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Oh J, Schweitzer JB, Buckley JP, Upadhyaya S, Kannan K, Herbstman JB, Ghassabian A, Schmidt RJ, Hertz-Picciotto I, Bennett DH. Early childhood exposures to phthalates in association with attention-deficit/hyperactivity disorder behaviors in middle childhood and adolescence in the ReCHARGE study. Int J Hyg Environ Health 2024; 259:114377. [PMID: 38692176 DOI: 10.1016/j.ijheh.2024.114377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/19/2024] [Accepted: 03/31/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Early-life exposure to phthalates alters behaviors in animals. However, epidemiological evidence on childhood phthalate exposure and attention-deficit/hyperactivity disorder (ADHD) behaviors is limited. METHODS This study included 243 children from the ReCHARGE (Revisiting Childhood Autism Risks from Genetics and Environment) study, who were previously classified as having autism spectrum disorder (ASD), developmental delay, other early concerns, and typical development in the CHARGE case-control study. Twenty phthalate metabolites were measured in spot urine samples collected from children aged 2-5 years. Parents reported on children's ADHD symptoms at ages 8-18 years using Conners-3 Parent Rating Scale. Covariate-adjusted negative binomial generalized linear models were used to investigate associations between individual phthalate metabolite concentrations and raw scores. Weighted quantile sum (WQS) regression with repeated holdout validation was used to examine mixture effects of phthalate metabolites on behavioral scores. Effect modification by child sex was evaluated. RESULTS Among 12 phthalate metabolites detected in >75% of the samples, higher mono-2-heptyl phthalate (MHPP) was associated with higher scores on Inattentive (β per doubling = 0.05, 95% confidence interval [CI]: 0.02, 0.08) and Hyperactive/Impulsive scales (β = 0.04, 95% CI: 0.00, 0.07), especially among children with ASD. Higher mono-carboxy isooctyl phthalate (MCiOP) was associated with higher Hyperactivity/Impulsivity scores (β = 0.07, 95% CI: -0.01, 0.15), especially among typically developing children. The associations of the molar sum of high molecular weight (HMW) phthalate metabolites and a phthalate metabolite mixture with Hyperactivity/Impulsivity scores were modified by sex, showing more pronounced adverse associations among females. CONCLUSION Exposure to phthalates during early childhood may impact ADHD behaviors in middle childhood and adolescence, particularly among females. Although our findings may not be broadly generalizable due to the diverse diagnostic profiles within our study population, our robust findings on sex-specific associations warrant further investigations.
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Affiliation(s)
- Jiwon Oh
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Sacramento, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sudhi Upadhyaya
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kurunthachalam Kannan
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Akhgar Ghassabian
- Department of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA.
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Oh J, Kim K, Kannan K, Parsons PJ, Mlodnicka A, Schmidt RJ, Schweitzer JB, Hertz-Picciotto I, Bennett DH. Early childhood exposure to environmental phenols and parabens, phthalates, organophosphate pesticides, and trace elements in association with attention deficit hyperactivity disorder (ADHD) symptoms in the CHARGE study. Environ Health 2024; 23:27. [PMID: 38486233 PMCID: PMC10938747 DOI: 10.1186/s12940-024-01065-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/23/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND A growing body of literature investigated childhood exposure to environmental chemicals in association with attention-deficit/hyperactivity disorder (ADHD) symptoms, but limited studies considered urinary mixtures of multiple chemical classes. This study examined associations of concurrent exposure to non-persistent chemicals with ADHD symptoms in children diagnosed with autism spectrum disorder (ASD), developmental delay (DD), and typical development (TD). METHODS A total of 549 children aged 2-5 years from the Childhood Autism Risks from Genetics and Environment (CHARGE) case-control study were administered the Aberrant Behavior Checklist (ABC). This study focused on the ADHD/noncompliance subscale and its two subdomains (hyperactivity/impulsivity, inattention). Sixty-two chemicals from four classes (phenols/parabens, phthalates, organophosphate pesticides, trace elements) were quantified in child urine samples, and 43 chemicals detected in > 70% samples were used to investigate their associations with ADHD symptoms. Negative binomial regression was used for single-chemical analysis, and weighted quantile sum regression with repeated holdout validation was applied for mixture analysis for each chemical class and all chemicals. The mixture analyses were further stratified by diagnostic group. RESULTS A phthalate metabolite mixture was associated with higher ADHD/noncompliance scores (median count ratio [CR] = 1.10; 2.5th, 97.5th percentile: 1.00, 1.21), especially hyperactivity/impulsivity (median CR = 1.09; 2.5th, 97.5th percentile: 1.00, 1.25). The possible contributors to these mixture effects were di-2-ethylhexyl phthalate (DEHP) metabolites and mono-2-heptyl phthalate (MHPP). These associations were likely driven by children with ASD as these were observed among children with ASD, but not among TD or those with DD. Additionally, among children with ASD, a mixture of all chemicals was associated with ADHD/noncompliance and hyperactivity/impulsivity, and possible contributors were 3,4-dihydroxy benzoic acid, DEHP metabolites, MHPP, mono-n-butyl phthalate, and cadmium. CONCLUSIONS Early childhood exposure to a phthalate mixture was associated with ADHD symptoms, particularly among children with ASD. While the diverse diagnostic profiles limited generalizability, our findings suggest a potential link between phthalate exposure and the comorbidity of ASD and ADHD.
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Affiliation(s)
- Jiwon Oh
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA.
| | - Kyoungmi Kim
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Kurunthachalam Kannan
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Patrick J Parsons
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Agnieszka Mlodnicka
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California at Davis (UC Davis), Sacramento, CA, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Julie B Schweitzer
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California at Davis (UC Davis), Sacramento, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
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3
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Weng X, Zhu Q, Liao C, Jiang G. Cumulative Exposure to Phthalates and Their Alternatives and Associated Female Reproductive Health: Body Burdens, Adverse Outcomes, and Underlying Mechanisms. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023. [PMID: 37196176 DOI: 10.1021/acs.est.3c00823] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The global birth rate has recently shown a decreasing trend, and exposure to environmental pollutants has been identified as a potential factor affecting female reproductive health. Phthalates have been widely used as plasticizers in plastic containers, children's toys, and medical devices, and their ubiquitous presence and endocrine-disrupting potential have already raised particular concerns. Phthalate exposure has been linked to various adverse health outcomes, including reproductive diseases. Given that many phthalates are gradually being banned, a growing number of phthalate alternatives are becoming popular, such as di(isononyl) cyclohexane-1,2-dicarboxylate (DINCH), di(2-ethylhexyl) adipate (DEHA), and di(2-ethylhexyl) terephthalate (DEHTP), and they are beginning to have a wide range of environmental effects. Studies have shown that many phthalate alternatives may disrupt female reproductive function by altering the estrous cycle, causing ovarian follicular atresia, and prolonging the gestational cycle, which raises growing concerns about their potential health risks. Herein, we summarize the effects of phthalates and their common alternatives in different female models, the exposure levels that influence the reproductive system, and the effects on female reproductive impairment, adverse pregnancy outcomes, and offspring development. Additionally, we scrutinize the effects of phthalates and their alternatives on hormone signaling, oxidative stress, and intracellular signaling to explore the underlying mechanisms of action on female reproductive health, because these chemicals may affect reproductive tissues directly or indirectly through endocrine disruption. Given the declining global trends of female reproductive capacity and the potential ability of phthalates and their alternatives to negatively impact female reproductive health, a more comprehensive study is needed to understand their effects on the human body and their underlying mechanisms. These findings may have an important role in improving female reproductive health and in turn decreasing the number of complications during pregnancy.
