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Jung KJ, Cho J, Yang MJ, Hwang JH, Song J. Exposure to polyhexamethyleneguanidine phosphate in early life dampens pulmonary damage compared to adult mice. Chem Biol Interact 2024; 399:111134. [PMID: 38969276 DOI: 10.1016/j.cbi.2024.111134] [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: 03/07/2024] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
Polyhexamethyleneguanidine phosphate (PHMG-P) is a biocide of guanidine family that can cause a fatal lung damage if exposed directly to the lungs. No reports exist regarding the toxicity of PHMG-P in neonatal animals. Therefore, this study aimed to determine PHMG-P toxicity in neonatal and 8-week-old mice after they were intranasally instilled with 1.5 mg/kg, 3 mg/kg, and 4.5 mg/kg PHMG-P. PHMG-P lung exposure resulted in more severe pulmonary toxicity in adult mice than in newborn mice. In the high-dose group of newborn mice, a minimal degree of inflammatory cell infiltration and fibrosis in the lung were detected, whereas more severe pathological lesions including granulomatous inflammation, fibrosis, and degeneration of the bronchiolar epithelium were observed in adult mice. At day 4, C-C motif chemokine ligand 2 (CCL2), a potent chemokine for monocytes, was upregulated but recovered to normal levels at day 15 in newborn mice. However, increased CCL2 and IL-6 levels were sustained at day 15 in adult mice. When comparing the differentially expressed genes of newborn and adult mice through RNA-seq analysis, there were expression changes in several genes associated with inflammation in neonates that were similar or different from those in adults. Although no significant lung damage occurred in newborns, growth inhibition was observed which was not reversed until the end of the experiment. Further research is needed to determine how growth inhibition from neonatal exposure to PHMG-P affects adolescent and young adult health.
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Affiliation(s)
- Kyung Jin Jung
- Immunotoxicology Research Group, Korea Institute of Toxicology, Daejeon, 34114, Republic of Korea
| | - Jeonghee Cho
- Center for Vascular Research, Institute for Basci Science, Daejeon, 34126, Republic of Korea
| | - Mi-Jin Yang
- Jeonbuk Pathology Research Group, Korea Institute of Toxicology, Jeonbuk, 56212, Republic of Korea
| | - Jeong Ho Hwang
- Animal Model Research Group, Korea Institute of Toxicology, Jeongeup, 56212, Republic of Korea
| | - Jeongah Song
- Animal Model Research Group, Korea Institute of Toxicology, Jeongeup, 56212, Republic of Korea.
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Kim D, Shin Y, Park JI, Lim D, Choi H, Choi S, Baek YW, Lim J, Kim Y, Kim HR, Chung KH, Bae ON. A systematic review and BMD modeling approach to develop an AOP for humidifier disinfectant-induced pulmonary fibrosis and cell death. CHEMOSPHERE 2024:143010. [PMID: 39098349 DOI: 10.1016/j.chemosphere.2024.143010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 08/06/2024]
Abstract
Dosimetry modeling and point of departure (POD) estimation using in vitro data are essential for mechanism-based hazard identification and risk assessment. This study aimed to develop a putative adverse outcome pathway (AOP) for humidifier disinfectant (HD) substances used in South Korea through a systematic review and benchmark dose (BMD) modeling. We collected in vitro toxicological studies on HD substances, including polyhexamethylene guanidine hydrochloride (PHMG-HCl), PHMG phosphate (PHMG-p), a mixture of 5-chloro-2-methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one (CMIT/MIT), CMIT, and MIT from scientific databases. A total of 193 sets of dose-response data were extracted from 34 articles reporting in vitro experimental results of HD toxicity. The risk of bias (RoB) in each study was assessed following the office of health assessment and translation (OHAT) guideline. The BMD of each HD substance at different toxicity endpoints was estimated using the US Environmental Protection Agency (EPA) BMD software (BMDS). Interspecies- or interorgan differences or most critical effects in the toxicity of the HD substances were analyzed using a 95% lower confidence limit of the BMD (BMDL). We found a critical molecular event and cells susceptible to each HD substance and constructed an AOP of PHMG-p- or CMIT/MIT-induced damage. Notably, PHMG-p induced ATP depletion at the lowest in vitro concentration, endoplasmic reticulum (ER) stress, epithelial-to-mesenchymal transition (EMT), inflammation, leading to fibrosis. CMIT/MIT enhanced mitochondrial reactive oxygen species (ROS) production, oxidative stress, mitochondrial dysfunction, resulting in cell death. Our approach will increase the current understanding of the effects of HD substances on human health and contribute to evidence-based risk assessment of these compounds.
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Affiliation(s)
- Donghyun Kim
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University ERICA Campus, Ansan, South Korea
| | - Yusun Shin
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University ERICA Campus, Ansan, South Korea
| | - Jong-In Park
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University ERICA Campus, Ansan, South Korea
| | - Donghyeon Lim
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University ERICA Campus, Ansan, South Korea
| | - Hyunjoon Choi
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University ERICA Campus, Ansan, South Korea
| | - Seongwon Choi
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University ERICA Campus, Ansan, South Korea
| | - Yong-Wook Baek
- Humidifier Disinfectant Health Center, Environmental Health Research, National Institute of Envrironmental Research, Incheon 22689, Republic of Korea
| | - Jungyun Lim
- Humidifier Disinfectant Health Center, Environmental Health Research, National Institute of Envrironmental Research, Incheon 22689, Republic of Korea
| | - Younghee Kim
- Humidifier Disinfectant Health Center, Environmental Health Research, National Institute of Envrironmental Research, Incheon 22689, Republic of Korea
| | - Ha Ryong Kim
- College of Pharmacy, Korea University, Sejong, South Korea
| | - Kyu Hyuck Chung
- College of Pharmacy, Kyungsung University, Busan, South Korea
| | - Ok-Nam Bae
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University ERICA Campus, Ansan, South Korea.
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Kim C, Jeong SH, Lee H, Nam YJ, Lee H, Choi JY, Lee YS, Kim J, Park YH, Lee JH. Subchronic particulate matter exposure underlying polyhexamethylene guanidine phosphate-induced lung injury: Quantitative and qualitative evaluation with chest computed tomography. Heliyon 2024; 10:e34562. [PMID: 39113974 PMCID: PMC11305277 DOI: 10.1016/j.heliyon.2024.e34562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
Our study was to explore the effects of subchronic particulate matter (PM) exposure on lung injury induced by polyhexamethylene guanidine phosphate (PHMG-p) in a rat model. Specifically, we investigated pulmonary inflammation, fibrosis, and tumor formation using chest computed tomography (CT), and histopathologic examination. PHMG-p was administered intratracheally to 20 male rats. After an initial week of PHMG-p treatment, the experimental group (PM group) received intratracheal administration of PM suspension, while the control group received normal saline. This regimen was continued for 10 weeks to induce subchronic PM exposure. Chest CT scans were conducted on all rats, followed by the extraction of both lungs for histopathological analysis. All CT images underwent comprehensive quantitative and qualitative analyses. Pulmonary inflammation was markedly intensified in rats subjected to subchronic PM exposure in the PM group compared to those in the control. Similarly, lung fibrosis was more severe in the PM group as observed on both chest CT and histopathologic examination. Quantitative chest CT analysis revealed that the mean lesion volume was significantly greater in the PM group than in the control group. Although the incidence of bronchiolo-alveolar hyperplasia was higher in the PM group compared to the control group, this difference was not statistically significant. In summary, subchronic PM exposure exacerbated pulmonary inflammation and fibrosis underlying lung injury induced by PHMG-p.
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Affiliation(s)
- Cherry Kim
- Department of Radiology, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Sang Hoon Jeong
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Hong Lee
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Yoon Jeong Nam
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Hyejin Lee
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Jin Young Choi
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Yu-Seon Lee
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Jaeyoung Kim
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Yoon Hee Park
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
| | - Ju-Han Lee
- Department of Pathology, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, South Korea
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Lee S, Kim SY, Kwon E, Choi S, Jung DM, Kim KK, Kim EM. A novel G3BP1-GFP reporter human lung cell system enabling real-time monitoring of stress granule dynamics for in vitro lung toxicity assessment. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 269:115755. [PMID: 38039847 DOI: 10.1016/j.ecoenv.2023.115755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 12/03/2023]
Abstract
Under various cellular stress conditions, including exposure to toxic chemicals, RNA-binding proteins (RBPs), including Ras GTPase-activating protein-binding protein 1 (G3BP1), aggregate and form stress granule complexes, which serve as hallmarks of cellular stress. The existing methods for analyzing stress granule assembly have limitations in the rapid detection of dynamic cellular stress and ignore the effects of constitutively overexpressed RBP on cellular stress and stress-related processes. Therefore, to overcome these limitations, we established a G3BP1-GFP reporter in a human lung epithelial cell line using CRISPR/Cas9-based knock-in as an alternative system for stress granule analysis. We showed that the G3BP1-GFP reporter system responds to stress conditions and forms a stress granule complex similar to that of native G3BP1. Furthermore, we validated the stress granule response of an established cell line under exposure to various household chemicals. Overall, this novel G3BP1-GFP reporter human lung cell system is capable of monitoring stress granule dynamics in real time and can be used for assessing the lung toxicity of various substances in vitro.
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Affiliation(s)
- Sangsoo Lee
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon 34134, South Korea
| | - Seung-Yeon Kim
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon 34134, South Korea; Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, South Korea
| | - Eunhye Kwon
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon 34134, South Korea
| | - Sunkyung Choi
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon 34134, South Korea
| | - Da-Min Jung
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon 34134, South Korea
| | - Kee K Kim
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon 34134, South Korea.
| | - Eun-Mi Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, South Korea.
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Zhang J, Jiang X, Li X, Sun H, Wang M, Zhang W, Li H, Wang H, Zhuang M, Zhang L, Lu L, Tang J. Pulmonary Toxicity Assessment after a Single Intratracheal Inhalation of Chlorhexidine Aerosol in Mice. TOXICS 2023; 11:910. [PMID: 37999562 PMCID: PMC10675078 DOI: 10.3390/toxics11110910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023]
Abstract
Guanidine disinfectants are important chemical agents with a broad spectrum of activity that are effective against most microorganisms. Chlorhexidine, one of the most used guanidine disinfectants, is added to shampoo and mouthwash and applied in medical device sterilization. During the use of chlorhexidine, aerosols with micron particle size may be formed, which may cause inhalation toxicity. To assess the toxicity of inhaled chlorhexidine aerosol, mice underwent the intratracheal instillation of different concentrations of chlorhexidine (0, 0.125%, 0.25%, 0.5%, and 1%) using a MicroSprayer Aerosolizer. The mice were exposed for eight weeks and then sacrificed to obtain lung tissue for subsequent experiments. Histopathology staining revealed damaged lung tissues and increased collagen exudation. At the same time, pulmonary function tests showed that chlorhexidine exposure could cause restrictive ventilatory dysfunction, consistent with pulmonary fibrosis. The results of transcriptome analyses suggest that chlorhexidine may trigger an inflammatory response and promote the activation of pathways related to extracellular matrix deposition. Further, we identified that chlorhexidine exposure might enhance mucus secretion by up-regulating Muc5b and Muc5ac genes, thereby inducing fibrosis-like injury. These findings underscore the need for standardized use of disinfectants and the assessment of their inhalation toxicity.
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Affiliation(s)
- Jianzhong Zhang
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China; (J.Z.); (X.J.); (L.Z.)
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - Xinmin Jiang
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China; (J.Z.); (X.J.); (L.Z.)
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - Xin Li
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - He Sun
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - Mingyue Wang
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - Wanjun Zhang
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - Haonan Li
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - Hongmei Wang
- Department of Respiratory Medicine, Affiliated Hospital of Medical College of Qingdao University, Qingdao 266021, China; (H.W.); (M.Z.)
| | - Min Zhuang
- Department of Respiratory Medicine, Affiliated Hospital of Medical College of Qingdao University, Qingdao 266021, China; (H.W.); (M.Z.)
| | - Lin Zhang
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China; (J.Z.); (X.J.); (L.Z.)
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - Lin Lu
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China; (J.Z.); (X.J.); (L.Z.)
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
| | - Jinglong Tang
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China; (J.Z.); (X.J.); (L.Z.)
- Department of Environmental and Occupational Health, School of Public Health, Qingdao University, Qingdao 266071, China; (X.L.); (H.S.); (M.W.); (W.Z.); (H.L.)
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Hong M, Ju MJ, Yoon J, Lee W, Lee S, Jo EK, Choi SY, Yang W, Choi YH. Exposures to humidifier disinfectant and various health conditions in Korean based on personal exposure assessment data of claimants for compensation. BMC Public Health 2023; 23:1800. [PMID: 37779205 PMCID: PMC10544189 DOI: 10.1186/s12889-023-16389-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/25/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Humidifier disinfectants (HDs) were commonly used household chemicals to prevent microbial growth in a humidifier water tank in South Korea. A growing body of evidence has indicated that its airborne exposure can induce severe lung injury. However, there has been low awareness of other health outcomes in HD users. This study aimed to evaluate health conditions appealed by claimants for compensation in relation with an increased exposure to HD. METHODS From survey data of personal HD exposure assessment of claimants for compensation in Korea, we included a total of 4,179 subjects [cases in each dataset were defined by nine reported health conditions, i.e., pneumonia, asthma, cardiovascular disease, respiratory disease, otorhinolaryngologic disease, brain disease (including cerebrovascular disease), dermatological disease, lung cancer, and all cancers]. HD exposures was considered as the following exposure criteria: exposure duration, exposure proximity, exposure direction, chemical type, cumulative exposure time, indoor air concentration, and cumulative exposure level. Logistic regression models were used to evaluate the associations between HD exposure and health conditions. RESULTS After adjusting for sociodemographic and health behavioral factors and other chemical exposures (households, environmental, and occupational exposures), an increase in cumulative HD exposure time was significantly associated with risks of all nine diseases (all p-trends < 0.05). An increase in HD exposure duration was associated with asthma, respiratory disease, otorhinolaryngologic disease, dermatological disease, all cancers, and lung cancer (p-trends < 0.05). Indoor HD concentration was associated with only pneumonia (p-trend = 0.015). CONCLUSIONS Our findings suggest that cumulative exposures to airborne HD might potentially increase the risk of various reported health outcomes.
