Effects of new generation progestins, including as mixtures and in combination with other classes of steroid hormones, on zebrafish early life stages

Environmental Risks of Pharmaceutical Mixtures in Aquatic Ecosystems: Reflections on a Decade of Research

Pharmaceuticals and personal care products (PPCPs) occur as variable mixtures in surface waters receiving discharges of human and animal wastes. A key question identified a decade ago is how to assess the effects of long-term exposures of these PPCP mixtures on nontarget organisms. We review the recent progress made on assessing the aquatic ecotoxicity of PPCP mixtures-with a focus on active pharmaceutical ingredients-and the challenges and research needs that remain. New knowledge has arisen from the use of whole-mixture testing combined with component-based approaches, and these studies show that mixtures often result in responses that meet the concentration addition model. However, such studies have mainly been done on individual species over shorter time periods, and longer-term, multispecies assessments remain limited. The recent use of targeted and nontargeted gene analyses has improved our understanding of the diverse pathways that are impacted, and there are promising new "read-across" methods that use mammalian data to predict toxicity in wildlife. Risk assessments remain challenging given the paucity of ecotoxicological and exposure data on PPCP mixtures. As such, the assessment of PPCP mixtures in aquatic environments should remain a priority given the potential for additive-as well as nontarget-effects in nontarget organisms. In addition, we need to improve our understanding of which species, life stages, and relevant endpoints are most sensitive to which types of PPCP mixtures and to expand our knowledge of environmental PPCP levels in regions of the globe that have been poorly studied to date. We recommend an increased use of new approach methodologies, in particular "omics," to advance our understanding of the molecular mechanics of mixture effects. Finally, we call for systematic research on the role of PPCP mixtures in the development of antimicrobial resistance. Environ Toxicol Chem 2024;43:549-558. © 2023 SETAC.

Experimental exploration of estrogenic effects of norethindrone and 17α-ethinylestradiol on zebrafish (Danio rerio) gonads

Synthetic progestins and xenoestrogens found in aquatic habitats are currently gaining attention on global scale. The current study aimed to investigate the time-and dose-dependent effects of synthetic progestin Norethindrone (NET; 100, 500 and 1000 ng/L) and estrogen 17α-ethinylestradiol (EE2; 100 ng/L) individually as well as in binary mixture (1000 ng/L NET + 100 ng/L EE2) on reproductive histology and transcriptional expression profile of genes in adult zebrafish. For this, 20 female (3.15 ± 0.18 cm & 0.33 ± 0.06 g) and 20 male zebrafish in each group (2.93 ± 0.13 cm & 0.29 ± 0.04 g) were exposed to drugs dissolved in water for 30 days in 12 L rectangular tanks. We found that both NET and EE2 exposure reduced the gonadosomatic index in females, while only EE2 exposure caused significant reduction in males (p ≤ 0.05). Interestingly, NET delayed oocyte maturation in females and accelerated spermatogenesis in males, while EE2 consistently suppressed sperm maturation throughout the experiment. Further, qRT-PCR results revealed differential expression pattern of the study genes (er-α, er-β1, er-β2, pgr, vegfaa and p53) in male and female zebrafish. Co-exposure indicated potential inconsistencies in steroidal function in mixtures rather than single exposures. Our findings imply that changes in gonadal histology after NET and EE2 exposure may result from unique regulation of steroid hormone receptors. Additionally, significantly reduced p53 levels (p ≤ 0.05) following co-exposure in both sexes may suggest an elevated risk of neoplastic transformations. Further research with mammalian models will help to explore the mechanisms behind differing effects of alone and co-exposures.