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Affiliation(s)
- Xueyu Weng
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Qingqing Zhu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Chunyang Liao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
- Institute of Environment and Health, Jianghan University, Wuhan 430056, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310024, China
- Institute of Environment and Health, Jianghan University, Wuhan 430056, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
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Oh J, Kim K, Kannan K, Parsons PJ, Mlodnicka A, Schmidt RJ, Schweitzer JB, Hertz-Picciotto I, Bennett DH. Early childhood exposure to environmental phenols and parabens, phthalates, organophosphate pesticides, and trace elements in association with attention deficit hyperactivity disorder (ADHD) symptoms in the CHARGE study. RESEARCH SQUARE 2023:rs.3.rs-2565914. [PMID: 36798220 PMCID: PMC9934759 DOI: 10.21203/rs.3.rs-2565914/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Background Agrowing body of literature investigated childhood exposure to environmental chemicals in association with attention deficit hyperactivity disorder (ADHD) symptoms, but limited studies considered urinary mixtures of multiple chemical classes. This study examined associations of concurrent exposure to non-persistent chemicals with ADHD symptoms in children diagnosed with autism spectrum disorder (ASD), developmental delay, and typical development. Methods A total of 574 children aged 2-5 years from the Childhood Autism Risks from Genetics and Environment (CHARGE) case-control study was administered the Aberrant Behavior Checklist (ABC). This study focused on the Hyperactivity subscale and its two subdomains (hyperactivity/impulsivity, inattention). Sixty-two chemicals from four classes (phenols/parabens, phthalates, organophosphate pesticides, trace elements) were quantified in child urine samples, and 43 chemicals detected in >70% samples were used in statistical analyses. Weighted quantile sum regression for negative binomial outcomes with repeated holdout validation was performed to investigate covariate-adjusted associations between mixtures and ABC scores in 574 children. The mixture analyses were further restricted to 232 children with ASD. Results Phthalate metabolite mixtures, weighted for mono-n-butylphthalate (MNBP), mono-2-heptyl phthalate, and mono-carboxy isononyl phthalate, were associated with the Hyperactivity subscale (mean incidence rate ratio [mIRR] = 1.11; 2.5th, 97.5th percentile: 1.00, 1.23), especially the hyperactivity/impulsivity subdomain (mIRR = 1.14; 2.5th, 97.5th percentile: 1.06, 1.26). These associations remained similar after restricting to children with ASD. The inattention subdomain was associated with a phenols/parabens mixture, weighted for several parabens and bisphenols (mIRR = 1.13; 2.5th, 97.5th percentile: 1.00, 1.28) and a total mixture, weighted for 3,4-dihydroxy benzoic acid, MNBR and mono-(2-ethyl-5-carboxypentyl) phthalate (mIRR = 1.11; 2.5th, 97.5th percentile: 1.01,1.25) only among children with ASD. Conclusions Concurrent exposure to phthalate mixtures was associated with hyperactivity in early childhood. Though causal inference cannot be made based on our cross-sectional findings, this study warrants further research on mixtures of larger number of chemicals from multiple classes in association with ADHD-related behaviors in young children.
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Han Y, Jin S, Liu L, Qu Z, Gao L, Li P, Xiong W, Zhang X. Exploring associations between urine levels of phthalates and autism spectrum disorder symptoms: a case-control study in Tianjin, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:80805-80816. [PMID: 35729382 DOI: 10.1007/s11356-022-21526-x] [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: 01/14/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
Autism spectrum disorder (ASD) comprises a group of neurodevelopmental disorders. The etiology of autism remains unclear, but a growing body of evidence indicates that phthalates play a role in its pathogenesis. The aim of this study was to compare the urine levels of phthalates in children with ASD and healthy children. We also explored whether phthalates have an effect on ASD symptoms. The participants in this study included 101 children with ASD (79 boys and 22 girls) and 101 sex- and age-matched controls. The levels of phthalates were analyzed by gas chromatography-mass spectrometry (GC-MS). We detected significant differences in monoethyl phthalate (MEP) levels between the severe ASD and control groups (p < 0.05). Mono-n-butyl phthalate (MBP) concentration was positively correlated with language skill impairment in ASD (β: 0.387, p = 0.041). MEP levels were associated with the CARS "Imitation" score in all children (OR: 1.470). MBP levels were associated with the "Nonverbal Communication" score among boys (OR: 1.233), and MEP levels were associated with the "Nonverbal Communication" score among girls (OR: 2.648). MEP levels were related to the CARS total score after adjustment for sex (β: 1.524, p = 0.047). Compared with the reference mono(2-ethylhexyl) phthalate (MEHP) group, children with ASD in the medium-exposure group had an OR of 3.370 for aggravating ASD severity. These results suggested that increased exposure to phthalates contributes to more ASD symptoms and that there are potentially sex-specific associations. These findings warrant further confirmation.
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Affiliation(s)
- Yu Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China
| | - Shihao Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China
| | - Liyuan Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China
| | - Zhiyi Qu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China
| | - Lei Gao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China
| | - Peiying Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China
| | - Wenjuan Xiong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, People's Republic of China.
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Singh S, Sharma P, Pal N, Kumawat M, Shubham S, Sarma DK, Tiwari RR, Kumar M, Nagpal R. Impact of Environmental Pollutants on Gut Microbiome and Mental Health via the Gut–Brain Axis. Microorganisms 2022; 10:microorganisms10071457. [PMID: 35889175 PMCID: PMC9317668 DOI: 10.3390/microorganisms10071457] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 02/01/2023] Open
Abstract
Over the last few years, the microbiome has emerged as a high-priority research area to discover missing links between brain health and gut dysbiosis. Emerging evidence suggests that the commensal gut microbiome is an important regulator of the gut–brain axis and plays a critical role in brain physiology. Engaging microbiome-generated metabolites such as short-chain fatty acids, the immune system, the enteric nervous system, the endocrine system (including the HPA axis), tryptophan metabolism or the vagus nerve plays a crucial role in communication between the gut microbes and the brain. Humans are exposed to a wide range of pollutants in everyday life that impact our intestinal microbiota and manipulate the bidirectional communication between the gut and the brain, resulting in predisposition to psychiatric or neurological disorders. However, the interaction between xenobiotics, microbiota and neurotoxicity has yet to be completely investigated. Although research into the precise processes of the microbiota–gut–brain axis is growing rapidly, comprehending the implications of environmental contaminants remains challenging. In these milieus, we herein discuss how various environmental pollutants such as phthalates, heavy metals, Bisphenol A and particulate matter may alter the intricate microbiota–gut–brain axis thereby impacting our neurological and overall mental health.
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Affiliation(s)
- Samradhi Singh
- National Institute for Research in Environmental Health, Bhopal 462030, India; (S.S.); (P.S.); (N.P.); (M.K.); (S.S.); (D.K.S.); (R.R.T.)
| | - Poonam Sharma
- National Institute for Research in Environmental Health, Bhopal 462030, India; (S.S.); (P.S.); (N.P.); (M.K.); (S.S.); (D.K.S.); (R.R.T.)
| | - Namrata Pal
- National Institute for Research in Environmental Health, Bhopal 462030, India; (S.S.); (P.S.); (N.P.); (M.K.); (S.S.); (D.K.S.); (R.R.T.)
| | - Manoj Kumawat
- National Institute for Research in Environmental Health, Bhopal 462030, India; (S.S.); (P.S.); (N.P.); (M.K.); (S.S.); (D.K.S.); (R.R.T.)
| | - Swasti Shubham
- National Institute for Research in Environmental Health, Bhopal 462030, India; (S.S.); (P.S.); (N.P.); (M.K.); (S.S.); (D.K.S.); (R.R.T.)
| | - Devojit Kumar Sarma
- National Institute for Research in Environmental Health, Bhopal 462030, India; (S.S.); (P.S.); (N.P.); (M.K.); (S.S.); (D.K.S.); (R.R.T.)
| | - Rajnarayan R. Tiwari
- National Institute for Research in Environmental Health, Bhopal 462030, India; (S.S.); (P.S.); (N.P.); (M.K.); (S.S.); (D.K.S.); (R.R.T.)
| | - Manoj Kumar
- National Institute for Research in Environmental Health, Bhopal 462030, India; (S.S.); (P.S.); (N.P.); (M.K.); (S.S.); (D.K.S.); (R.R.T.)
- Correspondence: (M.K.); (R.N.)
| | - Ravinder Nagpal
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, FL 32302, USA
- Correspondence: (M.K.); (R.N.)
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Fekih-Romdhane F, Cheour M. A rare case report of teen-onset pica in a female patient with a clinical high risk for psychosis. Early Interv Psychiatry 2022; 16:808-811. [PMID: 34427054 DOI: 10.1111/eip.13214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/06/2021] [Accepted: 08/15/2021] [Indexed: 11/27/2022]
Abstract
AIM We aimed to further elucidate the under-researched, underdiagnosed and misunderstood comorbid pica in the context of psychosis. METHOD We report a case of teen-onset plastophagia in an antipsychotic-naïve girl at ultra-high risk (UHR) for psychosis. RESULTS HA is a 17-year-old unmarried girl who had a history of good premorbid functioning, no personal psychiatric history and an uncle with schizophrenia. She was referred to our psychiatry department with the complaint of having the habit of eating plastic for about 2 years. A thorough clinical history revealed that she developed, since more than a year, difficulty in school and interpersonal functioning. After clinical evaluation, a diagnosis of UHR with major depressive disorder, iron deficiency anaemia and pica was made. CONCLUSION We draw attention to the possibility of an overlap between the pathogenesis of pica and psychosis, and we highlight the importance of early diagnosis and management of both pica and UHR since they can lead to serious medical and mental consequences.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
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Metcalfe CD, Bayen S, Desrosiers M, Muñoz G, Sauvé S, Yargeau V. An introduction to the sources, fate, occurrence and effects of endocrine disrupting chemicals released into the environment. ENVIRONMENTAL RESEARCH 2022; 207:112658. [PMID: 34990614 DOI: 10.1016/j.envres.2021.112658] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 06/14/2023]
Abstract
Many classes of compounds are known or suspected to disrupt the endocrine system of vertebrate and invertebrate organisms. This review of the sources and fate of selected endocrine disrupting chemicals (EDCs) in the environment includes classes of compounds that are "legacy" contaminants, as well as contaminants of emerging concern. EDCs included for discussion are organochlorine compounds, halogenated aromatic hydrocarbons, brominated flame retardants, per- and polyfluoroalkyl substances, alkylphenols, phthalates, bisphenol A and analogues, pharmaceuticals, drugs of abuse and steroid hormones, personal care products, and organotins. An exhaustive survey of the fate of these contaminants in all environmental media (e.g., air, water, soil, biota, foods and beverages) is beyond the scope of this review, so the priority is to highlight the fate of EDCs in environmental media for which there is a clear link between exposure and endocrine effects in humans or in biota from other taxa. Where appropriate, linkages are also made between the fate of EDCs and regulatory limits such as environmental quality guidelines for water and sediments and total daily intake values for humans.