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Affiliation(s)
- Myeongjin Hong
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Min Jae Ju
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- School of Health and Environmental Science, College of Health Science, Korea University, 145 Anam-Ro, Seongbuk-Gu, 02841, Seoul, Republic of Korea
| | - Jeonggyo Yoon
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Wonyoung Lee
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Seula Lee
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Korean Society of Environmental Health, Seoul, Korea
| | - Eun-Kyung Jo
- Korean Society of Environmental Health, Seoul, Korea
| | - Seo-Youn Choi
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wonho Yang
- Department of Occupational Health, Daegu Catholic University, Gyeongbuk, Korea
| | - Yoon-Hyeong Choi
- School of Health and Environmental Science, College of Health Science, Korea University, 145 Anam-Ro, Seongbuk-Gu, 02841, Seoul, Republic of Korea.
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Kim JW, Jeong MH, Yu HT, Park YJ, Kim HS, Chung KH. Fibrinogen on extracellular vesicles derived from polyhexamethylene guanidine phosphate-exposed mice induces inflammatory effects via integrin β. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 252:114600. [PMID: 36736230 DOI: 10.1016/j.ecoenv.2023.114600] [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: 10/28/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
Polyhexamethylene guanidine phosphate (PHMG-p), used as a humidifier disinfectant, causes interstitial lung disease, obliterative bronchiolitis, and lung fibrosis; however, little is known about its effect on intercellular interactions. Extracellular vesicles (EVs), which carry diverse compounds including proteins, RNA, and DNA to mediate cell-to-cell communication through their paracrine effects, have been highlighted as novel factors in lung fibrogenesis. This study aimed to identify the effect of proteins on small EVs (sEVs) from bronchoalveolar lavage fluid (BALF) of the recipient cells after PHMG-p exposure. A week after intratracheal administration of PHMG-p, sEVs were isolated from BALF of tissue showing overexpressed inflammatory and fibrosis markers. To investigate the role of sEVs in inflammation, naïve macrophages were cultured with sEVs, which induced their activation. To identify sEV proteins that are associated with these responses, proteomics analysis was performed. In the gene ontology analysis, coagulation, fibrinolysis, and hemostasis were associated with the upregulated proteins in sEVs. The highest increase was observed in fibrinogen levels, which was also related to those gene ontologies. We validated role of exosomal fibrinogen in inflammation using recombinant fibrinogen and an inhibitor of the integrin, which is the binding receptor for fibrinogen. Overall, we elucidated that increased fibrinogen levels in the early sEVs-PHMG activated inflammatory response during early fibrosis. These results suggest that sEVs from the BALF of PHMG-p-exposed mice could aggravate fibrogenesis by activating naïve macrophages via various proteins in the sEVs, Furthermore, this finding will be broadening the spectrum of communicating mediators.
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Affiliation(s)
- Jun Woo Kim
- Sungkyunkwan University, School of Pharmacy, Suwon, Gyeonggi-do 16419, Republic of Korea
| | - Mi Ho Jeong
- Massachusetts General Hospital, Center for Systems Biology, Boston, MA 02114, USA
| | - Hyeong Tae Yu
- Sungkyunkwan University, School of Pharmacy, Suwon, Gyeonggi-do 16419, Republic of Korea
| | - Yong Joo Park
- Kyungsung University, College of Pharmacy, Busan 48434, Republic of Korea
| | - Hyung Sik Kim
- Sungkyunkwan University, School of Pharmacy, Suwon, Gyeonggi-do 16419, Republic of Korea.
| | - Kyu Hyuck Chung
- Sungkyunkwan University, School of Pharmacy, Suwon, Gyeonggi-do 16419, Republic of Korea.
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Yang HS, Yang M, Kang M, Kim B, Lee K. Inhalation toxicity of polyhexamethylene guanidine-phosphate in rats: A 4-week inhalation exposure and 24-week recovery period study. CHEMOSPHERE 2023; 312:137232. [PMID: 36379427 DOI: 10.1016/j.chemosphere.2022.137232] [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: 07/01/2022] [Revised: 10/12/2022] [Accepted: 11/10/2022] [Indexed: 06/16/2023]
Abstract
Humidifier disinfectant (HD) is a causative agent of atypical lung injury reported in 2011 in South Korea, and various diseases caused by HD after exposure cessation have been reported to date. However, there is limited research on most of the reported diseases in terms of their association with HD exposure, and information on the progression of diseases caused by HD exposure is also limited. Therefore, we investigated the effects of HD inhalation on the body in rats. Rats were exposed to 0.15, 0.50, and 1.60 mg/m3 polyhexamethylene guanidine-phosphate (PHMG-p), which is the major component of HDs and most closely related to HD-associated lung injury. We conducted necropsy four times during the recovery period (0, 4, 12, and 24 weeks) and evaluated general systemic toxicities. There were significant changes in the mortality rate, body weight, and food consumption in the PHMG-p-exposed groups. Hematology revealed changes in hemoglobin level, hematocrit, red blood cell, reticulocyte, and white blood cell counts until 12 weeks of the recovery period. PHMG-p induced a delay in prothrombin time until 12 weeks of the recovery period. The aspartate aminotransferase, alanine aminotransferase, total bilirubin, and triglyceride levels were higher in the PHMG-p-exposed groups than in the control group at week 4 of the recovery period, and these parameters normalized after 12 weeks of the recovery period. Histopathological examination in PHMG-p exposed groups revealed several changes in the lungs, including the presence of alveolar macrophages, chronic inflammation, squamous metaplasia, alveolar emphysema, and pulmonary fibrosis. The severity of these symptoms was maintained or exacerbated till 24 weeks. Overall, PHMG-p inhalation can induce irreversible histological changes in the lungs and cause various types of damage throughout the body, even after exposure ends.
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Affiliation(s)
- Hyo-Seon Yang
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup, Jeollabuk-do 56212, Republic of Korea; Biosafety Research Institute and Laboratory of Pathology, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Jeollabuk do, Republic of Korea.
| | - Mijin Yang
- Jeonbuk Pathology Research Group, Korea Institute of Toxicology, Jeongeup, Jeollabuk-do 56212, Republic of Korea.
| | - Mihyun Kang
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup, Jeollabuk-do 56212, Republic of Korea.
| | - Bumseok Kim
- Biosafety Research Institute and Laboratory of Pathology, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Jeollabuk do, Republic of Korea.
| | - Kyuhong Lee
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup, Jeollabuk-do 56212, Republic of Korea; Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Republic of Korea.
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Choi YJ, Yang HS, Zhang Y, Lee W, Yun SH, Nam YA, Lee G, Jung BH, Chang TS, Lee K, Lee BH. Intratracheal exposure to polyhexamethylene guanidine phosphate disrupts coordinate regulation of FXR-SHP-mediated cholesterol and bile acid homeostasis in mouse liver. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 247:114213. [PMID: 36306612 DOI: 10.1016/j.ecoenv.2022.114213] [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: 07/27/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
A public health crisis in the form of a significant incidence of fatal pulmonary disease caused by repeated use of humidifier disinfectants containing polyhexamethylene guanidine phosphate (PHMG) recently arose in Korea. Although the mechanisms of pulmonary fibrosis following respiratory exposure to PHMG are well described, distant-organ effect has not been reported. In this study, we investigated whether intratracheal administration of PHMG affects liver pathophysiology and metabolism. Our PHMG mouse model showed a significant decrease in liver cholesterol level. An mRNA-seq analysis of liver samples revealed an alteration in the gene expression associated with cholesterol biosynthesis and metabolism to bile acids. The expression of genes involved in cholesterol synthesis was decreased in a real-time PCR analysis. To our surprise, we found that the coordinate regulation of cholesterol and bile acid homeostasis was completely disrupted. Despite the decreased cholesterol synthesis and low bile acid levels, the farnesoid X receptor/small heterodimer partner pathway, which controls negative feedback of bile acid synthesis, was activated in PHMG mice. As a consequence, gene expression of Cyp7a1 and Cyp7b1, the rate-limiting enzymes of the classical and alternative pathways of bile acid synthesis, was significantly downregulated. Notably, the changes in gene expression were corroborated by the hepatic concentrations of the bile acids. These results suggest that respiratory exposure to PHMG could cause cholestatic liver injury by disrupting the physiological regulation of hepatic cholesterol and bile acid homeostasis.
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Affiliation(s)
- You-Jin Choi
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Hyo-Seon Yang
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup, Republic of Korea; College of Veterinary Medicine, Jeonbuk University, Iksan, Republic of Korea
| | - Yunfan Zhang
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Wonseok Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Sung Ho Yun
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Yoon Ah Nam
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Gakyung Lee
- Department of Integrative Biological Sciences and Industry, Sejong University, Seoul, Republic of Korea; Center for Advanced Biomolecular Recognition, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea
| | - Byung Hwa Jung
- Center for Advanced Biomolecular Recognition, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea; Division of Bio-Medical Science and Technology, KIST School, Korea University of Science and Technology (UST), Seoul, Republic of Korea
| | - Tong-Shin Chang
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Kyuhong Lee
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup, Republic of Korea; Human and Environmental Toxicology, University of Science and Technology, Daejeon, Republic of Korea.
| | - Byung-Hoon Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
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10
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Kim J, Baek YW, Kim C, Nam YJ, Lee YS, Lee H, Kang JY, Lee H, Choi JY, Park YH, Park SA, Park EK, Jeong SH, Lee JH. Evaluating the comparative MT1B, MT1F, MT1G, and MT1H expression in human pulmonary alveolar epithelial cells treated with polyhexamethylene guanidine-phosphate, chloromethylisothiazolinone/methylisothiazolinone, oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride, benzalkonium chloride, and sodium dichloroisocyanurate. Mol Cell Toxicol 2022. [DOI: 10.1007/s13273-022-00311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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11
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Gene expression related to lung cancer altered by PHMG-p treatment in PBTE cells. Mol Cell Toxicol 2022. [DOI: 10.1007/s13273-022-00319-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Song JH, Ahn J, Park MY, Park J, Lee YM, Myong JP, Koo JW, Lee J. Health Effects Associated With Humidifier Disinfectant Use: A Systematic Review for Exploration. J Korean Med Sci 2022; 37:e257. [PMID: 35996934 PMCID: PMC9424740 DOI: 10.3346/jkms.2022.37.e257] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/29/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND It has been 10 years since the outbreak of lung disease caused by humidifier disinfectants in Korea, but the health effects have not yet been summarized. Therefore, this study aims to systematically examine the health effects of humidifier disinfectants that have been discovered so far. METHODS All literature with humidifier disinfectants and their representative components as the main words were collected based on the web, including PubMed, Research Information Sharing Service, and government publication reports. A total of 902 studies were searched, of which 196 were selected. They were divided into four groups: published human studies (group 1), published animal and cytotoxicology studies (group 2), technical reports (group 3), and gray literature (group 4). RESULTS Out of the 196 studies, 97 (49.5%) were published in peer-reviewed journals as original research. Group 1 consisted of 49 articles (50.5%), while group 2 consisted of 48 articles (49.5%). Overall, respiratory diseases such as humidifier disinfectant associated lung injury, interstitial lung disease, and asthma have a clear correlation, but other effects such as liver, heart, thymus, thyroid, fetal growth, metabolic abnormalities, and eyes are observed in toxicological experimental studies, but have not yet been identified in epidemiologic studies. CONCLUSION The current level of evidence does not completely rule out the effects of humidifier disinfectants on extrapulmonary disease. Based on the toxicological evidence so far, it is required to monitor the population of humidifier disinfectant exposure continuously to see if similar damage occurs.
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Affiliation(s)
- Ji-Hun Song
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joonho Ahn
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Young Park
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jaeyoung Park
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yu Min Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea
| | - Jun-Pyo Myong
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung-Wan Koo
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jongin Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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13
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Kim D, Shin Y, Kim EH, Lee Y, Kim S, Kim HS, Kim HC, Leem JH, Kim HR, Bae ON. Functional and dynamic mitochondrial damage by chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT) mixture in brain endothelial cell lines and rat cerebrovascular endothelium. Toxicol Lett 2022; 366:45-57. [PMID: 35803525 DOI: 10.1016/j.toxlet.2022.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/23/2022]
Abstract
The mixture of 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT, chloromethylisothiazolinone) and 2-methyl-4-isothiazolin-3-one (MIT, methylisothiazolinone) is a commonly used biocide in consumer products. Despite the health issues related to its usage in cosmetics and humidifier disinfectants (HD), understanding its adverse outcome is still limited. Using in vitro cell lines and ex vivo rat models, we examined the effects of CMIT/MIT on the cellular redox homeostasis and energy metabolism in the brain microvascular endothelium, a highly restrictive interface between the bloodstream and brain. In murine bEND.3 and human hCMEC/D3, CMIT/MIT significantly amplified the mitochondrial-derived oxidative stress causing disruption of the mitochondrial membrane potential and oxidative phosphorylation at a sub-lethal concentration (1 μg/mL) or treatment duration (1 h). In addition, CMIT/MIT significantly increased a dynamic imbalance between mitochondrial fission and fusion, and endogenous pathological stressors significantly potentiated the CMIT/MIT-induced endothelial dysfunction. Notably, in the brain endothelium isolated from intravenously CMIT/MIT-administered rats, we observed significant mitochondrial damage and decreased tight junction protein. Taken together, we report that CMIT/MIT significantly impaired mitochondrial function and dynamics resulting in endothelial barrier dysfunction, giving an insight into the role of mitochondrial damage in CMIT/MIT-associated systemic health effects.