Baseline progestins characterization in surface waters of three main Portuguese estuaries

Synthetic progestins are micropollutants of special concern, due to their growing use in human and veterinary therapies and their risks to aquatic life. Currently, there is a lack of environmental information on these compounds, worldwide. The main objective of this work was to characterize the levels of the most consumed progestins in Portugal. For that, Ria de Aveiro, Tagus estuary and Ria Formosa were sampled in a temporal perspective to evaluate levels of drospirenone (DRO), desogestrel (DSG), gestodene (GST) and levonorgestrel (LNG). Drospirenone and desogestrel were the most abundant progestins. In the North of Portugal, DSG was the most abundant (Aveiro: 193.9 ng L-1 in summer), while DRO was more representative in the South (Tagus: 178.9 ng L-1; Formosa: 125.7 ng L-1) and also in summer. These spatial differences can be associated with the hydrodynamics of each estuarine system as well as the distinct population and tourist levels associated with each site.

Formulation Controls the Potential Neuromuscular Toxicity of Polyethylene Photoproducts in Developing Zebrafish

Sunlight transforms plastic into water-soluble products, the potential toxicity of which remains unresolved, particularly for vertebrate animals. We evaluated acute toxicity and gene expression in developing zebrafish larvae after 5 days of exposure to photoproduced (P) and dark (D) leachates from additive-free polyethylene (PE) film and consumer-grade, additive-containing, conventional, and recycled PE bags. Using a "worst-case" scenario, with plastic concentrations exceeding those found in natural waters, we observed no acute toxicity. However, at the molecular level, RNA sequencing revealed differences in the number of differentially expressed genes (DEGs) for each leachate treatment: thousands of genes (5442 P, 577 D) for the additive-free film, tens of genes for the additive-containing conventional bag (14 P, 7 D), and none for the additive-containing recycled bag. Gene ontology enrichment analyses suggested that the additive-free PE leachates disrupted neuromuscular processes via biophysical signaling; this was most pronounced for the photoproduced leachates. We suggest that the fewer DEGs elicited by the leachates from conventional PE bags (and none from recycled bags) could be due to differences in photoproduced leachate composition caused by titanium dioxide-catalyzed reactions not present in the additive-free PE. This work demonstrates that the potential toxicity of plastic photoproducts can be product formulation-specific.

Combined effects of climate change and environmentally relevant mixtures of endocrine disrupting compounds on the fitness and gonads' maturation dynamics of Nucella lapillus (Gastropoda)

Coastal areas are affected by multiple stressors like climate change and endocrine disruptors (EDCs). In the laboratory, we investigated the combined effects of increased temperature and EDCs (drospirenone and mercury) on the fitness and gonads' maturation dynamics of the marine gastropod Nucella lapillus for 21 days. Survival was negatively affected by all the stressors alone, while, in combination, a synergistic negative effect was observed. Both chemicals, as single factors, did not cause any effect on the maturation stage of ovaries and testis. However, in the presence of a higher temperature, it was clear a delay in the maturation stage of the ovaries, but not in the testis, suggesting a higher negative impact of the stressors in females than in males. In summary, drospirenone caused a low negative impact in aquatic species, like gastropods, but in combination with other EDCs and/or increased temperature can be a matter of concern.

From polyethylene waste bottles to UIO-66 (Zr) for preconcentration of steroid hormones from river water

Metal-organic framework (UiO-66 (Zr) was synthesized using polyethylene terephthalate (PET) and used as an adsorbent for extraction and preconcentration of steroid hormones in river water. Polyethylene waste bottles were used as the source of polyethylene terephthalate (PET) ligands. The UIO-66(Zr), which the PET was made from recycled waste plastics, was used for the first time for the extraction and preconcentration of four different types of steroid hormones in river water samples. Various analytical characterization techniques were employed to characterize the synthesized material. The steroid hormones were detected and quantified using high-performance liquid chromatography coupled with diode array detector (HPLC-DAD). The results were further validated using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Experimental variables, such as sample pH, the mass of adsorbent and extraction time, were optimized using Box-Behnken design (BBD). The dispersive solid phase extraction method combined with HPLC-DAD, displayed good linearity (0.004-1000 µg/L) low limits of detections (LODs, 1.1-16 ng/L for ultrapure water and 2.6-5.3 ng/L for river water) and limits of quantification (LOQs, 3.7-5.3 ng/L for ultrapure water and 8.7-11.0 ng/L for river water samples) and acceptable extraction recoveries (86-101%). The intraday (n = 10) and interday (n = 5) precisions expressed in terms of relative standard deviations (%RSD) were all less than 5%. The steroid hormones were detected in most of the river water samples (Vaal River and Rietspruit River). The DSPE/HPLC method offered a promising approach for simultaneous extraction, preconcentration and determination of steroid hormones in water.