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Affiliation(s)
| | - S Bayen
- McGill University, Montréal, QC, Canada
| | - M Desrosiers
- Ministère du Développement durable, de l'Environnement et de la Lutte contre les changements climatiques du Québec. Québec City, QC, Canada
| | - G Muñoz
- Université de Montréal, Montréal, QC, Canada
| | - S Sauvé
- Université de Montréal, Montréal, QC, Canada
| | - V Yargeau
- McGill University, Montréal, QC, Canada
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9
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Zhang J, Sun C, Lu R, Zou Z, Liu W, Huang C. Association of childhood rhinitis with phthalate acid esters in household dust in Shanghai residences. Int Arch Occup Environ Health 2022; 95:629-643. [PMID: 35192054 DOI: 10.1007/s00420-021-01797-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Phthalate acid esters (PAEs) have been identified to be associated with children's health. Present study was conducted to assess associations between PAEs in household dust and childhood rhinitis. METHODS Based on phase II of CCHH study (China, Children, Home, Health) conducted in Shanghai, China, 266 indoor dust samples were collected from participants' families. Concentrations of PAEs in dust samples were measured by chemical treatment and gas chromatograph-mass spectrometer. Information about individuals and residences was surveyed by questionnaires. Logistic regression models were applied to obtain the associations between PAEs and childhood rhinitis. RESULTS Higher concentrations of benzyl butyl phthalate (BBP) were found in those families with children who had diagnosed rhinitis. Significantly higher concentrations of bis(2-ethylhexyl) phthalate (DEHP) and PAEs with high molecular weight (HMW-PAEs) were found in the positive group of lifetime rhinitis. Using the multiple and ordinal logistic regression models adjusted by covariates, dibutyl phthalate (DBP), DEHP, and HMW-PAEs were found to be significantly associated with diagnosed rhinitis. Boys who exposure to higher concentrations of DBP, DEHP, HMW-PAEs, and total PAEs have significant associations with diagnosed rhinitis compared with girls who exposure to lower concentration of PAEs. CONCLUSIONS Present observational study indicated that exposure to high concentrations of DBP, DEHP, and HMW-PAEs in house settled dust was a risk factor for rhinitis for children, especially for boys.
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Affiliation(s)
- Jialing Zhang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, People's Republic of China
| | - Chanjuan Sun
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, People's Republic of China
| | - Rongchun Lu
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, People's Republic of China
| | - Zhijun Zou
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, People's Republic of China
| | - Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, People's Republic of China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, People's Republic of China.
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Wang LJ, Huang YH, Chou WJ, Lee SY, Chang HY, Chen CC, Chao HR. Interrelationships among growth hormone, thyroid function, and endocrine-disrupting chemicals on the susceptibility to attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-021-01886-4. [PMID: 35119524 DOI: 10.1007/s00787-021-01886-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 09/23/2021] [Indexed: 11/03/2022]
Abstract
Abnormal growth hormones and thyroid function may be linked to pathophysiology of attention-deficit/hyperactivity disorder (ADHD). Phthalates and bisphenol-A (BPA), two endocrine-disrupting chemicals (EDCs), may affect the human endocrine system. In this study, we aimed to perform a comprehensive investigation of whether growth hormone, thyroid function, and EDCs exhibited differential levels between ADHD patients and healthy controls. In total, 144 children with ADHD and 70 healthy control subjects were enrolled. Their endocrine systems were evaluated using the serum levels of insulin-like growth factor-1 (IGF-1), IGF-binding protein-3 (IGFBP-3), thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), and Free T4. The urinary levels of EDCs, including monoethyl phthalate (MEP), mono-methyl phthalate (MMP), monoethylhexyl phthalate (MEHP), mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), and BPA, were also examined. Patients with ADHD had lower IGF-1 levels than healthy controls (p = 0.003), but we observed no significant difference in IGFBP-3, TSH, T3, T4, or Free T4. Compared to the control group, patients with ADHD demonstrated higher MEHP levels (p = 0.043), MnBP (p = 0.033), and MBzP (p = 0.040). Furthermore, MEHP levels (p < 0.001) and BPA levels (p = 0.041) were negatively correlated with IGF-1 levels, while IGF-1 levels were negatively correlated with principal components consisting of ADHD clinical symptoms and neuropsychological performance variables. We suggest that MEHP exposure may be associated with decreased serum levels of IGF-1 and increased risk of ADHD. The mechanism underlying this association may be important for protecting children from environmental chemicals that adversely affect neurodevelopment.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Ying-Hua Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, College of Medicine, Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Yu Chang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Cheng Chen
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - How-Ran Chao
- Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung County, 912, Taiwan.,Institute of Food Safety Management, College of Agriculture, National Pingtung University of Science and Technology, Pingtung County, 912, Taiwan.,Emerging Compounds Research Center, General Research Service Center, National Pingtung University of Science and Technology, Pingtung County, 912, Taiwan.,School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City, 80708, Taiwan
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11
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Vanhorebeek I, Malarvannan G, Güiza F, Poma G, Derese I, Wouters PJ, Joosten K, Verbruggen S, Jorens PG, Covaci A, Van den Berghe G. Phasing out DEHP from plastic indwelling medical devices used for intensive care: Does it reduce the long-term attention deficit of critically ill children? ENVIRONMENT INTERNATIONAL 2022; 158:106962. [PMID: 34739923 PMCID: PMC8685605 DOI: 10.1016/j.envint.2021.106962] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/08/2021] [Accepted: 10/25/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Children who have been critically ill face long-term developmental impairments. Iatrogenic exposure to di(2-ethylhexyl)phthalate (DEHP), a plasticizer leaching from plastic indwelling medical devices used in the pediatric intensive care unit (PICU), has been associated with the pronounced attention deficit observed in children 4 years after critical illness. As concerns about DEHP toxicity increased, governmental authorities urged the phase out of DEHP in indwelling medical devices and replacement with alternative plasticizers. We hypothesized that exposure to DEHP decreased over the years, attenuating the pronounced long-term attention deficit of these vulnerable children. METHODS We compared plasma concentrations of 3 oxidative DEHP metabolites (5cx-MEPP, 5OH-MEHP, 5oxo-MEHP) on the last PICU day in 216 patients who participated in the Tight Glucose Control study (2004-2007) and 334 patients who participated in the PEPaNIC study (2012-2015) and survived PICU stay. Corresponding minimal exposures to these metabolites (plasma concentration multiplied with number of days in PICU) were also evaluated. In patients with 4-year follow-up data, we compared measures of attention (standardized reaction times and consistency). Comparisons were performed with univariable analyses and multivariable linear regression analyses adjusted for baseline risk factors. RESULTS In the PEPaNIC patients, last PICU day plasma concentrations of 5cx-MEPP, 5OH-MEHP, 5oxo-MEHP and their sum, and corresponding minimal exposures, were reduced to 17-69% of those in the Tight Glucose Control study (p < 0.0001). Differences remained significant after multivariable adjustment (p ≤ 0.001). PEPaNIC patients did not show better attention than patients in the Tight Glucose Control study, also not after multivariable adjustment for risk factors. CONCLUSION Exposure of critically ill children to DEHP in the PICU decreased over the years, but the lower exposure did not translate into improved attention 4 years later. Whether the residual exposure may still be toxic or whether the plasticizers replacing DEHP may not be safe for neurodevelopment needs further investigation.