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Affiliation(s)
- Donghyun Kim
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, South Korea
| | - Yusun Shin
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, South Korea
| | - Eun-Hye Kim
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, South Korea
| | - Youngmee Lee
- Humidifier Disinfectant Health Center, National Institute of Environmental Research, Incheon, South Korea
| | - Seongmi Kim
- Humidifier Disinfectant Health Center, National Institute of Environmental Research, Incheon, South Korea
| | - Hyung Sik Kim
- Division of Toxicology, School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University, Incheon, South Korea
| | - Jong-Han Leem
- Department of Occupational and Environmental Medicine, Inha University, Incheon, South Korea
| | - Ha Ryong Kim
- College of Pharmacy, Daegu Catholic University, Daegu, South Korea
| | - Ok-Nam Bae
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, South Korea.
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14
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Lee H, Jeong SH, Lee H, Kim C, Nam YJ, Kang JY, Song MO, Choi JY, Kim J, Park EK, Baek YW, Lee JH. Analysis of lung cancer-related genetic changes in long-term and low-dose polyhexamethylene guanidine phosphate (PHMG-p) treated human pulmonary alveolar epithelial cells. BMC Pharmacol Toxicol 2022; 23:19. [PMID: 35354498 PMCID: PMC8969249 DOI: 10.1186/s40360-022-00559-5] [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: 10/12/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung injury elicited by respiratory exposure to humidifier disinfectants (HDs) is known as HD-associated lung injury (HDLI). Current elucidation of the molecular mechanisms related to HDLI is mostly restricted to fibrotic and inflammatory lung diseases. In our previous report, we found that lung tumors were caused by intratracheal instillation of polyhexamethylene guanidine phosphate (PHMG-p) in a rat model. However, the lung cancer-related genetic changes concomitant with the development of these lung tumors have not yet been fully defined. We aimed to discover the effect of long-term exposure of PHMG-p on normal human lung alveolar cells. METHODS We investigated whether PHMG-p could increase distorted homeostasis of oncogenes and tumor-suppressor genes, with long-term and low-dose treatment, in human pulmonary alveolar epithelial cells (HPAEpiCs). Total RNA sequencing was performed with cells continuously treated with PHMG-p and harvested after 35 days. RESULTS After PHMG-p treatment, genes with transcriptional expression changes of more than 2.0-fold or less than 0.5-fold were identified. Within 10 days of exposure, 2 protein-coding and 5 non-coding genes were selected, whereas in the group treated for 27-35 days, 24 protein-coding and 5 non-coding genes were identified. Furthermore, in the long-term treatment group, 11 of the 15 upregulated genes and 9 of the 14 downregulated genes were reported as oncogenes and tumor suppressor genes in lung cancer, respectively. We also found that 10 genes of the selected 24 protein-coding genes were clinically significant in lung adenocarcinoma patients. CONCLUSIONS Our findings demonstrate that long-term exposure of human pulmonary normal alveolar cells to low-dose PHMG-p caused genetic changes, mainly in lung cancer-associated genes, in a time-dependent manner.
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Affiliation(s)
- Hong Lee
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Sang Hoon Jeong
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Hyejin Lee
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Cherry Kim
- Department of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Yoon Jeong Nam
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Ja Young Kang
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Myeong Ok Song
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Jin Young Choi
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Jaeyoung Kim
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, Republic of Korea
| | - Yong-Wook Baek
- Environmental Health Research Department, Humidifier Disinfectant Health Center, National Institute of Environmental Research, Incheon, Republic of Korea
| | - Ju-Han Lee
- Department of Pathology, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi, Republic of Korea.
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15
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Disruption of Membrane Integrity as a Molecular Initiating Event Determines the Toxicity of Polyhexamethylene Guanidine Phosphate Depending on the Routes of Exposure. Int J Mol Sci 2022; 23:ijms23063289. [PMID: 35328708 PMCID: PMC8955148 DOI: 10.3390/ijms23063289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 02/01/2023] Open
Abstract
Polyhexamethylene guanidine phosphate (PHMG-P), a cationic biocide, is widely used in household products due to its strong bactericidal activity and low toxicity. However, it causes fatal lung damage when inhaled. In this study, we investigated why PHMG-P causes fatal lung injury when inhaled, and demonstrated that the disruption of membrane integrity through ionic interaction—a molecular initiating event of PHMG-P—determines toxicity. Mice were injected intravenously with 0.9 or 7.2 mg/kg PHMG-P (IV group), or instilled intratracheally with 0.9 mg/kg PHMG-P (ITI group); they were euthanatized at 4 h and on days 1 and 7 after treatment. Increased total BAL cell count and proinflammatory cytokine production, along with fibrotic changes in the lungs, were detected in the ITI group only. Levels of hepatic enzymes and hepatic serum amyloid A mRNA expression were markedly upregulated in the 7.2 mg/kg IV and ITI groups at 4 h or day 1 after treatment, but returned to baseline. No pathological findings were detected in the heart, liver, or kidneys. To simulate the IV injection, A549, THP-1, and HepG2 cells were treated with PHMG-P in cell culture media supplemented with different serum concentrations. Increased serum concentration was associated with an increase in cell viability. These results support the idea that direct contact between PHMG-P and cell membranes is necessary for PHMG-induced toxicity.
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16
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Choi S, Choi J, Cheon S, Song J, Kim SY, Kim JE, Nam DH, Manzar G, Kim SM, Kang HS, Kim KK, Jeong SH, Lee JH, Park EK, Lee M, Lee HA, Kim KS, Park HJ, Oh WK, Park C, Lee CH, Kim EM. Pulmonary fibrosis model using micro-CT analyzable human PSC-derived alveolar organoids containing alveolar macrophage-like cells. Cell Biol Toxicol 2022; 38:557-575. [PMID: 35267148 PMCID: PMC8907399 DOI: 10.1007/s10565-022-09698-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/26/2022] [Indexed: 12/14/2022]
Abstract
Human lung organoids (hLOs) are useful for disease modelling and drug screening. However, a lack of immune cells in hLOs limits the recapitulation of in vivo cellular physiology. Here, we generated hLOs containing alveolar macrophage (AMφ)–like cells derived from pluripotent stem cells (PSC). To bridge hLOs with advanced human lung high-resolution X-ray computed tomography (CT), we acquired quantitative micro-CT images. Three hLO types were observed during differentiation. Among them, alveolar hLOs highly expressed not only lung epithelial cell markers but also AMφ-specific markers. Furthermore, CD68+ AMφ-like cells were spatially organized on the luminal epithelial surface of alveolar hLOs. Bleomycin-treated alveolar hLOs showed upregulated expression of fibrosis-related markers and extracellular matrix deposits in the alveolar sacs. Alveolar hLOs also showed structural alterations such as excessive tissue fraction under bleomycin treatment. Therefore, we suggest that micro-CT analyzable PSC-derived alveolar hLOs are a promising in vitro model to predict lung toxicity manifestations, including fibrosis.
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Affiliation(s)
- Seri Choi
- Department of Predictive Toxicology, Korea Institute of Toxicology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea.,Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul, 08826, Republic of Korea
| | - Jiwoong Choi
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, School of Medicine, University of Kansas, Kansas City, KS, 66160, USA
| | - Seongmin Cheon
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Jihong Song
- Department of Internal Medicine, Santa Clara Valley Medical Center, San Jose, CA, 95128, USA
| | - Seung-Yeon Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea.,Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, 34134, Republic of Korea
| | - Ji-Eun Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea
| | - Dae-Hwan Nam
- Immune Research Institute, Seegene Medical Foundation, Seoul, 04805, Republic of Korea
| | - Gohar Manzar
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77025, USA
| | - Su-Man Kim
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Hyung-Sik Kang
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Kee K Kim
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, Daejeon, 34134, Republic of Korea
| | - Sang Hoon Jeong
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, Republic of Korea
| | - Ju-Han Lee
- Department of Pathology, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi, 15355, Republic of Korea
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, 49267, Republic of Korea
| | - Minseob Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, 03080, Republic of Korea
| | - Hyang-Ae Lee
- Department of Predictive Toxicology, Korea Institute of Toxicology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea
| | - Ki-Suk Kim
- R&D Center for Advanced Pharmaceuticals and Evaluation, Korea Institute of Toxicology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea
| | - Han-Jin Park
- Department of Predictive Toxicology, Korea Institute of Toxicology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea
| | - Won Keun Oh
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul, 08826, Republic of Korea
| | - Chungoo Park
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186, Republic of Korea.
| | - Chang Hyun Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, 03080, Republic of Korea.
| | - Eun-Mi Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, 141 Gajeong-ro, Yuseong-gu, Daejeon, 34114, Republic of Korea.
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17
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Lee J, Choi SJ, Jeong JS, Kim SY, Lee SJ, Baek SK, Kwon N, Lee SH, Kim W, Cho JW, Koh EM, Lee K, Jeong EJ, Nam SY, Yu WJ. Adverse postnatal developmental effects in offspring from humidifier disinfectant biocide inhaled pregnant rats. CHEMOSPHERE 2022; 286:131636. [PMID: 34358894 DOI: 10.1016/j.chemosphere.2021.131636] [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: 01/22/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
Inhalation exposure to polyhexamethylene guanidine phosphate (PHMG-P), one of the primary biocides used in humidifier disinfectants, caused a fatal pulmonary disease in Korea. Pregnant women were also exposed to PHMG-P, and subsequent studies showed that PHMG-P inhalation during pregnancy adversely affects their health and embryo-fetal development. However, the postnatal developmental effects after birth on prenatally PHMG-P-exposed offspring have not yet been investigated. Therefore, in this study, we aimed to examine the postnatal development of prenatally PHMG-P-exposed offspring. Pregnant rats (22 or 24 females per group) were exposed to PHMG-P during pregnancy in a whole-body inhalation chamber at the target concentrations of 0, 0.14, 1.60, and 3.20 mg/m3. After parturition, the prenatally exposed offspring were transferred to non-exposed surrogate mothers to minimize the secondary effects of severe maternal toxicities. Postnatal development of offspring was then examined with a modified extended one-generation reproductive toxicity study design. At 3.20 mg/m3 PHMG-P, increased perinatal death rates and decreased viability index (postnatal survival of offspring between birth and postnatal day 4) were observed. In addition, F1 offspring had lower body weight at birth that persisted throughout the study. PHMG-P-exposed pregnant rats also had severe systemic toxicities and increased gestation period. At 1.60 mg/m3 PHMG-P, a decreased viability index was also observed with systemic toxicities of PHMG-P-exposed pregnant rats. These results indicate that prenatal PHMG-P exposure adversely affects the offspring's future health and could be used for human risk assessment.
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Affiliation(s)
- Jinsoo Lee
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea; College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Seong-Jin Choi
- Department of Chemical Assessment, Korea Environment Corporation, Incheon, Republic of Korea
| | - Ji-Seong Jeong
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang Yun Kim
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Seung-Jin Lee
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang-Ki Baek
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Nayun Kwon
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang-Hyub Lee
- Department of Chemical Assessment, Korea Environment Corporation, Incheon, Republic of Korea
| | - Woojin Kim
- Toxicologic Pathology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Jae-Woo Cho
- Toxicologic Pathology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Eun Mi Koh
- Bioanalytical and Immunoanalytical Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Kyuhong Lee
- Inhalation Toxicology Research Group, Korea Institute of Toxicology, Jeongeup, Republic of Korea; Department of Human and Environmental Toxicology, University of Science & Technology, Daejeon, Republic of Korea
| | - Eun Ju Jeong
- Chemical Risk Assessment Research Committee, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang-Yoon Nam
- College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Wook-Joon Yu
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea.
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18
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Choi S, Choi S, Choi Y, Cho N, Kim SY, Lee CH, Park HJ, Oh WK, Kim KK, Kim EM. Polyhexamethylene guanidine phosphate increases stress granule formation in human 3D lung organoids under respiratory syncytial virus infection. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 229:113094. [PMID: 34942421 DOI: 10.1016/j.ecoenv.2021.113094] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Polyhexamethylene guanidine phosphate (PHMG-p), a humidifier disinfectant, is known to cause lung toxicity, including inflammation and pulmonary fibrosis. In this study, we aimed to investigate the effect of PHMG-p on human lung tissue models (2D epithelial cells and 3D organoids) under conditions of oxidative stress and viral infection. The effect of PHMG-p was studied by evaluating the formation of stress granules (SGs), which play a pivotal role in cellular adaptation to various stress conditions. Under oxidative stress and respiratory syncytial virus (RSV) infection, exposure to PHMG-p remarkably increased eIF2α phosphorylation, which is essential for SG-related signalling, and significantly increased SG formation. Furthermore, PHMG-p induced fibrotic gene expression and caused cell death due to severe DNA damage, which was further increased under oxidative stress and RSV infection, indicating that PHMG-p induces severe lung toxicity under stress conditions. Taken together, toxicity evaluation under various stressful conditions is necessary to accurately predict potential lung toxicity of chemicals affecting the respiratory tract.
