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Yi H, Wu H, Zhu W, Lin Q, Zhao X, Lin R, Luo Y, Wu L, Lin D. Phthalate exposure and risk of ovarian dysfunction in endometriosis: human and animal data. Front Cell Dev Biol 2023; 11:1154923. [PMID: 37560165 PMCID: PMC10407402 DOI: 10.3389/fcell.2023.1154923] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/13/2023] [Indexed: 08/11/2023] Open
Abstract
Objective: We aimed to explore the correlations between and possible mechanisms of common environmental endocrine disruptors, phthalates, and ovarian dysfunction in endometriosis. Methods: Subjects were included in the case group (n = 107) who were diagnosed with endometriosis by postoperative pathology in Fujian Maternal and Child Hospital from February 2018 to February 2021, and the women who were excluded from endometriosis by surgery were as the control group (n = 70). The demographic information of the subjects were evaluated by questionnaire, and the clinical characteristics were evaluated by medical records and 3-year follow-up results. Gas chromatography‒mass spectrometry was used to quantify 10 metabolites of phthalates, including dimethyl ortho-phthalate (DMP), mono-n-methyl phthalate (MMP), dioctyl ortho-phthalate (DEP), mono-ethyl phthalate (MEP), di-n-butyl ortho-phthalate (DBP), mono-butyl phthalate (MBP), benzylbutyl phthalate (BBzP), mono-benzyl; phthalate (MBzP), diethylhexyl phthalate (DEHP) and mono-ethylhexyl phthalate (MEHP), in the urine samples of the subjects. Furthermore, a total of 54 SD rats were exposed to DEHP 0, 5, 50, 100, 250, 500, 1,000, 2000, and 3,000 mg/kg/day for 2 weeks. The SD rats' body weight, oestrus cycle changes, and serum anti-mullerian hormone (AMH) levels were evaluated. After sacrifice, the mass index of the rat uterus and bilateral ovaries were calculated. Finally, bioinformatics analysis of rat ovarian tissues was performed to explore the possible mechanism. SPSS 24.0 (IBM, United States) was used for data analysis. p-value <0.05 was considered statistically significant. Results: The human urinary levels of DMP (p < 0.001), MMP (p = 0.001), DEP (p = 0.003), MEP (p = 0.002), DBP (p = 0.041), MBP (p < 0.001), BBzP (p = 0.009), DEHP (p < 0.001), and MEHP (p < 0.001) were significantly higher in women with endometriosis than in controls. Notably, DEHP was a significant risk factor for endometriosis (OR: 11.0, 95% CI: 5.4-22.6). The area under the ROC curve increased when multiple phthalates were diagnosed jointly, reaching 0.974 as the highest value, which was helpful for the diagnosis of endometriosis. In vivo experiments showed that after DEHP exposure in rats, the mass index of the ovary and uterus decreased in a dose-dependent manner; the oestrus cycle of SD rats was irregularly prolonged and disordered; and the serum AMH level was negatively correlated with the DEHP exposure dose (Rho = -0.8, p < 0.001). Bioinformatics analysis of rat ovarian tissues showed that seven genes involved in the steroid biosynthesis pathway were upregulated and may play a negative role in ovarian function. Conclusion: Exposure to phthalates, especially DEHP, is associated with the occurrence of endometriosis and affects women's reproductive prognosis and ovarian function. The steroid biosynthesis pathway may be related to ovarian dysfunction. The detection of phthalate in urine may become a new biological target for the diagnosis of endometriosis.