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Affiliation(s)
- Ilse Vanhorebeek
- Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
| | | | - Fabian Güiza
- Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Giulia Poma
- Toxicological Center, University of Antwerp, Wilrijk, Belgium
| | - Inge Derese
- Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Pieter J Wouters
- Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Koen Joosten
- Intensive Care Unit, Department of Pediatrics and Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Sascha Verbruggen
- Intensive Care Unit, Department of Pediatrics and Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Philippe G Jorens
- Department of Intensive Care Medicine and Clinical Pharmacology, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Adrian Covaci
- Toxicological Center, University of Antwerp, Wilrijk, Belgium
| | - Greet Van den Berghe
- Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
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12
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Morová M, Kršková L. Autistic-like traits in laboratory rodents exposed to phthalic acid esters during early development - an animal model of autism? Physiol Res 2021; 70:345-361. [PMID: 33982578 DOI: 10.33549/physiolres.934570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Phthalates are chemical substances that are widely used to provide flexibility and durability to plastic materials. They leach from products in which they are mixed and reach living organisms. Results from experimental studies suggest that exposure to phthalates can have a negative impact on an individual's neuronal system and behavior. In this regard, exposure during early ontogenesis seems to be particularly dangerous due to the extensive growth and development of body structures and functions. Disruption during this critical time can result in alterations of behavior and the emergence of neurodevelopmental disorders, such as autism spectrum disorder (ASD). Various animal models have been used to elucidate the pathogenesis of this disease. They are fundamental for research, and although the translation of results to humans is difficult, new animal models are being developed. The aim of this review is to summarize laboratory rodent studies in which early developmental phthalate exposure resulted in brain alterations and autistic-like behavioral traits. We also discuss the possibility of using early developmental phthalate exposure in rodents to create a new animal model of autism.
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Affiliation(s)
- M Morová
- Department of Animal Physiology and Ethology, Faculty of Natural Sciences, Comenius University in Bratislava, Bratislava 4, Slovak Republic.
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13
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Watkins DJ, Meeker JD, Tamayo-Ortiz M, Sánchez BN, Schnaas L, Peterson KE, Téllez-Rojo MM. Gestational and peripubertal phthalate exposure in relation to attention performance in childhood and adolescence. ENVIRONMENTAL RESEARCH 2021; 196:110911. [PMID: 33640497 PMCID: PMC8119354 DOI: 10.1016/j.envres.2021.110911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
The prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) has been increasing. Research suggests that exposure to endocrine disrupting chemicals such as phthalates may play a role, but studies of in utero phthalate exposure and ADHD-related symptoms beyond early childhood are limited. We investigated associations between measures of in utero phthalate exposure and ADHD symptoms, such as inattention and impulsivity, in childhood (age 6-11 years, n = 221) and in adolescence (age 9-18 years, n = 200), as well as cross-sectional relationships between phthalate exposure and ADHD symptoms in adolescence (n = 491) among participants in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohort. Women provided urine samples up to three times during pregnancy and adolescents provided a urine sample at 9-18 years of age for phthalate metabolite measurement. We administered the Conners' Continuous Performance Test (CPT) when children were age 6-11 years and again at 9-18 years of age. We used multivariable linear regression to examine associations between the geometric mean of phthalate metabolite levels across pregnancy and CPT scores in childhood or adolescence separately, adjusting for age, years schooling (at 9-18 only), maternal education, and specific gravity. Although average in utero phthalate concentrations were not associated with CPT scores in childhood, interquartile range (IQR) increases of in utero MBzP, MCPP, and MBP were associated with 4.2%, 4.7%, and 4.5% (p < 0.05) higher Omissions scores in adolescence, respectively, indicating higher inattention. In utero MiBP levels were also associated with higher Inter-Stimulus Interval (ISI) and Variability scores (5.4% and 5.5% per IQR, p < 0.05) in adolescence. In addition, urinary DEHP metabolite levels during adolescence were cross-sectionally associated with poorer scores on several CPT indices indicating greater inattention. These findings suggest that in utero phthalate exposure may have adverse effects on attention, but these effects may not appear until adolescence, a period of extensive neurodevelopment. Future research investigating the long-term effects of in utero phthalate exposure on attention and ADHD in adolescence, as well as identification of potential mechanisms involved, is needed.
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Affiliation(s)
- Deborah J Watkins
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - John D Meeker
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Marcela Tamayo-Ortiz
- National Council of Science and Technology, National Institute of Public Health, Mexico City, Mexico
| | - Brisa N Sánchez
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Lourdes Schnaas
- National Institute of Perinatology, ABC Hospital, Mexico City, Mexico
| | - Karen E Peterson
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Martha María Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
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14
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Xu H, Sheng J, Wu X, Zhan K, Tao S, Wen X, Liu W, Cudjoe O, Tao F. Moderating effects of plastic packaged food on association of urinary phthalate metabolites with emotional symptoms in Chinese adolescents. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 216:112171. [PMID: 33812210 DOI: 10.1016/j.ecoenv.2021.112171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/02/2021] [Accepted: 03/17/2021] [Indexed: 05/26/2023]
Abstract
Previous research reports that diet is the main source of phthalate exposure to adolescents, and phthalate is associated with adolescent mental and behavioral problems. However, no study has explored the moderating effects of eating behavior in this association. This study aimed to analyze the moderating effects of plastic packaged food consumption in the longitudinal association between phthalate metabolite concentration and emotional symptoms in adolescents. This school-based survey was carried out among adolescents in two Chinese provinces. We conducted a baseline and follow-up surveys for 893 freshmen using the purposive sampling method from December 2018 to November 2019. We used food frequency questionnaire to assess eating behavior. The Chinese version of 21-item Depression Anxiety Stress Scales was used to assess emotional symptoms, and high-performance liquid chromatography-tandem mass spectrometry was used to analyze the concentration of six urine phthalate metabolites. The results of latent moderation model indicated that plastic packaged food consumption moderated the association of low molecular weight phthalate (LMWP) with depressive symptoms (β = 0.27, P = 0.002), anxiety symptoms (β = 0.89, P < 0.01), and stress symptoms (β = 0.23, P = 0.019). The moderating effects were significant at the higher scores (β = 0.14-0.35, P < 0.05) and/or the lower scores (β = -0.35 to -0.12, P < 0.05) of plastic packaged food consumption. The results suggest that plastic packaged food consumption to some extent moderates the longitudinal association of phthalate exposure with emotional symptoms in adolescents.
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Affiliation(s)
- Honglv Xu
- School of Medicine, Kunming University, 2 Puxin Road, Kunming 650214, Yunnan, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Jie Sheng
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Kai Zhan
- Anhui Key Laboratory of Livestock and Poultry Product Safety Engineering, Institute of Animal Husbandry and Veterinary Medicine, Anhui Academy of Agricultural Science, Hefei 230031, Anhui, PR China
| | - Shuman Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Xing Wen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Wenwen Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Obed Cudjoe
- University of Cape Coast, Department of Microbiology and Immunology, School of Medical Sciences, Cape Coast, Ghana; Department and the Key Laboratory of Microbiology and Parasitology, Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China.
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15
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Minatoya M, Kishi R. A Review of Recent Studies on Bisphenol A and Phthalate Exposures and Child Neurodevelopment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073585. [PMID: 33808331 PMCID: PMC8036555 DOI: 10.3390/ijerph18073585] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/20/2021] [Accepted: 03/25/2021] [Indexed: 01/17/2023]
Abstract
Purpose of Review: Bisphenol A and phthalate have been found in the environment, as well as in humans. In this narrative review pre- and postnatal bisphenol A and phthalate exposures, their relationship to neurodevelopment, and the behavioral outcomes of children are elucidated, focusing in particular on the recent case-control, cross-sectional, and longitudinal studies. This review also introduces some of the possible mechanisms behind the observed associations between exposures and outcomes. Recent Findings: Although bisphenol A and phthalate exposure have been reported to influence neurobehavioral development in children, there are various kinds of test batteries for child neurodevelopmental assessment at different ages whose findings have been inconsistent among studies. In addition, the timing and number of exposure assessments have varied. Summary: Overall, this review suggests that prenatal exposure to bisphenol A and phthalates may contribute to neurobehavioral outcomes in children. The evidence is still limited; however, Attention Deficit Hyperactivity Disorder (ADHD) symptoms, especially among boys, constantly suggested association with both prenatal and concurrent exposure to bisphenol A. Although there is limited evidence on the adverse effects of prenatal and postnatal bisphenol A and phthalate exposures provided, pregnant women and young children should be protected from exposure based on a precautionary approach.