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Affiliation(s)
- Seri Choi
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, South Korea; Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, South Korea
| | - Sunkyung Choi
- Department of Biochemistry, Chungnam National University, Daejeon 34134, South Korea
| | - Yeongsoo Choi
- Department of Biochemistry, Chungnam National University, Daejeon 34134, South Korea
| | - Namjoon Cho
- Department of Biochemistry, Chungnam National University, Daejeon 34134, South Korea
| | - Seung-Yeon Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, South Korea; Department of Biochemistry, Chungnam National University, Daejeon 34134, South Korea
| | - Chang Hyun Lee
- Institute of Radiation Medicine, Seoul National University Hospital and College of Medicine, Seoul National University, Seoul 08826, South Korea; Department of Radiology, Seoul National University College of Medicine and Hospital, Seoul National University, Seoul 03080, South Korea
| | - Han-Jin Park
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, South Korea
| | - Won Keun Oh
- Korea Bioactive Natural Material Bank, Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul 08826, South Korea
| | - Kee K Kim
- Department of Biochemistry, Chungnam National University, Daejeon 34134, South Korea.
| | - Eun-Mi Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, South Korea.
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Need for individual-based evaluation to determine the association between humidifier disinfectants and health injuries. Ann Occup Environ Med 2021; 33:e21. [PMID: 34754482 PMCID: PMC8264121 DOI: 10.35371/aoem.2021.33.e21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Injuries caused by humidifier disinfectants (HDs) can no longer be grouped under the concept of HD lung injury. Focusing on individual cases, we were able to evaluate the relevance not only of diseases for which epidemiological correlation is recognized but also all diseases and symptoms that the victims complain of. Methods In-depth interviews and reassessment of 113 HD-exposed patients who had not been acknowledged as victims by the government were conducted, and their medical records were reviewed. Based on these processes, an assessment questionnaire for the injuries related to HDs was completed and the involvement of HDs was assessed either as “strong association,” “association,” or “no association.” Results In this study, of the 113 patients included who claimed damages, 78 (69.0%) had HD-related injuries. Among the cases of 22 patients who applied for injury acknowledgment due to upper respiratory inflammation that was not included among the acknowledged diseases, 17 (77.3%) were judged to be HD-related injuries (strong association vs. association: 10 [45.5%] vs. 7 [31.8%]). When the cases of 12 rhinitis patients were reassessed, 9 were HD-related injuries (strong association vs. association: 4 [33.3%] vs. 5 [41.7%]). When the cases of 18 asthma patients unacknowledged as a victim were reassessed, 17 (94.4%) were humidifier-related injuries (strong association vs. association: 12 [66.6%] vs. 5 [27.8%]). Among 4 interstitial lung disease patients unacknowledged as a victim, 2 (50.0%) were HD-related injuries. Conclusions HD-related health injuries should be assessed through both individual interviews and detailed chart reviews for more accurate injury acknowledgment. In the future, efforts should go beyond existing methods based on the adherence to acknowledgment criteria to directly listen to the victims.
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Park CM, Kim HY, Jeon D, Shin YJ, Kim IH, Choi SJ, Kim KC, Lee K, Kim SH, Kim MS. Anti-fibrotic effect of pycnogenol® in a polyhexamethylene guanidine-treated mouse model. Respir Physiol Neurobiol 2021; 296:103802. [PMID: 34653662 DOI: 10.1016/j.resp.2021.103802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/15/2021] [Accepted: 10/10/2021] [Indexed: 01/09/2023]
Abstract
Pulmonary fibrosis (PF) is a respiratory disease that causes serious respiratory problems. The effects of French marine pine bark extract (Pycnogenol®), with antioxidant and anti-inflammatory properties, were investigated on lung fibrosis in polyhexamethylene guanidine (PHMG)-treated mice. Mice were separated into four groups (n = 6): vehicle control (VC, saline 50 μl); PHMG (1.1 mg/kg); PHMG + Pycnogenol® (0.3 mg/kg/day); and PHMG + Pycnogenol® (1 mg/kg/day). PF was induced via intratracheal instillation of PHMG. Treatment with PHMG decreased body weight and increased lung weight, both of which were improved by treatment with PHMG + Pycnogenol® (1 mg/kg). Enzyme-linked immunosorbent assay, western blotting, and PCR revealed that Pycnogenol® attenuated PHMG-induced increase in inflammatory cytokines and fibrosis-related factors in a dose-dependent manner. Finally, histopathological analysis revealed reduced inflammation/fibrosis in the PHMG + Pycnogenol® (1 mg/kg) group. Collectively, the results indicate that Pycnogenol® can be used to treat PF as it hinders fibrosis progression by inhibiting inflammatory responses in the lungs of PHMG-treated mice.
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Affiliation(s)
- Chul-Min Park
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea
| | - Hyeon-Young Kim
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea
| | - Doin Jeon
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea
| | - Young-Jun Shin
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea
| | - In-Hyeon Kim
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea
| | - Seong-Jin Choi
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea
| | - Ki Cheon Kim
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea
| | - Kyuhong Lee
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea; Department of Human and Environmental Toxicology, University of Science & Technology, Daejeon, 34113, Republic of Korea
| | - Sung-Hwan Kim
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea.
| | - Min-Seok Kim
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Jeongeup-si, Jeollabuk-do, 56212, Republic of Korea.
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Song J, Jung KJ, Cho JW, Park T, Han SC, Park D. Transcriptomic Analysis of Polyhexamethyleneguanidine-Induced Lung Injury in Mice after a Long-Term Recovery. TOXICS 2021; 9:toxics9100253. [PMID: 34678949 PMCID: PMC8540838 DOI: 10.3390/toxics9100253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/02/2021] [Accepted: 10/03/2021] [Indexed: 02/06/2023]
Abstract
Polyhexamethyleneguanidine phosphate (PHMG-P) is one of the causative agents of humidifier disinfectant-induced lung injury. Direct exposure of the lungs to PHMG-P causes interstitial pneumonia with fibrosis. Epidemiological studies showed that patients with humidifier disinfectant-associated lung injuries have suffered from restrictive lung function five years after the onset of the lung injuries. We investigated whether lung damage was sustained after repeated exposure to PHMG-P followed by a long-term recovery and evaluated the adverse effects of PHMG-P on mice lungs. Mice were intranasally instilled with 0.3 mg/kg PHMG-P six times at two weeks intervals, followed by a recovery period of 292 days. Histopathological examination of the lungs showed the infiltration of inflammatory cells, the accumulation of extracellular matrix in the lung parenchyma, proteinaceous substances in the alveoli and bronchiolar–alveolar hyperplasia. From RNA-seq, the gene expression levels associated with the inflammatory response, leukocyte chemotaxis and fibrosis were significantly upregulated, whereas genes associated with epithelial/endothelial cells development, angiogenesis and smooth muscle contraction were markedly decreased. These results imply that persistent inflammation and fibrotic changes caused by repeated exposure to PHMG-P led to the downregulation of muscle and vascular development and lung dysfunction. Most importantly, this pathological structural remodeling induced by PHMG-P was not reversed even after long-term recovery.
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Affiliation(s)
- Jeongah Song
- Animal Model Research Group, Korea Institute of Toxicology, Jeongeup 56212, Korea
- Correspondence: (J.S.); (D.P.); Tel.: +82-63-850-8553 (J.S.); +82-42-610-8844 (D.P.)
| | - Kyung-Jin Jung
- Bioanalytical and Immunoanalytical Research Group, Korea Institute of Toxicology, Daejeon 34114, Korea;
| | - Jae-Woo Cho
- Toxicologic Pathology Research Group, Korea Institute of Toxicology, Daejeon 34114, Korea;
| | - Tamina Park
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, Korea;
- Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Korea
| | - Su-Cheol Han
- Jeonbuk Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup 56212, Korea;
| | - Daeui Park
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, Korea;
- Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Korea
- Correspondence: (J.S.); (D.P.); Tel.: +82-63-850-8553 (J.S.); +82-42-610-8844 (D.P.)
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Shin YJ, Kim SH, Park CM, Kim HY, Kim IH, Yang MJ, Lee K, Kim MS. Exposure to cigarette smoke exacerbates polyhexamethylene guanidine-induced lung fibrosis in mice. J Toxicol Sci 2021; 46:487-497. [PMID: 34602533 DOI: 10.2131/jts.46.487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Cigarette smoke (CS) is the leading cause of chronic pulmonary diseases, including lung cancer, chronic obstructive pulmonary disease, and pulmonary fibrosis. In this study, we aimed to investigate the effects of repeated CS exposure on polyhexamethylene guanidine (PHMG)-induced pulmonary fibrosis in mice. A single intratracheal instillation of 0.6 mg/kg PHMG enhanced the immune response of mice by increasing the number of total and specific inflammatory cell types in the bronchoalveolar lavage fluid. It induced histopathological changes such as granulomatous inflammation/fibrosis and macrophage infiltration in the lungs. These responses were upregulated upon exposure to a combination of PHMG and CS. In contrast, a 4-hr/day exposure to 300 mg/m3 CS alone for 2 weeks by nose-only inhalation resulted in minimal inflammation in the mouse lung. Furthermore, PHMG administration increased the expression of fibrogenic mediators, especially in the pulmonary tissues of the PHMG + CS group compared with that in the PHMG alone group. However, there was no upregulation in the expression of inflammatory cytokines following exposure to a combination of PHMG and CS. Our results demonstrate that repeated exposure to CS may promote the development of PHMG-induced pulmonary fibrosis.
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Affiliation(s)
- Young-Jun Shin
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Korea
| | - Sung-Hwan Kim
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Korea
| | - Chul Min Park
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Korea
| | - Hyeon-Young Kim
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Korea
| | - In-Hyeon Kim
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Korea
| | - Mi-Jin Yang
- Pathology Research Group, Korea Institute of Toxicology, Korea
| | - Kyuhong Lee
- Inhalation Toxicology Center for Airborne Risk Factors, Korea Institute of Toxicology, Korea.,Department of Human and Environmental Toxicology, University of Science & Technology, Korea
| | - Min-Seok Kim
- Inhalation Toxicity Research Group, Korea Institute of Toxicology, Korea
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23
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Woo JH, Kim KC, Kim HY, Kim IH, Kim SH, Lee K. Comparative toxicity of polyhexamethylene guanidine phosphate in three strains of rats. Mol Cell Toxicol 2021. [DOI: 10.1007/s13273-021-00169-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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24
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Kim C, Jeong SH, Kim J, Kang JY, Nam YJ, Togloom A, Cha J, Lee KY, Lee CH, Park EK, Lee JH. Evaluation of the long-term effect of polyhexamethylene guanidine phosphate in a rat lung model using conventional chest computed tomography with histopathologic analysis. PLoS One 2021; 16:e0256756. [PMID: 34492061 PMCID: PMC8423271 DOI: 10.1371/journal.pone.0256756] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 08/15/2021] [Indexed: 12/26/2022] Open
Abstract
There have been no studies on the effects of polyhexamethylene guanidine phosphate (PHMG) after a long period of exposure in the rodent model. We aimed to evaluate long-term lung damage after PHMG exposure using conventional chest computed tomography (CT) and histopathologic analysis in a rat model. A PHMG solution was intratracheally administrated to 24 male rats. At 8, 26, and 52 weeks after PHMG instillation, conventional chest CT was performed in all rats and both lungs were extracted for histopathologic evaluation. At 52 weeks after PHMG instillation, four carcinomas had developed in three of the eight rats (37.5%). Bronchiolo-alveolar hyperplasia and adenoma were found in rats at 8, 26, and 52 weeks post-instillation. The number of bronchiolo-alveolar hyperplasia significantly increased over time (P-value for trend< 0.001). The severity of lung fibrosis and fibrosis scores significantly increased over time (P-values for trend = 0.002 and 0.023, respectively). Conventional chest CT analysis showed that bronchiectasis and linear density scores suggestive of fibrosis significantly increased over time (P-value for trend < 0.001). Our study revealed that one instillation of PHMG in a rat model resulted in lung carcinomas and progressive and irreversible fibrosis one year later based on conventional chest CT and histopathologic analysis. PHMG may be a lung carcinogen in the rat model.
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Affiliation(s)
- Cherry Kim
- Department of Radiology, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
| | - Sang Hoon Jeong
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
| | - Jaeyoung Kim
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
| | - Ja Young Kang
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
| | - Yoon Jeong Nam
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
| | - Ariunaa Togloom
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
| | - Jaehyung Cha
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
| | - Ki Yeol Lee
- Department of Radiology, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
| | - Chang Hyun Lee
- Department of Radiology, College of Medicine, Seoul National University, Seoul National University Hospital, Seoul, South Korea
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea
| | - Ju-Han Lee
- Department of Pathology, Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan-si, Gyeonggi, South Korea
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Reprogrammed lung epithelial cells by decrease of miR-451a in extracellular vesicles contribute to aggravation of pulmonary fibrosis. Cell Biol Toxicol 2021; 38:725-740. [PMID: 34460027 DOI: 10.1007/s10565-021-09626-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/21/2021] [Indexed: 12/22/2022]
Abstract
Extracellular vesicles (EVs) play novel roles in homeostasis through cell-to-cell communication in human airways via transferring miRNAs. However, the contribution of EV miRNAs to pulmonary phenotypic homeostasis is not clearly understood. Hence, the aim of this study was to elucidate the functional role of miRNAs obtained from epithelium-derived EVs in lung fibrogenesis. Pulmonary fibrosis was induced by exposure of polyhexamethylene guanidine phosphate (PHMG-p)-instilled mice. In histopathological changes, a clear phenotypic change was observed in bronchial epithelium. For figuring out the role of EVs derived from conditioned media of untreated cells (EV-Con) and PHMG-p-treated BEAS-2B (EV-PHMG), significant increase in EVs released from PHMG-p-treated BEAS-2B was detected. Functional analysis with targets of differentially expressed miRNAs in EVs was annotated to epithelial-mesenchymal transition (EMT). Especially, the most abundant miRNA, miR-451a, was downregulated in EV of PHMG-p-treated BEAS-2B cells. We found that odd-skipped related 1 (OSR1) was a putative target for miR-451a, which had been known as a transcription factor of several fibrosis-associated genes. Transfer of decreased miR-451a via EV-PHMG upregulated OSR1 and induced EMT compared to Con-EV-treated cells. In pulmonary fibrosis mice, miR-451a levels were significantly reduced in EV derived from bronchoalveolar lavage fluid and OSR1 expression was increased in lung tissues of mice with PHMG-p exposure. MiR-451a-transfected EVs markedly alleviated fibrogenesis in the PHMG-p-exposed lungs. Low level of miR-451a in EVs modulated EMT and fibrogenesis in recipient cells by increasing OSR1 levels in vitro and in vivo. Our results suggest that transferring EV miR-451a induces anti-fibrotic autocrine effect by downregulating its target, OSR1 maintaining pulmonary homeostasis disrupted by PHMG-p exposure, which can be a potential therapeutic target.
