1
|
Zhang M, Wang C, Zhang X, Song H, Li Y. Association between exposure to air pollutants and attention-deficit hyperactivity disorder (ADHD) in children: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:207-219. [PMID: 32248699 DOI: 10.1080/09603123.2020.1745764] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Recent studies have reached mixed conclusions regarding the association between exposure to air pollutants and attention-deficit hyperactivity disorder (ADHD). We performed systematic review and meta-analysis to determine whether air pollutants were risk factors for the development of ADHD in children. We systematically searched databases for all relevant studies up to 2 July 2019. Together, the studies indicated that exposure to PAHs (risk ratio (RR): 0.98, 95% confidence interval (CI): 0.82-1.17), NOx (RR: 1.04, 95% CI: 0.94-1.15), and PM (RR: 1.11, 95% CI: 0.93-1.33) did not have any material relationship with an increased risk of ADHD. Heterogeneity of study data was low (I2: 2.7%, P = 0.409) for studies examining PAHs, but was substantial for NOx and PM (I2: 68.4%, P = 0.007 and I2: 60.1%, P = 0.014, respectively). However, these results should be interpreted with caution since the number of epidemiological studies investigating this issue were limited.
Collapse
Affiliation(s)
- Mengjie Zhang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changhong Wang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Xinxin Zhang
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Huiling Song
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan Li
- Department of Children, Adolescents and Women Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
2
|
Fluegge K. Nitrous Oxide (N2O) as a Treatment for Refractory Depression: A Word of Caution. J Clin Psychopharmacol 2021; 40:517-518. [PMID: 32858620 DOI: 10.1097/jcp.0000000000001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research Columbus, OH
| |
Collapse
|
3
|
Fluegge K. Influence of Seasonality and Altitude in ADHD Prevalence: A Role for Environmental Nitrous Oxide Exposure. J Atten Disord 2021; 25:233-234. [PMID: 29681218 DOI: 10.1177/1087054718770290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
4
|
Mesnil M, Defamie N, Naus C, Sarrouilhe D. Brain Disorders and Chemical Pollutants: A Gap Junction Link? Biomolecules 2020; 11:51. [PMID: 33396565 PMCID: PMC7824109 DOI: 10.3390/biom11010051] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023] Open
Abstract
The incidence of brain pathologies has increased during last decades. Better diagnosis (autism spectrum disorders) and longer life expectancy (Parkinson's disease, Alzheimer's disease) partly explain this increase, while emerging data suggest pollutant exposures as a possible but still underestimated cause of major brain disorders. Taking into account that the brain parenchyma is rich in gap junctions and that most pollutants inhibit their function; brain disorders might be the consequence of gap-junctional alterations due to long-term exposures to pollutants. In this article, this hypothesis is addressed through three complementary aspects: (1) the gap-junctional organization and connexin expression in brain parenchyma and their function; (2) the effect of major pollutants (pesticides, bisphenol A, phthalates, heavy metals, airborne particles, etc.) on gap-junctional and connexin functions; (3) a description of the major brain disorders categorized as neurodevelopmental (autism spectrum disorders, attention deficit hyperactivity disorders, epilepsy), neurobehavioral (migraines, major depressive disorders), neurodegenerative (Parkinson's and Alzheimer's diseases) and cancers (glioma), in which both connexin dysfunction and pollutant involvement have been described. Based on these different aspects, the possible involvement of pollutant-inhibited gap junctions in brain disorders is discussed for prenatal and postnatal exposures.