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16
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Hlisníková H, Petrovičová I, Kolena B, Šidlovská M, Sirotkin A. Effects and mechanisms of phthalates’ action on neurological processes and neural health: a literature review. Pharmacol Rep 2021; 73:386-404. [DOI: 10.1007/s43440-021-00215-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/15/2020] [Accepted: 01/05/2021] [Indexed: 12/17/2022]
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Praveena SM, Munisvaradass R, Masiran R, Rajendran RK, Lin CC, Kumar S. Phthalates exposure and attention-deficit/hyperactivity disorder in children: a systematic review of epidemiological literature. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:44757-44770. [PMID: 32895790 DOI: 10.1007/s11356-020-10652-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 08/26/2020] [Indexed: 06/11/2023]
Abstract
Epidemiological studies have proven that children mental health can be affected by environmental pollutants which are believed to be visible in the form of psychological disorder later in their childhood. Moreover, the effects of children mental health are evidently clear in the case of phthalates which have been observed to increase psychological disorder, specifically attention-deficit hyperactivity disorder (ADHD). Hence, the present study aims to conduct a systematic review and provide an overview of the existing literature on the association between urinary phthalate metabolite concentrations and ADHD symptoms among children by emphasizing the confounding factors and limitations. Additionally, this review addressed the possible phthalate mechanism insights in human body including its impact on ADHD symptoms. In this case, 16 epidemiological studies (five cross-sectional, nine cohort and two case control studies) that met all the inclusion criteria were selected out of the total of 427 papers screened to show varying quantitative associations between phthalate exposure and ADHD symptoms among children with confounding factors and limitations in the existing studies in regard to the exposure and outcomes. This review also attempted to present possible explanation on phthalate mechanism in children body and its connection on neurodevelopment and ADHD symptom development which remains unclear in most of the studies. Finally, it is highly recommended for further research to carefully design cohort studies from prenatal to later childhood development with a complete sample size in order to understand phthalate impacts on children health.
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Affiliation(s)
- Sarva Mangala Praveena
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Science, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia.
- Food Safety and Food Integrity, Institute of Tropical, Agriculture and Food Security, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia.
| | - Rusheni Munisvaradass
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Science, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | - Ruziana Masiran
- Department of Psychiatry, Faculty of Medicine and Health Science, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | - Ranjith Kumar Rajendran
- Graduate Institute of Environmental Engineering, National Central University, No.300, Zhongda Rd., Zhongli District, Taoyuan City, 32001, Taiwan
| | - Chu-Ching Lin
- Graduate Institute of Environmental Engineering, National Central University, No.300, Zhongda Rd., Zhongli District, Taoyuan City, 32001, Taiwan
| | - Suresh Kumar
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Science, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
- Department of Biotechnology, BIHER, Bharath University, Chennai, 600 073, Tamil Nadu, India
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Sears CG, Braun JM. Phthalate Exposure, Adolescent Health, and the Need for Primary Prevention. Endocrinol Metab Clin North Am 2020; 49:759-770. [PMID: 33153678 DOI: 10.1016/j.ecl.2020.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Phthalates, a class of endocrine-disrupting chemicals, are used widely in many consumer products, and exposure can interfere with a range of hormonal functions during early life. These disruptions may alter development during late childhood and adolescence. This article discusses the potential effects of phthalate exposure on adiposity, puberty, and neurodevelopment during late childhood and adolescence. It also highlights studies of behavioral interventions to reduce phthalate exposures and the roles of health care professionals and policy makers in preventing phthalate exposure.
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Affiliation(s)
- Clara G Sears
- Department of Epidemiology, Brown University School of Public Health, Box G-S121-2, 121 South Main Street, Providence, RI 02912, USA.
| | - Joseph M Braun
- Department of Epidemiology, Brown University School of Public Health, Box G-S121-2, 121 South Main Street, Providence, RI 02912, USA. https://twitter.com/JosephMBraun1
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Phthalates, Para-Hydroxybenzoic Acids, Bisphenol-A, and Gonadal Hormones' Effects on Susceptibility to Attention-Deficit/Hyperactivity Disorder. TOXICS 2020; 8:toxics8030057. [PMID: 32823738 PMCID: PMC7560246 DOI: 10.3390/toxics8030057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/09/2020] [Accepted: 08/11/2020] [Indexed: 11/16/2022]
Abstract
This study aimed to examine whether endocrine-disrupting chemicals (EDCs), such as phthalates, para-hydroxybenzoic acids, and bisphenol-A (BPA), affect gonadal hormones and further link to the susceptibility to attention-deficit/hyperactivity disorder (ADHD). We recruited 98 boys with ADHD, 32 girls with ADHD, 42 boys without ADHD and any other psychiatric disorders, and 26 girls without ADHD and any other psychiatric disorders. Urine levels of EDCs, including mono-methyl phthalate (MMP), monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), monoethylhexyl phthalate (MEHP), methylparaben (MP), ethylparaben (EP), propylparaben (PP), butylparaben (BP), and bisphenol A (BPA), were examined. Endocrine systems were evaluated by using the serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, free testosterone, estradiol, progesterone, sex hormone-binding globulin (SHBG), and prolactin. We found that boys with ADHD had higher levels of MnBP and EP than control boys. There were no significant differences regarding EDCs between the females with ADHD and control groups. No significant differences in testosterone, free testosterone, FSH, LH, estradiol, progesterone, or SHBG were found between the ADHD group and controls among either boys or girls. Among boys with ADHD, urine MBzP and MEHP levels were positively correlated with serum testosterone levels. Among girls, urine MEP levels were positively correlated with serum LH, testosterone, and free testosterone levels. The findings suggest that the possibility of an adverse impact of EDCs on gonadal hormones and neurodevelopment may exist. However, the results could be subject to potential selection bias, and the findings in this study should be interpreted with caution.
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20
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Tien J, Lewis GD, Liu J. Prenatal risk factors for internalizing and externalizing problems in childhood. World J Pediatr 2020; 16:341-355. [PMID: 31617077 PMCID: PMC7923386 DOI: 10.1007/s12519-019-00319-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 09/24/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND A growing body of research has documented the effects of prenatal risk factors on a wide spectrum of adverse offspring health outcomes. Childhood behavior problems, such as externalizing and internalizing problems, are no exception. This comprehensive literature review aims to summarize and synthesize current research about commonly experienced prenatal risk factors associated with internalizing and externalizing problems, with a focus on their impact during childhood and adolescence. Potential mechanisms as well as implications are also outlined. DATA SOURCES The EBSCO, Web of Science, PubMed, Google Scholar, and Scopus databases were searched for studies examining the association between prenatal risk factors and offspring internalizing/externalizing problems, using keywords "prenatal" or "perinatal" or "birth complications" in combination with "internalizing" or "externalizing". Relevant articles, including experimental research, systematic reviews, meta-analyses, cross-sectional and longitudinal cohort studies, and theoretical literature, were reviewed and synthesized to form the basis of this integrative review. RESULTS Prenatal risk factors that have been widely investigated with regards to offspring internalizing and externalizing problems encompass health-related risk factors, including maternal overweight/obesity, substance use/abuse, environmental toxicant exposure, maternal infection/inflammation, as well as psychosocial risk factors, including intimate partner violence, and anxiety/depression. Collectively, both epidemiological and experimental studies support the adverse associations between these prenatal factors and increased risk of emotional/behavioral problem development during childhood and beyond. Potential mechanisms of action underlying these associations include hormonal and immune system alterations. Implications include prenatal education, screening, and intervention strategies. CONCLUSIONS Prenatal risk factors are associated with a constellation of offspring internalizing and externalizing problems. Identifying these risk factors and understanding potential mechanisms will help to develop effective, evidence-based prevention, and intervention strategies.
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Affiliation(s)
- Joyce Tien
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Gary D Lewis
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jianghong Liu
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Xu H, Wu X, Liang C, Shen J, Tao S, Wen X, Liu W, Zou L, Yang Y, Xie Y, Jin Z, Li T, Tao F. Association of urinary phthalates metabolites concentration with emotional symptoms in Chinese university students. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 262:114279. [PMID: 32443185 DOI: 10.1016/j.envpol.2020.114279] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/30/2020] [Accepted: 02/25/2020] [Indexed: 06/11/2023]
Abstract
Previous studies have shown the associations between phthalates exposure and psychological behavior problems in children and adolescents, but such associations have not been fully elucidated in university students, especially among Chinese university students. This study aims to examine the association between urinary phthalates metabolites concentration and emotional symptoms in Chinese university students. A school-based cross-sectional survey was carried out among 990 university students aged 17-24 years from two universities in Anhui and Jiangxi provinces of China. Concentration of six phthalate metabolites in urine was determined by high-performance liquid chromatography-tandem mass spectrometry and the emotional symptoms were assessed by the 21-item Depression, Anxiety, and Stress Scale. The detection rate of six phthalate metabolites in urine ranged from 79.6% to 99.7%. The median concentration of six phthalate metabolites ranged from 2.90 to 119.64 ng/mL. The positive rates of depressive symptoms, anxiety symptoms, and stress were 17.4%, 24.8%, and 9.5%, respectively. After adjusting for the confounding variables, mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) was found to be associated with depressive symptoms (β = 8.84, P = 0.017), anxiety symptoms (β = 8.46, P = 0.015), and stress symptoms (β = 9.95, P = 0.012) in males; whereas, monobutyl phthalate (MBP) was found to be associated with depressive symptoms (β = 1.86, P = 0.002), anxiety symptoms (β = 1.81, P = 0.005), and stress symptoms (β = 1.48, P = 0.047) in females. Our study demonstrates that Chinese university students are widely exposed to phthalates; and high- and low-molecular weight phthalates are associated with emotional symptoms in males and females, respectively.
