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Antoniou EE, Dekant W. Childhood PFAS exposure and immunotoxicity: a systematic review and meta-analysis of human studies. Syst Rev 2024; 13:176. [PMID: 38982538 PMCID: PMC11232141 DOI: 10.1186/s13643-024-02596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Exposure to poly- and perfluoroalkyl substances (PFAS) may affect infant and childhood health through immunosuppression. However, the findings of epidemiological literature examining relationships between prenatal/childhood PFAS exposure and vaccine response and infection in humans are still inconclusive. The aim of this review was to examine the effects of PFAS exposure on vaccine antibody response and infection in humans. METHODS The MEDLINE/Pubmed database was searched for publications until 1 February 2023 to identify human studies on PFAS exposure and human health. Eligible for inclusion studies had to have an epidemiological study design and must have performed logistic regression analyses of gestational or childhood exposure to PFAS against either antibody levels for pediatric vaccines or the occurrence of children's infectious diseases. Information on baseline exposure to PFAS (in ng/mL), the age of PFAS exposure (gestational or in years), and the outcome was measured, potentially leading to multiple exposure-outcome comparisons within each study was collected. Percentage change and standard errors of antibody titers and occurrence of infectious diseases per doubling of PFAS exposure were calculated, and a quality assessment of each study was performed. RESULTS Seventeen articles were identified matching the inclusion criteria and were included in the meta-analysis. In general, a small decrease in antibody response and some associations between PFAS exposure and childhood infections were observed. CONCLUSIONS This meta-analysis summarizes the findings of PFAS effects on infant and childhood immune health. The immunosuppression findings for infections yielded suggestive evidence related to PFAS exposure, particularly PFOS, PFOA, PFHxS, and PFNA but moderate to no evidence regarding antibody titer reduction. SYSTEMATIC REVIEW REGISTRATION The research protocol of this systematic review is registered and accessible at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/5M2VU ).
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Affiliation(s)
| | - Wolfgang Dekant
- Department of Toxicology, University of Würzburg, Würzburg, Germany
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2
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Porter AK, Kleinschmidt SE, Andres KL, Reusch CN, Krisko RM, Taiwo OA, Olsen GW, Longnecker MP. Occurrence of COVID-19 and serum per- and polyfluoroalkyl substances: A case-control study among workers with a wide range of exposures. GLOBAL EPIDEMIOLOGY 2024; 7:100137. [PMID: 38293561 PMCID: PMC10826147 DOI: 10.1016/j.gloepi.2024.100137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 02/01/2024] Open
Abstract
Per- and polyfluoroalkyl substances (PFAS) are a broad class of synthetic chemicals; some are present in most humans in developed countries. Some studies suggest that certain PFAS may have immunotoxic effects in humans, which could put individuals with high levels of exposure at increased risk for infectious diseases such as COVID-19. We conducted a case-control study to examine the association between COVID-19 diagnosis and PFAS serum concentrations among employees and retirees from two 3 M facilities, one of which historically generated perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorohexane sulfonic acid (PFHxS). Participants completed enrollment and follow-up study visits in the Spring of 2021. Participants were categorized as cases if they reported a COVID-19 diagnosis or became sick with at least one symptom of COVID-19 when someone else in their household was diagnosed, otherwise they were categorized as a control. COVID-19 diagnosis was modeled in relation to concentration of serum PFAS measured at enrollment after adjusting for covariates. The analytic sample comprised 573 individuals, 111 cases (19.4%) and 462 controls (80.6%). In adjusted models, the odds ratio of COVID-19 was 0.94 per interquartile range (14.3 ng/mL) increase in PFOS (95% confidence interval 0.85, 1.04). Results for PFOA, PFHxS, and perfluorononanoic acid (PFNA) were similar. Other PFAS present at lower concentrations were examined as categorical variables (above the limit of quantification [LOQ], yes vs. no [referent category]), and also showed no positive associations. In our study, which used individual-level data and included people with high occupational exposure, the serum concentrations of all PFAS examined were not associated with an increased odds ratio for COVID-19. At this point, the epidemiologic data supporting no association of COVID-19 occurrence with PFAS exposure are stronger than those suggesting a positive association.
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Affiliation(s)
- Anna K. Porter
- Ramboll U.S. Consulting, 3214 Charles B. Root Wynd, Suite 130, Raleigh, NC 27612, United States of America
| | - Sarah E. Kleinschmidt
- 3M Company, Corporate Occupational Medicine, St. Paul, MN 55144, United States of America
| | - Kara L. Andres
- 3M Company, Corporate Occupational Medicine, St. Paul, MN 55144, United States of America
| | - Courtney N. Reusch
- 3M Company, Corporate Occupational Medicine, St. Paul, MN 55144, United States of America
| | - Ryan M. Krisko
- 3M Company, Environment, Health, Safety and Product Stewardship, St. Paul, MN 55144, United States of America
| | - Oyebode A. Taiwo
- 3M Company, Corporate Occupational Medicine, St. Paul, MN 55144, United States of America
| | - Geary W. Olsen
- 3M Company, Corporate Occupational Medicine, St. Paul, MN 55144, United States of America
| | - Matthew P. Longnecker
- Ramboll U.S. Consulting, 3214 Charles B. Root Wynd, Suite 130, Raleigh, NC 27612, United States of America
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Reimann B, Remy S, Koppen G, Schoeters G, Den Hond E, Nelen V, Franken C, Covaci A, Bruckers L, Baeyens W, Loots I, van Larebeke N, Voorspoels S, De Henauw S, Nawrot TS, Plusquin M. Prenatal exposure to mixtures of per- and polyfluoroalkyl substances and organochlorines affects cognition in adolescence independent of postnatal exposure. Int J Hyg Environ Health 2024; 257:114346. [PMID: 38447259 DOI: 10.1016/j.ijheh.2024.114346] [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: 10/30/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Studies on cognitive and neurodevelopmental outcomes have shown inconsistent results regarding the association with prenatal exposure to perfluoroalkyl substance (PFAS) and organochlorines. Assessment of mixture effects of correlated chemical exposures that persist in later life may contribute to the unbiased evaluation and understanding of dose-response associations in real-life exposures. METHODS For a subset of the 4th Flemish Environment and Health Study (FLEHS), concentrations of four PFAS and six organochlorines were measured in respectively 99 and 153-160 cord plasma samples and 15 years later in adolescents' peripheral serum by Ultra Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS). Sustained and selective attention were measured at 14-15 years with the Continuous Performance Test (CPT) and Stroop Test as indicators of potential neurodevelopmental deficits. Quantile g-computation was applied to assess the joint associations between prenatal exposure to separate and combined groups of PFAS and organochlorines and performance in the CPT and Stroop Test at adolescence. Subsequently, individual effects of each chemical compound were analyzed in mixed effects models with two sets of covariates. Analytical data at birth and at the time of cognitive assessment allowed for off-setting postnatal exposure. RESULTS In mixtures analysis, a simultaneous one-quantile increase in the natural log-transformed values of PFAS and organochlorines combined was associated with a decrease in the mean reaction time (RT) and the reaction time variability (RTV) in the CPT (β = -15.54, 95% CI:-29.64, -1.45, and β = -7.82, 95% CI: -14.97, -0.67 respectively) and for the mixture of PFAS alone with RT (β = -11.94, 95% CI: -23.29, -0.60). In the single pollutant models, these results were confirmed for the association between perfluorohexanesulfonate (PFHxS) with RT (β = -17.95, 95% CI = -33.35, -2.69) and hexachlorobenzene with RTV in the CPT (β = -5.78, 95% CI: -10.39, -0.76). Furthermore, the participants with prenatal exposure above the limit of quantification for perfluorononanoic acid (PFNA) had a significantly shorter RT and RTV in the CPT (β = -23.38, 95% CI: -41.55, -5.94, and β = -9.54, 95% CI: -19.75, -0.43, respectively). CONCLUSION Higher prenatal exposure to a PFAS mixture and a mixture of PFAS and organochlorines combined was associated with better sustained and selective attention during adolescence. The associations seemed to be driven by PFHxS and were not linked to exposure levels at the time of assessment.
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Affiliation(s)
- Brigitte Reimann
- Centre for Environmental Sciences, Hasselt University, 3590, Diepenbeek, Belgium
| | - Sylvie Remy
- Vlaamse Instelling voor Technologisch Onderzoek (VITO), Environmental Toxicology Unit, Mol, Belgium
| | - Gudrun Koppen
- Vlaamse Instelling voor Technologisch Onderzoek (VITO), Environmental Toxicology Unit, Mol, Belgium
| | - Greet Schoeters
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Elly Den Hond
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium; Family Medicine and Population Health (FAMPOP), University of Antwerp, Gouverneur Kingsbergencentrum, Doornstraat 331, 2610, Wilrijk, Belgium
| | - Vera Nelen
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Carmen Franken
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Liesbeth Bruckers
- Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, 3590, Diepenbeek, Belgium
| | - Willy Baeyens
- Department of Analytical, Environmental and Geochemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050, Elsene, Belgium
| | - Ilse Loots
- University of Antwerp, Department of Sociology (CRESC and IMDO), Sint-Jacobstraat 2, 2000, Antwerp, Belgium
| | - Nicolas van Larebeke
- Department of Analytical, Environmental and Geochemistry (AMGC), Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050, Elsene, Belgium; Study Centre for Carcinogenesis and Primary Prevention of Cancer, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - Stefan Voorspoels
- Vlaamse Instelling voor Technologisch Onderzoek (VITO), Environmental Toxicology Unit, Mol, Belgium
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, 3590, Diepenbeek, Belgium; School of Public Health, Occupational & Environmental Medicine, Leuven University, 3000, Leuven, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, 3590, Diepenbeek, Belgium.
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Massarsky A, Parker JA, Gloekler L, Donnell MT, Binczewski NR, Kozal JS, McKnight T, Patterson A, Kreider ML. Assessing potential human health and ecological implications of PFAS from leave-in dental products. Toxicol Ind Health 2024; 40:91-103. [PMID: 38171534 DOI: 10.1177/07482337231224990] [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] [Indexed: 01/05/2024]
Abstract
Contaminated water and food are the main sources of documented per- and polyfluoroalkyl substances (PFAS) exposure in humans. However, other sources may contribute to the overall PFAS intake. While several studies documented the presence of PFAS in consumer products, PFAS evaluation in dental products has been limited to floss and tape to date. This study estimated PFAS exposures from a convenience sample of leave-in dental products (night guards and whitening trays), which remain in contact with the mouth for longer durations than previously evaluated dental products. This analysis evaluated whether consumer usage of these dental products meaningfully contributes to oral exposure of PFAS. Leaching of PFAS upon disposal of products was also considered. Out of 24 PFAS measured, perfluorobutanoic acid (PFBA; 3.24-4.17 ng/product or 0.67-0.83 ng/g) and perfluorooctanesulfonic acid (PFOS; 7.25-16.45 ng/product or 1.2-2.3 ng/g) were detected in night guards, and no PFAS were detected in whitening trays. Non-targeted analysis showed additional possible PFAS, which could not be characterized. The findings showed that PFOS and/or PFBA present in night guards were unlikely to pose a health concern. From an ecological perspective, the dental products examined were shown to constitute a negligible contribution to environmental PFAS. In conclusion, the examined dental products do not represent a significant source of exposure to PFAS for humans or the environment. The study demonstrates how risk assessment can be integrated by the industry into product stewardship programs to evaluate the potential health and environmental impacts of chemicals in consumer products.
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Affiliation(s)
| | | | | | | | | | | | - Taryn McKnight
- Eurofins Environment Testing Northern California, LLC, West Sacramento, CA, USA
| | - Andrew Patterson
- Eurofins Environment Testing Northern California, LLC, West Sacramento, CA, USA
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Sigvaldsen A, Højsager FD, Paarup HM, Beck IH, Timmermann CAG, Boye H, Nielsen F, Halldorsson TI, Nielsen C, Möller S, Barington T, Grandjean P, Jensen TK. Early-life exposure to perfluoroalkyl substances and serum antibody concentrations towards common childhood vaccines in 18-month-old children in the Odense Child Cohort. ENVIRONMENTAL RESEARCH 2024; 242:117814. [PMID: 38042520 DOI: 10.1016/j.envres.2023.117814] [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: 06/12/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/04/2023]
Abstract
Exposure to per- and polyfluoroalkyl substances (PFAS) has been associated with reduced antibody response to childhood vaccinations. Previous studies have mostly focused on antibodies against diphtheria or tetanus, while fewer studies have assessed antibodies toward attenuated viruses, such as measles, mumps or rubella (MMR). Therefore, we set out to determine associations between prenatal and early postnatal PFAS exposure and vaccine-specific Immunoglobulin G (IgG) in the background-exposed Odense Child Cohort. Blood samples were drawn in pregnancy at gestation weeks 8-16 and from the offspring at age 18 months. In the maternal serum samples we quantified perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA). In the offspring serum samples we quantified the same five PFAS compounds and IgG towards diphtheria, tetanus and MMR. A total of 880 and 841 children were included in the analyses of diphtheria and tetanus or MMR, respectively. Multiple linear regression models were used for estimation of difference in virus-specific IgG per doubling of PFAS concentrations. Maternal PFAS concentrations were non-significantly inversely associated with most vaccine-specific antibody concentrations. Likewise, child PFAS concentrations were associated with non-significant reductions of antibodies towards tetanus and MMR. A significant reduction in the percent difference in mumps antibody concentration per doubling of child PFNA (-9.2% (95% confidence interval: -17.4;-0.2)), PFHxS (-8.3% (-15.0;-1.0) and PFOS (-7.9% (-14.8;-0.4) was found. These findings are of public health concern, as inadequate response towards childhood vaccines may represent a more general immune dysfunction.
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Affiliation(s)
- Annika Sigvaldsen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
| | - Frederik Damsgaard Højsager
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | | | - Iben Have Beck
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | | | - Henriette Boye
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Odense Child Cohort, Odense University Hospital, Odense, Denmark
| | - Flemming Nielsen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000, Odense, Denmark
| | | | - Christel Nielsen
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Sören Möller
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Torben Barington
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Philippe Grandjean
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000, Odense, Denmark; Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, USA
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
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6
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Merrill SM, Letourneau N, Giesbrecht GF, Edwards K, MacIsaac JL, Martin JW, MacDonald AM, Kinniburgh DW, Kobor MS, Dewey D, England-Mason G, The APrON Study Team. Sex-Specific Associations between Prenatal Exposure to Di(2-ethylhexyl) Phthalate, Epigenetic Age Acceleration, and Susceptibility to Early Childhood Upper Respiratory Infections. EPIGENOMES 2024; 8:3. [PMID: 38390895 PMCID: PMC10885049 DOI: 10.3390/epigenomes8010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Di(2-ethylhexyl) phthalate (DEHP) is a common plasticizer that can affect immune system development and susceptibility to infection. Aging processes (measured as epigenetic age acceleration (EAA)) may mediate the immune-related effects of prenatal exposure to DEHP. This study's objective was to examine associations between prenatal DEHP exposure, EAA at three months of age, and the number of upper respiratory infections (URIs) from 12 to 18 months of age using a sample of 69 maternal-child pairs from a Canadian pregnancy cohort. Blood DNA methylation data were generated using the Infinium HumanMethylation450 BeadChip; EAA was estimated using Horvath's pan-tissue clock. Robust regressions examined overall and sex-specific associations. Higher prenatal DEHP exposure (B = 6.52, 95% CI = 1.22, 11.81) and increased EAA (B = 2.98, 95% CI = 1.64, 4.32) independently predicted more URIs. In sex-specific analyses, some similar effects were noted for boys, and EAA mediated the association between prenatal DEHP exposure and URIs. In girls, higher prenatal DEHP exposure was associated with decreased EAA, and no mediation was noted. Higher prenatal DEHP exposure may be associated with increased susceptibility to early childhood URIs, particularly in boys, and aging biomarkers such as EAA may be a biological mechanism. Larger cohort studies examining the potential developmental immunotoxicity of phthalates are needed.