Collapse
Affiliation(s)
- Marc Mesnil
- Laboratoire STIM, ERL7003 CNRS-Université de Poitiers, 1 rue G. Bonnet–TSA 51 106, 86073 Poitiers, France; (M.M.); (N.D.)
| | - Norah Defamie
- Laboratoire STIM, ERL7003 CNRS-Université de Poitiers, 1 rue G. Bonnet–TSA 51 106, 86073 Poitiers, France; (M.M.); (N.D.)
| | - Christian Naus
- Faculty of Medicine, Department of Cellular & Physiological Sciences, Life Sciences Institute, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC V6T1Z3, Canada;
| | - Denis Sarrouilhe
- Laboratoire de Physiologie Humaine, Faculté de Médecine et Pharmacie, 6 rue de La Milétrie, bât D1, TSA 51115, 86073 Poitiers, France
| |
Collapse
|
5
|
Fluegge K, Fluegge K. Attention-Deficit/Hyperactivity Disorder and Comorbid Asthma. Chest 2019; 153:1279-1280. [PMID: 29731041 DOI: 10.1016/j.chest.2018.01.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 10/17/2022] Open
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH.
| | - Kyle Fluegge
- Institute of Health and Environmental Research, Cleveland, OH; New York City Department of Health and Mental Hygiene, New York, NY
| |
Collapse
|
6
|
Affiliation(s)
- Keith Fluegge
- Keith Fluegge is with the Institute of Health and Environmental Research, Cleveland, OH
| |
Collapse
|
7
|
Markevych I, Tesch F, Datzmann T, Romanos M, Schmitt J, Heinrich J. Outdoor air pollution, greenspace, and incidence of ADHD: A semi-individual study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 642:1362-1368. [PMID: 30045516 DOI: 10.1016/j.scitotenv.2018.06.167] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/03/2018] [Accepted: 06/13/2018] [Indexed: 05/14/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a frequently occurring neurodevelopmental disorder, symptoms of which first appear in early childhood. Etiology of ADHD is not well understood. We investigated whether outdoor air pollution and greenspace affect ADHD incidence in children residing in Saxony. METHODS 66,823 children, all beneficiaries of the statutory health insurance company AOK PLUS and born between 2000 and 2004, were followed until 2014. We considered any child with at least one ICD-10-GM F90 diagnosis by a child/adolescent psychiatrist, neuropaediatrician, or psychotherapist an ADHD case. Children's home addresses were known up to their four-digit postal code area. Population-weighted mean values of particulate matter with diameter of < 10 μm (PM10), nitrogen dioxide (NO2), and MODIS Normalized Difference Vegetation Index (NDVI) were calculated for 186 postal code areas. Associations with each exposure were assessed by two-level adjusted Poisson regression models. RESULTS 2044 children (3.06%) were diagnosed with ADHD within the observation period. An increase of PM10 and NO2 by 10 μg/m3 raised the relative risk of ADHD by a factor of 1.97 [95% CI: 1.35-2.86] and 1.32 [1.10-1.58], respectively. A 0.1-unit increase in NDVI decreased the relative risk of ADHD by a factor of 0.82 [0.68-0.98]. Better access to child/adolescent psychiatrists was the most important confounder that increased ADHD risk across all models. CONCLUSION Our results provide some evidence that air pollution might affect ADHD. Future studies with more detailed address information and better control for confounders, in particular socioeconomic status and parental psychopathology, should replicate the observed associations.