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Humidifier Disinfectant Consumption and Humidifier Disinfectant-Associated Lung Injury in South Korea: A Nationwide Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116136. [PMID: 34204162 PMCID: PMC8201190 DOI: 10.3390/ijerph18116136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022]
Abstract
Humidifier disinfectant (HD) is a household biocidal product used in humidifier water tanks to prevent the growth of microorganisms. In 2011, a series of lung injury cases of unknown causes emerged in children and pregnant women who had used HD in Korea. This study investigated changes in the nationwide number of cases of humidifier disinfectant-associated lung injury (HDLI) in concordance with nationwide HD consumption using data covering the entire Korean population. More than 25 kinds of HD products were sold between 1994 and 2011. The number of diagnosed HDLI, assessed by S27.3 (other injuries of lungs) of the Korea National Health Insurance Service (NHIS) data, sharply increased by 2005, subsequently decreased after 2005, and almost disappeared after 2011 in concordance with the annual number of HD sales. The number of self-reported HDLIs, assessed using data from all suspected HDLI cases registered in the Korea Ministry of Environment, changed with the annual number of HD sales, with a delay pattern, potentially induced by the late awareness of lung injury diseases. The present study suggests that changes in the nationwide annual consumption of HD products were consistent with changes in the annual number of HDLI cases in Korea.
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Kwon TY, Jeong J, Park E, Cho Y, Lim D, Ko UH, Shin JH, Choi J. Physical analysis reveals distinct responses of human bronchial epithelial cells to guanidine and isothiazolinone biocides. Toxicol Appl Pharmacol 2021; 424:115589. [PMID: 34029620 DOI: 10.1016/j.taap.2021.115589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/18/2021] [Accepted: 05/19/2021] [Indexed: 02/06/2023]
Abstract
Changes in the physical state of the cells can serve as important indicators of stress responses because they are closely linked with the changes in the pathophysiological functions of the cells. Physical traits can be conveniently assessed by analyzing the morphological features and the stresses at the cell-matrix and cell-cell adhesions in both single-cell and monolayer model systems in 2D. In this study, we investigated the mechano-stress responses of human bronchial epithelial cells, BEAS-2B, to two functionally distinct groups of biocides identified during the humidifier disinfectant accident, namely, guanidine (PHMG) and isothiazolinone (CMIT/MIT). We analyzed the physical traits, including cell area, nuclear area, and nuclear shape. While the results showed inconsistent average responses to the biocides, the degree of dispersion in the data set, measured by standard deviation, was remarkably higher in CMIT/MIT treated cells for all traits. As mechano-stress endpoints, traction and intercellular stresses were also measured, and the cytoskeletal actin structures were analyzed using immunofluorescence. This study demonstrates the versatility of the real-time imaging-based biomechanical analysis, which will contribute to identifying the temporally sensitive cellular behaviors as well as the emergence of heterogeneity in response to exogenously imposed stress factors. This study will also shed light on a comparative understanding of less studied substance, CMIT/MIT, in relation to a more studied substance, PHMG, which will further contribute to more strategic planning for proper risk management of the ingredients involved in toxicological accidents.
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Affiliation(s)
- Tae Yoon Kwon
- Department of Mechanical Engineering, KAIST, 291 Daehakro, Yuseong-gu, Daejeon 34034, Republic of Korea
| | - Jaeseong Jeong
- School of Environmental Engineering, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, Republic of Korea
| | - Eunyoung Park
- Department of Mechanical Engineering, KAIST, 291 Daehakro, Yuseong-gu, Daejeon 34034, Republic of Korea
| | - Youngbin Cho
- Department of Mechanical Engineering, KAIST, 291 Daehakro, Yuseong-gu, Daejeon 34034, Republic of Korea
| | - Dongyoung Lim
- School of Environmental Engineering, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, Republic of Korea
| | - Ung Hyun Ko
- Department of Mechanical Engineering, KAIST, 291 Daehakro, Yuseong-gu, Daejeon 34034, Republic of Korea
| | - Jennifer H Shin
- Department of Mechanical Engineering, KAIST, 291 Daehakro, Yuseong-gu, Daejeon 34034, Republic of Korea.
| | - Jinhee Choi
- School of Environmental Engineering, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, Republic of Korea.
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Song MK, Kim DI, Lee K. Causal relationship between humidifier disinfectant exposure and Th17-mediated airway inflammation and hyperresponsiveness. Toxicology 2021; 454:152739. [PMID: 33640443 DOI: 10.1016/j.tox.2021.152739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/03/2021] [Accepted: 02/23/2021] [Indexed: 12/15/2022]
Abstract
In this study, we investigated whether humidifier disinfectants (HDs) induce asthmatic airway inflammation in an animal model and compared the features of HD-induced inflammatory symptoms with ovalbumin (OVA)-induced allergic asthma. Mice were intratracheally instilled three times with either the control or 0.1, 0.3, or 0.5 mg/kg of polyhexamethylene guanidine phosphate (PHMG-P). To characterize asthmatic features, the following parameters were analyzed: (i) differential cell counts and cytokine expression in the bronchoalveolar lavage fluid (BALF); (ii) presence of mucus-producing goblet cells and pulmonary eosinophilic infiltration in the lungs; (iii) serum immunoglobulin levels; and (iv) airway hyperresponsiveness (AHR). RNA-Seq and bioinformatics tools were used to investigate whether PHMG-P altered asthma-related gene expression in lung tissues. The PHMG-P exposure groups showed higher peribronchial/perivascular inflammation, elevated goblet cell hyperplasia, and inhaled methacholine-induced airway resistance. Additionally, IL-13 and IL-17 in BALF were significantly increased in the PHMG-P exposure groups. However, there were no significant differences in total serum IgE and BALF IL-4 and IL-5 levels in the PHMG-P exposure groups compared to the control group. PHMG-P exposure modulated the expression of genes related to Th17 signaling pathways including the IL-17A, IL-23, and STAT3 signaling pathways, but not the Th2 signaling pathway. Altogether, our results suggest that repeated exposure to low does PHMG-P induces asthma-like symptoms and is thus a possible risk factor for developing asthma. The PHMG-P-induced asthmatic airway inflammation showed a different pattern from that found in typical allergic asthma and may be related to irritant-induced airway inflammation and hyperresponsiveness characterized by Th2-low, Th17-related, IgE-independent, and mixed granulocytic features.
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Affiliation(s)
- Mi-Kyung Song
- National Center for Efficacy Evaluation for Respiratory Disease Products, Korea Institute of Toxicology, 30 Baehak1-gil, Jeongeup, Jeollabuk-do, 56212, Republic of Korea; Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon, 34113, Republic of Korea
| | - Dong Im Kim
- National Center for Efficacy Evaluation for Respiratory Disease Products, Korea Institute of Toxicology, 30 Baehak1-gil, Jeongeup, Jeollabuk-do, 56212, Republic of Korea
| | - Kyuhong Lee
- National Center for Efficacy Evaluation for Respiratory Disease Products, Korea Institute of Toxicology, 30 Baehak1-gil, Jeongeup, Jeollabuk-do, 56212, Republic of Korea; Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon, 34113, Republic of Korea.
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Lee SH, Ahn JR, Go HN, Lee SY, Park MJ, Song KB, Yoon J, Jung S, Cho HJ, Lee E, Yang SI, Hong SJ. Exposure to Polyhexamethylene Guanidine Exacerbates Bronchial Hyperresponsiveness and Lung Inflammation in a Mouse Model of Ovalbumin-Induced Asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:655-664. [PMID: 34212551 PMCID: PMC8255342 DOI: 10.4168/aair.2021.13.4.655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 11/20/2022]
Abstract
Humidifier disinfectants (HDs) exposure has now been associated with acute lung injury and pulmonary fibrosis; polyhexamethylene guanidine (PHMG) has been confirmed to cause severe lung inflammation and fibrosis in mice. Recent evidence also indicates that HDs exposure increases the asthma risk in children, but the underlying mechanisms remain unclear. We aimed to investigate the effects of PHMG exposure on asthma in mice and the potential underlying mechanisms. BALB/c mice were intranasally administered PHMG (0.1 mg/kg/day; 5 days per week) during 2 episodes of ovalbumin (OVA) sensitization and were then challenged with 1% OVA by inhalation. Bronchial hyperresponsiveness (BHR), inflammatory cell influx into bronchoalveolar lavage (BAL) fluid, serum total and OVA-specific immunoglobulin (Ig) E levels, and histopathological changes in the lung were analyzed. The levels of asthma-related cytokines and chemokines were assayed in the lung tissues to evaluate possible mechanisms. Exposure to PHMG following OVA sensitization and challenge significantly enhanced BHR, inflammatory cell counts in BAL fluid, airway inflammation, and total serum IgE levels in the asthma mouse model. In addition, the levels of chemokine ligand (CCL) 11 and serpine F1/pigment epithelium-derived factor (SERPINF1) were significantly elevated in the lungs of these mice compared to those in the control and OVA-treated only groups. Our findings suggest that PHMG can enhance the development of allergic responses and lung inflammation via CCL11- and SERPINF1-induced signaling in a mouse model of asthma.
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Affiliation(s)
- Seung Hwa Lee
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Rin Ahn
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Han Na Go
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - So Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Jee Park
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kun Baek Song
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jisun Yoon
- Department of Pediatrics, Mediplex Sejong Hospital, Incheon, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyun Ju Cho
- Department of Pediatrics, International St. Mary's hospital, Catholic Kwandong University, Incheon, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University College of Medicine, Gwangju, Korea
| | - Song I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Soo Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Characteristics of Exposure to Chloromethylisothiazolinone (CMIT) and Methylisothiazolinone (MIT) among Humidifier Disinfectant-Associated Lung Injury (HDLI) Patients in South Korea. Molecules 2020; 25:molecules25225284. [PMID: 33198358 PMCID: PMC7697974 DOI: 10.3390/molecules25225284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/03/2020] [Accepted: 11/10/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed to quantify both chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) dissolved in different product brands and to characterize the exposure to these chemicals among humidifier disinfectant-associated lung injury (HDLI) patients. Both CMIT and MIT dissolved in different humidifier disinfectant (HD) products were quantified using gas chromatography-mass spectrometry. The inhalation level of CMIT and MIT was estimated based on HD-associated factors as reported by HDLI patients. A total of eleven HD products marketed until the end of 2011 were found to contain CMIT and/or MIT. The level of combined CMIT and/or MIT dissolved in these HD products ranged from 12 to 353 ppm. The level varied among HD products and the year of manufacture. The average inhalation levels were estimated to be 7.5, 4.1, and 3.2 μg/m3 for the definite, probable, and possible groups, respectively. If probable and possible groups were collapsed together, the inhalation level of the collapsed group was significantly different from that of the definite group (p < 0.001). All HDLI patients responded as having used HD not only while sleeping, but also as having a humidifier treated with HD within close proximity every day in insufficiently ventilated spaces. These HD use characteristics of patients may be directly/indirectly linked to the HDLI development.
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Zhu X, Kong X, Ma S, Liu R, Li X, Gao S, Ren D, Zheng Y, Tang J. TGFβ/Smad mediated the polyhexamethyleneguanide areosol-induced irreversible pulmonary fibrosis in subchronic inhalation exposure. Inhal Toxicol 2020; 32:419-430. [PMID: 33148071 DOI: 10.1080/08958378.2020.1836091] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM Polyhexamethylene guanidine (PHMG) is widely used as a disinfectant with broad spectra of bactericidal activity and low oral toxicity. However, inhalation of PHMG can cause pulmonary injury and severe pulmonary fibrosis. The mechanism underlying PHMG aerosol induced pulmonary fibrosis remains unclear. In this study, we aimed to examine the subchronic lung injury and determine potential cytokines involved in PHMG aerosol induced fibrosis. METHODS C57BL/6N mice were exposed to 1.03 mg/m3 PHMG through aerosol inhalation for 3 weeks, or 3 weeks followed by other 3 weeks recovery. RESULTS The results indicated that the expression of transforming growth factor-beta1 (TGF-β1) and extracellular matrix remodeling markers were up-regulated in the PHMG-treated mice and these parameters were aggravated after 3 weeks recovery. Bronchoalveolar lavage fluids (BALFs) analysis showed that the number of total cells was significantly decreased in exposure group. The percentage of macrophages in BALFs decreased significantly whereas the percentage of neutrophils and lymphocytes increased. Extensive collagen deposition was observed in the peribronchiolar and interstitial areas in the PHMG exposed lungs. CONCLUSION In conclusion, even low-does PHMG aerosol exposure could induce mice pulmonary local inflammation and irreversible fibrosis. In addition, TGF-β/Smad signaling pathway mediated the extracellular matrix remodeling involved in the development of pulmonary fibrosis.