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Affiliation(s)
- Sarah M Merrill
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School at Brown University, Providence, RI 02903, USA
- Department of Medical Genetics, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC V6H 0B3, Canada
| | - Nicole Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Karlie Edwards
- Department of Medical Genetics, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC V6H 0B3, Canada
| | - Julia L MacIsaac
- Department of Medical Genetics, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC V6H 0B3, Canada
| | - Jonathan W Martin
- Science for Life Laboratory, Department of Environmental Science, Stockholm University, 106 91 Stockholm, Sweden
| | - Amy M MacDonald
- Alberta Centre for Toxicology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - David W Kinniburgh
- Alberta Centre for Toxicology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Michael S Kobor
- Department of Medical Genetics, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC V6H 0B3, Canada
- Program in Child and Brain Development, Canadian Institute for Advanced Research, Toronto, ON M5G 1M1, Canada
| | - Deborah Dewey
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Gillian England-Mason
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - The APrON Study Team
- University of Calgary, Calgary, AB T2N 1N4, Canada
- University of Alberta, Edmonton, AB T6G 2R3, Canada
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7
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Li C, Zhang H, Mo J, Zuo J, Ye L. Caspase-3/GSDME dependent pyroptosis contributes to offspring lung injury induced by gestational PFOS exposure via PERK/ATF4 signaling. Arch Toxicol 2024; 98:207-221. [PMID: 37955688 PMCID: PMC10761489 DOI: 10.1007/s00204-023-03626-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023]
Abstract
Perfluorooctane sulfonate (PFOS) is widely used in industry and consumer products. Previous studies have showed that PFOS gestational exposure is associated with offspring lung damage in rat. However, the underlying mechanisms remain poorly understood. In this study, we investigated the role of gasdermin E (GSDME) in lung injury of offspring and its underlying mechanisms using in vivo and in vitro approaches. Pregnant SD rats were exposed to PFOS (1 mg/kg BW/d) between gestational day 12-18, and the lung tissue of the offspring was evaluated on postnatal day 7. PFOS treated animals exhibited alveolar septal thickening and inflammation-related damages, with an increased expression of GSDME in alveolar type II epithelial cells (AECII). Furthermore, in vitro experiments demonstrated that PFOS exposure (with 225 μM and up) upregulated the caspase-3/GSDME signaling pathway in AECII. Also, ultrastructure analysis revealed significant changes in the endoplasmic reticulum (ER) structure in PFOS-induced pyroptotic cells, which is consistent with the ER stress detected in these cells. Additionally, PFOS exposure led to increased expression of ER stress-related proteins, including p-PERK, p-eIF2α, ATF4, and CHOP. Subsequently, using specific inhibitors, we found that the PERK/ATF4 pathway acted as an upstream signal regulating GSDME-dependent pyroptosis. Overall, our findings show that GSDME-dependent pyroptosis plays a crucial role in the lung injury induced by gestational PFOS exposure, and the PERK/ATF4 pathway may function as a possible mediator of this process.
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Affiliation(s)
- Cong Li
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
| | - Huishan Zhang
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200120, China
| | - Jiali Mo
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
| | - Jingye Zuo
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
| | - Leping Ye
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China.
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8
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Zell-Baran LM, Venter C, Dabelea D, Norris JM, Glueck DH, Adgate JL, Brown JM, Calafat AM, Pickett-Nairne K, Starling AP. Prenatal exposure to poly- and perfluoroalkyl substances and the incidence of asthma in early childhood. ENVIRONMENTAL RESEARCH 2023; 239:117311. [PMID: 37805178 PMCID: PMC10843093 DOI: 10.1016/j.envres.2023.117311] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
EXPOSURE TO POLY: and perfluoroalkyl substances (PFAS) in early life may increase the risk of childhood asthma, but evidence has been inconsistent. We estimated associations between maternal serum concentrations of PFAS during pregnancy and clinician-diagnosed asthma incidence in offspring through age eight. We included 597 mother-child pairs with PFAS quantified in mid-pregnancy serum and childhood medical records reviewed for asthma diagnoses. We used separate Cox proportional hazards models to assess the relationship between log-transformed concentrations of five PFAS and the incidence of asthma. We estimated associations between the PFAS mixture and clinician-diagnosed asthma incidence using quantile-based g-computation. PFAS concentrations were similar to those among females in the US general population. Seventeen percent of children (N = 104) were diagnosed with asthma during follow-up. Median (interquartile range) duration of follow-up was 4.7 (4.0, 6.2) years, and median age at asthma diagnosis was 1.7 (0.9, 2.8) years. All adjusted hazard ratios (HRs) were elevated, but all 95% confidence intervals (CI) included the null. The HR (95% CI) of asthma for a one-quartile increase in the PFAS mixture was 1.17 (0.86, 1.61). In this cohort of children followed to eight years of age, prenatal PFAS concentrations were not significantly associated with incidence of clinician-diagnosed asthma.
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Affiliation(s)
- Lauren M Zell-Baran
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA.
| | - Carina Venter
- Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jill M Norris
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Deborah H Glueck
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jared M Brown
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kaci Pickett-Nairne
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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9
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Phelps DW, Palekar AI, Conley HE, Ferrero G, Driggers JH, Linder KE, Kullman SW, Reif DM, Sheats MK, DeWitt JC, Yoder JA. Legacy and emerging per- and polyfluoroalkyl substances suppress the neutrophil respiratory burst. J Immunotoxicol 2023; 20:2176953. [PMID: 36788734 PMCID: PMC10361455 DOI: 10.1080/1547691x.2023.2176953] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
Per- and polyfluoroalkyl substances (PFASs) are used in a multitude of processes and products, including nonstick coatings, food wrappers, and fire-fighting foams. These chemicals are environmentally-persistent, ubiquitous, and can be detected in the serum of 98% of Americans. Despite evidence that PFASs alter adaptive immunity, few studies have investigated their effects on innate immunity. The report here presents results of studies that investigated the impact of nine environmentally-relevant PFASs [e.g. perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid potassium salt (PFOS-K), perfluorononanoic acid (PFNA), perfluorohexanoic acid (PFHxA), perfluorohexane sulfonic acid (PFHxS), perfluorobutane sulfonic acid (PFBS), ammonium perfluoro(2-methyl-3-oxahexanoate) (GenX), 7H-perfluoro-4-methyl-3,6-dioxa-octane sulfonic acid (Nafion byproduct 2), and perfluoromethoxyacetic acid sodium salt (PFMOAA-Na)] on one component of the innate immune response, the neutrophil respiratory burst. The respiratory burst is a key innate immune process by which microbicidal reactive oxygen species (ROS) are rapidly induced by neutrophils in response to pathogens; defects in the respiratory burst can increase susceptibility to infection. The study here utilized larval zebrafish, a human neutrophil-like cell line, and primary human neutrophils to ascertain whether PFAS exposure inhibits ROS production in the respiratory burst. It was observed that exposure to PFHxA and GenX suppresses the respiratory burst in zebrafish larvae and a human neutrophil-like cell line. GenX also suppressed the respiratory burst in primary human neutrophils. This report is the first to demonstrate that these PFASs suppress neutrophil function and support the utility of employing zebrafish larvae and a human cell line as screening tools to identify chemicals that may suppress human immune function.
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Affiliation(s)
- Drake W. Phelps
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC
- Center for Environmental and Health Effects of PFAS, North Carolina State University, Raleigh, NC
| | - Anika I. Palekar
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Haleigh E. Conley
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Giuliano Ferrero
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
- Center for Environmental and Health Effects of PFAS, North Carolina State University, Raleigh, NC
| | - Jacob H. Driggers
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Keith E. Linder
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC
| | - Seth W. Kullman
- Center for Environmental and Health Effects of PFAS, North Carolina State University, Raleigh, NC
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC
- Department of Biological Sciences, College of Sciences, North Carolina State University, Raleigh, NC
- Toxicology Program, North Carolina State University, Raleigh, NC
| | - David M. Reif
- Center for Environmental and Health Effects of PFAS, North Carolina State University, Raleigh, NC
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC
- Department of Biological Sciences, College of Sciences, North Carolina State University, Raleigh, NC
- Toxicology Program, North Carolina State University, Raleigh, NC
| | - M. Katie Sheats
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - Jamie C. DeWitt
- Center for Environmental and Health Effects of PFAS, North Carolina State University, Raleigh, NC
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC
- Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC
| | - Jeffrey A. Yoder
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC
- Center for Environmental and Health Effects of PFAS, North Carolina State University, Raleigh, NC
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC
- Toxicology Program, North Carolina State University, Raleigh, NC
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10
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Huang H, Li X, Deng Y, San S, Qiu D, Guo X, Xu L, Li Y, Zhang H, Li Y. The Association between Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Respiratory Tract Infections in Preschool Children: A Wuhan Cohort Study. TOXICS 2023; 11:897. [PMID: 37999549 PMCID: PMC10674762 DOI: 10.3390/toxics11110897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023]
Abstract
This study investigates the association between prenatal exposure to per- and polyfluoroalkyl substances (PFASs) and the incidence and frequency of respiratory tract infections (RTIs) in preschool children. We selected 527 mother-infant pairs from Wuhan Healthy Baby Cohort (WHBC), China. Ten PFASs were measured in umbilical cord serum, and we collected data on common RTIs in preschool children aged 4 years through a questionnaire. Associations of single PFASs with the incidence and frequency of RTIs were analyzed via Logistic regression and Poisson regression, while the collective effect was assessed by weighted quantile sum (WQS) regression. Furthermore, stratified and interaction analyses were performed to evaluate if there were sex-specific associations. We found a positive correlation between perfluorododecanoic acid (PFDoDA) and the incidence of tonsillitis, with several PFASs also showing positive associations with its frequency. Moreover, perfluorotridecanoic acid (PFTrDA) showed a positive link with the frequency of common cold. The results of WQS regression revealed that after adjusting for other covariates, PFASs mixture showed a positive association with the incidence of tonsillitis, the frequency of common cold, and episodes. In particular, perfluoroundecanoic acid (PFUnDA), PFDoDA, PFTrDA, perfluorodecanoic acid (PFDA) and 8:2 chlorinated polyfluorinated ether sulfonic acid (8:2 Cl-PFESA) had the most significant impact on this combined effect. The results suggest that both single and mixed exposures to PFASs may cause RTIs in preschool children. However, there was no statistically significant interaction between different PFASs and sex.
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Affiliation(s)
- Haiyun Huang
- School of Medicine and Health, Wuhan Polytechnic University, Wuhan 430023, China; (H.H.); (Y.D.); (S.S.); (D.Q.)
| | - Xiaojun Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;
| | - Yican Deng
- School of Medicine and Health, Wuhan Polytechnic University, Wuhan 430023, China; (H.H.); (Y.D.); (S.S.); (D.Q.)
| | - Siyi San
- School of Medicine and Health, Wuhan Polytechnic University, Wuhan 430023, China; (H.H.); (Y.D.); (S.S.); (D.Q.)
| | - Dongmei Qiu
- School of Medicine and Health, Wuhan Polytechnic University, Wuhan 430023, China; (H.H.); (Y.D.); (S.S.); (D.Q.)
| | - Xiaoyu Guo
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan 430023, China; (X.G.); (L.X.); (Y.L.)
| | - Lingyun Xu
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan 430023, China; (X.G.); (L.X.); (Y.L.)
| | - Yang Li
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan 430023, China; (X.G.); (L.X.); (Y.L.)
| | - Hongling Zhang
- School of Medicine and Health, Wuhan Polytechnic University, Wuhan 430023, China; (H.H.); (Y.D.); (S.S.); (D.Q.)
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;
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11
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Philippat C, Coiffier O, Lyon-Caen S, Boudier A, Jovanovic N, Quentin J, Gioria Y, Haug LS, Thomsen C, Bayat S, Slama R, Siroux V. In utero exposure to poly- and perfluoroalkyl substances and children respiratory health in the three first years of life. ENVIRONMENTAL RESEARCH 2023; 234:116544. [PMID: 37406719 DOI: 10.1016/j.envres.2023.116544] [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: 02/28/2023] [Revised: 06/15/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Poly- and perfluoroalkyl substances (PFAS) are used in a wide range of products. Experimental studies suggested impaired lung development and pro-inflammatory response following exposure to some PFAS. We aimed to assess the associations between prenatal exposure to PFAS and children respiratory health. METHODS The study is based on 433 mother-child pairs. 26 PFAS were measured in maternal serum collected during pregnancy. Lung function parameters were measured at 2 months using tidal breathing flow-volume loops and multiple-breath nitrogen washout and at 36 months using oscillometry. Incidence of respiratory health diseases (asthma, wheeze, bronchitis, bronchiolitis) in the first 36 months of life was assessed by repeated questionnaires. A cluster-based analysis was applied to identify prenatal PFAS exposure patterns. Adjusted linear and logistic regressions were performed to assess the associations between PFAS exposure patterns as well as individual PFAS, and each respiratory health parameter. RESULTS We excluded 13 PFAS due to low quantification (<5%). Relying on the 13 remaining PFAS, we identified three exposure clusters, characterized by low (N = 163), medium (N = 236) and high (N = 51) pregnancy PFAS concentrations. Compared to children belonging to the low exposure group, children in the moderate exposure group had higher reactance at 7 Hz (X7) and lower frequency dependence of resistance between 7 Hz and 19 Hz (R7-19) at 36 months, suggesting better lung function. No association of any exposure metric was detected with respiratory diseases in the first 3 years of life. CONCLUSIONS Our study relying on both mixture and uni-pollutant analyses, does not provide evidence for a deleterious effect of prenatal PFAS exposure on respiratory health at an early age.