Efficient in vivo and in silico assessments of antiandrogenic potential in zebrafish

This study aimed to establish zebrafish-based in vivo and in silico assay systems to evaluate the antiandrogenic potential of environmental chemicals. Zebrafish embryos were exposed to 17α-methyltestosterone (TES) alone or coexposed to TES and representative antiandrogens including flutamide, p,p'-DDE, vinclozolin, fenitrothion, and linuron. We assessed the transcript expression of the androgen-responsive gene sulfotransferase family 2, cytosolic sulfotransferase 3 (sult2st3). The expression of sult2st3 was significantly induced by TES in the later stages of embryonic development. However, the TES-induced expression of sult2st3 was inhibited by flutamide in a concentration-dependent manner (IC₅₀: 5.7 μM), suggesting that the androgen receptor (AR) plays a role in sult2st3 induction. Similarly, p,p'-DDE, vinclozolin, and linuron repressed the TES-induced expression of sult2st3 (IC_50s: 0.35, 3.9, and 52 μM, respectively). At the highest concentration tested (100 μM), fenitrothion also suppressed sult2st3 expression almost completely. Notably, p,p'-DDE and linuron did not inhibit sult2st3 induction due to higher concentrations of TES; instead, they potentiated TES-induced sult2st3 expression. Fenitrothion and linuron, which had relatively low antiandrogenic potentials in terms of sult2st3 inhibition, induced broader toxicities in zebrafish embryos; thus, the relationship between developmental toxicities and antiandrogenic potency was unclear. Additionally, an in silico docking simulation showed that all five chemicals interact with the zebrafish AR at relatively low interaction energies and with Arg702 as a key amino acid in ligand binding. Our findings suggest that a combination of zebrafish-based in vivo and in silico assessments represents a promising tool to assess the antiandrogenic potentials of environmental chemicals.

Synthetic Progestins in Waste and Surface Waters: Concentrations, Impacts and Ecological Risk

Synthetic progestins (PGs) are a large family of hormones used in continuously growing amounts in human and animal contraception and medicinal therapies. Because wastewater treatment plants (WWTPs) are unable to eradicate PGs after excretion, they are discharged into aquatic systems, where they can also be regenerated from conjugated PG metabolites. This review summarises the concentrations of 12 PGs in waters from 2015 to 2021. The selected PGs were considered of particular interest due to their wide use, activity, and hormonal derivation (from testosterone, progesterone, and spirolactone). We concluded that PGs had been analysed in WWTPs influents and effluents and, to a lesser extent, in other matrices, including surface waters, where their concentrations range from ng/L to a few µg/L. Because of their high affinity for cell hormone receptors, PGs are endocrine disruptor compounds that may alter the reproductive fitness and development of biota. This review focused on their biological effects in fish, which are the most used aquatic model organisms to qualify the impacts of PGs, highlighting the risks that environmental concentrations pose to their health, fecundity, and fertility. It is concluded that PGs research should be expanded because of the still limited data on their environmental concentrations and effects.