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Affiliation(s)
- Xiaoxiao Zhu
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, China
| | - Xiao Kong
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, China
| | - Sai Ma
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, China
| | - Rui Liu
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, China
| | - Xin Li
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, China
| | - Shaobo Gao
- Department of Respiratory Medicine, the Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Dunqiang Ren
- Department of Respiratory Medicine, the Affiliated Hospital of Medical College Qingdao University, Qingdao, China
| | - Yuxin Zheng
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, China
| | - Jinglong Tang
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, China
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Song MK, Kim DI, Lee K. Kathon Induces Fibrotic Inflammation in Lungs: The First Animal Study Revealing a Causal Relationship between Humidifier Disinfectant Exposure and Eosinophil and Th2-Mediated Fibrosis Induction. Molecules 2020; 25:molecules25204684. [PMID: 33066398 PMCID: PMC7587358 DOI: 10.3390/molecules25204684] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 12/21/2022] Open
Abstract
Currently available toxicity data on humidifier disinfectants are primarily limited to polyhexamethylene guanidine phosphate-induced lung fibrosis. We, therefore, investigated whether the sterilizer component Kathon, which is a mixture of chloromethylisothiazolinone and methylisothiazolinone, induces fibrotic lung injury following direct lung exposure in an animal model. Mice were intratracheally instilled with either the vehicle or Kathon. Differential cell counts, cytokine analysis, and histological analysis of lung tissue were then performed to characterize the injury features, and we investigated whether Kathon altered fibrosis-related gene expression in lung tissues via RNA-Seq and bioinformatics. Cell counting showed that Kathon exposure increased the proportion of macrophages, eosinophils, and neutrophils. Moreover, T helper 2 (Th2) cytokine levels in the bronchoalveolar lavage were significantly increased in the Kathon groups. Histopathological analysis revealed increased perivascular/alveolar inflammation, eosinophilic cells, mucous cell hyperplasia, and pulmonary fibrosis following Kathon exposure. Additionally, Kathon exposure modulated the expression of genes related to fibrotic inflammation, including the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway, extracellular signal regulated kinase (ERK)1 and ERK2 cascade, extracellular matrix (ECM)-receptor interaction pathway, transforming growth factor beta receptor signaling pathway, cellular response to tumor necrosis factor, and collagen fibril organization. Our results suggest that Kathon exposure is associated with fibrotic lung injury via a Th2-dependent pathway and is thus a possible risk factor for fibrosis.
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Affiliation(s)
- Mi-Kyung Song
- National Center for Efficacy Evaluation of Respiratory Disease Product, Korea Institute of Toxicology, 30 Baehak1-gil, Jongeup, Jeollabuk-do 56212, Korea; (M.-K.S.); (D.I.K.)
- Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Korea
| | - Dong Im Kim
- National Center for Efficacy Evaluation of Respiratory Disease Product, Korea Institute of Toxicology, 30 Baehak1-gil, Jongeup, Jeollabuk-do 56212, Korea; (M.-K.S.); (D.I.K.)
| | - Kyuhong Lee
- National Center for Efficacy Evaluation of Respiratory Disease Product, Korea Institute of Toxicology, 30 Baehak1-gil, Jongeup, Jeollabuk-do 56212, Korea; (M.-K.S.); (D.I.K.)
- Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Korea
- Correspondence: or ; Tel.: +82-63-570-8740
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Assessment of acute and repeated pulmonary toxicities of oligo(2-(2-ethoxy)ethoxyethyl guanidium chloride in mice. Toxicol Res 2020; 37:99-113. [PMID: 33489861 DOI: 10.1007/s43188-020-00058-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/16/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022] Open
Abstract
Oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH) and polyhexamethyleneguanidine phosphate (PHMG-P) are cationic biocides containing a guanidine group. Direct exposure of the lungs to PHMG-P is known to induce pulmonary inflammation and fibrotic changes. Few studies have assessed the pulmonary toxicity of PGH, another member of the guanidine family. In this study, we assessed the acute and repeated toxicity of PGH and PHMG-P to compare the pathological progression induced by both chemicals. PGH (1.5 mg/kg) or PHMG (0.6 mg/kg) was instilled intratracheally to mice once or three times every 4 days; subsequently, cytokine levels were quantified and a histopathological examination was performed. To verify the toxic mechanism of PGH, we quantified cell viability and cytokine production induced by PGH or PHMG-P in the presence or absence of anionic material in cells. Instillation of PGH and PHMG-P into the mouse lung increased cytokine production, immune cell infiltration, and pulmonary fibrotic changes. These pathological changes were exacerbated over time in the single- and the repeated-dose PHMG-P groups, but were resolved over time in the PGH groups. PGH or PHMG-P showed cytotoxic effects, IL-1β secretion, and ROS production in a dose-dependent manner in human cell lines. However, the co-treatment of anionic materials with PGH or PHMG-P significantly reduced these toxic responses, which confirmed that the cation of PGH disrupted the plasma membrane via ionic interaction, as observed for PHMG-P. In addition, we suggest the disruption of plasma membrane as a molecular initiating event of cationic chemicals-induced adverse outcomes when exposed directly to the lungs.
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Lee E, Lee SY, Hong SJ. The past, present, and future of humidifier disinfectant-associated interstitial lung diseases in children. Clin Exp Pediatr 2020; 63:251-258. [PMID: 32024320 PMCID: PMC7374007 DOI: 10.3345/cep.2019.01326] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/03/2019] [Indexed: 12/19/2022] Open
Abstract
Exposure to environmental factors can cause interstitial lung diseases (ILDs); however, such types of ILDs are rare. From 2007 to 2011, an ILD epidemic occurred in South Korea owing to inhalational exposure to toxic chemicals in humidifier disinfectants (HDs). HD-associated ILDs (HD-ILDs) are characterized by rapidly progressing respiratory failure with pulmonary fibrosis and a high mortality rate of 43.8%-58.0%. Although 18.1%-31.1% of the general population used HDs, only a small proportion of HD users were diagnosed with HD-ILDs. This finding suggests that investigation of the pathophysiologies underlying HD-ILDs is needed in addition to the identification of susceptibility to HD-ILDs. Further, there have been several concerns regarding the diverse health effects of exposure to toxic chemicals in HDs, including those that have not been identified, and long-term prognoses in terms of pulmonary function and residual pulmonary lesions observed on follow-up chest images. In this review, we summarize the clinical features, pathologic findings, and changes in radiologic findings over time in patients with HD-ILDs and the results of previous experimental research on the mechanisms underlying the effects of toxic chemicals in HDs. Studies are currently underway to identify the pathophysiologies of HD-ILDs and possible health effects of exposure to HDs along with the development of targeted therapeutic strategies. The experience of identification of HD-ILDs has encouraged stricter control of safe chemicals in everyday life.
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Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Song J, Eghan K, Lee S, Park JS, Yoon S, Pimtong W, Kim WK. A Phenotypic and Genotypic Evaluation of Developmental Toxicity of Polyhexamethylene Guanidine Phosphate Using Zebrafish Embryo/Larvae. TOXICS 2020; 8:E33. [PMID: 32370250 PMCID: PMC7355787 DOI: 10.3390/toxics8020033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 11/16/2022]
Abstract
Polyhexamethylene guanidine-phosphate (PHMG-P), a guanidine-based cationic antimicrobial polymer, is an effective antimicrobial biocide, potent even at low concentrations. Due to its resilient bactericidal properties, it has been used extensively in consumer products. It was safely used until its use in humidifiers led to a catastrophic event in South Korea. Epidemiological studies have linked the use of PHMG-P as a humidifier disinfectant to pulmonary fibrosis. However, little is known about its harmful impacts other than pulmonary fibrosis. Thus, we applied a zebrafish embryo/larvae model to evaluate developmental and cardiotoxic effects and transcriptome changes using RNA-sequencing. Zebrafish embryos were exposed to 0.1, 0.2, 0.3, 0.4, 0.5, 1, and 2 mg/L of PHMG-P from 3 h to 96 h post fertilization. 2 mg/L of PHMG-P resulted in total mortality and an LC50 value at 96 h was determined at 1.18 mg/L. Significant developmental changes were not observed but the heart rate of zebrafish larvae was significantly altered. In transcriptome analysis, immune and inflammatory responses were significantly affected similarly to those in epidemiological studies. Our qPCR analysis (Itgb1b, TNC, Arg1, Arg2, IL-1β, Serpine-1, and Ptgs2b) also confirmed this following a 96 h exposure to 0.4 mg/L of PHMG-P. Based on our results, PHMG-P might induce lethal and cardiotoxic effects in zebrafish, and crucial transcriptome changes were linked to immune and inflammatory response.
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Affiliation(s)
- Jeongah Song
- Jeonbuk Department of Inhalation Research, Korea Institute of Toxicology, Jeongeup 56212, Korea;
| | - Kojo Eghan
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, Korea; (K.E.); (S.L.); (J.-S.P.); (S.Y.)
- Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Korea
| | - Sangwoo Lee
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, Korea; (K.E.); (S.L.); (J.-S.P.); (S.Y.)
| | - Jong-Su Park
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, Korea; (K.E.); (S.L.); (J.-S.P.); (S.Y.)
| | - Seokjoo Yoon
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, Korea; (K.E.); (S.L.); (J.-S.P.); (S.Y.)
- Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Korea
| | - Wittaya Pimtong
- Nano Environmental and Health Safety Research Team, National Nanotechnology Center, National Science and Technology Development Agency, Pathum Thani 12120, Thailand;
| | - Woo-Keun Kim
- Department of Predictive Toxicology, Korea Institute of Toxicology, Daejeon 34114, Korea; (K.E.); (S.L.); (J.-S.P.); (S.Y.)
- Human and Environmental Toxicology, University of Science and Technology, Daejeon 34113, Korea
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Rim KT. Adverse outcome pathways for chemical toxicity and their applications to workers' health: a literature review. TOXICOLOGY AND ENVIRONMENTAL HEALTH SCIENCES 2020; 12:99-108. [PMID: 32412554 PMCID: PMC7222038 DOI: 10.1007/s13530-020-00053-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE AND METHODS Various papers related to the application of adverse outcome pathways (AOPs) for the prevention of occupational disease were reviewed. The Internet was used as the primary tool to search for the necessary research data and information, using such online resources as Google Scholar, ScienceDirect, Scopus, NDSL, and PubMed. The key search terms were "adverse outcome pathway," "toxicology," "risk assessment," "human," "worker," "occupational safety and health," and so on. RESULTS AND CONCLUSION The aim of this paper is to explain the use of AOP for the understanding of chemical toxicity as a conceptual means and to predict the toxic mechanism. The tools of AOP have emerged as a forward-looking alternative to the existing chemical risk assessment paradigm. AOP is being applied to the assessment of acute toxicity and to chronic toxic chemicals in the workplace. Not only can it lead to breakthroughs in occupational and environmental cancer prevention, it is also widely used in chemical risk assessment and has led to breakthroughs in the prevention of occupational disease in the workplace.
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Affiliation(s)
- Kyung-Taek Rim
- Chemicals Research Bureau, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Daejeon, Korea
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Association between use of humidifier disinfectant and allergic rhinitis in Korean children: a cross-sectional study based on the eighth Panel Study on Korean Children (PSKC). Ann Occup Environ Med 2020; 32:e9. [PMID: 32161652 PMCID: PMC7049669 DOI: 10.35371/aoem.2020.32.e9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/07/2020] [Indexed: 12/22/2022] Open
Abstract
Background Rhinitis was the most frequently diagnosed disorder among users of humidifier disinfectants (HDs). The aim of our study was to investigate on the relationship between allergic rhinitis (AR) and HD uses. Methods Our study used the data from the eighth Panel Study on Korean Children; a total of 1,540 participants were enrolled. The χ2 test and multiple logistic regression analyses were conducted to debunk the association between AR and HD uses. Results In our analysis, odds ratios (ORs) of doctor-diagnosed AR increased significantly when simply the response of whether HDs were used in the past was considered. When the brands of HD were considered, ORs of doctor-diagnosed AR were found to be increased significantly for those who have used polyhexamethylene guanidine phosphate/oligo(2-[2-ethoxy]-ethoxyethyl)guanidinium-containing HDs (model 3: 1.41, 95% confidence interval [CI]: 1.02-1.95). However, once duration of usage was additionally considered, ORs of doctor-diagnosed AR increased significantly only for those who have used chloromethylisothiazolinone/methylisothiazolinone-containing HDs for more than or equal to 3 months (model 3: 2.08, 95% CI: 1.17-3.69). Further, past use of HD was associated with significantly increased ORs of AR diagnosed before 2013 (model 3: 1.35, 95% CI: 1.02-1.79). Conclusions Results of our study suggest that past uses of HDs may be associated with an increased risk of AR.