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Affiliation(s)
- Claire Philippat
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France.
| | - Ophélie Coiffier
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France
| | - Sarah Lyon-Caen
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France
| | - Anne Boudier
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France; Pediatrics, CHU Grenoble-Alpes, Grenoble, France
| | - Nicolas Jovanovic
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France
| | - Joane Quentin
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France; Department of Pulmonology and Physiology, CHU Grenoble Alpes, Grenoble, France
| | - Yoann Gioria
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France; Department of Pulmonology and Physiology, CHU Grenoble Alpes, Grenoble, France
| | - Line Smastuen Haug
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Cathrine Thomsen
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Sam Bayat
- Department of Pulmonology and Physiology, CHU Grenoble Alpes, Grenoble, France
| | - Rémy Slama
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France
| | - Valérie Siroux
- University Grenoble Alpes, Inserm U1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences 38000, Grenoble, France
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12
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Bailey JM, Wang L, McDonald JM, Gray JS, Petrie JG, Martin ET, Savitz DA, Karrer TA, Fisher KA, Geiger MJ, Wasilevich EA. Immune response to COVID-19 vaccination in a population with a history of elevated exposure to per- and polyfluoroalkyl substances (PFAS) through drinking water. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:725-736. [PMID: 37337047 PMCID: PMC10541329 DOI: 10.1038/s41370-023-00564-8] [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: 01/12/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Exposure to per- and polyfluoroalkyl substances (PFAS) has been linked to lower vaccine-induced antibody concentrations in children, while data from adults remains limited and equivocal. Characteristics of PFAS exposure and age at vaccination may modify such effects. OBJECTIVE We used the mass administration of novel COVID-19 vaccines to test the hypothesis that prior exposure to environmentally-relevant concentrations of PFAS affect antibody response to vaccines in adolescents and adults. METHODS Between April and June 2021, 226 participants aged 12-90 years with a history of exposure to PFAS in drinking water and who received an mRNA COVID-19 vaccine participated in our prospective cohort study. SARS-CoV-2 anti-spike and anti-nucleocapsid antibodies (IgG) were quantified before the first and second vaccine doses and again at two follow-ups in the following months (up to 103 days post dose 1). Serum PFAS concentrations (n = 39 individual PFAS) were measured once for each participant during baseline, before their first vaccination. The association between PFAS exposure and immune response to vaccination was investigated using linear regression and generalized estimating equation (GEE) models with adjustment for covariates that affect antibody response. PFAS mixture effects were assessed using weighted quantile sum and Bayesian kernel machine regression methods. RESULTS The geometric mean (standard deviation) of perfluorooctane sulfonate and perfluorooctanoic acid serum concentrations in this population was 10.49 (3.22) and 3.90 (4.90) µg/L, respectively. PFAS concentrations were not associated with peak anti-spike antibody response, the initial increase in anti-spike antibody response following vaccination, or the waning over time of the anti-spike antibody response. Neither individual PFAS concentrations nor their evaluation as a mixture was associated with antibody response to mRNA vaccination against COVID-19. IMPACT STATEMENT Given the importance of understanding vaccine response among populations exposed to environmental contaminants and the current gaps in understanding this relationship outside of early life/childhood vaccinations, our manuscript contributes meaningful data from an adolescent and adult population receiving a novel vaccination.
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Affiliation(s)
- Jordan M Bailey
- Division of Environmental Health, Michigan Department of Health and Human Services, Lansing, MI, USA.
| | - Ling Wang
- Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Jennifer M McDonald
- Division of Environmental Health, Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Jennifer S Gray
- Division of Environmental Health, Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Joshua G Petrie
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Emily T Martin
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Timothy A Karrer
- Division of Chemistry and Toxicology, Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Keri A Fisher
- Division of Chemistry and Toxicology, Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Matthew J Geiger
- Division of Chemistry and Toxicology, Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Elizabeth A Wasilevich
- Division of Environmental Health, Michigan Department of Health and Human Services, Lansing, MI, USA
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Dragon J, Hoaglund M, Badireddy AR, Nielsen G, Schlezinger J, Shukla A. Perfluoroalkyl Substances (PFAS) Affect Inflammation in Lung Cells and Tissues. Int J Mol Sci 2023; 24:8539. [PMID: 37239886 PMCID: PMC10218140 DOI: 10.3390/ijms24108539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Adverse lung outcomes from exposure to per-and polyfluoroalkyl substances (PFAS) are known; however, the mechanism of action is poorly understood. To explore this, human bronchial epithelial cells were grown and exposed to varied concentrations of short-chain (perfluorobutanoic acid, perflurobutane sulfonic acid and GenX) or long-chain (PFOA and perfluorooctane sulfonic acid (PFOS)) PFAS, alone or in a mixture to identify cytotoxic concentrations. Non-cytotoxic concentrations of PFAS from this experiment were selected to assess NLRP3 inflammasome activation and priming. We found that PFOA and PFOS alone or in a mixture primed and activated the inflammasome compared with vehicle control. Atomic force microscopy showed that PFOA but not PFOS significantly altered the membrane properties of cells. RNA sequencing was performed on the lungs of mice that had consumed PFOA in drinking water for 14 weeks. Wild type (WT), PPARα knock-out (KO) and humanized PPARα (KI) were exposed to PFOA. We found that multiple inflammation- and immune-related genes were affected. Taken together, our study demonstrated that PFAS exposure could alter lung biology in a significant manner and may contribute to asthma/airway hyper-responsiveness.
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Affiliation(s)
- Julie Dragon
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA; (J.D.); (M.H.); (A.R.B.); (G.N.); (J.S.)
| | - Michael Hoaglund
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA; (J.D.); (M.H.); (A.R.B.); (G.N.); (J.S.)
| | - Appala Raju Badireddy
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA; (J.D.); (M.H.); (A.R.B.); (G.N.); (J.S.)
| | - Greylin Nielsen
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Jennifer Schlezinger
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Arti Shukla
- Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA; (J.D.); (M.H.); (A.R.B.); (G.N.); (J.S.)
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14
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Burbank AJ, Fry RC, Keet CA. Associations between serum per- and polyfluoroalkyl substances and asthma morbidity in the National Health and Nutrition Examination Survey (2003-18). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100078. [PMID: 37274185 PMCID: PMC10237357 DOI: 10.1016/j.jacig.2023.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/25/2022] [Accepted: 11/25/2022] [Indexed: 06/06/2023]
Abstract
Background Per- and polyfluoroalkyl substances (PFAS) are a class of chemicals widely used in manufacturing and are highly resistant to degradation, so they accumulate in the environment. Serum concentrations of these so-called forever chemicals have been associated with impairment of innate and adaptive immune responses. The relationship between serum PFAS levels and asthma morbidity has not been studied. Objective We tested the association between serum PFAS concentration and asthma exacerbations. Methods We performed secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES, 2003-18). We fit multivariable logistic regression models to estimate odds ratios and 95% CIs for asthma exacerbation in the prior 12 months, given serum concentrations of PFAS. Models were adjusted for relevant covariates. Results Of 1101 participants with self-reported current asthma and available serum PFAS data, we observed that higher serum perfluorooctanoic and perfluorodecanoic acids were associated with greater odds of asthma attacks in the previous 12 months (respectively, adjusted odds ratio 1.16, 95% CI 1.01, 1.33; and adjusted odds ratio 1.21, 95% CI 1.03, 1.43). After stratification by age, the association between perfluorooctanoic acid and asthma attacks was significant in the 12-18-year-old group only (adjusted odds ratio 1.56, 95% CI 1.06, 2.31). No significant relationships were observed between PFAS and asthma-related emergency department visits. After correction for multiple comparison testing, none of the associations reached the threshold of significance. Conclusion The role of these bioaccumulative forever chemicals in susceptibility to asthma attacks warrants further examination in longitudinal studies. (J Allergy Clin Immunol Global 2023;2:100078.).
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Affiliation(s)
- Allison J. Burbank
- Department of Pediatrics, Division of Allergy and Immunology, University of North Carolina, Chapel Hill
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Institute for Environmental Health Solutions, Gillings School of Public Health, University of North Carolina, Chapel Hill
| | - Corinne A. Keet
- Department of Pediatrics, Division of Allergy and Immunology, University of North Carolina, Chapel Hill
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15
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Rudzanova B, Vlaanderen J, Kalina J, Piler P, Zvonar M, Klanova J, Blaha L, Adamovsky O. Impact of PFAS exposure on prevalence of immune-mediated diseases in adults in the Czech Republic. ENVIRONMENTAL RESEARCH 2023; 229:115969. [PMID: 37116680 DOI: 10.1016/j.envres.2023.115969] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/14/2023] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFASs) are emerging environmental contaminants with multiple hazardous properties including immunomodulation potency. Human exposure to PFASs has been associated with various immune-mediated diseases and outcomes. This study aimed to investigate the association between PFAS exposure and immune-mediated diseases such as allergies, eczemas, and autoimmune diseases in a population of adults in the Czech Republic. METHODS This study included 309 adults from the Central European Longitudinal Study of Parents and Children: Young Adults (CELSPAC: YA). 12 PFASs were measured in participants' serum by HPLC-MS/MS, 3 PFASs were removed from the subsequent analyses due to low detection frequency. The associations of 9 PFASs with 9 immune-mediated diseases were assessed by logistic regression. Furthermore, Bayesian kernel machine regression (BKMR) was used to estimate the effect of the PFAS mixture on immune-mediated diseases. All analyses were adjusted for sex, age, BMI, smoking, education, and family history of immune-mediated diseases. In cases of a statistically significant interaction of PFASs and sex, stratified analyses were performed for men and women. RESULTS Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) were negatively associated with both atopic eczema (OR per IQR increase 0.58 (95% CI 0.37-0.90) for PFOA and 0.56 (0.32-0.95) for PFOS) and contact dermatitis (0.37 (0.16-0.85) for PFOA and 0.33 (0.11-0.94) for PFOS). Perfluoroundecanoate (PFUnDA) was negatively associated with pollen, dust, and mite allergy (0.62 (0.43-0.89)). BKMR modelling showed a negative tendency in the overall effect of PFAS mixture on immune-health outcomes. Based on the stratified analysis, sex was suggested to be an effect modifier in the association of PFOS and atopic eczema. CONCLUSION Our results contribute to the body of literature that observes the immunosuppressive effect of PFAS exposure during eczemas and allergies, both for PFASs individually and as a mixture.
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Affiliation(s)
- Barbora Rudzanova
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 602 00, Brno, Czech Republic
| | - Jelle Vlaanderen
- Institute of Risk Assessment Sciences, Utrecht University, Yalelaan 2, Utrecht, 3584CM, Netherlands
| | - Jiří Kalina
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 602 00, Brno, Czech Republic
| | - Pavel Piler
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 602 00, Brno, Czech Republic
| | - Martin Zvonar
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 602 00, Brno, Czech Republic; Department of Physical Activity and Health, Faculty of Sports Studies, Masaryk University, Kamenice 753/5, Brno, Czech Republic
| | - Jana Klanova
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 602 00, Brno, Czech Republic
| | - Ludek Blaha
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 602 00, Brno, Czech Republic
| | - Ondrej Adamovsky
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, 602 00, Brno, Czech Republic.
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Shi S, Ding Y, Wu B, Hu P, Chen M, Dong N, Vinturache A, Gu H, Dong X, Ding G. Association of perfluoroalkyl substances with pulmonary function in adolescents (NHANES 2007-2012). ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:53948-53961. [PMID: 36869952 DOI: 10.1007/s11356-023-26119-w] [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: 07/30/2022] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Perfluoroalkyl substances (PFASs) constitute an environmentally persistent and widespread class of anthropogenic chemicals that have been used in industrial and commercial applications in the USA and around the world. Animal studies suggested its toxic impact on lung development, but the adverse effect of PFAS exposure on childhood pulmonary function has not been clearly determined. We investigated the potential cross-sectional association of environmental PFAS exposures with pulmonary function in 765 adolescents aged 12-19 years from the US National Health and Nutrition Examination Survey (NHANES) 2007-2012. Exposure to PFASs was estimated by measuring serum concentrations, and pulmonary function was assessed by spirometry. Linear regression and weighted quantile sum (WQS) regression were performed to estimate the associations of individual chemicals and chemical mixtures with pulmonary function. Median concentrations of PFOA, PFOS, PFNA, and PFHxS (detection frequencies > 90%) were 2.70, 6.40, 0.98, and 1.51 ng/mL, respectively. No associations were found between the four individual congeners and Σ4PFASs and the pulmonary function measures in total adolescents. Sensitive analyses were further conducted stratified by age (12-15 and 16-19 years) and sex (boys and girls). In adolescents aged 12-15 years, PFNA was negatively associated with FEV1:FVC (p-trend = 0.007) and FEF25-75% (p-trend = 0.03) among girls, while PFNA was positively associated with FEV1: FVC (p-trend = 0.018) among boys. No associations were found among adolescents aged 16-19 years, either boys or girls. The aforementioned associations were confirmed when further applying WQS models, and PFNA was identified to be the most heavily weighing chemical. Our results suggested that environmental exposure to PFNA may affect pulmonary function among adolescents aged 12-15 years. Given the cross-sectional analysis and less consistent results, further replications of the association in large prospective cohort studies are warranted.
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Affiliation(s)
- Shuang Shi
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Ding
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Beirong Wu
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peipei Hu
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ming Chen
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Dong
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Angela Vinturache
- Department of Obstetrics & Gynecology, Grande Prairie General Hospital, Grande Prairie, Alberta, Canada
- Department of Obstetrics & Gynecology, University of Alberta, Alberta, Canada
| | - Haoxiang Gu
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guodong Ding
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Pan Z, Guo Y, Zhou Q, Wang Q, Pan S, Xu S, Li L. Perfluoroalkyl substance exposure is associated with asthma and innate immune cell count in US adolescents stratified by sex. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:52535-52548. [PMID: 36840869 DOI: 10.1007/s11356-023-26065-7] [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: 07/05/2022] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Exposure to perfluoroalkyl substances (PFAS) may be harmful to humans; however, previous studies have been inconsistent regarding the potential for PFAS-induced immunosuppresion. This study explored the relationship between PFAS exposure and risks of asthma, wheezing, and immunosuppression in 12-19 year-olds using the National Health and Nutrition Examination Survey (NHANES) data. Logistic regression models were used to reveal associations between serum PFAS levels and risks of asthma, wheezing, asthma attack, and emergency department visits. Pearson's correlation was used to determine the relationship between serum PFAS levels and leukocyte count. Data were also stratified by sex. We found that medium-low levels of serum perfluorooctane sulfonate (PFOS) (6.90-12.40 ng/mL) and serum perfluorooctanoic acid (PFOA) (2.43-3.60 ng/mL) were negatively related, respectively, to current asthma and wheezing in boys, and to wheezing in girls. Meanwhile, boys with medium-high levels (1.50-3.00 ng/mL) of serum perfluorohexanesulfonate (PFHxS) had a high risk of wheezing. Among asthmatic participants, both medium-high levels (3.75-5.07 ng/mL) of serum PFOA and high levels (> 3.92 ng/mL) of PFHxS correlated with asthma attacks in boys; likewise, medium-low levels (0.70-0.99 ng/mL) of serum PFNA correlated with asthma attacks in girls. Also, PFOA and PFNA levels were weakly positively correlated with basophil count, whereas PFOS levels were weakly negatively correlated with eosinophils in asthmatic boys, indicating that basophils may be important in the immune response to PFAS exposure among asthmatics.
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Affiliation(s)
- Zhenzhen Pan
- Department of Pediatric Respiratory, Wuxi Children's Hospital affiliated to Jiangnan University, No. 299-1 at Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Yun Guo
- Department of Pediatric Respiratory, Wuxi Children's Hospital affiliated to Jiangnan University, No. 299-1 at Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Qin Zhou
- Department of Pediatric Respiratory, Wuxi Children's Hospital affiliated to Jiangnan University, No. 299-1 at Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Qian Wang
- Department of Pediatric Respiratory, Wuxi Children's Hospital affiliated to Jiangnan University, No. 299-1 at Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Shanshan Pan
- Department of Pediatric Respiratory, Wuxi Children's Hospital affiliated to Jiangnan University, No. 299-1 at Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Shiyao Xu
- Department of Pediatric Respiratory, Wuxi Children's Hospital affiliated to Jiangnan University, No. 299-1 at Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Ling Li
- Department of Pediatric Respiratory, Wuxi Children's Hospital affiliated to Jiangnan University, No. 299-1 at Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China.