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Affiliation(s)
- Huan Yi
- National Key Gynecology Clinical Specialty Construction Unit of China, Fujian Provincial Key Gynecology Clinical Specialty, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Huamin Wu
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Fuzhou, Fuzhou, Fujian, China
| | - Wenbin Zhu
- National Key Gynecology Clinical Specialty Construction Unit of China, Fujian Provincial Key Gynecology Clinical Specialty, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Qi Lin
- Fujian Health College, Health Management Department, Fuzhou, Fujian, China
| | - Xiaoyan Zhao
- National Key Gynecology Clinical Specialty Construction Unit of China, Fujian Provincial Key Gynecology Clinical Specialty, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Rong Lin
- National Key Gynecology Clinical Specialty Construction Unit of China, Fujian Provincial Key Gynecology Clinical Specialty, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yan Luo
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Fuzhou, Fuzhou, Fujian, China
| | - Lixiang Wu
- National Key Gynecology Clinical Specialty Construction Unit of China, Fujian Provincial Key Gynecology Clinical Specialty, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Danmei Lin
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Fuzhou, Fuzhou, Fujian, China
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Zhan W, Yang H, Zhang J, Chen Q. Association between co-exposure to phenols and phthalates mixture and infertility risk in women. ENVIRONMENTAL RESEARCH 2022; 215:114244. [PMID: 36058272 DOI: 10.1016/j.envres.2022.114244] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Exposure to phenols and phthalates has been separately linked to increased risks of infertility in women of reproductive age. However, the combined effect of phenols and phthalates exposure on infertility has not been explored. METHODS Data from the National Health and Nutrition Examination Surveys (NHANES) were used. A total of 857 women of reproductive age (18-45 years) with available information on urinary phenol and phthalate metabolites, reproductive questionnaires, and covariates were included in the present study. The definition of infertility was based on self-reports. Multivariable logistic regression, principal component analysis (PCA), and Bayesian kernel machine regression (BKMR) with stratified variable selection were applied to determine what associations were found between combined exposure to these mixtures and risk of infertility among women of reproductive age. RESULTS After adjusting for potential confounders, bisphenol A (BPA), mono(3-carboxypropyl) phthalate (MCPP) and four di(2-ethylhexyl) phthalate (DEHP) metabolites [mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP)] were positively associated with infertility. PCA revealed that the DEHP-BPA factor's PC score was significantly positively related to the likelihood of infertility [adjusted odds ratio (aOR) = 1.45; 1.08, 1.82]. The DEHP-BPA component consistently had the highest group posterior inclusion probability (PIP) in BKMR models. The BKMR model also found that MEOHP, MEHHP, and BPA were positively associated with infertility risk when the remaining combination concentrations were held at their median values. In addition, we observed that the probability of infertility increased dramatically as the quantiles of total mixture concentration increased. CONCLUSION Our findings indicate that a combination of phenol and phthalate metabolites is linked to infertility among reproductive-age women. BPA and DEHP, in particular, are significantly related to the risk of infertility.
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Affiliation(s)
- Wenqiang Zhan
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Yang
- Hainan Women and Children's Medical Center, Haikou, Hainan, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Pogrmic-Majkic K, Samardzija Nenadov D, Tesic B, Fa Nedeljkovic S, Kokai D, Stanic B, Andric N. Mapping DEHP to the adverse outcome pathway network for human female reproductive toxicity. Arch Toxicol 2022; 96:2799-2813. [PMID: 35790550 PMCID: PMC9352620 DOI: 10.1007/s00204-022-03333-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/15/2022] [Indexed: 01/09/2023]
Abstract
Adverse outcome pathways (AOPs) and AOP networks are tools for mechanistic presentation of toxicological effects across different levels of biological organization. These tools are used to better understand how chemicals impact human health. In this study, a four-step workflow was used to derive the AOP network of human female reproductive toxicity (HFRT-AOP) from five AOPs available in the AOP-Wiki and ten AOPs obtained from the literature. Standard network analysis identified key events (KEs) that are point of convergence and divergence, upstream and downstream KEs, and bottlenecks across the network. To map di-(2-ethylhexyl) phthalate (DEHP) to the HFRT-AOP network, we extracted DEHP target genes and proteins from the Comparative Toxicogenomic and the CompTox Chemicals Dashboard databases. Enriched GO terms analysis was used to identify relevant biological processes in the ovary that are DEHP targets, whereas screening of scientific literature was performed manually and automatically using AOP-helpFinder. We combined this information to map DEHP to HFRT-AOP network to provide insight on the KEs and system-level perturbations caused by this endocrine disruptor and the emergent paths. This approach can enable better understanding of the toxic mechanism of DEHP-induced human female reproductive toxicity and reveal potential novel DEHP female reproductive targets for experimental studies.
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Affiliation(s)
- Kristina Pogrmic-Majkic
- Department of Biology and Ecology, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 2, 21000, Novi Sad, Serbia.