Collapse
Affiliation(s)
- Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
| | - Falko Tesch
- Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thomas Datzmann
- Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Allergy and Lung Health Unit School of Population and Global Health, University of Melbourne, Melbourne, Australia
| |
Collapse
|
8
|
Saez M, Barceló MA, Farrerons M, López-Casasnovas G. The association between exposure to environmental factors and the occurrence of attention-deficit/hyperactivity disorder (ADHD). A population-based retrospective cohort study. ENVIRONMENTAL RESEARCH 2018; 166:205-214. [PMID: 29890425 DOI: 10.1016/j.envres.2018.05.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/02/2018] [Accepted: 05/09/2018] [Indexed: 05/23/2023]
Abstract
BACKGROUND A number of factors contribute to attention deficit hyperactivity disorder (ADHD) and although they are not fully known, the occurrence of ADHD seems to be a consequence of an interaction between multiple genetic and environmental factors. However, apart from pesticides, the evidence is inadequate and inconsistent as it differs not only in the population and time period analysed, but also in the type of study, the control of the confounding variables and the statistical methods used. In the latter case, the studies also differ in the adjustment of spatial and temporal variability. Our objective here, is to provide evidence on an association between environmental factors and ADHD. METHODS In our study, we used a population-based retrospective cohort in which we matched cases and controls (children free of the disease) by sex and year of birth (n = 5193, 78.9% boys). The cases were children born between 1998 and 2012 and diagnosed with ADHD (n = 116). To evaluate whether there was a geographical pattern in the incidence of ADHD, we first represented the smoothed standardized incidence rates on a map of the region being studied. We then estimated the probability of being a case by using a generalized liner mixed model with a binomial link. As explanatory variables of interest, we included the following environmental variables: distance to agricultural areas, distance to roads (stratified into three categories according to traffic density and intensity), distance to petrol stations, distance to industrial estates, and land use. We control for both observed (individual and family specific variables and deprivation index) and unobserved confounders (in particular, individual and familial heterogeneity). In addition, we adjusted for spatial extra variability. RESULTS We found a north-south pattern containing two clusters (one in the centre of the study region and another in the south) in relation to the risk of developing ADHD. The results from the multivariate model suggest that these clusters could be related to some of the environmental variables. Specifically, living within 100 m from an agricultural area or a residential street and/or living fewer than 300 m from a motorway, dual carriageway or one of the industrial estates analysed was associated (statistically significant) with an increased risk of ADHD. CONCLUSION Our results indicate that some environmental factors could be associated with ADHD occurring, particularly those associated with exposure to pesticides, organochlorine compounds and air pollutants because of traffic.
Collapse
Affiliation(s)
- Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain.
| | - Maria A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain
| | - Mònica Farrerons
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; Medical Student, University of Girona, Spain
| | - Guillem López-Casasnovas
- Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain; Department of Economics and Business, Universitat Pompeu Fabra, Barcelona, Spain; Barcelona Graduate School (BSGE), Universitat Pompeu Fabra, Barcelona, Spain
| |
Collapse
|
9
|
Buoli M, Grassi S, Caldiroli A, Carnevali GS, Mucci F, Iodice S, Cantone L, Pergoli L, Bollati V. Is there a link between air pollution and mental disorders? ENVIRONMENT INTERNATIONAL 2018; 118:154-168. [PMID: 29883762 DOI: 10.1016/j.envint.2018.05.044] [Citation(s) in RCA: 161] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 05/21/2023]
Abstract
Several studies have demonstrated the association between air pollution and different medical conditions including respiratory and cardiovascular diseases. Air pollutants might have a role also in the etiology of mental disorders in the light of their toxicity on central nervous system. Purpose of the present manuscript was to review and summarize available data about an association between psychiatric disorders and air pollution. A research in the main database sources has been conducted to identify relevant papers about the topic. Different air pollutants and in particular PM and nitric oxides have been associated with poor mental health; long exposition to PM2.5 has been associated with an increased risk of new onset of depressive symptoms (Cohen's effect size d: 0.05-0.81), while increased concentration of nitric dioxide in summer with worsening of existing depressive conditions (Cohen's effect size d: 0.05-1.77). However, the interpretation of these finding should take into account the retrospective design of most of studies, different periods of observations, confounding factors such as advanced age or medical comorbidity. Further studies with rigorous methodology are needed to confirm the results of available literature about this topic.