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Ehrlich V, Bil W, Vandebriel R, Granum B, Luijten M, Lindeman B, Grandjean P, Kaiser AM, Hauzenberger I, Hartmann C, Gundacker C, Uhl M. Consideration of pathways for immunotoxicity of per- and polyfluoroalkyl substances (PFAS). Environ Health 2023; 22:19. [PMID: 36814257 PMCID: PMC9944481 DOI: 10.1186/s12940-022-00958-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/30/2022] [Indexed: 05/02/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are of public health concern, because of their ubiquitous and extremely persistent occurrence, and depending on their structure, their bio-accumulative, mobile and toxic properties. Human health effects associated with exposure to PFAS include adverse effects on the immune system. In 2020, EFSA (the European Food Safety Authority) defined adverse effects on the immune system as the most critical effect for human health risk assessment, based on reduced antibody responses to childhood vaccines and similar effects observed in experimental animal studies. Likewise, the U.S. EPA (Environmental Protection Agency) considers PFAS-induced immunotoxicity, especially in children, as the critical effect for risk assessment. However, the mechanisms by which antibody concentrations are impacted are not completely understood. Furthermore, other targets of the immune system functions have been reported in the literature. OBJECTIVE The aim of this review is to explore PFAS-associated immune-related effects. This includes, relevant mechanisms that may underlie the observed effects on the immune system, immunosuppression as well as immunoenhancement, such as i) modulation of cell signalling and nuclear receptors, such as NF-κB and PPARs; ii) alteration of calcium signalling and homoeostasis in immune cells; iii) modulation of immune cell populations; iv) oxidative stress and v) impact on fatty acid metabolism & secondary effects on the immune system. METHODS A literature research was conducted using three databases (Web of Science, PubMed, and Scopus), which were searched in July 2021 for relevant studies published in the time frame from 2018 to 2021. In total, 487 publications were identified as potentially eligible and following expert-based judgement, articles relevant for mechanisms of PFAS induced immunotoxicity are discussed. CONCLUSIONS Taken together, we show that there is substantial evidence from both in vitro and in vivo experimental as well as epidemiological studies, supporting that various PFAS, not only PFOA and PFOS, affect multiple aspects of the immune system. Timing of exposure is critical, because the developing immune system is especially vulnerable to toxic insults, resulting in a higher risk of particularly adverse immune effects but also other organs later in life.
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Affiliation(s)
- Veronika Ehrlich
- Environment Agency Austria (Umweltbundesamt GmbH), Spittelauer Lände 5, 1090, Vienna, Austria
| | - Wieneke Bil
- Centre for Safety of Substances and Products, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Rob Vandebriel
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Berit Granum
- Division of Climate and Environment Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Mirjam Luijten
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Birgitte Lindeman
- Division of Climate and Environment Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Philippe Grandjean
- Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, USA
| | - Andreas-Marius Kaiser
- Environment Agency Austria (Umweltbundesamt GmbH), Spittelauer Lände 5, 1090, Vienna, Austria
| | - Ingrid Hauzenberger
- Environment Agency Austria (Umweltbundesamt GmbH), Spittelauer Lände 5, 1090, Vienna, Austria
| | - Christina Hartmann
- Environment Agency Austria (Umweltbundesamt GmbH), Spittelauer Lände 5, 1090, Vienna, Austria
| | - Claudia Gundacker
- Center for Pathobiochemistry and Genetics, Medical University of Vienna, Vienna, Austria
| | - Maria Uhl
- Environment Agency Austria (Umweltbundesamt GmbH), Spittelauer Lände 5, 1090, Vienna, Austria.
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Crawford L, Halperin SA, Dzierlenga MW, Skidmore B, Linakis MW, Nakagawa S, Longnecker MP. Systematic review and meta-analysis of epidemiologic data on vaccine response in relation to exposure to five principal perfluoroalkyl substances. ENVIRONMENT INTERNATIONAL 2023; 172:107734. [PMID: 36764183 DOI: 10.1016/j.envint.2023.107734] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/28/2022] [Accepted: 01/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Epidemiologic studies of serum per- and polyfluoroalkyl substances (PFAS) and antibody response to vaccines have suggested an adverse association, but the consistency and magnitude of this association remain unclear. OBJECTIVE The goal of this systematic review was to determine the size of the association between a doubling in perfluoroalkyl substances (PFAS) serum concentration and difference in loge antibody concentration following a vaccine, with a focus on five PFAS: perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA). DATA SOURCE We conducted online searches of PubMed and Web of Science through May 17, 2022 and identified 14 eligible reports published from 2012 to 2022. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS We included studies conducted in humans, including mother-child pairs, which examined serum PFAS concentration in relation to serum concentration of antibody to a specific antigen following a vaccine. STUDY APPRAISAL AND SYNTHESIS METHODS We used the risk of bias assessment for non-randomized studies of exposure and certainty assessment method proposed by Morgan et al. (2019). Using a multilevel meta-regression model, we quantitatively synthesized the data. RESULTS The 14 reports represented 13 unique groups of subjects; the frequency of studies of a given antibody was Tetanus (n = 7); followed by Diphtheria (6); Measles (4); Rubella (3); Haemophilus influenzae type b and Influenza A H1N1 (2 each); and Hepatitis A, Hepatitis B, Influenza A H2N3, Influenza B, and Mumps (1 each). There were approximately 4,830 unique participants included in the analyses across the 14 reports. The models of coefficients between antibody concentration and the five principal PFAS showed homogeneity of associations across antibody types for each principal PFAS. In the models with all antibodies treated as one type, evidence of effect modification by life stage was present for PFOA and PFOS, and for consistency, all associations were evaluated for all ages and for children. The summary associations (coefficients for difference in loge[antibody concentration] per doubling of serum PFAS) with 95% confidence intervals that excluded zero ("statistical support"), and certainty of evidence ratings were as follows: for PFOA and all antibodies treated as one type in all ages, -0.06 (-0.10, -0.01; moderate) and in children, -0.10 (-0.16, -0.03; moderate); for Diphtheria in children, -0.12 (-0.23, -0.00; high); for Rubella in all ages, -0.09 (-0.17, -0.01; moderate), and for Tetanus in children, -0.12 (-0.24, -0.00; moderate). For PFOS the summary associations were, for all antibodies treated as one type in all ages, -0.06 (-0.11, -0.01; moderate) and in children, -0.10 (-0.18, -0.03; moderate); for Rubella in all ages, -0.09 (-0.15, -0.03; high) and in children, -0.12 (-0.20, -0.04; high). For PFHxS the summary associations were, for all antibodies treated as one type in all ages, -0.03 (-0.06, -0.00; moderate) and in children, -0.05 (-0.09, -0.00; low); and for Rubella in children, -0.07 (-0.11, -0.02; high). Summary associations for PFNA and PFDA did not have statistical support, but all PFAS studied tended to have an inverse association with antibody concentrations. LIMITATIONS AND CONCLUSIONS Epidemiologic data on immunosuppression and five principal PFAS suggest an association, with support across antibodies against multiple types of antigens. Data on Diphtheria, Rubella, and Tetanus were more supportive of an association than for other antibodies, and support was greater for associations with PFOA, PFOS, and PFHxS, than for PFNA or PFDA. The data on any specific antibody were scarce. Confounding factors that might account for the relation were not identified. Nearly all studies evaluated were judged to have a low or moderate risk of bias.
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Affiliation(s)
- Lori Crawford
- Ramboll U.S. Consulting, Inc., 28 Amity St., Suite 2A, Amherst, MA 01002, USA.
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax, Canada; Department of Pediatrics, Dalhousie University, Halifax, Canada; Department of Microbiology and Immunology, Dalhousie University , Halifax, Canada.
| | - Michael W Dzierlenga
- Ramboll U.S. Consulting, Inc., Raleigh, NC 27612 Current address, U.S. E.P.A., Research Triangle Park, NC 27711, USA.
| | - Becky Skidmore
- Skidmore Research & Information Consulting Inc., Address: 3104 Apple Hill Drive, Ottawa, Ontario K1T 3Z2, Canada.
| | | | - Shinichi Nakagawa
- Evolution & Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales, Kensington, NSW, Australia.
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20
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Li X, Liu H, Wan H, Li Y, Xu S, Xiao H, Xia W. Sex-specific associations between legacy and novel per- and polyfluoroalkyl substances and telomere length in newborns in Wuhan, China: Mixture and single pollutant associations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159676. [PMID: 36283531 DOI: 10.1016/j.scitotenv.2022.159676] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/26/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Telomere length (TL) at birth predicts later life TL and is related to health. Prenatal exposure to environmental pollutants might affect TL, but the associations between intrauterine per- and polyfluoroalkyl substances (PFASs) exposure and neonatal TL remained inconclusive. This study aimed to explore the single pollutant and mixture associations between legacy and novel PFASs and TL in newborns. In 908 mother-newborn pairs from Wuhan, China, thirteen PFASs were measured in cord serum, and TL was determined in cord leukocytes. Weighted quantile sum (WQS) regression and generalized linear model (GLM) were utilized to analyze the associations between PFASs mixture and single PFASs and TL in newborns. Furthermore, stratified and interaction analyses were performed to evaluate if there were sex-specific associations. The concentrations of perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA) ranked the highest (geometric mean, 4.12, 1.61, and 0.77 ng/mL, respectively) among the 13 measured PFASs. Each unit increase in WQS index of PFASs mixture was associated with -5.19 % change (95% CI, -9.44, -0.73) of neonatal TL, and 8:2 Cl-PFESA contributed most (32.59 %) to the mixture association. In stratified analyses by neonatal sex, PFOS (-4.73 % change, 95% CI, -8.40, -0.93 for per doubling concentration) and 8:2 Cl-PFESA (-4.52 % change, 95% CI, -8.20, -0.70) were negatively associated with neonatal TL in male newborns, but no significant association appeared in females. In summary, intrauterine exposure to PFASs in mixture was associated with shorter neonatal TL, and the negative associations of 8:2 Cl-PFESA and PFOS with neonatal TL were observed only in boys. Future risk assessments are needed to pay more attention to the health effects of novel PFASs.
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Affiliation(s)
- Xiaojun Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Hongxiu Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Hongxia Wan
- Ningguo Meilin Hospital, Ningguo, Anhui 242321, PR China.
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Han Xiao
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
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21
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Sly PD, Trottier B, Ikeda-Araki A, Vilcins D. Environmental Impacts on Infectious Disease: A Literature View of Epidemiological Evidence. Ann Glob Health 2022; 88:91. [PMID: 36348708 PMCID: PMC9585978 DOI: 10.5334/aogh.3670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/09/2022] [Indexed: 01/09/2023] Open
Abstract
Background This article summarises a session from the recent Pacific Basin Consortium for Environment and Health Focus meeting on Environmental Impacts on Infectious Disease. Objective To provide an overview of the literature underpinning the presentations from this session. Methods References used in developing the presentations were obtained from the presenters. Additional references were obtained from PubMed using key words from the presentations. Findings and Conclusions The Hokkaido longitudinal children's study has found that exposure to chemicals in early life, such as persistent organic pollutants and per/polyfluorinated compounds, is associated with a range of immunological outcomes such as decreased cord blood IgE, otitis media, wheeze, increased risk of infections and higher risk of food allergy.Epidemiological evidence links exposure to poor air quality to increased severity and mortality of Covid-19 in many parts of the world. Most studies suggest that long-term exposure has a more marked effect than acute exposure.Components of air pollution, such as a newly described combustion product known as environmentally persistent free radicals, induce oxidative stress in exposed individuals. Individuals with genetic variations predisposing them to oxidative stress are at increased risk of adverse health effects from poor air quality.
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Affiliation(s)
- Peter D. Sly
- Children’s Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
| | - Brittany Trottier
- Superfund Research Program, National Institute of Environmental Health Sciences, USA
| | - Atsuko Ikeda-Araki
- Faculty of Health Sciences, Hokkaido University, JP; Center for Environmental and Health Sciences, Hokkaido University, Japan
| | - Dwan Vilcins
- Children’s Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
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22
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Association of Polyfluoroalkyl Substances and Allergy in US Adolescents. J Occup Environ Med 2022; 64:737-741. [DOI: 10.1097/jom.0000000000002560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Immunomodulation and exposure to per- and polyfluoroalkyl substances: an overview of the current evidence from animal and human studies. Arch Toxicol 2022; 96:2261-2285. [PMID: 35695909 DOI: 10.1007/s00204-022-03303-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 02/07/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) have been widely used and represent a class of environmental persistent chemicals. An association of a reduction of vaccination efficacy with PFAS serum levels in humans was used by the European Food Safety Authority as a key effect for PFAS risk assessment. The data support for using this association is reviewed by a critical analysis of the respective human epidemiology and the available animal studies on the immunomodulation of PFAS. Based on an analysis of the available human epidemiology, the overall level of evidence regarding associations between PFAS serum levels and reduced antibody response remains weak. Absence of an association between an increase in clinical infections and PFAS serum levels and the limited understanding of the importance of antibody levels as an isolated data point further support this conclusion. Animal toxicity studies with PFAS focusing on immunomodulation also provide only limited support for immunomodulation as an important endpoint in PFAS toxicity. While immunomodulation is observed after PFAS administration, generally at blood concentrations several orders of magnitude above those seen in environmentally exposed humans, the relevance of these observation is hampered by the high doses required to influence immune endpoints, the limited number of endpoints assessed, and inconsistent results. The limitations of the current database on associations of human PFAS exposures outlined here indicate that more evidence is required to select immunomodulation as a critical endpoint for human PFAS risk assessment.
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24
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Lee HY, You DJ, Taylor-Just AJ, Linder KE, Atkins HM, Ralph LM, De la Cruz G, Bonner JC. Pulmonary exposure of mice to ammonium perfluoro(2-methyl-3-oxahexanoate) (GenX) suppresses the innate immune response to carbon black nanoparticles and stimulates lung cell proliferation. Inhal Toxicol 2022; 34:244-259. [PMID: 35704474 DOI: 10.1080/08958378.2022.2086651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) have been associated with respiratory diseases in humans, yet the mechanisms through which PFAS cause susceptibility to inhaled agents is unknown. Herein, we investigated the effects of ammonium perfluoro(2-methyl-3-oxahexanoate) (GenX), an emerging PFAS, on the pulmonary immune response of mice to carbon black nanoparticles (CBNP). We hypothesized that pulmonary exposure to GenX would increase susceptibility to CBNP through suppression of innate immunity. METHODS Male C57BL/6 mice were exposed to vehicle, 4 mg/kg CBNP, 10 mg/kg GenX, or CBNP and GenX by oropharyngeal aspiration. Bronchoalveolar lavage fluid (BALF) was collected at 1 and 14 days postexposure for cytokines and total protein. Lung tissue was harvested for histopathology, immunohistochemistry (Ki67 and phosphorylated (p)-STAT3), western blotting (p-STAT3 and p-NF-κB), and qRT-PCR for cytokine mRNAs. RESULTS CBNP increased CXCL-1 and neutrophils in BALF at both time points evaluated. However, GenX/CBNP co-exposure reduced CBNP-induced CXCL-1 and neutrophils in BALF. Moreover, CXCL-1, CXCL-2 and IL-1β mRNAs were increased by CBNP in lung tissue but reduced by GenX. Western blotting showed that CBNP induced p-NF-κB in lung tissue, while the GenX/CBNP co-exposed group displayed decreased p-NF-κB. Furthermore, mice exposed to GenX or GenX/CBNP displayed increased numbers of BALF macrophages undergoing mitosis and increased Ki67 immunostaining. This was correlated with increased p-STAT3 by western blotting and immunohistochemistry in lung tissue from mice co-exposed to GenX/CBNP. CONCLUSIONS Pulmonary exposure to GenX suppressed CBNP-induced innate immune response in the lungs of mice yet promoted the proliferation of macrophages and lung epithelial cells.