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Affiliation(s)
- Honglv Xu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Xiaoyan Wu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Chunmei Liang
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Jie Shen
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Shuman Tao
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Xing Wen
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Wenwen Liu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Liwei Zou
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Yajuan Yang
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Yang Xie
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Zhongxiu Jin
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Tingting Li
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, 230032, Anhui, PR China.
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22
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Radke EG, Braun JM, Nachman RM, Cooper GS. Phthalate exposure and neurodevelopment: A systematic review and meta-analysis of human epidemiological evidence. ENVIRONMENT INTERNATIONAL 2020; 137:105408. [PMID: 32045779 PMCID: PMC8453372 DOI: 10.1016/j.envint.2019.105408] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/30/2019] [Accepted: 12/09/2019] [Indexed: 05/09/2023]
Abstract
OBJECTIVE We performed a systematic review of the epidemiology literature to identify the neurodevelopmental effects associated with phthalate exposure. DATA SOURCES AND STUDY ELIGIBILITY CRITERIA Six phthalates were included in the review: di(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DINP), dibutyl phthalate (DBP), diisobutyl phthalate (DIBP), butyl benzyl phthalate (BBP), and diethyl phthalate (DEP). The initial literature search (of PubMed, Web of Science, and Toxline) included all studies of neurodevelopmental effects in humans, and outcomes were selected for full systematic review based on data availability. STUDY EVALUATION AND SYNTHESIS METHODS Studies of neurodevelopmental effects were evaluated using criteria defined a priori for risk of bias and sensitivity by two reviewers using a domain-based approach. Evidence was synthesized by outcome and phthalate and strength of evidence was summarized using a structured framework. For studies of cognition and motor effects in children ≤4 years old, a random effects meta-analysis was performed. RESULTS The primary outcomes reviewed here are (number of studies in parentheses): cognition (14), motor effects (9), behavior, including attention deficit hyperactivity disorder (20), infant behavior (3), and social behavior, including autism spectrum disorder (7). For each phthalate/outcome combination, there was slight or indeterminate evidence of an association, with the exception of motor effects for BBP, which had moderate evidence. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Overall, there is not a clear pattern of association between prenatal phthalate exposures and neurodevelopment. There are several possible reasons for the observed null associations related to exposure misclassification, periods of heightened susceptibility, sex-specific effects, and the effects of phthalate mixtures. Until these limitations are adequately addressed in the epidemiology literature, these findings should not be interpreted as evidence that there are no neurodevelopmental effects of phthalate exposure. The views expressed are those of the authors and do not necessarily represent the views or policies of the U.S. EPA.
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Affiliation(s)
- Elizabeth G Radke
- U.S. Environmental Protection Agency, National Center for Environmental Assessment, United States.
| | - Joseph M Braun
- Brown University, School of Public Health, United States
| | - Rebecca M Nachman
- U.S. Environmental Protection Agency, National Center for Environmental Assessment, United States
| | - Glinda S Cooper
- U.S. Environmental Protection Agency, National Center for Environmental Assessment, United States; The Innocence Project, United States
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The potential role of clock genes in children attention-deficit/hyperactivity disorder. Sleep Med 2020; 71:18-27. [PMID: 32460137 DOI: 10.1016/j.sleep.2020.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Attention deficit/ hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder and is thought to be associated with circadian system. METHODS We performed a pathway-based study to test individual single nucleotide polymorphisms (SNPs) and the overall evidence of genetic polymorphisms involved in the circadian pathway in association with children ADHD susceptibility among a Chinese population. A community-based case-control study was conducted among Chinese children, and 168 ADHD patients and 233 controls were recruited using a combination diagnosis based on the diagnostic and statistical manual of mental disorders iv (DSM-IV) ADHD rating scale, Swanson, Nolan, and Pelham rating scale (SNAP-IV) rating scale, and semi-structured clinical interview. RESULTS The results of single-loci analyses identified that PER1 rs2518023 and ARNTL2 rs2306074 were nominally association with ADHD susceptibility (P < 0.05). Next, we applied multifactor dimensionality reduction (MDR), and classification and regression tree (CART) analyses to explore high-order gene-gene interactions among the functional SNPs to ADHD risks. The results indicated that interactions among the PER1 rs2518023, ARNTL2 rs2306074 and NR1D1 rs939347 were associated with the risk of ADHD in children. Individuals carrying the combination genotypes of the PER1 rs2518023 GG or GT, ARNTL2 rs2306074 TC or TT and NR1D1 rs939347 GA or AA displayed a significantly higher risk for ADHD than who carry the PER1 rs2518023 TT and CRY2 rs2292910 CA/CC genotypes (adjusted OR = 4.37, 95% CI = 2.16-8.85, P < 0.001). CONCLUSIONS These findings revealed the importance of genetic variations related to the circadian clock system to the susceptibility of children ADHD.
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24
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Nilsen FM, Tulve NS. A systematic review and meta-analysis examining the interrelationships between chemical and non-chemical stressors and inherent characteristics in children with ADHD. ENVIRONMENTAL RESEARCH 2020; 180:108884. [PMID: 31706600 PMCID: PMC6937727 DOI: 10.1016/j.envres.2019.108884] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/25/2019] [Accepted: 10/29/2019] [Indexed: 05/05/2023]
Abstract
Children may be more vulnerable to the combined interactions of chemical and non-chemical stressors from their built, natural, and social environments when compared to adults. Attention deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed childhood neurodevelopmental disorder and is considered a major public health issue, as 75% of childhood cases persist into adulthood. ADHD is characterized by developmentally inappropriate levels of hyperactivity, impulsivity, and inattention, with the neurotransmitter serotonin regulating these symptoms. Monoamine oxidase A (MAOA) aids in serotonin uptake and is often implicated in behavioral and emotional disorders, including ADHD. When children are exposed to cigarette smoke, bisphenol A (BPA), or organophosphate pesticides, MAOA activity is inhibited. Non-chemical stressors, such as traumatic childhood experiences, and lifestyle factors, complicate the relationship between genotype and exposures to chemical stressors. But the co-occurrence among outcomes between exposures to chemical stressors, non-chemical stressors, and the low activity MAOA genotype suggest that mental illness in children may be influenced by multiple interacting factors. In this systematic review, we examine the existing literature that combines exposures to chemical and non-chemical stressors (specifically childhood trauma), MAOA characteristics, and ADHD diagnosis to investigate the interrelationships present. We observe that chemical (lead [Pb], phthalates/plasticizers, persistent organic pollutants, and cigarette smoke) exposure is significantly related to ADHD in children. We also observed that existing literature examining the interaction between MAOA, exposures to chemical stressors, and traumatic experiences and their effect on ADHD outcomes is sparse. We recommend that future studies investigating childhood ADHD include chemical and non-chemical stressors and inherent characteristics to gain a holistic understanding of childhood mental health outcomes.
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Affiliation(s)
- Frances M Nilsen
- Oak Ridge Institute for Science and Education Post-Doctoral Participant, U.S. EPA, Office of Research and Development, National Exposure Research Laboratory, 109 TW Alexander Dr., Research Triangle Park, NC, USA.
| | - Nicolle S Tulve
- U.S. EPA, Office of Research and Development, National Exposure Research Laboratory, 109 TW Alexander Dr., Research Triangle Park, NC, USA.
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25
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Kim YS, Kim JS, Sun G, Cheong WJ. Development of a New Solid Phase Extraction Cartridge Filled with Organic Monolith Particles for Extraction of di‐Alkyl Phthalates. B KOREAN CHEM SOC 2019. [DOI: 10.1002/bkcs.11919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Yune Sung Kim
- Department of ChemistryInha University Incheon 22212 South Korea
| | - Jeong Soo Kim
- Department of ChemistryInha University Incheon 22212 South Korea
| | - Genlin Sun
- Department of ChemistryInha University Incheon 22212 South Korea
| | - Won Jo Cheong
- Department of ChemistryInha University Incheon 22212 South Korea
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26
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Jankowska A, Polańska K, Koch HM, Pälmke C, Waszkowska M, Stańczak A, Wesołowska E, Hanke W, Bose-O'Reilly S, Calamandrei G, Garí M. Phthalate exposure and neurodevelopmental outcomes in early school age children from Poland. ENVIRONMENTAL RESEARCH 2019; 179:108829. [PMID: 31677502 DOI: 10.1016/j.envres.2019.108829] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/06/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
Some phthalates are known endocrine disrupting chemicals (EDC). They are widely present in the environment thus their impact on children's health is of particular scientific interest. The aim of the study was to evaluate the association between phthalate exposure and neurodevelopmental outcomes, in particular behavioral, cognitive and psychomotor development, in 250 early school age children from the Polish Mother and Child Cohort (REPRO_PL). Urine samples were collected at the time of children's neurodevelopmental assessment and were analysed for 21 metabolites of 11 parent phthalates. Behavioral and emotional problems were assessed by the Strengths and Difficulties Questionnaire (SDQ) filled in by the mothers. To assess children's cognitive and psychomotor development, Polish adaptation of the Intelligence and Development Scales (IDS) was administered. The examination was performed by trained psychologists. Dimethyl phthalate (DMP) and di-n-butyl phthalate (DnBP) were the two phthalates showing the highest statistically significant associations, with higher total difficulties scores (β = 1.5, 95% CI 0.17; 2.7; β = 1.5, 95% CI 0.25; 2.8, respectively) as well as emotional symptoms and hyperactivity/inattention problems for DnBP (β = 0.46, 95% CI -0.024; 0.94; β = 0.72, 95% CI 0.065; 1.4, respectively), and peer relationships problems for DMP (β = 0.37, 95% CI -0.013; 0.76). In addition, DnBP and DMP have been found to be negatively associated with fluid IQ (β = -0.14, 95% CI -0.29; 0.0041) and crystallized IQ (β = -0.16, 95% CI -0.29; -0.025), respectively. In the case of mathematical skills, three phthalates, namely DMP (β = -0.17, 95% CI -0.31; -0.033), DEP (β = -0.16, 95% CI -0.29; -0.018) and DnBP (β = -0.14, 95% CI -0.28; 0.0012), have also shown statistically significant associations. This study indicates that exposure to some phthalates seems to be associated with adverse effects on behavioral and cognitive development of early school age children. Further action including legislation, educational and interventional activities to protect this vulnerable population is still needed.