Spatiotemporal distribution, source apportionment and risk assessment of typical hormones and phenolic endocrine disrupting chemicals in environmental and biological samples from the mariculture areas in the Pearl River Delta, China

The present work studied the levels, distribution, potential sources, ecological and human health risks of typical hormones and phenolic endocrine disrupting chemicals (EDCs) in the mariculture areas of the Pearl River Delta (PRD), China. The environmental levels of 11 hormones (6 estrogens, 4 progestogens, and 1 androgen) and 2 phenolic EDCs were quantified in various matrices including water, sediment, cultured fish and shellfish. Ultrahigh performance liquid chromatography-triple quadrupole tandem mass spectrometry analyses showed that all the 13 target compounds were detected in biotic samples, whereas 10 were detected in water and sediment, respectively. The total concentrations ranged from 35.06-364.53 ng/L in water and 6.31-29.30 ng/g in sediment, respectively. The average contaminant levels in shellfish (Ostrea gigas, Mytilus edulis and Mimachlamys nobilis) were significantly higher than those in fish (Culter alburnus, Ephippus orbis and Ephippus orbis). Source apportionment revealed that the pollution of hormones and phenolic EDCs in PRD mariculture areas was resulted from the combination of coastal anthropogenic discharges and mariculture activities. The hazard quotient values of the contaminants were all less than 1, implying no immediate human health risk. Overall, the present study is of great significance for scientific mariculture management, land-based pollution control, ecosystem protection, and safeguarding human health.

Steroid hormones in the aquatic environment

Steroid hormones are extremely important natural hormones in all vertebrates. They control a wide range of physiological processes, including osmoregulation, sexual maturity, reproduction and stress responses. In addition, many synthetic steroid hormones are in widespread and general use, both as human and veterinary pharmaceuticals. Recent advances in environmental analytical chemistry have enabled concentrations of steroid hormones in rivers to be determined. Many different steroid hormones, both natural and synthetic, including transformation products, have been identified and quantified, demonstrating that they are widespread aquatic contaminants. Laboratory ecotoxicology experiments, mainly conducted with fish, but also amphibians, have shown that some steroid hormones, both natural and synthetic, can adversely affect reproduction when present in the water at extremely low concentrations: even sub-ng/L. Recent research has demonstrated that mixtures of different steroid hormones can inhibit reproduction even when each individual hormone is present at a concentration below which it would not invoke a measurable effect on its own. Limited field studies have supported the conclusions of the laboratory studies that steroid hormones may be environmental pollutants of significant concern. Further research is required to identify the main sources of steroid hormones entering the aquatic environment, better describe the complex mixtures of steroid hormones now known to be ubiquitously present, and determine the impacts of environmentally-realistic mixtures of steroid hormones on aquatic vertebrates, especially fish. Only once that research is completed can a robust aquatic risk assessment of steroid hormones be concluded.

Biotransformation of Current-Use Progestin Dienogest and Drospirenone in Laboratory-Scale Activated Sludge Systems Forms High-Yield Products with Altered Endocrine Activity

Dienogest (DIE) and drospirenone (DRO) are two fourth-generation synthetic progestins widely used as oral contraceptives. Despite their increasing detection in wastewaters and surface waters, their fate during biological wastewater treatment is unclear. Here, we investigated DIE and DRO biotransformation with representative activated sludge batch incubations and identified relevant transformation products (TPs) using high-resolution mass spectrometry. DIE exhibited slow biotransformation (16-30 h half-life) and proceeded through a quantitative aromatic dehydrogenation to form TP 309 (molar yields of ∼55%), an aromatic TP ∼30% estrogenic as 17β-estradiol. DRO experienced more rapid biotransformation (<0.5 h half-life), and 1,2-dehydrogenation formed the major TP 364 (molar yields of ∼40%), an antimineralocorticoid drug candidate named as spirorenone. Lactone ring hydrolysis was another important biotransformation pathway for DRO (molar yields of ∼20%) and generated pharmacologically inactive TP 384. Other minor pathways for DIE and DRO included hydroxylation, methoxylation, and 3-keto and C4(5) double-bond hydrogenation; distinct bioactivities are plausible for such TPs, including antigestagenic activity, antigonadotropic activity, and pregnancy inhibition effects. Thus, biotransformation products of DIE and DRO during wastewater treatment should be considered in environmental assessments of synthetic progestins, especially certain TPs such as the estrogenic TP 309 of DIE and the antimineralocorticoid spirorenone (TP 364) of DRO.