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Affiliation(s)
- Ho Young Lee
- Toxicology Program, Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Dorothy J You
- Toxicology Program, Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Alexia J Taylor-Just
- Toxicology Program, Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Keith E Linder
- Department of Population Health and Pathobiology, North Carolina State University, Raleigh, NC, USA
| | - Hannah M Atkins
- Department of Population Health and Pathobiology, North Carolina State University, Raleigh, NC, USA.,Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Lauren M Ralph
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Gabriela De la Cruz
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - James C Bonner
- Toxicology Program, Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
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25
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Zhang Y, Mustieles V, Sun Y, Oulhote Y, Wang YX, Messerlian C. Association between serum per- and polyfluoroalkyl substances concentrations and common cold among children and adolescents in the United States. ENVIRONMENT INTERNATIONAL 2022; 164:107239. [PMID: 35447424 PMCID: PMC10250187 DOI: 10.1016/j.envint.2022.107239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 06/11/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) exert immunosuppressive effects in experimental animals. Few epidemiologic studies investigated PFAS exposure and immune-related clinical outcomes such as common cold, especially during childhood when the immune system is developing. METHODS This study used data from the National Health and Nutrition Examination Survey and included 517 children 3-11 years (2013-2014 cycle) and 2732 adolescents 12-19 years (2003-2016 cycles). Serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA) and perfluorohexane sulfonic acid (PFHxS) were quantified. Common cold was self-reported by the participant or parent as having a head cold or chest cold in the last month. Multivariable logistic regression models were applied to examine the covariate-adjusted odds ratios (ORs) between individual PFAS concentrations and common cold incidence in the past month. The joint effect of PFAS mixtures was evaluated using Probit Bayesian Kernel Machine Regression (BKMR). RESULTS A doubling of serum PFHxS concentration was associated with a 31% higher odds (OR = 1.31, 95% CI: 1.06, 1.62) of common cold among children. Serum PFNA (OR = 1.36, 95% CI: 0.93, 1.98) and PFOA (OR = 1.32, 95% CI: 0.67, 2.62) concentrations were also related to common cold among children, as were serum PFOS concentrations among adolescents (OR = 1.13, 95% CI: 0.96, 1.32). ORs were higher in male than female children and adolescents. BKMR showed a clear increasing trend of common cold estimates across quantiles of the total PFAS mixture concentration among children, while no obvious pattern emerged in adolescents. DISCUSSION Among children in the United States, serum concentrations of PFAS mixtures, especially PFHxS and PFNA, were associated with higher odds of common cold. Among adolescents, PFOS was associated with increased common cold in the last month. This study contributes to the existing evidence supporting the immunotoxicity of PFAS in childhood and adolescence.
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Affiliation(s)
- Yu Zhang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Vicente Mustieles
- University of Granada, Center for Biomedical Research (CIBM), Spain; Instituto de Investigación Biosanitaria Ibs GRANADA, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Yang Sun
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Yi-Xin Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Carmen Messerlian
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Massachusetts General Hospital Fertility Center, Vincent Center for Reproductive Biology, Department of Obstetrics and Gynecology, Boston, MA, USA
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Albano GD, Montalbano AM, Gagliardo R, Anzalone G, Profita M. Impact of Air Pollution in Airway Diseases: Role of the Epithelial Cells (Cell Models and Biomarkers). Int J Mol Sci 2022; 23:2799. [PMID: 35269941 PMCID: PMC8911203 DOI: 10.3390/ijms23052799] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/18/2022] [Accepted: 02/26/2022] [Indexed: 02/05/2023] Open
Abstract
Biomedical research is multidisciplinary and often uses integrated approaches performing different experimental models with complementary functions. This approach is important to understand the pathogenetic mechanisms concerning the effects of environmental pollution on human health. The biological activity of the substances is investigated at least to three levels using molecular, cellular, and human tissue models. Each of these is able to give specific answers to experimental problems. A scientific approach, using biological methods (wet lab), cell cultures (cell lines or primary), isolated organs (three-dimensional cell cultures of primary epithelial cells), and animal organisms, including the human body, aimed to understand the effects of air pollution on the onset of diseases of the respiratory system. Biological methods are divided into three complementary models: in vitro, ex vivo, and in vivo. In vitro experiments do not require the use of whole organisms (in vivo study), while ex vivo experiments use isolated organs or parts of organs. The concept of complementarity and the informatic support are useful tools to organize, analyze, and interpret experimental data, with the aim of discussing scientific notions with objectivity and rationality in biology and medicine. In this scenario, the integrated and complementary use of different experimental models is important to obtain useful and global information that allows us to identify the effect of inhaled pollutants on the incidence of respiratory diseases in the exposed population. In this review, we focused our attention on the impact of air pollution in airway diseases with a rapid and descriptive analysis on the role of epithelium and on the experimental cell models useful to study the effect of toxicants on epithelial cells.
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Affiliation(s)
- Giusy Daniela Albano
- Institute of Translational Pharmacology, National Research Council of Italy (CNR), 00133 Rome, Italy; (G.D.A.); (A.M.M.); (R.G.)
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 90100 Palermo, Italy;
| | - Angela Marina Montalbano
- Institute of Translational Pharmacology, National Research Council of Italy (CNR), 00133 Rome, Italy; (G.D.A.); (A.M.M.); (R.G.)
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 90100 Palermo, Italy;
| | - Rosalia Gagliardo
- Institute of Translational Pharmacology, National Research Council of Italy (CNR), 00133 Rome, Italy; (G.D.A.); (A.M.M.); (R.G.)
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 90100 Palermo, Italy;
| | - Giulia Anzalone
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 90100 Palermo, Italy;
| | - Mirella Profita
- Institute of Translational Pharmacology, National Research Council of Italy (CNR), 00133 Rome, Italy; (G.D.A.); (A.M.M.); (R.G.)
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 90100 Palermo, Italy;
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Wang Z, Shi R, Ding G, Yao Q, Pan C, Gao Y, Tian Y. Association between maternal serum concentration of perfluoroalkyl substances (PFASs) at delivery and acute infectious diseases in infancy. CHEMOSPHERE 2022; 289:133235. [PMID: 34896425 DOI: 10.1016/j.chemosphere.2021.133235] [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: 09/24/2021] [Revised: 12/04/2021] [Accepted: 12/07/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFASs) are persistent and bio-accumulative compounds that have been recognized as important immune hazards by animal studies. However, epidemiological studies regarding the impact on infant infections were inconsistent. OBJECTIVES We investigated the associations between prenatal exposure to PFASs and acute infectious diseases including common cold, bronchitis/pneumonia, and diarrhea in early childhood. METHODS Participating 235 mother-infant pairs were recruited from the Laizhou Wan (Bay) birth cohort (LWBC), a prospective study in Shandong, China between September 2010 and 2013. Ten selected PFASs congeners including PFOA, PFOS, PFNA, PFDA, PFUA, PFDoA, PFHxS, PFBS, PFHpA, and PFOSA were measured from maternal serum by HPLC-MS/MS. Detailed information on parent-reported frequency of acute infectious diseases was collected from questionnaires at 1-year follow-up, which was confirmed by the medical records. Logistic and Poisson regression models were used on binary health outcomes (yes/no) and the number of episodes of outcomes, which were reported as odds ratio (OR) and incidence rate-ratio (IRR), respectively. RESULTS The risk of diarrhea increased by 4.99 (95% CI = 1.86, 13.39) per log-unit increase in PFOA. The frequencies of diarrhea increased by 97%-116% for each 10-fold increase in PFOA, PFNA, and PFDA. Moreover, when stratified by exclusively breastfeeding duration (at least 4 months or not), the adverse effects of PFASs exposures on diarrhea were more pronounced among the breastfed infants. There were no associations between prenatal PFASs exposure and common cold or bronchitis/pneumonia. CONCLUSIONS Exposure to PFASs was associated with increased risks of diarrhea during the first year of life, and these effects were stronger among the breastfed infants. Due to the small sample size, our results should be interpreted with caution and additional studies on larger populations are needed to confirm our findings.
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Affiliation(s)
- Zixia Wang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Shi
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guodong Ding
- Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, 1400 West Beijing Road, Shanghai, 200040, China
| | - Qian Yao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengyu Pan
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Gao
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ying Tian
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Costopoulou D, Vassiliadou I, Leondiadis L. PFASs intake from fish, eggs and drinking water in Greece in relation to the safety limits for weekly intake proposed in the EFSA scientific opinion of 2020. CHEMOSPHERE 2022; 286:131851. [PMID: 34391114 DOI: 10.1016/j.chemosphere.2021.131851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/04/2021] [Accepted: 08/07/2021] [Indexed: 06/13/2023]
Abstract
Food consumption has been recognized as the most significant contributor to human exposure to polyfluoroalkyl and perfluoroalkyl substances (PFASs) for the general population. In 2020, EFSA introduced for the first time safety limit of 4.4 ng/kg body weight (bw) for weekly intake for the sum of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA) and perfluorohexane sulfonic acid (PFHxS) which are all perfluoralkyl acids (PFAAs) that belong to PFASs group. Fish and eggs have been found to contribute significantly, almost 50 % to PFOS and PFOA dietary intake of the Greek population. In the present study, estimation of human intake of these four PFASs from fish, eggs and drinking water consumption is attempted. Data from EFSA food consumption database for fish and eggs are used for assessment. Mean weekly intake estimated is above the tolerable weekly intake (TWI) recently proposed, mainly due to fish consumption. Exceedance of the proposed TWI emphasizes the need for continuous monitoring of levels of PFASs in food in parallel with efforts to lower these levels.
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Affiliation(s)
- Danae Costopoulou
- Mass Spectrometry and Dioxin Analysis Laboratory, INRASTES, NCSR "Demokritos", 15310, Athens, Greece.
| | - Irene Vassiliadou
- Mass Spectrometry and Dioxin Analysis Laboratory, INRASTES, NCSR "Demokritos", 15310, Athens, Greece
| | - Leondios Leondiadis
- Mass Spectrometry and Dioxin Analysis Laboratory, INRASTES, NCSR "Demokritos", 15310, Athens, Greece
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Timmermann CAG, Pedersen HS, Weihe P, Bjerregaard P, Nielsen F, Heilmann C, Grandjean P. Concentrations of tetanus and diphtheria antibodies in vaccinated Greenlandic children aged 7-12 years exposed to marine pollutants, a cross sectional study. ENVIRONMENTAL RESEARCH 2022; 203:111712. [PMID: 34343554 PMCID: PMC11061314 DOI: 10.1016/j.envres.2021.111712] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/02/2021] [Accepted: 07/14/2021] [Indexed: 05/14/2023]
Abstract
Previous studies have shown immunotoxic effects of environmental chemicals, and the European Food Safety Authority (EFSA) recently identified a need for more studies on PFAS immunotoxicity in different populations. In the Arctic, populations are exposed to several environmental chemicals through marine diet, and the objective of this study was therefore to examine the association between Greenlandic children's exposure to major environmental chemicals and their concentrations of diphtheria and tetanus vaccine antibodies after vaccination. The study includes cross-sectional data from Greenlandic children aged 7-12 years examined during 2012-2015. A total of 338 children were eligible for the study, and 175 of these had available vaccination records. A parent or guardian participated in a structured interview, and a blood sample from the child was analyzed for specific antibodies against diphtheria and tetanus as well as perfluoroalkyl substances (PFASs), polychlorinated biphenyls (PCBs) and total mercury. Furthermore, for a subgroup, blood samples from pregnancy were available and analyzed for environmental contaminants. The associations between the environmental exposures and antibody concentrations and odds of having antibody concentrations below the protective level were examined in linear and logistic regression models. In crude analyses, elevated concentrations of some of the contaminants were associated with higher concentrations of diphtheria and tetanus antibodies, but the associations were reversed when adjusting for area of residence, and duration of being breastfed and including children with a known vaccination date only. Each 1 ng/mL increase in serum concentrations of perfluorohexane sulfonic acid (PFHxS) and perfluorooctane sulfonic acid (PFOS) was associated with decreases of 78 % (95 % CI: 25-94 %) and 9 % (95 % CI: 2-16 %), respectively, in diphtheria antibody concentrations. Exposure to PCBs and all PFASs was associated with markedly increased odds of having diphtheria antibody concentrations below the protective level. For each 1 ng/mL increase in serum concentrations of PFHxS, PFOS, perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), odds of not having protective levels of diphtheria antibodies were increased 6.44 times (95 % CI: 1.51-27.36), 1.14 times (95 % CI: 1.04-1.26), 1.96 times (95 % CI: 1.07-3.60), and 5.08 times (95 % CI: 1.32-19.51, respectively. No consistent associations were seen between maternal contaminant concentrations and vaccine antibody concentrations. In conclusion, we found that increased exposure to environmental chemicals among children in this Arctic population were associated with a decrease in post-vaccination antibody concentrations and with increased odds of not being protected against diphtheria despite appropriate vaccination. These findings emphasize the risk of environmental chemical exposures also in this Arctic population.
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Affiliation(s)
- Clara Amalie Gade Timmermann
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Henning Sloth Pedersen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark; Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands; Center of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark
| | - Flemming Nielsen
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Carsten Heilmann
- Pediatric Clinic, Rigshospitalet - National University Hospital, Copenhagen, Denmark
| | - Philippe Grandjean
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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von Holst H, Nayak P, Dembek Z, Buehler S, Echeverria D, Fallacara D, John L. Perfluoroalkyl substances exposure and immunity, allergic response, infection, and asthma in children: review of epidemiologic studies. Heliyon 2021; 7:e08160. [PMID: 34712855 PMCID: PMC8529509 DOI: 10.1016/j.heliyon.2021.e08160] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/19/2021] [Accepted: 10/08/2021] [Indexed: 02/05/2023] Open
Abstract
Background Increased exposure to perfluoroalkyl substances (PFAS) potentially affects infant and childhood health through immunosuppression. Given rapidly evolving research on PFAS, it is important to comprehensively examine the impact of PFAS exposure among the pediatric population as new research becomes available due to potential fragility of the developing immune system. Objectives This review assessed the effects of PFAS fetal, infant and childhood exposures upon the development of immune function during early life stages. Methods Researchers completed a literature review, searching PubMed for human studies published since 2010 for PFAS and health outcomes among infants and children. Included articles incorporated key search terms in the title or abstract; non-research reports and non-English papers were excluded. The search identified 518 studies for possible inclusion. Following hands-on review, 34 were determined relevant. Subsequent analyses found 8 additional relevant articles, totaling 42 studies. Results Major immune-related sequelae from PFAS exposures on infant and child health outcomes documented in recent literature include: • Strong indication of immunosuppression, with diminished childhood antibody response to vaccination, particularly with PFOA, PFOS and PFHxS exposures. • Some indication of increased risks of childhood infectious diseases/infections, particularly from PFOS exposures. • Limited indication of an effect of PFAS exposure on allergic reactions/allergen specific IgE antibodies. • Limited indication of an effect of PFAS exposure on atopic dermatitis (AD). • Limited indication of an effect of PFAS exposure on asthma and lung function. Conclusion This review summarizes recent findings of PFAS effects on infant and childhood immune health. Evidence of immunosuppression, diminished vaccine efficacy, and increased risk of infections, allergies, asthma and AD were described following in utero, infant, and early childhood PFAS exposures. Further investigation is warranted to characterize PFAS exposure pathways and potential modes of action in relation to PFAS effects on the developing immune system. Incontrovertible proof of PFAS immunotoxic effects could optimally be obtained by a large prospective study cohort of mothers and children from infancy through school-age. Regular assessments of circulating antibodies and response to infant and childhood vaccines during growth years could prove invaluable. This review summarizes findings of PFAS effects on infant and child immune health. In utero, infant, and early childhood PFAS exposures were examined. Strong evidence of PFAS exposure on diminished childhood antibody vaccination response. Moderate evidence of PFAS exposure on increased risk of childhood infectious diseases. Limited evidence of PFAS exposure on allergic reactions, atopic dermatitis, asthma.
