50 to 100 mg/kg b.w. per day, respectively, are above but not too far from the corresponding values for the investigated parameters of peroxisome proliferation. Thus, with respect to dose alone, worst-case exposure in hemodialysis patients is at least 16-fold below the LOEL of any characterized PP-specific effect of DEHP and approximately 100-fold below that of DEHP-related tumorigenesis. Also, primates are less responsive to PP than rats with respect to the investigated biochemical and morphological parameters. If this lower primate responsiveness is extrapolated to estimate carcinogenicity in humans, we might thus arrive at an even larger safety margin than when based on exposure alone. Doses of PP hypolipidemics that had clearly induced several indicators of peroxisome proliferation in rats did not cause any clear-cut enhancements in the peroxisomes of patients, even though most of these hypolipidemics were considerably stronger PP than DEHP. Thus, an actual threat to humans by DEHP seems rather unlikely. Accordingly, hepatocarcinogenesis was neither enhanced in workers exposed to DEHP nor in patients treated with hypolipidemics.
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Affiliation(s)
- W W Huber
- Institut für Tumorbiologie und Krebsforschung, University of Vienna, Austria
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Mass B, Huber C, Krämer I. Plasticizer extraction of Taxol infusion solution from various infusion devices. PHARMACY WORLD & SCIENCE : PWS 1996; 18:78-82. [PMID: 8739262 DOI: 10.1007/bf00579710] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Taxol solution extracts the plasticizer DEHP (di(2-ethylhexyl)phthalate) from polyvinyl chloride (PVC) materials. In order to minimize patient exposure to DEHP, Taxol solutions should be prepared and administered in PVC-free materials. Particulate matter may form in Taxol infusion solution over time, so that in-line filtration with microporous membranes not greater than 0.22 microns is advisable. The purpose of this study was to evaluate the suitability of various administration- and in-line filter-sets for Taxol application. The extent of leached DEHP was determined using a Reversed Phase HPLC assay specific for DEHP. The four tested administration-sets, labeled as PVC-free, were all found to be suitable for Taxol application. The tested standard PVC-lined administration-set should not be used for Taxol application. Baxter Intermate LV 250 can be recommended as a disposable infusion device for ambulatory Taxol application. It can be connected with all the tested filter sets.
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Affiliation(s)
- B Mass
- Apotheke, Klinikum J. Gutenberg Universität, Mainz, Germany
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Doelman CJ, Borm PJ, Bast A. Plasticisers, another burden for asthmatics? AGENTS AND ACTIONS. SUPPLEMENTS 1990; 31:81-4. [PMID: 2080768 DOI: 10.1007/978-3-0348-7379-6_10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The widely used plasticiser di(2-ethylhexyl)phthalate (DEHP) has been reported to have some toxicological effects on pulmonary tissue. Inhalation of DEHP may cause pulmonary edema and bronchial asthma. Moreover intravenous injection of DEHP induces pulmonary inflammation and hemorrhage of the lungs. We now report that DEHP might cause bronchial hyperresponsiveness. The metabolite of DEHP mono(2-ethylhexyl)phthalate (MEHP) induces in vitro a dose-dependent increase in -log EC50 for methacholine dose response curves in rat tracheal tissue. Moreover MEHP induces a decrease in maximal effect of the methacholine dose response curve. We concluded that DEHP due to the formation of MEHP in vivo, may cause bronchial hyperresponsiveness.
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Affiliation(s)
- C J Doelman
- Department of Pharmacochemistry, Faculty of Chemistry, Vrije Universiteit, Amsterdam, The Netherlands
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Abstract
Pulmonary tissue can be damaged in different ways, for instance by xenobiotics (paraquat, butylated hydroxytoluene, bleomycin), during inflammation, ischemia reperfusion, or exposure to mineral dust or to normobaric pure oxygen levels. Reactive oxygen species are partly responsible for the observed pulmonary tissue damage. Several mechanisms leading to toxicity are described in this review. The reactive oxygen species induce bronchoconstriction, elevate mucus secretion, and cause microvascular leakage, which leads to edema formation. Reactive oxygen species even induce an autonomic imbalance between muscarinic receptor-mediated contraction and the beta-adrenergic-mediated relaxation of the pulmonary smooth muscle. Vitamin E and selenium have a regulatory role in this balance between these two receptor responses. The autonomic imbalance might be involved in the development of bronchial hyperresponsiveness, occurring in lung inflammation. Finally, several antioxidants are discussed which may be beneficial as therapeutics in several lung diseases.