Emerging contaminant occurrence and toxic effects on zebrafish embryos to assess the adverse effects caused by mixtures of substances in the environment

The contaminants of emerging concern (CECs) have been receiving global attention due to their worldwide presence in water bodies. The CECs could be originated from synthetic or natural sources, and they are not commonly monitored, although these substances are continuously reaching the aquatic environment. The main goal of this study was to determine the occurrence of some target CECs in São Paulo state surface water, once there is practically no information on the presence and concentration range of these substances at the studied sites. In addition, the present study aimed to assess adverse effects in the non-target fish embryo of Danio rerio (zebrafish) after exposure to surface water organic extract samples during 96 h using FET test. The CECs in surface water samples were determined by solid-phase extraction and liquid chromatography coupled by mass spectrometry. A 2-year study was assessed in 7 rivers and 3 reservoirs at São Paulo state, where 25 of the 30 analyzed substances were quantified, being caffeine the substance with the highest concentration range (5.5 ng L^-1 to 69 μg L^-1) and detected in 95% of analyzed samples, followed by bisphenol A (6.5-1300 ng L^-1) and carbendazim (4.7-285 ng L^-1), found in 50% and 85% of the analyzed samples, respectively. The chemical analysis and biological test were not performed in order to show a direct relationship between concentrations and observed effects on embryos; however, the combined approach can provide a better understanding of the adverse effects caused by mixtures of substances at relevant environmental concentrations. Regarding the adverse effects, it was observed that in the samples from sites with higher anthropogenic activity in the surroundings, there was also a higher mortality rate in organisms. At the Ribeirão Pires River and Sapucaí-Guaçu River, the mortality rate during the 2-year study was 21.6% and 9.3%, respectively. The morphological abnormality rates were higher at Ribeirão Grande (21.4%) and Ribeirão Pires (29.5%) Rivers. The obtained results aim to show that even in low concentrations (ng-μg L^-1) the CECs can cause adverse effects on non-target species, and because of that, new chemical indicators would be important to monitor the water quality and protect the aquatic biota.

Environmental chemicals affect circadian rhythms: An underexplored effect influencing health and fitness in animals and humans

Circadian rhythms control the life of virtually all organisms. They regulate numerous aspects ranging from cellular processes to reproduction and behavior. Besides the light-dark cycle, there are additional environmental factors that regulate the circadian rhythms in animals as well as humans. Here, we outline the circadian rhythm system and considers zebrafish (Danio rerio) as a representative vertebrate organism. We characterize multiple physiological processes, which are affected by circadian rhythm disrupting compounds (circadian disrupters). We focus on and summarize 40 natural and anthropogenic environmental circadian disrupters in fish. They can be divided into six major categories: steroid hormones, metals, pesticides and biocides, polychlorinated biphenyls, neuroactive drugs and other compounds such as cyanobacterial toxins and bisphenol A. Steroid hormones as well as metals are most studied. Especially for progestins and glucocorticoids, circadian dysregulation was demonstrated in zebrafish on the molecular and physiological level, which comprise mainly behavioral alterations. Our review summarizes the current state of knowledge on circadian disrupters, highlights their risks to fish and identifies knowledge gaps in animals and humans. While most studies focus on transcriptional and behavioral alterations, additional effects and consequences are underexplored. Forthcoming studies should explore, which additional environmental circadian disrupters exist. They should clarify the underlying molecular mechanisms and aim to better understand the consequences for physiological processes.