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Affiliation(s)
- Haley von Holst
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | - Pratibha Nayak
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | - Zygmunt Dembek
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | | | - Diana Echeverria
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | - Dawn Fallacara
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
| | - Lisa John
- Battelle Memorial Institute, 505 King Ave, Columbus, OH, 43201, USA
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Ji J, Song L, Wang J, Yang Z, Yan H, Li T, Yu L, Jian L, Jiang F, Li J, Zheng J, Li K. Association between urinary per- and poly-fluoroalkyl substances and COVID-19 susceptibility. ENVIRONMENT INTERNATIONAL 2021; 153:106524. [PMID: 33773143 PMCID: PMC7972714 DOI: 10.1016/j.envint.2021.106524] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 05/18/2023]
Abstract
BACKGROUND AND OBJECTIVE The growing impact of the COVID-19 pandemic has heightened the urgency of identifying individuals most at risk of infection. Per- and poly-fluoroalkyl substances (PFASs) are manufactured fluorinated chemicals widely used in many industrial and household products. The objective of this case-control study was to assess the association between PFASs exposure and COVID-19 susceptibility and to elucidate the metabolic dysregulation associated with PFASs exposure in COVID-19 patients. METHODS Total 160 subjects (80 COVID-19 patients and 80 symptom-free controls) were recruited from Shanxi and Shandong provinces, two regions heavily polluted by PFASs in China. Twelve common PFASs were quantified in both urine and serum. Urine metabolome profiling was performed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). RESULTS In unadjusted models, the risk of COVID-19 infection was positively associated with urinary levels of perfluorooctanesulfonic acid (PFOS) (Odds ratio: 2.29 [95% CI: 1.52-3.22]), perfluorooctanoic acid (PFOA) (2.91, [1.95-4.83], and total PFASs (∑ (12) PFASs) (3.31, [2.05-4.65]). After controlling for age, sex, body mass index (BMI), comorbidities, and urine albumin-to-creatinine ratio (UACR), the associations remained statistically significant (Adjusted odds ratio of 1.94 [95% CI: 1.39-2.96] for PFOS, 2.73 [1.71-4.55] for PFOA, and 2.82 [1.97-3.51] for ∑ (12) PFASs). Urine metabolome-PFASs association analysis revealed that 59% of PFASs-associated urinary endogenous metabolites in COVID-19 patients were identified to be produced or largely regulated by mitochondrial function. In addition, the increase of PFASs exposure was associated with the accumulation of key metabolites in kynurenine metabolism, which are involved in immune responses (Combined β coefficient of 0.60 [95% CI: 0.25-0.95, P = 0.001]). Moreover, alternations in PFASs-associated metabolites in mitochondrial and kynurenine metabolism were also correlated with clinical lab biomarkers for mitochondrial function (serum growth/differentiation factor-15) and immune activity (lymphocyte percentage), respectively. CONCLUSION Elevated exposure to PFASs was independently associated with an increased risk of COVID-19 infection. PFASs-associated metabolites were implicated in mitochondrial function and immune activity. Larger studies are needed to confirm our findings and further understand the underlying mechanisms of PFASs exposure in the pathogenesis of SARS-CoV2 infection.
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Affiliation(s)
- Junjun Ji
- Department of Radiology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China; Jiangsu Metabo Life Technology, Danyang, Jiangsu, China
| | - Lingyan Song
- Department of Clinical Laboratory, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
| | - Jing Wang
- Department of Critical Care Medicine, Yantai Yuhuangding Hospital Affiliated with Medical College of Qingdao University, Yantai, Shandong, China
| | - Zhiyun Yang
- Graduate School, Changzhi Medical College, Changzhi, Shanxi, China
| | - Haotian Yan
- Peking University First Hospital, Beijing, China
| | - Ting Li
- Department of Radiology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
| | - Li Yu
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China; School of Medicine, University of California, San Diego, CA, USA
| | - Lingyu Jian
- Graduate School, Changzhi Medical College, Changzhi, Shanxi, China
| | | | - Junfeng Li
- Department of Radiology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China.
| | - Jinping Zheng
- School of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China.
| | - Kefeng Li
- School of Medicine, University of California, San Diego, CA, USA.
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Abraham K, Koletzko B, Mildenberger E, Rouw E, von Gartzen A, Ensenauer R. Per- und polyfluorierte Alkylsubstanzen (PFAS) und Stillen: Nutzen-Risiken-Abwägungen. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01203-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Yang M, Li LY, Qin XD, Ye XY, Yu S, Bao Q, Sun L, Wang ZB, Bloom MS, Jalava P, Hu LW, Yu HY, Zeng XW, Yang BY, Dong GH, Li CW. Perfluorooctanesulfonate and perfluorooctanoate exacerbate airway inflammation in asthmatic mice and in vitro. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 766:142365. [PMID: 33601665 DOI: 10.1016/j.scitotenv.2020.142365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/18/2020] [Accepted: 09/09/2020] [Indexed: 05/14/2023]
Abstract
Emerging evidence suggests associations between Perfluoroalkyl substances (PFASs) exposure and asthma, but the findings are inconsistent. The current study sought to investigate whether perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) could contribute to asthma exacerbation and to clarify the underlying biological mechanisms. The objectives are a) to determine whether PFOS or PFOA could aggravate the mouse asthma and pulmonary inflammation b) to investigate whether PFOS and PFOA regulate the balance of Th1/Th2 through the JAK-STAT signaling pathway and aggravated asthma. Ovalbumin (OVA) induced asthmatic mice were exposed to PFOS or PFOA by gavage. PFOS and PFOA serum level and toxicity in organs were assessed; and the impacts on respiratory symptoms, lung tissue pathology, T helper cell (Th2) response, and STAT6 pathway activity were also evaluated. In vitro Jurkat cells were used to study the mechanisms of PFOS and PFOA mediated Th1 and Th2 responses. Both PFOS and PFOA exacerbated lung tissue inflammation (greater number of eosinophils and mucus hyperproduction), upregulated Th2 cytokine production (IL-4 and IL-13), and promoted Th2 cells and STAT6 activation. Furthermore, PFOS and PFOA enhanced the Th2 response in Jurkat cells via STAT6 activation; and the effect of PFOS exposure on GATA-3, IL-4 and IFN-γ was blocked after the expression of STAT6 was suppressed in Jurkat cells, however, the effects of PFOA exposure were only partially blocked. PFOS and PFOA aggravated inflammation among OVA-induced asthmatic mice, by promoting the Th2 response in lymphocytes and disturbing the balance of Th1/Th2 through the JAK-STAT signaling pathway.
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Affiliation(s)
- Mo Yang
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li-Yue Li
- Guangzhou Key Laboratory of Otorhinolaryngology, Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Di Qin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Yan Ye
- Guangzhou Key Laboratory of Otorhinolaryngology, Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shu Yu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qing Bao
- Guangzhou Key Laboratory of Otorhinolaryngology, Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lin Sun
- Guangzhou Key Laboratory of Otorhinolaryngology, Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi-Bin Wang
- Department of Environmental Health Sciences, Laboratory of Human Environmental Epigenomes, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Michael S Bloom
- Departments of Environmental Health Sciences and Epidemiology & Biostatistics, University at Albany School of Public Health, Albany, USA
| | - Pasi Jalava
- Department of Environmental and Biological Science, University of Eastern Finland, Kuopio, Finland
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hong-Yao Yu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Chun-Wei Li
- Guangzhou Key Laboratory of Otorhinolaryngology, Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Dalsager L, Christensen N, Halekoh U, Timmermann CAG, Nielsen F, Kyhl HB, Husby S, Grandjean P, Jensen TK, Andersen HR. Exposure to perfluoroalkyl substances during fetal life and hospitalization for infectious disease in childhood: A study among 1,503 children from the Odense Child Cohort. ENVIRONMENT INTERNATIONAL 2021; 149:106395. [PMID: 33508532 DOI: 10.1016/j.envint.2021.106395] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/10/2020] [Accepted: 01/09/2021] [Indexed: 05/14/2023]
Abstract
INTRODUCTION The immunosuppressive properties of PFASs are widely recognized. Early-life exposure to PFAS has been linked to reduced immune response to childhood vaccinations and increased rates of common infectious diseases, but implications for hospitalizations are unclear. OBJECTIVES To investigate the association between maternal serum concentrations of five PFASs during pregnancy and the child's rate of hospitalization due to common infectious diseases between birth and 4 years of age. METHODS Serum samples from first trimester pregnant women from the Odense Child Cohort (OCC) collected in 2010-2012 were analyzed for concentrations of perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA) and three other PFASs. Data on child hospitalizations with an ICD-10 code for infectious disease was obtained from the Danish National Patient Register. The following were identified: upper respiratory tract infections (URTI), lower respiratory tract infections (LRTI), gastrointestinal infections (GI), and other infections. The Andersen-Gill Cox proportional hazard model for recurrent events was used to investigate the association between PFAS exposure and hospitalizations. The resulting estimates were hazard ratios (HRs), which express the relative change in the instantaneous risk of hospitalization with a doubling in maternal PFAS concentration. RESULTS A total of 1,503 mother-child pairs were included, and 26% of the children were hospitalized at least once for infectious disease. A doubling in maternal PFOS concentration was associated with a 23% increase in the risk of hospitalization due to any infection (HR: 1.23 (95% CI: 1.05, 1.44). There was indication of an interaction between child sex and PFOS (p = 0.07) and PFDA (p = 0.06), although in opposite directions. Further, every doubling of PFOA or PFOS increased the risk of LRTI by 27% (HR: 1.27 (1.01, 1.59)) and 54% (HR: 1.54 (1.11, 2.15)), respectively. Similar tendencies were seen for URTI and the group of other infections. For GIs, the opposite pattern of association was seen as HR's were consistently below 1 (PFOA, HR: 0.55 (0.32, 0.95)). DISCUSSION We found an association between PFOS and the overall risk of infectious disease, and between PFOS and PFOA exposures and the risk of LRTI's. These results are in agreement with previous findings from the OCC, in which maternal PFOS and PFOA concentrations were positively associated with the number of days that the children experienced fever, thereby suggesting that PFOS and PFOA may affect the prevalence of both mild and more severe infectious diseases even in a rather low-exposed population.
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Affiliation(s)
- Louise Dalsager
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Nikolas Christensen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Ulrich Halekoh
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark
| | - Clara Amalie Gade Timmermann
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Flemming Nielsen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Steffen Husby
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Philippe Grandjean
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Tina Kold Jensen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Odense Patient data Explorative Network (OPEN), Odense, Denmark
| | - Helle Raun Andersen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Chae J, Kim HK. Birth cohort effects on maternal and child environmental health: a systematic review. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2021; 27:27-39. [PMID: 36311987 PMCID: PMC9334170 DOI: 10.4069/kjwhn.2021.03.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/22/2021] [Accepted: 03/12/2021] [Indexed: 11/22/2022] Open
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Sly PD, Trottier BA, Bulka CM, Cormier SA, Fobil J, Fry RC, Kim KW, Kleeberger S, Kumar P, Landrigan PJ, Lodrop Carlsen KC, Pascale A, Polack F, Ruchirawat M, Zar HJ, Suk WA. The interplay between environmental exposures and COVID-19 risks in the health of children. Environ Health 2021; 20:34. [PMID: 33771185 PMCID: PMC7996114 DOI: 10.1186/s12940-021-00716-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/07/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND An unusual feature of SARS-Cov-2 infection and the COVID-19 pandemic is that children are less severely affected than adults. This is especially paradoxical given the epidemiological links between poor air quality and increased COVID-19 severity in adults and that children are generally more vulnerable than adults to the adverse consequences of air pollution. OBJECTIVES To identify gaps in knowledge about the factors that protect children from severe SARS-Cov-2 infection even in the face of air pollution, and to develop a transdisciplinary research strategy to address these gaps. METHODS An international group of researchers interested in children's environmental health was invited to identify knowledge gaps and to develop research questions to close these gaps. DISCUSSION Key research questions identified include: what are the effects of SAR-Cov-2 infection during pregnancy on the developing fetus and child; what is the impact of age at infection and genetic susceptibility on disease severity; why do some children with COVID-19 infection develop toxic shock and Kawasaki-like symptoms; what are the impacts of toxic environmental exposures including poor air quality, chemical and metal exposures on innate immunity, especially in the respiratory epithelium; what is the possible role of a "dirty" environment in conveying protection - an example of the "hygiene hypothesis"; and what are the long term health effects of SARS-Cov-2 infection in early life. CONCLUSION A concerted research effort by a multidisciplinary team of scientists is needed to understand the links between environmental exposures, especially air pollution and COVID-19. We call for specific research funding to encourage basic and clinical research to understand if/why exposure to environmental factors is associated with more severe disease, why children appear to be protected, and how innate immune responses may be involved. Lessons learned about SARS-Cov-2 infection in our children will help us to understand and reduce disease severity in adults, the opposite of the usual scenario.
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Affiliation(s)
- Peter D Sly
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
| | - Brittany A Trottier
- Superfund Research Program, National Institute of Environmental Health Sciences, 530 Davis Drive, Durham, NC, 27709, USA
| | - Catherine M Bulka
- Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, USA
| | - Stephania A Cormier
- LSU Superfund Research Program, Louisiana State University, Baton Rouge, USA
| | - Julius Fobil
- Department of Biological, Environmental and Occupational Health Science, University of Ghana, Accra, Ghana
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, USA
| | - Kyoung-Woong Kim
- School of Earth Sciences and Environmental Engineering, Gwangju Institute of Science and Technology, Gwangju, South Korea
| | - Steven Kleeberger
- Immunity, Inflammation, and Disease Laboratory, National Institute of Environmental Health Sciences, Durham, USA
| | | | - Philip J Landrigan
- Schiller Institute for Integrated Science and Society, Boston College, Chestnut Hill, USA
| | - Karin C Lodrop Carlsen
- Division of Paediatric and Adolescent Medicine, University of Oslo & Oslo University Hospital, Oslo, Norway
| | - Antonio Pascale
- Department of Toxicology, Faculty of Medicine, University of the Republic, Montevideo, Uruguay
| | | | | | - Heather J Zar
- Dept of Paediatrics & Child Health and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - William A Suk
- Superfund Research Program, National Institute of Environmental Health Sciences, 530 Davis Drive, Durham, NC, 27709, USA.