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Affiliation(s)
- C J Doelman
- Department of Pharmacochemistry, Faculty of Chemistry Vrije Universiteit, Amsterdam, The Netherlands
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Roth B, Herkenrath P, Lehmann HJ, Ohles HD, Hömig HJ, Benz-Bohm G, Kreuder J, Younossi-Hartenstein A. Di-(2-ethylhexyl)-phthalate as plasticizer in PVC respiratory tubing systems: indications of hazardous effects on pulmonary function in mechanically ventilated, preterm infants. Eur J Pediatr 1988; 147:41-6. [PMID: 3422189 DOI: 10.1007/bf00442609] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Several PVC medical devices contain the plasticizer Di-(2-ethylhexyl)-phthalate (DEHP) in high concentration. Taken systematically DEHP only has minor toxic effects in the human organism. In three preterm infants artificially ventilated with PVC respiratory tubes unusual lung disorders resembling those observed in hyaline membrane disease, verified both clinically and radiologically, were observed during the fourth week of life. It was assumed that these lung disorders were causally related to the exposure to high doses of DEHP, which was released from the walls of the respiratory tubes. DEHP was found in the lung tissue of one patient who died of pneumothorax soon after birth after being artificially ventilated. It is strongly recommended that for disposable PVC respiratory devices the plasticizer DEHP should be used with more restrictions.
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Affiliation(s)
- B Roth
- Universitäts-Kinderklinik, Köln, Federal Republic of Germany
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Sjöberg P, Lindquist NG, Montin G, Plöen L. Effects of repeated intravenous infusions of the plasticizer di-(2-ethylhexyl) phthalate in young male rats. Arch Toxicol 1985; 58:78-83. [PMID: 4091660 DOI: 10.1007/bf00348313] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The effects of six iv infusions of an emulsion containing the plasticizer di(2-ethylhexyl) phthalate (DEHP) on the liver and testes were investigated in 40-day-old rats. Groups of five to six animals received the emulsion every other day in doses of 0, 5, 50 or 500 mg DEHP/kg body weight. Liver effects were studied by histological examination and by measuring bromosulfophthalein clearance, peroxisomal proliferation and certain enzymes in serum. Testicular effects were evaluated by light and electron microscopy. To investigate the possibility of an age-related effect on the testis, five 25-day-old rats were given six infusions of 500 mg DEHP/kg. Compared with control animals, the high-dose group showed a 36% increase in relative liver weight and a 41% increase in the number of peroxisomes. In Epon-embedded testicular material from animals given the highest dose, which is about 100 times the highest estimated human exposure, some altered Sertoli cells and some degenerated primary spermatocytes were observed. No age-related effect on the testis similar to that found following oral administration of DEHP was observed in this study.
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Abstract
The development of flexible plastic blood bags has permitted effective blood component production and therapy. However, the plasticizer di(2-ethylhexyl)phthalate (DEHP), whose toxicity in humans is still undefined, is known to leach from the plastic into stored blood. Despite the availability of bags made of plastics not using DEHP, the collection and storage of red cells is still done in DEHP plasticized packs, and in fact the storage life for red cells has recently been increased up to 49 days using new anticoagulant-preservative solutions. We examined the relationship between DEHP and stored red cells. We found that 28 percent of available 14C-DEHP binds immediately to sites in both the membrane and cytosol fractions of the red cells, and that the total amount and distribution of 14C-DEHP does not change significantly over 7 days. When red cell concentrates were stored with or without DEHP, using either plastic (polyolefin) bags not containing DEHP or glass, definite reduction in the osmotic stability of the red cells was found in the absence of DEHP. Plasma-free hemoglobin levels were 90.3 mg per dl after 35 days of storage in plastic packs containing DEHP and 181.7 mg per dl in the polyolefin bags. The advantages of improved in vitro stability of red cells stored in plastics containing DEHP must be weighed against the potential hazards of patient exposure to DEHP.
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Thomas JA, Thomas MJ. Biological effects of di-(2-ethylhexyl) phthalate and other phthalic acid esters. Crit Rev Toxicol 1984; 13:283-317. [PMID: 6386344 DOI: 10.3109/10408448409023761] [Citation(s) in RCA: 153] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Esters of o-phthalic acid are widely distributed in the ecosystem. The phthalate acid esters (PAE's) are used as plasticizers in the manufacture of polyvinylchlorides. They are also used as solvents in certain industrial processes and as vehicles for pesticides. The PAE's are used in enormous quantities for a variety of industrial uses in the formulation of plastics. While there are a number of important PAE's, di-ethylhexyl phthalate has perhaps been used the most extensively in the formulation of plastics used in medical devices and blood bag assemblies. The metabolism, biodistribution and excretion varies to some extent among the various PAE's. There are species differences with respect to the metabolism of the PAE's. The route of administration, and the level and length of exposure, are known to affect the toxicological profile of the various PAE's. There is little evidence of bioaccumulation of the various PAE's, and only at very large doses have there been reports of overt toxicity. Evidence for the carcinogenicity of certain PAE's apparently is related to prolonged exposure to high levels.