Collapse
Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.
| | - Silvia Grassi
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Greta Silvia Carnevali
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Francesco Mucci
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Simona Iodice
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via san Barnaba 8, 20122 Milan, Italy
| | - Laura Cantone
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via san Barnaba 8, 20122 Milan, Italy
| | - Laura Pergoli
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via san Barnaba 8, 20122 Milan, Italy
| | - Valentina Bollati
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via san Barnaba 8, 20122 Milan, Italy
| |
Collapse
|
10
|
Fluegge K. Letter to the Editor: Exposure to nitrous oxide and intrusive memory formation in psychological trauma. Psychol Med 2018; 48:874-875. [PMID: 28712366 DOI: 10.1017/s003329171700191x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- K Fluegge
- Institute of Health and Environmental Research,Cleveland,OH,USA
| |
Collapse
|
11
|
|
12
|
Fluegge K, Fluegge K. Antecedent ADHD, dementia, and metabolic dysregulation: A U.S. based cohort analysis. Neurochem Int 2018; 112:255-258. [DOI: 10.1016/j.neuint.2017.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/04/2017] [Accepted: 08/11/2017] [Indexed: 10/19/2022]
|
13
|
Fluegge K, Fluegge K. Environmental factors influencing the link between childhood ADHD and risk of adult coronary artery disease. Med Hypotheses 2017; 110:83-85. [PMID: 29317076 DOI: 10.1016/j.mehy.2017.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/14/2017] [Indexed: 01/09/2023]
Abstract
Yorbik et al. reported novel findings regarding a hypothesized relationship between childhood attention-deficit hyperactivity disorder (ADHD) and later risk for coronary heart disease in adulthood. The authors found that mean platelet volume (MPV), a marker of platelet reactivity and a presumable biomarker in patients with cardiovascular disease, was significantly elevated in children with ADHD compared to healthy controls. The mechanistic importance of this novel discovery remains unknown and warrants clarification. We have made the novel proposition that environmental exposure to the agricultural and combustion air pollutant, nitrous oxide (N2O), may be an etiological contributor to neurodevelopmental disorders. Clinical studies suggest that N2O may enhance platelet hyperaggregation, possibly via its biphasic role as an MAO inhibitor especially at trace levels of exposure or via the generation of oxidative stress. Therefore, this correspondence briefly details the hypothesis that altered biochemical profiles in neurodevelopmental disorders, derived from chronic environmental exposure to the agricultural and combustion air pollutant, N2O, may promote coronary artery disease in adulthood.
Collapse
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
| | - Kyle Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA; New York City Department of Health and Mental Hygiene, New York 11101-4132 USA
| |
Collapse
|
14
|
Fluegge K, Fluegge K. Use of anthropogenic nitrogen fertilizers in agriculture is associated with per capita ethanol consumption. Med Hypotheses 2017; 107:65-71. [PMID: 28915966 DOI: 10.1016/j.mehy.2017.07.027] [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: 10/26/2016] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 10/19/2022]
Abstract
It has previously been demonstrated that emissions of the agricultural pollutant, nitrous oxide (N2O), may be a confounder to the relationship between herbicide use and psychiatric impairments, including ADHD. This report attempts to extend this hypothesis by testing whether annual use of anthropogenic nitrogen-based fertilizers in U.S. agriculture (thought to be the most reliable indicator of environmental N2O emissions) is associated with per capita ethanol consumption patterns, a behavior often comorbid with ADHD. State estimates of anthropogenic nitrogen fertilizers from the United States Geological Survey (USGS) were obtained for the years between 1987 and 2006. Our dependent variable was annual per capita ethanol consumption. Ethanol consumption was categorized as beer, wine, spirits, and all alcoholic beverages. Least squares dummy variable method using two-ways fixed effects was utilized. Among states above the 50th percentile in farm use of anthropogenic nitrogen for all years (i.e., agricultural states), a one log-unit increase in farm use of anthropogenic nitrogen fertilizers is associated with a 0.13 gallon increase in total per capita ethanol consumption (p<0.0125). No statistically significant association between farm use of anthropogenic nitrogen and per capita ethanol consumption was found in states below the 50th percentile in farm use of anthropogenic nitrogen. The new findings are in agreement with both behavioral human studies demonstrating a link between N2O preference and alcohol and drug use history as well as molecular studies elucidating shared mechanisms between trace N2O antinociception and alcohol-seeking related behaviors.