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Shao W, Xu J, Xu C, Weng Z, Liu Q, Zhang X, Liang J, Li W, Zhang Y, Jiang Z, Gu A. Early-life perfluorooctanoic acid exposure induces obesity in male offspring and the intervention role of chlorogenic acid. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 272:115974. [PMID: 33218772 DOI: 10.1016/j.envpol.2020.115974] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 05/28/2023]
Abstract
Perfluorooctanoic acid (PFOA) is an emerging organic pollutant (EOP) hazardous to human health. Effects of maternal PFOA exposure on offspring as well as the underlying mechanisms remain unclear. In this study, ICR mouse models of gestational low PFOA exposure (0.05 mg/kg/day) were established to investigate the roles on metabolic disorders of offspring. Body weight, body composition, hepatic lipid levels, transcriptome and metabolome were analyzed. Expression of genes related to lipid metabolism, inflammasome formation and gut barrier integrity were measured. Furthermore, oral administration of chlorogenic acid (CGA) (100 mg/kg/day) was performed to observe the rescue effect on lipid disorders caused by PFOA exposure. Our findings demonstrated that gestational exposure to PFOA resulted in obesity, hepatic inflammation, disorders of lipid metabolism, and disruption of gut barrier integrity in male offspring. Notably, these adverse effects were attenuated by CGA supplementation. These data suggested that PFOA exposure during early life stage induced potential risks for later onset of obesity and metabolic disorder which could be ameliorated by CGA treatment.
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Affiliation(s)
- Wentao Shao
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China; Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China; School of Instrument Science and Engineering, Southeast University, Nanjing, 210096, PR China
| | - Jin Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Cheng Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Zhenkun Weng
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Qian Liu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Xin Zhang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Jingjia Liang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Wenxiang Li
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Yi Zhang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Zhaoyan Jiang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, Tongji University School of Medicine, Shanghai, China
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China; School of Instrument Science and Engineering, Southeast University, Nanjing, 210096, PR China.
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Chou WC, Lin Z. Development of a Gestational and Lactational Physiologically Based Pharmacokinetic (PBPK) Model for Perfluorooctane Sulfonate (PFOS) in Rats and Humans and Its Implications in the Derivation of Health-Based Toxicity Values. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:37004. [PMID: 33730865 PMCID: PMC7969127 DOI: 10.1289/ehp7671] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND There is a great concern on potential adverse effects of exposure to perfluorooctane sulfonate (PFOS) in sensitive subpopulations, such as pregnant women, fetuses, and neonates, due to its reported transplacental and lactational transfer and reproductive and developmental toxicities in animals and humans. OBJECTIVES This study aimed to develop a gestational and lactational physiologically based pharmacokinetic (PBPK) model in rats and humans for PFOS to aid risk assessment in sensitive human subpopulations. METHODS Based upon existing PBPK models for PFOS, the present model addressed a data gap of including a physiologically based description of basolateral and apical membrane transporter-mediated renal reabsorption and excretion in kidneys during gestation and lactation. The model was calibrated with published rat toxicokinetic and human biomonitoring data and was independently evaluated with separate data. Monte Carlo simulation was used to address the interindividual variability. RESULTS Model simulations were generally within 2-fold of observed PFOS concentrations in maternal/fetal/neonatal plasma and liver in rats and humans. Estimated fifth percentile human equivalent doses (HEDs) based on selected critical toxicity studies in rats following U.S. Environmental Protection Agency (EPA) guidelines ranged from 0.08 to 0.91 μ g / kg per day . These values are lower than the HEDs estimated in U.S. EPA guidance (0.51 - 1.6 μ g / kg per day ) using an empirical toxicokinetic model in adults. CONCLUSIONS The results support the importance of renal reabsorption/excretion during pregnancy and lactation in PFOS dosimetry and suggest that the derivation of health-based toxicity values based on developmental toxicity studies should consider gestational/lactational dosimetry estimated from a life stage-appropriate PBPK model. This study provides a quantitative tool to aid risk reevaluation of PFOS, especially in sensitive human subpopulations, and it provides a basis for extrapolating to other per- and polyfluoroalkyl substances (PFAS). All model codes and detailed tutorials are provided in the Supplemental Materials to allow readers to reproduce our results and to use this model. https://doi.org/10.1289/EHP7671.
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Affiliation(s)
- Wei-Chun Chou
- Institute of Computational Comparative Medicine, Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Zhoumeng Lin
- Institute of Computational Comparative Medicine, Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
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Fenton SE, Ducatman A, Boobis A, DeWitt JC, Lau C, Ng C, Smith JS, Roberts SM. Per- and Polyfluoroalkyl Substance Toxicity and Human Health Review: Current State of Knowledge and Strategies for Informing Future Research. ENVIRONMENTAL TOXICOLOGY AND CHEMISTRY 2021; 40:606-630. [PMID: 33017053 PMCID: PMC7906952 DOI: 10.1002/etc.4890] [Citation(s) in RCA: 624] [Impact Index Per Article: 208.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/29/2020] [Accepted: 09/20/2020] [Indexed: 01/09/2023]
Abstract
Reports of environmental and human health impacts of per- and polyfluoroalkyl substances (PFAS) have greatly increased in the peer-reviewed literature. The goals of the present review are to assess the state of the science regarding toxicological effects of PFAS and to develop strategies for advancing knowledge on the health effects of this large family of chemicals. Currently, much of the toxicity data available for PFAS are for a handful of chemicals, primarily legacy PFAS such as perfluorooctanoic acid and perfluorooctane sulfonate. Epidemiological studies have revealed associations between exposure to specific PFAS and a variety of health effects, including altered immune and thyroid function, liver disease, lipid and insulin dysregulation, kidney disease, adverse reproductive and developmental outcomes, and cancer. Concordance with experimental animal data exists for many of these effects. However, information on modes of action and adverse outcome pathways must be expanded, and profound differences in PFAS toxicokinetic properties must be considered in understanding differences in responses between the sexes and among species and life stages. With many health effects noted for a relatively few example compounds and hundreds of other PFAS in commerce lacking toxicity data, more contemporary and high-throughput approaches such as read-across, molecular dynamics, and protein modeling are proposed to accelerate the development of toxicity information on emerging and legacy PFAS, individually and as mixtures. In addition, an appropriate degree of precaution, given what is already known from the PFAS examples noted, may be needed to protect human health. Environ Toxicol Chem 2021;40:606-630. © 2020 SETAC.
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Affiliation(s)
- Suzanne E. Fenton
- National Toxicology Program Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Alan Ducatman
- West Virginia University School of Public Health, Morgantown, West Virginia, USA
| | - Alan Boobis
- Imperial College London, London, United Kingdom
| | - Jamie C. DeWitt
- Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Christopher Lau
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Carla Ng
- Departments of Civil and Environmental Engineering and Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James S. Smith
- Navy and Marine Corps Public Health Center, Portsmouth, Virginia, USA
| | - Stephen M. Roberts
- Center for Environmental & Human Toxicology, University of Florida, Gainesville, Florida, USA
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Huang H, Yu K, Zeng X, Chen Q, Liu Q, Zhao Y, Zhang J, Zhang X, Huang L. Association between prenatal exposure to perfluoroalkyl substances and respiratory tract infections in preschool children. ENVIRONMENTAL RESEARCH 2020; 191:110156. [PMID: 32871147 DOI: 10.1016/j.envres.2020.110156] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/18/2020] [Accepted: 08/24/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND Prenatal exposure to perfluoroalkyl substances (PFAS) is considered to affect adversely the immune function. However, the effect of prenatal PFAS exposure on respiratory tract infections (RTIs) in children is unclear. Thus, we evaluated whether cord blood PFAS levels were associated with RTI in the first 5 years of life. METHODS The Shanghai Prenatal Cohort is an on-going birth cohort, which included all the mothers during pregnancy. Children were followed by paediatricians once a year after birth. The levels of 10 PFAS in cord blood were tested using liquid chromatography-mass spectrometry. RTIs were diagnosed based on face-to-face interviews with the parents and review of medical records. Immunoglobulin G (IgG) and immunoglobulin E (IgE) levels, as biomarkers of humoral immunity, were assessed using enzyme-linked immunosorbent assay at age 5 years. Multivariable logistic and linear regression models were applied to study the association between prenatal PFAS exposure and RTIs. RESULTS A total of 743 children completed the follow-up, 344 of them had detail information of cord blood PFAS, IgG, and IgE concentrations. Eight PFAS were detected in more than 90% of the cord blood samples, except for perfluoroheptanoic acid (PFHpA) and perfluorooctane sulfonamide (FOSA). During the 5-year follow-up period, the frequency of RTIs increased with age, reaching a peak at age 4. Moreover, 20.6% of the children were diagnosed with recurrent RTIs. Children with recurrent RTIs had higher prenatal perfluorobutane sulfonic acid (PFBS) concentration. Higher prenatal PFBS concentration was positively associated with total RTI frequency (β = 6.05, 95% CI [0.84, 11.26]) in first 5 years of life and negatively associated with IgG level (β = -0.82, 95% CI [-1.67, -0.01]) at age 5. CONCLUSIONS Children with higher prenatal PFBS were more vulnerable to RTIs in early life, which may be attributed to immunosuppression of IgG production. These findings need to be further verified in larger prospective studies.
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Affiliation(s)
- Heyu Huang
- Department of Pediatric Infectious Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kan Yu
- Department of Pediatric Infectious Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinxin Zeng
- Department of Pediatric Infectious Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Chen
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Quanhua Liu
- Department of Pediatric Respiratory Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanjun Zhao
- Department of Developmental Behavior Pediatrics & Child Primary Care, Children's Hospital of Shanghai Jiao Tong University, China
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Lisu Huang
- Department of Pediatric Infectious Disease, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Luo Y, Deji Z, Huang Z. Exposure to perfluoroalkyl substances and allergic outcomes in children: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2020; 191:110145. [PMID: 32877702 DOI: 10.1016/j.envres.2020.110145] [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: 02/22/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFASs) are persistent organic pollutants and widespread throughout the environment. Although exposure to PFASs may contribute to the development of allergic diseases in children, evidence about this association remains inconclusive. OBJECTIVE To conduct a systematic review and meta-analysis to assess the association between PFASs exposure and allergic diseases in children based on current evidence. METHODS The databases including PubMed, EMBASE, and Web of Science were searched to identify all observational studies that examined the association between PFASs exposure and the risk of childhood allergic diseases. The Newcastle-Ottawa Scale was used to evaluate the quality of case-crossover studies, and a previously validated quality assessment framework was used for observational studies lacking control groups. Random-effects meta-analysis models were applied to pool odds ratio (OR) with 95% confidence intervals (CIs). RESULTS From an initial 94 articles (after duplicate removal), 13 studies through full-text assessment were included for quantitative assessment and descriptive synthesis. They are ten cohort studies, two cross-sectional studies, and one case-control study. The pooled estimates showed that perfluorononanoic acid (PFNA) was associated with eczema (OR = 0.89, 95% CI = 0.80-0.99), perfluorooctanesulfonic acid (PFOS) with atopic dermatitis (OR = 1.26, 95% CI = 1.01-1.58), and perfluorooctanoic acid (PFOA) with allergic rhinitis (OR = 1.33, 95% CI = 1.13-1.56). However, no such significant associations were found for wheeze and asthma. CONCLUSIONS The meta-analysis results suggest that PFASs exposure could potentially be associated with eczema, atopic dermatitis, and allergic rhinitis during childhood, but not with childhood asthma or wheeze. Future studies are needed to verify these findings.
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Affiliation(s)
- Yuehua Luo
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, PR China
| | - Zhuoma Deji
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, PR China
| | - Zhenzhen Huang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, PR China.
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Steenland K, Fletcher T, Stein CR, Bartell SM, Darrow L, Lopez-Espinosa MJ, Barry Ryan P, Savitz DA. Review: Evolution of evidence on PFOA and health following the assessments of the C8 Science Panel. ENVIRONMENT INTERNATIONAL 2020; 145:106125. [PMID: 32950793 DOI: 10.1016/j.envint.2020.106125] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND The C8 Science Panel was composed of three epidemiologists charged with studying the possible health effects of PFOA in a highly exposed population in the mid-Ohio Valley. The Panel determined in 2012 there was a 'probable link' (i.e., more probable than not based on the weight of the available scientific evidence) between PFOA and high cholesterol, thyroid disease, kidney and testicular cancer, pregnancy-induced hypertension, and ulcerative colitis. OBJECTIVE Here, former C8 Science Panel members and collaborators comment on the PFOA literature regarding thyroid disorders, cancer, immune and auto-immune disorders, liver disease, hypercholesterolemia, reproductive outcomes, neurotoxicity, and kidney disease. We also discuss developments regarding fate and transport, and pharmacokinetic models, and discuss causality assessment in cross-sectional associations among low-exposed populations. DISCUSSION For cancer, the epidemiologic evidence remains supportive but not definitive for kidney and testicular cancers. There is consistent evidence of a positive association between PFOA and cholesterol, but no evidence of an association with heart disease. There is evidence for an association with ulcerative colitis, but not for other auto-immune diseases. There is good evidence that PFOA is associated with immune response, but uneven evidence for an association with infectious disease. The evidence for an association between PFOA and thyroid and kidney disease is suggestive but uneven. There is evidence of an association with liver enzymes, but not with liver disease. There is little evidence of an association with neurotoxicity. Suggested reductions in birthweight may be due to reverse causality and/or confounding. Fate and transport models and pharmacokinetic models remain central to estimating past exposure for new cohorts, but are difficult to develop without good historical data on emissions of PFOA into the environment. CONCLUSION Overall, the epidemiologic evidence remains limited. For a few outcomes there has been some replication of our earlier findings. More longitudinal research is needed in large populations with large exposure contrasts. Additional cross-sectional studies of low exposed populations may be less informative.
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Affiliation(s)
- Kyle Steenland
- 1518 Clifton Rd, Rollins School of Public Health, Emory U., Atlanta, GA 30324, United States.
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Cheryl R Stein
- Hassenfeld Children's Hospital at NYU Langone, NY, NY, United States
| | - Scott M Bartell
- Program in Public Health, University of California Irvine, Irvine, Cal, United States
| | | | - Maria-Jose Lopez-Espinosa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO, Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - P Barry Ryan
- 1518 Clifton Rd, Rollins School of Public Health, Emory U., Atlanta, GA 30324, United States
| | - David A Savitz
- Brown University School of Public Health, Providence, Rhode Island, United States
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Starling AP, Liu C, Shen G, Yang IV, Kechris K, Borengasser SJ, Boyle KE, Zhang W, Smith HA, Calafat AM, Hamman RF, Adgate JL, Dabelea D. Prenatal Exposure to Per- and Polyfluoroalkyl Substances, Umbilical Cord Blood DNA Methylation, and Cardio-Metabolic Indicators in Newborns: The Healthy Start Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:127014. [PMID: 33356526 PMCID: PMC7759236 DOI: 10.1289/ehp6888] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are environmentally persistent chemicals widely detected in women of reproductive age. Prenatal PFAS exposure is associated with adverse health outcomes in children. We hypothesized that DNA methylation changes may result from prenatal PFAS exposure and may be linked to offspring cardio-metabolic phenotype. OBJECTIVES We estimated associations of prenatal PFAS with DNA methylation in umbilical cord blood. We evaluated associations of methylation at selected sites with neonatal cardio-metabolic indicators. METHODS Among 583 mother-infant pairs in a prospective cohort, five PFAS were quantified in maternal serum (median 27 wk of gestation). Umbilical cord blood DNA methylation was evaluated using the Illumina HumanMethylation450 array. Differentially methylated positions (DMPs) were evaluated at a false discovery rate ( FDR ) < 0.05 and differentially methylated regions (DMRs) were identified using comb-p (Šidák-adjusted p < 0.05 ). We estimated associations between methylation at candidate DMPs and DMR sites and the following outcomes: newborn weight, adiposity, and cord blood glucose, insulin, lipids, and leptin. RESULTS Maternal serum PFAS concentrations were below the median for females in the U.S. general population. Moderate to high pairwise correlations were observed between PFAS concentrations (ρ = 0.28 - 0.76 ). Methylation at one DMP (cg18587484), annotated to the gene TJAP1, was associated with perfluorooctanoate (PFOA) at FDR < 0.05 . Comb-p detected between 4 and 15 DMRs for each PFAS. Associated genes, some common across multiple PFAS, were implicated in growth (RPTOR), lipid homeostasis (PON1, PON3, CIDEB, NR1H2), inflammation and immune activity (RASL11B, RNF39), among other functions. There was suggestive evidence that two PFAS-associated loci (cg09093485, cg09637273) were associated with cord blood triglycerides and birth weight, respectively (FDR < 0.1 ). DISCUSSION DNA methylation in umbilical cord blood was associated with maternal serum PFAS concentrations during pregnancy, suggesting potential associations with offspring growth, metabolism, and immune function. Future research should explore whether DNA methylation changes mediate associations between prenatal PFAS exposures and child health outcomes. https://doi.org/10.1289/EHP6888.