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Bally MB, Opheim DJ, Shertzer HG. Di-(2-ethylhexyl) phthalate enhances the release of lysosomal enzymes from alveolar macrophages during phagocytosis. Toxicology 1980; 18:49-60. [PMID: 7210023 DOI: 10.1016/0300-483x(80)90037-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Lung tissue damage, histologically similar to protease induced lung lesions, has been previously demonstrated in animals exposed to the plasticizer, di-(2-ethylhexyl)phthalate (DEHP). In an attempt to identify the mechanism responsible for this damage, we have examined the effect of DEHP on alveolar macrophages. Serum solubilized DEHP has a significant effect on both the phagocytosis of latex particles and lysosomal enzyme released from rabbit alveolar macrophages. Pre-exposure to 2 mg% of DEHP caused a 2-fold increase in the rate of phagocytosis and an 8-fold and 10-fold increase, respectively, in the release of the lysosomal hydrolases beta-glucuronidase and acid phosphatase. Although exposure to 2 mg% DEHP caused an 8-fold increase in in vitro cell death, pre-exposure to DEHP had only minimal effect on death during subsequent cell culture, as indicated by measurement of dye exclusion and the release of the cytosolic enzyme lactate dehydrogenase. The relationship between the DEHP induced increase in lysosomal enzyme release from alveolar macrophages and the pathological and histological effects of DEHP on pulmonary tissue is discussed, particularly with respect to patients receiving multiple blood transfusions.
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Inouye B, Katayama Y, Ishida T, Ogata M, Utsumi K. Effects of aromatic bromine compounds on the function of biological membranes. Toxicol Appl Pharmacol 1979; 48:467-77. [PMID: 224528 DOI: 10.1016/0041-008x(79)90430-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Seth PK, Srivastava SP, Mushtaq M, Agarwal DK, Chandra SV. Effect of di-(2-ethylhexyl) phthalate on rat liver injured by chronic carbon tetrachloride treatment. ACTA PHARMACOLOGICA ET TOXICOLOGICA 1979; 44:161-7. [PMID: 219664 DOI: 10.1111/j.1600-0773.1979.tb02312.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The effect of Di-(2-ethylhexyl) phthalate (DEPH), a widely used plasticizer, was studied using histopathological and biochemical parameters on rat liver injured by carbon tetrachloride (CCl4). The mild centrilobular necrosis observed with CCl4 (7.7 mmol/kg subcutaneously and biweekly up to 38 days) and mild congestion and bile duct proliferation produced by DEHP (2.5 mmol/kg intraperitoneally daily for ten days after the day 28 of experiment) were modified into extensive necrosis of the parenchymal cells when the animals received both chemicals. Groups of hepatocytes mostly at the periphery of the lobules also showed coagulative necrosis and some central and portal veins were completely occluded. Alterations in the activity of serum and liver enzymes of the animals receiving both chemicals were not significantly different from those treated with CCl4 alone, except in case of glucose-6-phosphatase (G-6Pase) and SGPT. The characteristic decrease of G-6-Pase and increase of SGPT was less marked. Although the exact mechanism of the chemical interaction between CCl4 and DEHP is not known, the results indicate their combined toxic potentiality.
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Thomas JA, Darby TD, Wallin RF, Garvin PJ, Martis L. A review of the biological effects of di-(2-ethylhexyl) phthalate. Toxicol Appl Pharmacol 1978; 45:1-27. [PMID: 358497 DOI: 10.1016/0041-008x(78)90024-8] [Citation(s) in RCA: 124] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Persson PE, Penttinen H, Nuorteva P. DEHP in the vicinity of an industrial area in Finland. ACTA ACUST UNITED AC 1978. [DOI: 10.1016/0013-9327(78)90130-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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What is the Toxicological Importance of the Liberation of Phthalates from Plastic Containers into Blood, its Components and Derivatives? Vox Sang 1978. [DOI: 10.1111/j.1423-0410.1978.tb02476.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stern IJ, Miripol JE, Izzo RS, Lueck JD. Physicochemical aspects of the extraction in blood and the disposition in rats of di-(2-ethylhexyl) phthalate plasticizer. Toxicol Appl Pharmacol 1977; 41:507-22. [PMID: 918985 DOI: 10.1016/s0041-008x(77)80006-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fayz S, Herbert R, Martin AM. The release of plasticizer from polyvinyl chloride haemodialysis tubing. J Pharm Pharmacol 1977; 29:407-10. [PMID: 19578 DOI: 10.1111/j.2042-7158.1977.tb11354.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The extent of migration of plasticizer from haemodialysis lines into saline and plasma has been examined and a number of different types of tubing have been compared. A model system designed to simulate in vivo haemodialysis was evolved. The method uses a continuous cyclohexane extraction in order to mimic uptake of plasticizer by body tissues. Although not an ideal system, the results obtained are indicative of the extent to which the plasticizers are leached.
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Srivastava SP, Agarwal DK, Seth PK. Effect of di-2-ethylhexyl phthalate on the activity of succinic dehydrogenase and adenosine triphosphatase of some vital organs of rat. Toxicology 1977; 7:163-8. [PMID: 140478 DOI: 10.1016/0300-483x(77)90061-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Succinic dehydrogenase (SDH) and adenosine triphosphatase (ATPase) activity measured 21 days after 3 intraperitoneal injections of di-2-ethylhexyl phthalate (DEHP) was decreased in heart, lung and kidney while it remained unaltered in brain. Under in vitro conditions, only SDH was sensitive to DEHP, degree of inhibition being concentration-dependent. DEHP solubilized with Tween 80 inhibited the SDH activity significantly at small concentrations of 5 to 25 ppm. ATPase activity was not modified.
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