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Kim S, Park S, Jo H, Song S, Ham S, Yoon C. Behavioral characteristics of polyhexamethyleneguanidine (PHMG) particles in aqueous solution and air when sprayed into an ultrasonic humidifier. ENVIRONMENTAL RESEARCH 2020; 182:109078. [PMID: 31884194 DOI: 10.1016/j.envres.2019.109078] [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: 08/06/2019] [Revised: 12/12/2019] [Accepted: 12/21/2019] [Indexed: 06/10/2023]
Abstract
Polyhexamethyleneguanidine (PHMG) is widely used as a disinfectant to prevent microbial contamination in ultrasonic humidifiers in Korea; however, sales have been prohibited by the government after an outbreak of severe lung injury among humidifier disinfectant users. This study was therefore conducted to determine the characteristics of PHMG particles in aqueous solution and to investigate the behavior of airborne particles generated when using PHMG as a humidifier disinfectant. Three types of PHMG were selected (manufactured in Korea, USA, and China), with dynamic light scattering (DLS) used to determine their behavioral characteristics in aqueous solution. To determine the airborne behavioral characteristics, PHMG was diluted to obtain high (62.5-65 ppm) and low (6.25-6.5 ppm) concentrations, and then real-time monitoring instruments were used to measure the effect of using a diffusion dryer and thermodenuder to control moisture in a cleanroom. A polycarbonate filter sample was analyzed by field emission-scanning electron microscope-energy dispersive spectrometry (FE-SEM-EDS) to determine the particle morphology. The DLS intensity results for the three products showed a slightly right-shifted (~100 nm) bimodal distribution relative to the airborne particle size distribution. The size of the airborne PHMG particles increased during the spraying due to aggregation, with the particle size of aggregated particles confirmed by FE-SEM to be approximately 20 nm or more. As the PHMG concentration increased by 10 times, the airborne concentrations measured by the real-time monitoring instrument increased by 2-3 times for nanoparticles, and by 45-85 times for 1-10 μm particles during humidifier operation; however, 99% of the particles generated could be classified as PM1. Without ventilation, even after operating the humidifier, the PHMG particles could be airborne for about 2 h until the background concentration was reached. Therefore, we found that the airborne behavior was affected by PHMG concentration. Products from different manufacturers had no effect on the airborne behavior.
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Affiliation(s)
- Sunju Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Seonkyeong Park
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hyeri Jo
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Seungwhan Song
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Seunghon Ham
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Chungsik Yoon
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
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Lee JD, Kim HY, Kang K, Jeong HG, Song MK, Tae IH, Lee SH, Kim HR, Lee K, Chae S, Hwang D, Kim S, Kim HS, Kim KB, Lee BM. Integration of transcriptomics, proteomics and metabolomics identifies biomarkers for pulmonary injury by polyhexamethylene guanidine phosphate (PHMG-p), a humidifier disinfectant, in rats. Arch Toxicol 2020; 94:887-909. [DOI: 10.1007/s00204-020-02657-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 02/03/2020] [Indexed: 12/16/2022]
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Song MK, Kim DI, Lee K. Time-course transcriptomic alterations reflect the pathophysiology of polyhexamethylene guanidine phosphate-induced lung injury in rats. Inhal Toxicol 2020; 31:457-467. [PMID: 31971030 DOI: 10.1080/08958378.2019.1707912] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: Humidifier-disinfectant-induced lung injury is a new syndrome associated with a high mortality rate and characterized by severe hypersensitivity pneumonitis, acute interstitial pneumonia, or acute respiratory distress syndrome. Polyhexamethylene guanidine phosphate (PHMG-P), a guanidine-based antimicrobial agent, is a major component associated with severe lung injury. In-depth studies are needed to determine how PHMG-P affects pathogenesis at the molecular level. Therefore, in this study, we analyzed short-term (4 weeks) and long-term (10 weeks) PHMG-P-exposure-specific gene-expression patterns in rats to improve our understanding of time-dependent changes in fibrosis.Materials and methods: Gene-expression profiles were analyzed in rat lung tissues using DNA microarrays and bioinformatics tools.Results: Clustering analysis of gene-expression data showed different gene-alteration patterns in the short- and long-term exposure groups and higher sensitivity to gene-expression changes in the long-term exposure group than in the short-term exposure group. Supervised analysis revealed 34 short-term and 335 long-term exposure-specific genes, and functional analysis revealed that short-term exposure-specific genes were involved in PHMG-P-induced initial inflammatory responses, whereas long-term exposure-specific genes were involved in PHMG-P-related induction of chronic lung fibrosis.Conclusion: The results of transcriptomic analysis were consistent with lung histopathology results. These findings indicated that exposure-time-specific changes in gene expression closely reflected time-dependent pathological changes in PHMG-P-induced lung injury.
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Affiliation(s)
- Mi-Kyung Song
- National Center for Efficacy Evaluation for Respiratory Disease Product, Korea Institute of Toxicology, Jeongeup, Republic of Korea.,Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon, Republic of Korea
| | - Dong Im Kim
- National Center for Efficacy Evaluation for Respiratory Disease Product, Korea Institute of Toxicology, Jeongeup, Republic of Korea
| | - Kyuhong Lee
- National Center for Efficacy Evaluation for Respiratory Disease Product, Korea Institute of Toxicology, Jeongeup, Republic of Korea.,Department of Human and Environmental Toxicology, University of Science and Technology, Daejeon, Republic of Korea
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Kim H, Ji K. Exposure to humidifier disinfectants induces developmental effects and disrupts thyroid endocrine systems in zebrafish larvae. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 184:109663. [PMID: 31539807 DOI: 10.1016/j.ecoenv.2019.109663] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/28/2019] [Accepted: 09/07/2019] [Indexed: 06/10/2023]
Abstract
Humidifier disinfectants have been widely used in Korea to prevent the growth of microorganisms in humidifier water. However, their use has been banned since 2011 after epidemiological studies reported humidifier disinfectant induced lung injury. In the present study, the developmental effects of exposure to two humidifier disinfectants (Oxy® and Wiselect) and their main component, polyhexamethylene guanidine (PHMG)-phosphate, were investigated in zebrafish embryos/larvae for seven days. The effects on triiodothyronine (T3) and thyroxine (T4) hormones, reactive oxygen species (ROS) generation, antioxidant enzyme activities, and changes in expression of the genes related to the hypothalamus-pituitary-thyroid (HPT) axis and oxidative stress were also investigated. Zebrafish embryos exposed to the highest concentration (amounts recommended for use by the manufacturers) of all tested humidifier disinfectants showed an increase in embryo coagulation, leading to death without hatching. Exposure to Oxy® and Wiselect resulted in significantly decreased body length, increased ROS generation and antioxidant enzyme activities, decreased T4, and up-regulated genes related to the HPT axis (trh, trβ, and tpo) and oxidative damage (sod2 and gpx1b). The humidifier disinfectants and PHMG-phosphate could induce oxidative stress and disrupt thyroid hormone systems in zebrafish, leading to developmental retardation when used at sub-lethal concentrations. Potential effects of long-term exposure to humidifier disinfectants and mixture effects of several major components deserve further investigation.
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Affiliation(s)
- Hyojin Kim
- Department of Occupational and Environmental Health, Yongin University, Yongin, 17092, Republic of Korea
| | - Kyunghee Ji
- Department of Occupational and Environmental Health, Yongin University, Yongin, 17092, Republic of Korea.
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Lee YH, Seo DS, Lee MJ, Cha HG. Immunohistochemical characterization of oxidative stress in the lungs of rats exposed to the humidifier disinfectant polyhexamethylene guanidine hydrochloride. J Toxicol Pathol 2019; 32:311-317. [PMID: 31719760 PMCID: PMC6831495 DOI: 10.1293/tox.2019-0049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 07/13/2019] [Indexed: 12/18/2022] Open
Abstract
Polyhexamethylene guanidine hydrochloride (PHMG-HCl), an antimicrobial additive in humidifier disinfectants, was associated with the
pulmonary disease outbreak in South Korea. However, PHMG-mediated oxidative stress has
only been studied in vitro. Here, we evaluated PHMG-induced oxidative
stress in the lungs of rats exposed to PHMG-HCl. Male F344 rats were exposed to different
concentrations of PHMG-HCl for 13-weeks via whole-body inhalation. Histopathological
examination of the exposed rats showed the presence of lung lesions, including
alveolar/interstitial fibrosis with inflammatory cell infiltration, bronchioalveolar
hyperplasia, bronchiolar/alveolar squamous metaplasia, bronchial/bronchiolar epithelial
detachment, and alveolar hemorrhage. Immunohistochemical analysis showed that
4-hydroxynonenal (4-HNE) was expressed in the bronchiolar epithelium, mainly in Clara
cells and macrophages of the fibrotic tissue. The number of 4-HNE-positive cells increased
significantly in a dose-dependent manner. This is the first in vivo study
to report PHMG-induced oxidative stress. Our study provides clues to elucidate the
mechanisms underlying PHMG-induced damage in patients affected by humidifier
disinfectants.
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Affiliation(s)
- Yong-Hoon Lee
- Pathology Department, Inhalation Toxicity Research Center, Chemicals Research Bureau, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, 339-30 Expo-ro, Yuseong-gu, Daejeon 34122, Republic of Korea
| | - Dong-Seok Seo
- Pathology Department, Inhalation Toxicity Research Center, Chemicals Research Bureau, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, 339-30 Expo-ro, Yuseong-gu, Daejeon 34122, Republic of Korea
| | - Mi Ju Lee
- Pathology Department, Inhalation Toxicity Research Center, Chemicals Research Bureau, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, 339-30 Expo-ro, Yuseong-gu, Daejeon 34122, Republic of Korea
| | - Hyo-Geun Cha
- Pathology Department, Inhalation Toxicity Research Center, Chemicals Research Bureau, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, 339-30 Expo-ro, Yuseong-gu, Daejeon 34122, Republic of Korea
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Kim SH, Kwon D, Lee S, Ki SH, Jeong HG, Hong JT, Lee YH, Jung YS. Polyhexamethyleneguanidine Phosphate-Induced Cytotoxicity in Liver Cells Is Alleviated by Tauroursodeoxycholic Acid (TUDCA) via a Reduction in Endoplasmic Reticulum Stress. Cells 2019; 8:cells8091023. [PMID: 31484321 PMCID: PMC6770470 DOI: 10.3390/cells8091023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/26/2019] [Accepted: 08/30/2019] [Indexed: 02/06/2023] Open
Abstract
Polyhexamethyleneguanidine phosphate (PHMG-P) is a widely used polymeric antimicrobial agent known to induce significant pulmonary toxicity. Several studies have reported that the liver also can be a target organ of polyhexamethyleneguanidine (PHMG) toxicity, but the exact effect of this compound on liver cells is not well understood. To identify the mechanism of PHMG hepatotoxicity, HepG2 cells were exposed to PHMG-P for 72 h. The cell viability was significantly decreased by PHMG-P in a time- and concentration-dependent manner. The mitochondrial membrane potential was markedly reduced by PHMG-P and the apoptotic signaling cascade was activated. The increases observed in C/EBP homologous protein (CHOP), p-IRE, and p-JNK levels in PHMG-P-treated cells indicated the induction of endoplasmic reticulum stress. To verify the role of ER stress in PHMG-P-induced cytotoxicity, HepG2 cells were pretreated with the chemical chaperone, tauroursodeoxycholic acid (TUDCA) and then co-treated with TUDCA and PHMG-P for 24 h. Interestingly, TUDCA inhibited PHMG-P-induced ER stress and cytotoxicity in a dose-dependent manner. The apoptotic cell death and mitochondrial depolarization were also prevented by TUDCA. The proteins involved in the apoptotic pathway were all normalized to their control levels in TUDCA-treated cells. In conclusion, the results suggest that PHMG-P induced significant cytotoxicity in liver cells and ER stress-mediated apoptosis, which may be an important mechanism mediating this hepatotoxicity.
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Affiliation(s)
- Sou Hyun Kim
- Lab of Molecular Toxicology, College of Pharmacy, Pusan National University, Busan 46241, Korea.
| | - Doyoung Kwon
- Department of Cellular and Molecular Pharmacology, University of California San Francisco, San Francisco, CA 94158-2280, USA.
| | - Seunghyun Lee
- Lab of Molecular Toxicology, College of Pharmacy, Pusan National University, Busan 46241, Korea.
| | - Sung Hwan Ki
- College of Pharmacy, Chosun University, Gwangju 61452, Korea.
| | - Hye Gwang Jeong
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea.
| | - Jin Tae Hong
- College of Pharmacy, Chungbuk National University, Cheongju 28160, Korea.
| | - Yun-Hee Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Korea.
| | - Young-Suk Jung
- Lab of Molecular Toxicology, College of Pharmacy, Pusan National University, Busan 46241, Korea.
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Seo C, Kim SH, Lee HS, Ji M, Min J, Son YJ, Kim IH, Lee K, Paik MJ. Metabolomic study on bleomycin and polyhexamethylene guanidine phosphate-induced pulmonary fibrosis mice models. Metabolomics 2019; 15:111. [PMID: 31422500 DOI: 10.1007/s11306-019-1574-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 08/01/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Polyhexamethylene guanidine phosphate (PHMG) has been used as a disinfectant and biocide, and was known to be harmless and non-toxic. However, in 2011, PHMG used as a humidifier disinfectant was reported to be associated with lung diseases, such as, fibrosis in the toxicant studies on pulmonary fibrosis by PHMG. However, no metabolomics study has been performed in PHMG-induced mouse models of pulmonary fibrosis. OBJECTIVES We performed a metabolomic study to understand the biochemical events that occur in bleomycin (BLM)- and PHMG-induced mouse models of pulmonary fibrosis using gas chromatography-mass spectrometry (GC-MS), LC-tandem MS, and GC-tandem MS. RESULTS The levels of 61 metabolites of 30 amino acids, 13 organic acids, 12 fatty acids, 5 polyamines, and oxidized glutathione were determined in the pulmonary tissues of mice with BLM- and PHMG-induced pulmonary fibrosis and in normal controls. Principal component analysis and partial least squares discriminant analysis used to compare level of these 61 metabolites in pulmonary tissues. Levels of metabolites were significantly different in the BLM and PHMG groups as compared with the control group. In particular, the BLM- and PHMG-induced pulmonary fibrosis models showed elevated collagen synthesis and oxidative stress and metabolic disturbance of TCA related organic acids including fumaric acid by NADPH oxidase. In addition, polyamine metabolism showed severe alteration in the PHMG group than that of the BLM group. CONCLUSION This result suggests PHMG will be able to induce pulmonary fibrosis by arginine metabolism and NADPH oxidase signaling.