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Affiliation(s)
- Agnieszka Jankowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine (NIOM), Lodz, Poland
| | - Kinga Polańska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine (NIOM), Lodz, Poland
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany
| | - Claudia Pälmke
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany
| | - Małgorzata Waszkowska
- Department of Health and Work Psychology, Nofer Institute of Occupational Medicine (NIOM), Lodz, Poland
| | - Aleksander Stańczak
- Department of Health and Work Psychology, Nofer Institute of Occupational Medicine (NIOM), Lodz, Poland
| | - Ewelina Wesołowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine (NIOM), Lodz, Poland
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine (NIOM), Lodz, Poland
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Gemma Calamandrei
- Centre for Behavioral Sciences and Mental Health, National Institute of Health (ISS), Rome, Italy
| | - Mercè Garí
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Computational Biology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany.
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27
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Yao Y, Chen D, Wu Y, Zhou L, Cheng J, Li Y, Lu S, Yuan G, Liu G. Urinary phthalate metabolites in primary school starters in Pearl River Delta, China: Occurrences, risks and possible sources. ENVIRONMENTAL RESEARCH 2019; 179:108853. [PMID: 31678724 DOI: 10.1016/j.envres.2019.108853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/16/2019] [Accepted: 10/21/2019] [Indexed: 06/10/2023]
Abstract
Assessment of children's exposure risks of phthalates before puberty is important, as phthalates are ubiquitous and are associated with reproductive development. However, relevant data in Pearl River Delta, China are scarce. Nineteen phthalate metabolites were analyzed in urine samples from 1490 primary school starters (6-8 years old) recruited in 2016-2017 using ultra-performance liquid chromatography and tandem mass spectrometry (UHPLC-MS/MS). Nine phthalate metabolites were detected more than 80% of the urine samples. Monobutyl phthalate (MnBP) was the highest metabolite (median, 212 μg/g creatinine), followed by two short chained phthalate metabolites, four secondary metabolites of di(2-ethylhexyl) phthalate (DEHP), and the primary metabolites of DEHP. The MnBP level was the third highest of those reported worldwide while other metabolites were in the lower range compared with previous studies. Significantly positive associations were found between urinary metabolite levels and family income as well as parent education levels (p < 0.05). Duration since the latest interior decoration was inversely associated with phthalate metabolites (p < 0.05). Significantly positive associations had also been found between the frequency of eating takeaway food and four DEHP metabolites (p < 0.01). The geometric mean of estimated daily intake (EDI) of di-n-butyl phthalate (DnBP), DEHP, di-iso-butyl phthalate (DiBP), dimethyl phthalate, diethyl phthalate and butylbenzyl phthalate (BBzP) were 6.24, 2.67, 1.06, 0.64, 0.44, and 0.01 μg/kg bw/day, respectively. Hazard quotient (HQ) was defined as the ratio of EDI and the tolerable daily intake (TDI). Approximately 38% children had HQ DnBP >1 indicating potential reproductive risks caused by DnBP. To evaluate cumulative exposure risks, hazard index (HI) was calculated as the sum of the HQs of DnBP, DiBP, DEHP, and BBzP. Nearly 48% children had HI > 1 suggesting extremely high cumulative risks in children in Pearl River Delta, China. To our best knowledge, this was the largest study on evaluating phthalate exposure among children in China.
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Affiliation(s)
- Yao Yao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China; Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dingyan Chen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Yu Wu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Li Zhou
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China.
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Yingying Li
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Shaoyou Lu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangzhou, 510275, Guangdong, PR China
| | - Guanxiang Yuan
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Guihua Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
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28
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Huang HB, Kuo PH, Su PH, Sun CW, Chen WJ, Wang SL. Prenatal and childhood exposure to phthalate diesters and neurobehavioral development in a 15-year follow-up birth cohort study. ENVIRONMENTAL RESEARCH 2019; 172:569-577. [PMID: 30875510 DOI: 10.1016/j.envres.2019.02.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 02/15/2019] [Accepted: 02/19/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Longitudinal studies on neurobehavioral development in relation to prenatal and postnatal exposure to phthalates in school-age children and adolescents are limited. We investigated the association of prenatal and childhood phthalate exposure with the development of behavioral syndromes in 8-14-year-old children. METHOD We recruited 430 pregnant women from 2000 to 2001 and followed their children at the ages of 2, 5, 8, 11, and 14 years, yielding 153 mother-child pairs in total. Urine samples from pregnant women in the third trimester and from children at 2-8 years of age were analyzed for the concentrations of seven urinary phthalate metabolites: monomethyl phthalate, monoethyl phthalate, monobutyl phthalate, monobenzyl phthalate (MBzP), and three di(2-ethylhexyl) phthalate (DEHP) metabolites, namely mono-2-ethylhexyl phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate, and mono(2-ethyl-5-oxohexyl) phthalate. Behavioral syndromes in children aged 8-14 years were assessed using the Child Behavior Checklist. We constructed mixed models to examine these associations after adjustments for potential covariates. RESULTS Maternal urinary MEHP levels were associated with higher scores for internalizing problems (β = 0.028, 95% confidence interval [CI]: 0.0004, 0.055) and externalizing problems (β = 0.040, 95% CI: 0.013, 0.066). Associations of the maternal urinary sum of DEHP metabolite levels with delinquent behavior scores and externalizing problems scores were positive (β = 0.035, 95% CI: 0.013, 0.057 for delinquent behavior; β = 0.026, 95% CI: 0.001, 0.050 for externalizing problems). Furthermore, children's urinary MBzP levels were associated with higher scores for social problems (β = 0.018, 95% CI: 0.001, 0.035). Similar patterns were observed for borderline and clinical ranges. CONCLUSION Early-life exposure to phthalates may influence behavioral syndrome development in children. Future studies are needed to replicate these findings, and efforts to reduce exposures to phthalates during critical early life stages may be warranted.
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Affiliation(s)
- Han-Bin Huang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Pen-Hua Su
- Department of Pediatrics, Chung-Shan Medical University Hospital, School of Medicine, Taichung, Taiwan
| | - Chien-Wen Sun
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shu-Li Wang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Safety, Health, and Environmental Engineering, National United University, Miaoli, Taiwan.
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29
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Zhang Q, Chen XZ, Huang X, Wang M, Wu J. The association between prenatal exposure to phthalates and cognition and neurobehavior of children-evidence from birth cohorts. Neurotoxicology 2019; 73:199-212. [PMID: 31004626 DOI: 10.1016/j.neuro.2019.04.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Phthalate have been detected widely in the environment; while several studies have indicated that prenatal phthalate exposure has adverse effects on neurodevelopment, the results were inconsistent. OBJECTIVE We aimed to determine the current research status of the relationship between prenatal exposure to different types of phthalate and cognition and behavioral development in children. We conducted a systematic review to evaluate the current state of knowledge. METHODS We systematically searched PubMed, Web of Science, and EMBASE electronic databases up to May 2018 with manual searches of the references of retrieved publications and relevant reviews. Only birth cohort studies that reported on the association between phthalate exposure and cognitive or behavioral development were included in this review. We evaluated the risk of bias for each of the included studies using a modified instrument based on the Cochrane Collaboration's "Risk of Bias" tool. RESULT Twenty-six birth cohort studies met our inclusion criteria, nine of which investigated the impact of phthalate exposure during pregnancy on cognition, 13 on neurobehavior, and 4 on both cognition and neurobehavior. However, ten articles reported that the effect of prenatal exposure to phthalates on cognitive development was statistically significant, 15 articles reported that the effect of prenatal exposure to phthalates on neurobehavior was statistically significant. The effect of prenatal phthalate exposure on neurodevelopment differed according to sex, but the results are inconsistent, for instance, among the five studies investigating the association between mental development index (MDI) and Mono-n-butyl phthalate (MnBP), two of them showed a significantly decreasing MDI scores with increasing concentrations of MnBP among girls, but among boys one study showed the inverse association, another showed the positive association. CONCLUSION Di(2-ethylhexyl) phthalate, dibutyl phthalate, butyl-benzyl phthalate and di-ethyl phthalate exposure during pregnancy was associated with lower cognitive scores and worse behavior in offspring, and sex-specific effects on cognitive, psychomotor, and behavioral development were identified, especially the impact of phthalate exposure on neurobehavior in boys.