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Affiliation(s)
- Anne P. Starling
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cuining Liu
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Guannan Shen
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Ivana V. Yang
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Center for Genes, Environment and Health, National Jewish Health, Denver, Colorado, USA
| | - Katerina Kechris
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Sarah J. Borengasser
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kristen E. Boyle
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Weiming Zhang
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Harry A. Smith
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Antonia M. Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Richard F. Hamman
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - John L. Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Wang J, Pan Y, Wei X, Dai J. Temporal Trends in Prenatal Exposure (1998-2018) to Emerging and Legacy Per- and Polyfluoroalkyl Substances (PFASs) in Cord Plasma from the Beijing Cord Blood Bank, China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:12850-12859. [PMID: 32915549 DOI: 10.1021/acs.est.0c01877] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Due to developmental toxicity, prenatal exposure to per- and polyfluoroalkyl substances (PFASs) in animals may result in adverse effects on the fetus. However, little information is available on PFASs presence in the human cord plasma. Here, we measured the levels of 37 emerging and legacy PFASs in 650 cord plasma samples collected every 5 years spanning 1998 to 2018 by the Beijing Cord Blood Bank and evaluated changes in PFASs concentrations using generalized additive models. We observed an increase in the concentrations of 24 PFASs (Σ24PFASs) from 1998 to 2003 followed by a decrease every 5 years from 2003 to 2018. For legacy PFASs, similar trends were observed for PFOS, whereas PFOA levels did not decline until 2013. For emerging chemicals, 6:2 Cl-PFESA showed a similar trend as PFOS, and prenatal exposure to 6:2 Cl-PFESA could be traced back to 1998, with a median concentration of 0.411 ng/mL in plasma. Our data showed that prenatal exposure to legacy PFASs has gradually decreased in cord plasma from the Beijing Cord Blood Bank in recent years, and the discovery of the presence of emerging chemicals in 1998 suggested that further evaluation is needed to assess possible health risks to pregnant women and fetuses.
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Affiliation(s)
- Jinghua Wang
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yitao Pan
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Xiaofei Wei
- Beijing Cord Blood Bank, Beijing 100176, China
| | - Jiayin Dai
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
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Ait Bamai Y, Goudarzi H, Araki A, Okada E, Kashino I, Miyashita C, Kishi R. Effect of prenatal exposure to per- and polyfluoroalkyl substances on childhood allergies and common infectious diseases in children up to age 7 years: The Hokkaido study on environment and children's health. ENVIRONMENT INTERNATIONAL 2020; 143:105979. [PMID: 32717646 DOI: 10.1016/j.envint.2020.105979] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/27/2020] [Accepted: 07/12/2020] [Indexed: 05/22/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are widely used bio-accumulative chemicals in many industrial and household products. Experimental studies reported that exposure to PFAS results in immunotoxicity. We have previously reported that prenatal exposure to PFAS decreased the risk of allergies, while it increased the risk of infectious diseases at ages 2 and 4 years. However, it remains unclear whether the adverse effects of PFAS on allergies and infectious diseases continue until a reliable age of diagnosing allergies. This study aimed at investigating the effects of prenatal exposure to PFAS on the prevalence of allergies and infectious diseases in children up to age 7, from the Hokkaido Study. Among mother-child pairs enrolled in the Hokkaido study and followed up until the age of 7 years, 2689 participants with maternal PFAS, 1st trimester of pregnancy and 7-year-old questionnaire survey data were included in this study. Eleven PFAS in the 3rd-trimester plasma were measured using ultra-performance liquid chromatography coupled to triple quadrupole tandem mass spectrometry. Wheeze, rhino-conjunctivitis, and eczema were defined using the International Study of Asthma and Allergies on Childhood (ISAAC) questionnaire. History childhood infectious diseases diagnosed by a doctor was assessed by a mother-reported questionnaire at child's age 7. The relative risk of childhood allergies was calculated by generalized estimating equation models. The odds ratio of an episode of infectious diseases was calculated by logistic regression analysis, adjusted for potential confounders. The prevalence of various allergies and infectious diseases was: wheeze, 11.9%; rhino-conjunctivitis, 11.3%; eczema, 21.0%; chickenpox, 61.5%; otitis media, 55.7%; pneumonia, 30.6%; and respiratory syncytial virus infection, 16.8%. Prenatal exposure to perfluorooctanoic acid, perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA) was inversely associated with rhino-conjunctivitis, while that for perfluorooctanoate (PFOA), perfluorooctane sulfonate, PFUnDA, perfluorododecanoic acid (PFDoDA), and perfluorotridecanoic acid was inversely associated with eczema. For infectious diseases, PFDA and PFDoDA were associated with increased risk of pneumonia and PFOA was associated with increased risk of RSV infection among children not having any siblings (only-one-child). Our results corroborate the hypothesis on immunosuppressive and immunomodulating effects of PFAS on allergies and infectious diseases in children. These effects observed previously at 2 and 4 years continued until the age of 7 years. However, additional studies assessing inflammatory biomarkers along with ISAAC questionnaires, doctor-diagnosed allergies, and longer follow-ups are necessary to better assess the effects of exposure to chemicals on human immune outcomes.
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Affiliation(s)
- Yu Ait Bamai
- Hokkaido University, Center for Environmental and Health Sciences, Sapporo, Japan.
| | - Houman Goudarzi
- Hokkaido University, Center for Environmental and Health Sciences, Sapporo, Japan; Hokkaido University Center for Medical Education and International Relations, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Atsuko Araki
- Hokkaido University, Center for Environmental and Health Sciences, Sapporo, Japan
| | - Emiko Okada
- Hokkaido University, Center for Environmental and Health Sciences, Sapporo, Japan; National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Ikuko Kashino
- Hokkaido University, Center for Environmental and Health Sciences, Sapporo, Japan
| | - Chihiro Miyashita
- Hokkaido University, Center for Environmental and Health Sciences, Sapporo, Japan
| | - Reiko Kishi
- Hokkaido University, Center for Environmental and Health Sciences, Sapporo, Japan.
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Schrenk D, Bignami M, Bodin L, Chipman JK, del Mazo J, Grasl‐Kraupp B, Hogstrand C, Hoogenboom L(R, Leblanc J, Nebbia CS, Nielsen E, Ntzani E, Petersen A, Sand S, Vleminckx C, Wallace H, Barregård L, Ceccatelli S, Cravedi J, Halldorsson TI, Haug LS, Johansson N, Knutsen HK, Rose M, Roudot A, Van Loveren H, Vollmer G, Mackay K, Riolo F, Schwerdtle T. Risk to human health related to the presence of perfluoroalkyl substances in food. EFSA J 2020; 18:e06223. [PMID: 32994824 PMCID: PMC7507523 DOI: 10.2903/j.efsa.2020.6223] [Citation(s) in RCA: 217] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The European Commission asked EFSA for a scientific evaluation on the risks to human health related to the presence of perfluoroalkyl substances (PFASs) in food. Based on several similar effects in animals, toxicokinetics and observed concentrations in human blood, the CONTAM Panel decided to perform the assessment for the sum of four PFASs: PFOA, PFNA, PFHxS and PFOS. These made up half of the lower bound (LB) exposure to those PFASs with available occurrence data, the remaining contribution being primarily from PFASs with short half-lives. Equal potencies were assumed for the four PFASs included in the assessment. The mean LB exposure in adolescents and adult age groups ranged from 3 to 22, the 95th percentile from 9 to 70 ng/kg body weight (bw) per week. Toddlers and 'other children' showed a twofold higher exposure. Upper bound exposure was 4- to 49-fold higher than LB levels, but the latter were considered more reliable. 'Fish meat', 'Fruit and fruit products' and 'Eggs and egg products' contributed most to the exposure. Based on available studies in animals and humans, effects on the immune system were considered the most critical for the risk assessment. From a human study, a lowest BMDL 10 of 17.5 ng/mL for the sum of the four PFASs in serum was identified for 1-year-old children. Using PBPK modelling, this serum level of 17.5 ng/mL in children was estimated to correspond to long-term maternal exposure of 0.63 ng/kg bw per day. Since accumulation over time is important, a tolerable weekly intake (TWI) of 4.4 ng/kg bw per week was established. This TWI also protects against other potential adverse effects observed in humans. Based on the estimated LB exposure, but also reported serum levels, the CONTAM Panel concluded that parts of the European population exceed this TWI, which is of concern.
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Timmermann CAG, Jensen KJ, Nielsen F, Budtz-Jørgensen E, van der Klis F, Benn CS, Grandjean P, Fisker AB. Serum Perfluoroalkyl Substances, Vaccine Responses, and Morbidity in a Cohort of Guinea-Bissau Children. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:87002. [PMID: 32772733 PMCID: PMC7416537 DOI: 10.1289/ehp6517] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) are a group of widely used persistent chemicals with suspected immunotoxic effects. OBJECTIVES The present study aimed to examine the association between infant PFAS exposure and antibody responses to measles vaccination as well as morbidity in a low-income country. METHODS In a randomized controlled trial, children from Guinea-Bissau, West Africa, were followed from inclusion (4-7 months of age) through 2 years of age. Half the children received two measles vaccinations (at inclusion and at 9 months of age), and the other half received only one (at 9 months of age). In a subset of 237 children, six PFAS were quantified in serum at inclusion, and measles antibody concentrations were assessed at inclusion and at approximately 9 months and 2 years of age. At inclusion and at the 9-month visit, mothers were interviewed about infant morbidity. RESULTS All but one child had detectable serum concentrations of all six PFAS, although levels were lower than seen elsewhere. A doubling in perfluorooctane sulfonic acid (PFOS) and perfluorodecanoic acid (PFDA) were associated with 21% (95% CI: 2, 37%) and 25% (95% CI: 1, 43%), respectively, lower measles antibody concentrations at the 9-month visit among the children who had received a measles vaccine at inclusion. Elevated serum PFAS concentrations were also associated with reduced prevaccination measles antibody concentrations and increased morbidity. DISCUSSION The present study documents that PFAS exposure has reached West Africa and that infants show PFAS-associated increases in morbidity and decreases in measles-specific antibody concentrations before and after vaccination. These findings support the evidence on PFAS immunotoxicity at comparatively low serum concentrations. https://doi.org/10.1289/EHP6517.
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Affiliation(s)
| | - Kristoffer Jarlov Jensen
- Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark
- Experimental and Translational Immunology, Department of Health Technology, Technical University of Denmark, Kgs Lyngby, Denmark
| | - Flemming Nielsen
- Research Unit of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | | | - Fiona van der Klis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Christine Stabell Benn
- Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark
- Open Patient data Explorative Network, University of Southern Denmark/Odense University Hospital, Odense, Denmark
| | - Philippe Grandjean
- Research Unit of Environmental Medicine, University of Southern Denmark, Odense, Denmark
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ane Bærent Fisker
- Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark
- Open Patient data Explorative Network, University of Southern Denmark/Odense University Hospital, Odense, Denmark
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau
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48
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Jackson-Browne MS, Eliot M, Patti M, Spanier AJ, Braun JM. PFAS (per- and polyfluoroalkyl substances) and asthma in young children: NHANES 2013-2014. Int J Hyg Environ Health 2020; 229:113565. [PMID: 32485600 DOI: 10.1016/j.ijheh.2020.113565] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/11/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are a class of persistent chemicals used as industrial surfactants, fire-fighting foams, and textile treatments. Early childhood exposure to perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) may affect the immune system to increase the risk of allergic and respiratory diseases. However, there are substantial gaps in our knowledge about the relationship between PFAS and immune-mediated outcomes such as asthma in children. Thus, we examined the cross-sectional associations of serum PFOA, PFOS, PFNA, and PFHxS concentrations with childhood asthma. We used data from children aged 3-11 years who participated in the National Health and Nutrition Examination Survey (2013-2014). Serum PFAS concentrations were measured in serum using analytical chemistry methods. Asthma was assessed by parent-reported, doctor-diagnosed, asthma using a standardized questionnaire. Controlling for covariates, we estimated odds ratios for asthma per standard deviation increase in ln-transformed serum PFAS concentrations (n = 607). We also examined effect measure modification by child age, sex, and race/ethnicity. PFOA (1.1; 95% CI: 0.8, 1.4), PFOS (1.2; 95% CI: 0.8, 1.7), PFNA (1.1; 95% CI: 0.8, 1.6), and PFHxS (1.1; 95% CI: 0.9, 1.6) were weakly associated with an increased odds of asthma. Age modified associations between serum PFOS, but not other serum PFAS concentrations, and odds of asthma (age x PFOS interaction term p-value = 0.03). Sex and race/ethnicity did not modify these associations. We observed some evidence that serum PFAS concentrations are weakly associated with increased asthma prevalence in US children.
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Affiliation(s)
| | - Melissa Eliot
- Department of Epidemiology, Brown University, Providence, RI, United States
| | - Marisa Patti
- Department of Epidemiology, Brown University, Providence, RI, United States
| | - Adam J Spanier
- Department of Pediatrics, Division of General Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, United States
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Per- and polyfluoroalkyl substances (PFASs) modify lung surfactant function and pro-inflammatory responses in human bronchial epithelial cells. Toxicol In Vitro 2020; 62:104656. [DOI: 10.1016/j.tiv.2019.104656] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/27/2019] [Accepted: 09/15/2019] [Indexed: 12/25/2022]
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50
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Averina M, Hervig T, Huber S, Kjær M, Kristoffersen EK, Bolann B. Environmental pollutants in blood donors: The multicentre Norwegian donor study. Transfus Med 2020; 30:201-209. [DOI: 10.1111/tme.12662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Maria Averina
- Department of Laboratory MedicineUniversity Hospital of North Norway Tromsø Norway
- Department of Community Medicine, Faculty of Health SciencesUiT The Arctic University of Norway Tromsø Norway
| | - Tor Hervig
- Department of Clinical ScienceUniversity of Bergen, Norway
- Laboratory of Immunology and Transfusion MedicineHaugesund Hospital Haugesund Norway
| | - Sandra Huber
- Department of Laboratory MedicineUniversity Hospital of North Norway Tromsø Norway
| | | | - Einar K. Kristoffersen
- Department of Clinical ScienceUniversity of Bergen, Norway
- Department of Immunology and Transfusion MedicineHaukeland University Hospital Bergen Norway
| | - Bjørn Bolann
- Department of Clinical ScienceUniversity of Bergen, Norway
- Department of Medical Biochemistry and PharmacologyHaukeland University Hospital Bergen Norway
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