Collapse
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
| | - Kyle Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA; New York City Department of Health and Mental Hygiene, New York 11101-4132, USA
| |
Collapse
|
15
|
Fluegge K, Fluegge K. Air pollution and risk of hospitalization for epilepsy: the role of farm use of nitrogen fertilizers and emissions of the agricultural air pollutant, nitrous oxide. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:614-619. [DOI: 10.1590/0004-282x20170107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/07/2017] [Indexed: 12/15/2022]
Abstract
ABSTRACT The link between various air pollutants and hospitalization for epilepsy has come under scrutiny. We have proposed that exposure to air pollution and specifically the pervasive agricultural air pollutant and greenhouse gas, nitrous oxide (N2O), may provoke susceptibility to neurodevelopmental disorders. Evidence supports a role of N2O exposure in reducing epileptiform seizure activity, while withdrawal from the drug has been shown to induce seizure-like activity. Therefore, we show here that the statewide use of anthropogenic nitrogen fertilizers (the most recognized causal contributor to environmental N2O burden) is significantly negatively associated with hospitalization for epilepsy in all three pre-specified hospitalization categories, even after multiple pollutant comparison correction (p<.007), while the other identified pollutants were not consistently statistically significantly associated with hospitalization for epilepsy. We discuss potential neurological mechanisms underpinning this association between air pollutants associated with farm use of anthropogenic nitrogen fertilizers and hospitalization for epilepsy.
Collapse
Affiliation(s)
| | - Kyle Fluegge
- Institute of Health and Environmental Research, USA; New York City Department of Health and Mental Hygiene, USA
| |
Collapse
|
16
|
Fluegge K, Fluegge K. Exploring the potential confounder of nitrogen fertilizers in the relationship between pesticide exposures and risk of leukemia: a Poisson regression with two-way fixed-effects analysis. CHINESE JOURNAL OF CANCER 2017; 36:58. [PMID: 28709444 PMCID: PMC5513404 DOI: 10.1186/s40880-017-0225-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118 USA
| | - Kyle Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118 USA
- New York City Department of Health and Mental Hygiene, New York, NY 11101-4132 USA
| |
Collapse
|
17
|
Bumetanide Treatment for Psychiatric Disorders and the Modulation of Central Nitric Oxide Metabolism. Clin Neuropharmacol 2017; 40:192-193. [PMID: 28704252 DOI: 10.1097/wnf.0000000000000228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Fluegge K. Abnormal sensory experiences, synaesthesia, and neurodevelopmental disorders. J Autism Dev Disord 2017; 47:2942-2944. [PMID: 28681253 DOI: 10.1007/s10803-017-3216-z] [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: 11/28/2022]
Abstract
Preliminary evidence suggests that sensory processing may be affected in autism spectrum disorders (ASD). The purpose of this letter is to highlight a few recent studies on the topic and tie the findings to a recently identified epidemiological risk factor for ASD, principally environmental exposure to the air pollutant, nitrous oxide (N2O). Animal studies have shown that trace levels of chronic N2O exposure are thought to involve dynorphin opioid peptide release and altered serotonergic neurotransmission, both of which may elicit profound changes in consciousness and induce synaesthesia experiences. Future research investigating abnormal sensory sensitivity in ASD should consider environmental exposure to N2O, which may induce the requisite neurochemical changes thought to underpin sensory dysregulation even at trace levels of exposure.