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Affiliation(s)
- Qi Zhang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xin-Zhen Chen
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xin Huang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Min Wang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jing Wu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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30
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Mustafin RN, Enikeeva RF, Malykh SB, Valinurov RG, Khusnutdinova EK. [Genetics and epigenetics of attention deficit hyperactivity disorder]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 118:106-110. [PMID: 30335081 DOI: 10.17116/jnevro2018118091106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Molecular genetic studies of attention deficit hyperactivity disorder (ADHD) have demonstrated the involvement of multiple genes in the etiology of ADHD. A polygenic hypothesis of the etiopathogenesis was formulated without clear knowledge of common mechanisms of ADHD development. Twin, family and adoption studies have established the heritability of 70-80% for ADHD. Association studies have shown the relationship between ADHD and genes of dopaminergic (DRD4, DRD5, SLC6A3), serotoninergic (HTR1B, 5-HTTLPR), glutamatergic (mGluR, NDRG2) systems, metabolic pathways (SLC2A3, SLC6A4, CDH13, CFOD1, GFOD1), membrane proteins (KChIP1, ITGA1, SNAP-25) as well as tumour-suppressor (NDRG2, NF1) and cytokine genes. The marked comorbidity of ADHD with other psychiatric disorders and shared genetic risk factors were determined. Studies of a role of copy number variations (CNVs) provided more promising evidence that suggested the possible involvement of retroelements as the unifying factors of disease etiopathogenesis. Transposons, which are sensitive to stress, may cause CNVs and are key regulators of brain development and functioning. The dysregulation of transposons is thought to be important in changes in tuning of gene regulatory pathways and epigenetic regulation of neurons in ADHD that may be a common principle underlying the heterogeneous nature of ADHD. Research on noncoding RNAs will help to confirm the hypothesis and develop diagnostic algorithms of examination of ADHD patients as an important step in the implementation of personalized medicine in psychiatry.
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Affiliation(s)
| | - R F Enikeeva
- Bashkir State University, Ufa, Russia; Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
| | - S B Malykh
- Psychological Institute of Russian Academy of Education, Moscow, Russia
| | | | - E K Khusnutdinova
- Bashkir State University, Ufa, Russia; Institute of Biochemistry and Genetics of the Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
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Wang Y, Hu D, Chen W, Xue H, Du Y. Prenatal Tobacco Exposure Modulated the Association of Genetic variants with Diagnosed ADHD and its symptom domain in children: A Community Based Case-Control Study. Sci Rep 2019; 9:4274. [PMID: 30862909 PMCID: PMC6414688 DOI: 10.1038/s41598-019-40850-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 02/25/2019] [Indexed: 12/28/2022] Open
Abstract
The purpose of our study was to test the hypothesis that prenatal tobacco smoking exposure (PSE) could modulate the association of genetic variants with ADHD. A community based case-control study was conducted among Chinese children and 168 ADHD patients and 233 controls were recruited by using combination diagnosis of DSM-IV, SNAP-IV and semi-structured clinical interview. Logistic regression analysis was performed to estimate the effect of prenatal tobacco smoking exposure and genotype frequencies on ADHD susceptibility individually by adjustment for potential confounders. Multiplicative and additive interaction analysis were performed to evaluate the interactions between risk genes and PSE with regard to ADHD. Prenatal tobacco smoke exposure was a significant risk factor of ADHD even after adjusted for other potential confounders. ADRA2A rs553668, DRD2 rs1124491 and SLC6A4 rs6354 were identified to be associated with ADHD. A significant multiplicative and additive gene-environment interactions were observed between the PSE and the ADRA2A rs553668 in relation to ADHD and ADHD-ODD. The risk of the genetic variants in ADHD was increased significantly if the child had prenatal tobacco exposure. The genetic risk for ADHD could be influenced by the presence of environmental risks. The environmental and the genetic risks are not distinct to each other. More gene-environment interaction studies were needed to reveal the etiology of ADHD.
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Affiliation(s)
- Yanni Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, P. R. China
| | - Dan Hu
- Department of Child Health Care, Hospital of Maternal and Child Health of Dalian, Dalian, Liaoning, P. R. China
| | - Wenjing Chen
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
| | - Hongli Xue
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, P. R. China
| | - Yukai Du
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China.
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Yin N, Liang S, Liang S, Hu B, Yang R, Zhou Q, Jiang G, Faiola F. DEP and DBP induce cytotoxicity in mouse embryonic stem cells and abnormally enhance neural ectoderm development. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 236:21-32. [PMID: 29414342 DOI: 10.1016/j.envpol.2018.01.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/14/2018] [Accepted: 01/14/2018] [Indexed: 06/08/2023]
Abstract
Diethyl phthalate (DEP) and dibutyl phthalate (DBP) are two typical small phthalate esters, extensively used in personal care and consumer products. Although previous studies have linked phthalate esters to several health issues, it is still unclear whether they can affects the early stages of embryonic development. In this study, we evaluated the early developmental neurotoxicity as well as the cytotoxicity of DEP and DBP, using mouse embryonic stem cells (mESCs). Our results showed that both DEP and DBP could decrease mESC viability in a dose-dependent manner. Moreover, while DBP could activate the caspase-3/7 enzymes and cause cell membrane damage as well as intracellular ROS accumulation, interestingly DEP treatment only showed stimulation of ROS production. In addition, DEP and DBP treatment at non-cytotoxic concentrations, abnormally altered the expression levels of several vitally important regulators of embryo development. For instance, neural ectoderm markers, such as Pax6, Nestin, Sox1 and Sox3, were significantly up-regulated upon DEP and DBP exposure. In conclusion, our work suggests a potential developmental toxicity of DEP and DBP on mammals, especially for neural ectoderm specification. Our findings help better understand the association between health problems and DEP/DBP exposure and most significantly remind us of the importance of additional health risk tests for these two largely used chemicals.
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Affiliation(s)
- Nuoya Yin
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Shengxian Liang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Shaojun Liang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Bowen Hu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Renjun Yang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qunfang Zhou
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Francesco Faiola
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China.
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Shih JH, Zeng BY, Lin PY, Chen TY, Chen YW, Wu CK, Tseng PT, Wu MK. Association between peripheral manganese levels and attention-deficit/hyperactivity disorder: a preliminary meta-analysis. Neuropsychiatr Dis Treat 2018; 14:1831-1842. [PMID: 30140155 PMCID: PMC6054766 DOI: 10.2147/ndt.s165378] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Evidence has suggested that dysregulation of the dopaminergic system may play a significant role in the pathogenesis of attention-deficit/hyperactivity disorder (ADHD) in children. Manganese, a neurotoxicant, has been reported to exert its neurotoxicity by affecting the dopaminergic system. However, the association between peripheral manganese levels and ADHD has not been comprehensively reviewed. This study aimed to investigate the association between peripheral manganese levels and ADHD in children. An electronic search was performed on databases including PubMed, ProQuest, ClinicalKey, Cochrane Library, ClinicalTrials.gov, Embase, Web of Science, and ScienceDirect with last search on March 25th, 2018. As per the inclusion criteria, human observational studies investigating peripheral manganese levels in children with ADHD and controls were included. The meta-analysis was performed using a random-effects model, and possible confounders were examined by subgroup analysis. In total, four articles with 175 ADHD children and 999 controls were recruited. The manganese levels were significantly higher in ADHD children than in controls (p=0.033), when studies investigating blood levels and those investigating hair levels were included. However, when only studies investigating blood levels were included, there was no significant difference between ADHD children and controls (p=0.076). Our results support higher peripheral manganese levels in children diagnosed with ADHD than those in controls. Further primary studies are needed to clarify this association.
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Affiliation(s)
- Jun-Hao Shih
- Department of Occupational and Environmental Health Consultation, EMHA Consulting International Incorporation, Hsinchu, Taiwan.,Taiwan Environmental and Occupational Medicine Association, Tainan, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, .,Center for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan
| | - Ching-Kuan Wu
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung, Taiwan
| | - Ping-Tao Tseng
- WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan,
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
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