Fate and behavior of progestogens in activated sludge treatment: Kinetics and transformation products

Previous studies have shown the high ecotoxicological potential of progestogens (PGs) on the reproductive system of aquatic organisms. Yet the ubiquitous presence of several PGs in wastewater treatment plant (WWTP) effluents indicates an incomplete removal during treatment. To investigate the fate and behavior of PGs during biological wastewater treatment, nine commonly used PGs were incubated in aerobic lab-scale degradation experiments with activated sludge taken from a municipal WWTP. The degradation kinetics revealed a fast removal after 48 h for most of the compounds. Cyproterone acetate and dienogest were the most recalcitrant of the analyzed steroids with half-lives of 8.65 h and 4.55 h, respectively. Thus, only moderate removals of these PGs can be predicted in full-scale WWTPs. Moreover, numerous transformation products (TPs) were detected via high-resolution mass spectrometry. Hydrogenation or dehydrogenation of ring A and non-selective hydroxylations of 17α-hydroxyprogesterone derivatives (medroxyprogesterone acetate, chlormadinone acetate, cyproterone acetate) as well as for 19-nortestosterone derivatives (dienogest, norethisterone acetate, etonogestrel) were observed as major transformation reactions. Seven of the identified TPs were confirmed by reference standards. The biodegradation of cyproterone acetate revealed an almost quantitative transformation to 3α‑hydroxy cyproterone acetate which is reported to be genotoxic. In a comparative evaluation of the TPs formed and the steroid structure, it was observed that molecular structure played a role in the inhibition of several transformation reactions, explaining the increased recalcitrance of these compounds. In addition, aromatization of the steroid ring A was identified for the 19-nortestosterone derivatives leading to the formation of estrogen-like TPs. For instance, the degradation of norethisterone acetate led to the formation of 17α-ethinylestradiol, a well-known and very potent synthetic estrogen. The evidence of the conversion of progestogenic to estrogenic compounds and the formation of potentially hazardous TPs indicates the need of a more comprehensive environmental risk assessment for synthetic steroids. Two of the newly identified TPs (3α-hydroxy cyproterone acetate and ∆9,11-dehydro-17α-cyanomethyl estradiol) were detected in WWTP effluents for the first time.

Effects of environmental steroid mixtures are regulated by individual steroid receptor signaling

Fish are exposed to steroids of different classes in contaminated waters, but their effects are not sufficiently understood. Here we employed an anti-sense technique using morpholino oligonucleotides to knockdown the glucocorticoid receptors (GRs, GRα and GRβ) and androgen receptor (AR) to investigate their role in physiological and transcriptional responses. To this end, zebrafish embryos were exposed to clobetasol propionate (CLO), androstenedione (A4) and mixtures containing different classes of steroids. CLO caused a decrease of spontaneous muscle contraction and increase of heart rate, as well as transcriptional induction of pepck1, fkbp5, sult2st3 and vitellogenin (vtg1) at 24 and/or 48 h post fertilization (hpf). Knockdown of GRs eliminated these effects, while knockdown of AR decreased the ar transcript but caused no expressional changes, except induction of sult2st3 after exposure to A4 at 24 hpf. Exposure to a mixture of 6 steroids comprising progesterone (P4) and three progestins, cyproterone acetate, dienogest, drospirenone, 17β-estradiol (E2) and CLO caused a significant induction of pepck1, sult2st3, vtg1 and per1a. Knockdown of GRs eliminated the physiological effects and the up-regulation of vtg1, sult2st3, pepck1, fkbp5 and per1a. Thus, as with CLO, responses in mixtures were regulated by GRs independently from the presence of other steroids. Exposure to a mixture comprising A4, CLO, E2 and P4 caused induction of vtg1, cyp19b, sult2st3 and fkbp5. Knockdown of AR had no effect, indicating that regulation of these genes occurred by the GRs and estrogen receptor (ER). Our findings show that in early embryos GRs cause vtg1 and sult2st3 induction in addition to known glucocorticoid target genes. Each steroid receptor regulated its own target genes in steroid mixtures independently from other steroids. However, enhanced expressional induction occurred for vtg1 and fkbp5 in steroid mixtures, indicating an interaction/cross-talk between GRs and ER. These findings have importance for the understanding of molecular effects of steroid mixtures.