Collapse
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, P.O. Box 18442, Cleveland, OH, 44118, USA.
| |
Collapse
|
19
|
Fluegge K. Environmental contributors to modulation of brain estrogen signaling and male gender bias in autism: A reply to the oral contraceptive use hypothesis by Strifert (2015). Med Hypotheses 2017; 104:178-181. [PMID: 28673581 DOI: 10.1016/j.mehy.2017.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/29/2017] [Accepted: 06/20/2017] [Indexed: 11/28/2022]
Abstract
Strifert has recently put forward an interesting hypothesis regarding the role of oral contraceptive (OC) use in mothers and risk of offspring autism spectrum disorder (ASD). First, the author reports that combined oral contraceptives (COCs), containing both estrogen and progesterone, were developed in the late 1950s and early 60s, which is a time-frame distinct from Leo Kanner's documentation of infantile ASD in 1943 that Strifert just briefly mentions. While this important temporal inconsistency of ASD origin does not invalidate the potential role of OC use in contributing to the rise of ASD, it does support the likely possibility of other environmental exposures at play. Second, the epigenetic basis of the hypothesis is that the endocrine-disrupting components (i.e., ethinylestradiol) of OC perturb estrogenic signaling in the fetal brain by triggering aberrant DNA methylation of the estrogen receptor β (ERβ) gene, and such methylation patterns may be imprinted to future generations and could theoretically increase subsequent ASD offspring risk. The premise of the hypothesis is challenged, however, with the recognition that MeCP2, a "reader" of DNA methylation sites, is not only associated with age-dependent alteration in ERβ in females but is also significantly reduced in ASD brain. Furthermore, Strifert does not clearly address how the OC hypothesis accounts for the male bias in ASD. Therefore, the purpose of this correspondence is to address these inconsistencies by proposing a hypothesis that challenges these points. That is, gestational exposure to the agricultural and combustion air pollutant, nitrous oxide (N2O), may be a leading contributor to the development of an ASD phenotype. The mechanism undergirding this hypothesis suggests that compensatory estrogenic activity may mitigate the effects of fetal N2O exposure and thereby confer a protective effect against ASD development in a sex-dependent manner (i.e., male bias in ASD).
Collapse
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
| |
Collapse
|
20
|
Fluegge K, Fluegge K. Anesthetic agents, neurodevelopmental risk and the connection to bacterial infections. Microbes Infect 2017; 19:443-448. [PMID: 28666807 DOI: 10.1016/j.micinf.2017.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/05/2017] [Accepted: 06/12/2017] [Indexed: 11/16/2022]
Abstract
This short communication identifies a significant flaw in research investigating the neurodevelopmental consequences of general anesthesia exposure. We have identified that chronic environmental exposure to pervasive air pollutants that are also widely used as anesthetic agents, specifically nitrous oxide (N2O), may contribute to the rising prevalence of neurodevelopmental disorders. Consistent with the emerging link between microbes and psychiatric illness risk, this epidemiological analysis extends our prior conclusions by proposing that such exposures may alter host immunity so as to enhance vulnerability to certain pathogenic microbes that have been implicated in neurodevelopmental disorders, including Pseudomonas aeruginosa and Clostridium difficile.
Collapse
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA.
| | - Kyle Fluegge
- Institute of Health and Environmental Research, Cleveland, OH 44118, USA; New York City Department of Health and Mental Hygiene, New York 11101-4132, USA
| |
Collapse
|
21
|
Guan J, Li G. Guan and Li Respond. Am J Public Health 2017; 107:e3-e4. [DOI: 10.2105/ajph.2017.303830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Joseph Guan
- Both authors are with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY. Guohua Li is also with the Department of Anesthesiology, Columbia University College of Physicians and Surgeons
| | - Guohua Li
- Both authors are with the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY. Guohua Li is also with the Department of Anesthesiology, Columbia University College of Physicians and Surgeons
| |
Collapse
|
22
|
Fluegge K. Levels of peripheral neopterin in neurodevelopmental disorders. J Neuroimmunol 2017; 306:53-54. [PMID: 28385188 DOI: 10.1016/j.jneuroim.2017.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 03/10/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Keith Fluegge
- Institute of Health and Environmental Research, P.O. Box 18442, Cleveland, OH 44118, USA.
| |
Collapse
|