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Affiliation(s)
- Chan Seo
- College of Pharmacy, Sunchon National University, Suncheon, 540-950, Republic of Korea
| | - Sung-Hwan Kim
- National Center for Efficacy Evaluation of Respiratory Disease Product, Institute of Toxicology, Jeongeup-si, 56212, Republic of Korea
| | - Hyeon-Seong Lee
- College of Pharmacy, Sunchon National University, Suncheon, 540-950, Republic of Korea
| | - Moongi Ji
- College of Pharmacy, Sunchon National University, Suncheon, 540-950, Republic of Korea
| | - Jeuk Min
- College of Pharmacy, Sunchon National University, Suncheon, 540-950, Republic of Korea
| | - Young-Jin Son
- College of Pharmacy, Sunchon National University, Suncheon, 540-950, Republic of Korea
| | - In-Hyeon Kim
- National Center for Efficacy Evaluation of Respiratory Disease Product, Institute of Toxicology, Jeongeup-si, 56212, Republic of Korea
| | - Kyuhong Lee
- National Center for Efficacy Evaluation of Respiratory Disease Product, Institute of Toxicology, Jeongeup-si, 56212, Republic of Korea.
| | - Man-Jeong Paik
- College of Pharmacy, Sunchon National University, Suncheon, 540-950, Republic of Korea.
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Lee J, Jeong JS, Kim SY, Im WJ, Shin YJ, Lee K, Choi SJ, Heo Y, Jeong EJ, Nam SY, Yu WJ. Reproductive and developmental toxicity screening of polyhexamethylene guanidine phosphate by oral gavage in rats. Regul Toxicol Pharmacol 2019; 108:104440. [PMID: 31398363 DOI: 10.1016/j.yrtph.2019.104440] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/23/2019] [Accepted: 08/05/2019] [Indexed: 12/15/2022]
Abstract
Polyhexamethylene guanidine phosphate (PHMG-P) has effective antimicrobial activity against various microorganisms and has been widely used as a biocide in commercial products. However, its use as a humidifier disinfectant has provoked fatal idiopathic lung disease in South Korea, especially in pregnant or postpartum women and their young children. PHMG-P-related toxicological studies of reproduction and development in experimental animals have not been identified, and thus, we investigated the potential effects of early-stage oral exposure to PHMG-P by assessing its toxicological properties. PHMG-P was repeatedly administered by oral gavage at dose levels of 0, 13, 40 and 120 mg/kg to Sprague-Dawley rats during the pre-mating, mating, gestation and early lactation periods, and then general systemic and reproductive/developmental toxicities were investigated. At 120 mg/kg, PHMG-P-related toxicities including subdued behavior, thin appearance, decreased body weight, decreased food consumption and decreased F1 pup body weight were observed. Based on the results of this study, the no-observed-adverse-effect levels (NOAELs) of PHMG-P for both general systemic effects and development are considered to be 40 mg/kg/day.
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Affiliation(s)
- Jinsoo Lee
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea; College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Ji-Seong Jeong
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang Yun Kim
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Wan-Jung Im
- Toxicological Pathology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Young-Jun Shin
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Kyuhong Lee
- Inhalation Toxicology Research Group, Korea Institute of Toxicology, Jeongeup, Republic of Korea; Department of Human and Environmental Toxicology, University of Science & Technology, Daejeon, Republic of Korea
| | - Seong-Jin Choi
- Inhalation Toxicology Research Group, Korea Institute of Toxicology, Jeongeup, Republic of Korea
| | - Yongju Heo
- Inhalation Toxicology Research Group, Korea Institute of Toxicology, Jeongeup, Republic of Korea
| | - Eun Ju Jeong
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea
| | - Sang-Yoon Nam
- College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Wook-Joon Yu
- Developmental and Reproductive Toxicology Research Group, Korea Institute of Toxicology, Daejeon, Republic of Korea.
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Jeong MH, Kim HR, Park YJ, Chung KH. Akt and Notch pathways mediate polyhexamethylene guanidine phosphate-induced epithelial-mesenchymal transition via ZEB2. Toxicol Appl Pharmacol 2019; 380:114691. [PMID: 31348943 DOI: 10.1016/j.taap.2019.114691] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 12/18/2022]
Abstract
Polyhexamethylene guanidine phosphate (PHMG-p), an antimicrobial additive, was used as a humidifier disinfectant in Korea and caused severe lung injuries, including lung fibrosis, in hundreds of victims. As PHMG-p-induced lung fibrosis is different from that induced by known fibrogenic agents such as bleomycin, it is important to understand the molecular mechanisms underlying this effect. A recent study showed that epithelial-mesenchymal transition (EMT) could play key roles in PHMG-p-induced pulmonary fibrosis. Therefore, we aimed to characterize the molecular mechanisms associated with PHMG-p-induced EMT. We observed EMT, macrophage infiltration, and fibrosis in mouse lung tissues after intratracheal instillation of PHMG-p. Furthermore, PHMG-p-induced EMT was observed in A549 cells by the evaluation of cell morphology and quantitation of mRNA and protein expression. The use of EMT inhibitors revealed that PHMG-p induced EMT through the activation of Akt and Notch signaling. Moreover, the transcription factor ZEB2 was observed in PHMG-p-treated A549 cells and mouse lungs. The results indicated that upstream regulators, including Akt and Notch 1, acted as intracellular effectors that triggered ZEB2 expression after exposure to PHMG-p. Attenuation of PHMG-p-induced EMT following inhibition or silencing of Akt and Notch signaling or ZEB2 implied that PHMG-p-induced EMT was a result of Akt, Notch, and ZEB2 activation. Our findings showed that PHMG-p induced EMT through Akt/Notch signaling pathways and that ZEB2 played an important role in PHMG-p-induced lung toxicity. This study will help to understand the mechanisms of action of PHMG-p associated with lung fibrogenesis.
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Affiliation(s)
- Mi Ho Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Republic of Korea
| | - Ha Ryong Kim
- College of Pharmacy, Daegu Catholic University, Gyeongsan, Gyeongsangbuk-do 38430, Republic of Korea
| | - Yong Joo Park
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Republic of Korea.
| | - Kyu Hyuck Chung
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do 16419, Republic of Korea.
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Park JS, Park YJ, Kim HR, Chung KH. Polyhexamethylene guanidine phosphate-induced ROS-mediated DNA damage caused cell cycle arrest and apoptosis in lung epithelial cells. J Toxicol Sci 2019; 44:415-424. [PMID: 31168028 DOI: 10.2131/jts.44.415] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Polyhexamethylene guanidine phosphate (PHMG-p) is an active ingredient of humidifier disinfectants and causes severe lung injury resulting in pulmonary fibrosis. Current evidence indicates that pulmonary fibrosis is initiated as a result of epithelial damage, which can lead to an inflammatory response and fibrotic cell infiltration; however, the toxic mechanism of PHMG-p on the epithelium is still unknown. In this study, the toxic response of PHMG-p on human lung epithelial cells was evaluated, and its mechanisms associated with reactive oxygen species (ROS), DNA damage, and its relationship with p53 activation were investigated. The toxic responses of epithelial cells were assessed by flow cytometry analysis and western blot analysis. The results revealed that PHMG-p induced G1/S arrest and apoptosis in A549 cells. Interestingly, p53 was activated by PHMG-p treatment and p53 knockdown suppressed PHMG-p-induced apoptosis and cell cycle arrest. PHMG-p promoted ROS generation and consequently increased the expression of DNA damage markers such as ATM and H2AX phosphorylation. The antioxidant N-acetylcysteine reduced the expression of phosphorylated ATM and H2AX, and the ATM inhibitor, caffeine, inhibited p53 activation. Taken together, our results demonstrate that PHMG-p triggered G1/S arrest and apoptosis through the ROS/ATM/p53 pathway in lung epithelial cells.
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Affiliation(s)
- Ji Soo Park
- School of Pharmacy, Sungkyunkwan University, Korea
| | | | - Ha Ryong Kim
- College of Pharmacy, Daegu Catholic University, Korea
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Park YJ, Jeong MH, Bang IJ, Kim HR, Chung KH. Guanidine-based disinfectants, polyhexamethylene guanidine-phosphate (PHMG-P), polyhexamethylene biguanide (PHMB), and oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH) induced epithelial-mesenchymal transition in A549 alveolar epithelial cells. Inhal Toxicol 2019; 31:161-166. [PMID: 31179775 DOI: 10.1080/08958378.2019.1624896] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Abstracts Objective: The major active ingredient of humidifier disinfectant, polyhexamethylene guanidine-phosphate (PHMG-P), caused hundreds of deaths with pulmonary fibrosis. However, structurally similar guanidine-based disinfectants are still in use in various fields. Moreover, as they are precursors of excellent antimicrobial compounds, new chemicals with guanidine-based structures have been synthesized and introduced. In this study, we evaluated pulmonary fibrotic responses induced by PHMG-P, polyhexamethylene biguanide (PHMB), and oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH) and their toxicity mechanisms in type II alveolar epithelial A549 cells. Materials and methods: Cellular damage was compared by using the cytotoxicity test (WST-1 assay) and plasma membrane toxicity tests (Lactate dehydrogenase leakage detection assay and plasma membrane staining). As a measure of fibrotic response, induction of the epithelial-mesenchymal transition (EMT) was evaluated by measuring E-cadherin and α-smooth muscle actin (α-SMA) protein expression (epithelial and mesenchymal marker, respectively). Results: All tested compounds showed membrane damage; PHMG-P and PGH induced the highest and lowest damage, respectively. Moreover, they induced EMT when the test chemicals were treated with similar cytotoxic concentrations. Conclusions: Our study indicates that three guanidine-based disinfectants are potential fibrosis-inducing chemicals that induce EMT through cellular damage. Therefore, use of guanidine-based polymers should be strictly regulated by considering their potential adverse effects on the lungs.
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Affiliation(s)
- Yong Joo Park
- a School of Pharmacy , Sungkyunkwan University , Suwon , Republic of Korea
| | - Mi Ho Jeong
- a School of Pharmacy , Sungkyunkwan University , Suwon , Republic of Korea
| | - In Jae Bang
- a School of Pharmacy , Sungkyunkwan University , Suwon , Republic of Korea
| | - Ha Ryong Kim
- b College of Pharmacy , Daegu Catholic University , Gyeongsan , Republic of Korea
| | - Kyu Hyuck Chung
- a School of Pharmacy , Sungkyunkwan University , Suwon , Republic of Korea
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Song J, Jung KJ, Yoon SJ, Lee K, Kim B. Polyhexamethyleneguanidine phosphate induces cytotoxicity through disruption of membrane integrity. Toxicology 2019; 414:35-44. [PMID: 30629986 DOI: 10.1016/j.tox.2019.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 12/17/2018] [Accepted: 01/03/2019] [Indexed: 02/03/2023]
Abstract
Polyhexamethyleneguanidine phosphate (PHMG-P) is a polymeric biocide with a guanidine group. It has multiple positive charges in physiological conditions due to nitrogen atom in the guanidine and this cationic property contributes antimicrobial effect by disrupting cell membranes. To determine whether the cationic nature of PHMG-P results in cytotoxicity in human cell lines, anionic compounds were treated with PHMG-P. The cytotoxic effect was evaluated with ROS production and HMGB1 release into media. To verify the protection effect of anion against PHMG-P-induced cell death in vivo, a zebrafish assay was adopted. In addition, membrane disruption by PHMG-P was evaluated using fluorescein diacetate and propidium iodine staining. As a result, anionic substances such as DNA and poly-l-glutamic acids, decreased PHMG-P induced cell death in a dose-dependent manner. While HMGB1 and ROS production increased with PHMG-P concentration, the addition of anionic compounds with PHMG-P reduced the ROS production and HMGB1 release. The mortality of the zebrafish increased with PHMG-P concentration and co-treatment of anionic compounds with PHMG-P decreased mortality in a dose-dependent manner. In addition, FDA and PI staining confirmed that PHMG-P disrupts plasma membrane. Taken together, a cationic property is considered to be one of the main causes of PHMG-P-induced mammalian cell toxicity.
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Affiliation(s)
- Jeongah Song
- Animal Disease Research Center, Korea Institute of Toxicology, Jeonbuk 56212, Republic of Korea
| | - Kyung Jin Jung
- Analytical Research Center, Korea Institute of Toxicology, Daejeon 34114, Republic of Korea
| | - Seok-Joo Yoon
- Systems Toxicology Center, Predictive Toxicology Department, Korea Institute of Toxicology, Daejeon 34114, Republic of Korea
| | - Kyuhong Lee
- Inhalation Toxicology Research Center, Korea Institute of Toxicology, 30, Baekhak 1-Gil, Jeongeup-si, Jeollabuk-do 56212, Republic of Korea; Human and Environment Toxicology, University of Science and Technology, Daejeon 34114, Republic of Korea.
| | - Bumseok Kim
- Biosafety Research Institute and Laboratory of Pathology (BK21 Plus Program), College of Veterinary Medicine, Chonbuk National University, 79, Gobong-ro, Iksan, 54596, Republic of Korea.
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50
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CMIT/MIT induce apoptosis and inflammation in alveolar epithelial cells through p38/JNK/ERK1/2 signaling pathway. Mol Cell Toxicol 2018. [DOI: 10.1007/s13273-019-0005-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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