| | - Dragana Samardzija Nenadov
- Department of Biology and Ecology, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 2, 21000, Novi Sad, Serbia
| | - Biljana Tesic
- Department of Biology and Ecology, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 2, 21000, Novi Sad, Serbia
| | - Svetlana Fa Nedeljkovic
- Department of Biology and Ecology, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 2, 21000, Novi Sad, Serbia
| | - Dunja Kokai
- Department of Biology and Ecology, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 2, 21000, Novi Sad, Serbia
| | - Bojana Stanic
- Department of Biology and Ecology, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 2, 21000, Novi Sad, Serbia
| | - Nebojsa Andric
- Department of Biology and Ecology, Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovica 2, 21000, Novi Sad, Serbia
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Fletcher EJ, Santacruz-Márquez R, Mourikes VE, Neff AM, Laws MJ, Flaws JA. Effects of Phthalate Mixtures on Ovarian Folliculogenesis and Steroidogenesis. TOXICS 2022; 10:251. [PMID: 35622664 PMCID: PMC9143992 DOI: 10.3390/toxics10050251] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023]
Abstract
The female reproductive system is dependent upon the health of the ovaries. The ovaries are responsible for regulating reproduction and endocrine function. Throughout a female's reproductive lifespan, the ovaries undergo continual structural changes that are crucial for the maturation of ovarian follicles and the production of sex steroid hormones. Phthalates are known to target the ovaries at critical time points and to disrupt normal reproductive function. The US population is constantly exposed to measurable levels of phthalates. Phthalates can also pass placental barriers and affect the developing offspring. Phthalates are frequently prevalent as mixtures; however, most previous studies have focused on the effects of single phthalates on the ovary and female reproduction. Thus, the effects of exposure to phthalate mixtures on ovarian function and the female reproductive system remain unclear. Following a brief introduction to the ovary and its major roles, this review covers what is currently known about the effects of phthalate mixtures on the ovary, focusing primarily on their effects on folliculogenesis and steroidogenesis. Furthermore, this review focuses on the effects of phthalate mixtures on female reproductive outcomes. Finally, this review emphasizes the need for future research on the effects of environmentally relevant phthalate mixtures on the ovary and female reproduction.
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Affiliation(s)
| | | | | | | | | | - Jodi A. Flaws
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802, USA; (E.J.F.); (R.S.-M.); (V.E.M.); (A.M.N.); (M.J.L.)
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Chou Y, Tzeng C. The impact of phthalate on reproductive function in women with endometriosis. Reprod Med Biol 2021; 20:159-168. [PMID: 33850448 PMCID: PMC8022091 DOI: 10.1002/rmb2.12364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endometriosis is a common gynecological condition in which stromal or glandular epithelium is implanted in extrauterine locations. Endometriosis causes detrimental effects on the granulosa cells, and phthalate interferes with the biological and reproductive function of endometrial cells at a molecular level. METHODS This article retrospectively reviewed the studies on phthalate exposure and its relationship with endometriosis. A literature search was performed for scientific articles using the keywords "phthalate and endometriosis," "endometriosis and granulosa cells," "phthalate and granulosa cells," and "phthalates and endometrial cells." RESULTS Endometriosis can affect cytokine production, steroidogenesis, cell cycle progression, expression of estrogen receptor-α (ER-α)/progesterone receptor (PR), and cause endoplasmic reticulum stress, senescence, apoptosis, autophagy, and oxidative stress in the granulosa cells. Mono-n-butyl phthalate (MnBP) alters the expression of cytokines, cell cycle-associated genes, ovarian stimulation, steroidogenesis, and progesterone production. Several in vitro studies have demonstrated that phthalate caused inflammation, invasion, change in cytokines, increased oxidative stress, viability, resistance to hydrogen peroxide, and proliferation of endometrial cells. CONCLUSION This might provide new insights about the impact of phthalate on the pathogenesis of endometriosis and its consequences on the ovarian function.
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Affiliation(s)
- Ya‐Ching Chou
- Department of Biological Science and TechnologyCollege of Biological Science and TechnologyNational Chiao Tung UniversityHsinchuTaiwan
- Center for Intelligent Drug Systems and Smart Bio‐devices (IDSB)National Chiao Tung UniversityHsinchuTaiwan
| | - Chii‐Ruey Tzeng
- Department of Obstetrics and GynecologyTaipei Medical UniversityTaipeiTaiwan
- Taipei Fertility Center, TaipeiTaiwan
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DeWitt NA, Whirledge S, Kallen AN. Updates on molecular and environmental determinants of luteal progesterone production. Mol Cell Endocrinol 2020; 515:110930. [PMID: 32610113 PMCID: PMC7484338 DOI: 10.1016/j.mce.2020.110930] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 12/14/2022]
Abstract
Progesterone, a critical hormone in reproduction, is a key sex steroid in the establishment and maintenance of early pregnancy and serves as an intermediary for synthesis of other steroid hormones. Progesterone production from the corpus luteum is a tightly regulated process which is stimulated and maintained by multiple factors, both systemic and local. Multiple regulatory systems, including classic mediators of gonadotropin stimulation such as the cAMP/PKA pathway and TGFβ-mediated signaling pathways, as well as local production of hormonal factors, exist to promote granulosa cell function and physiological fine-tuning of progesterone levels. In this manuscript, we provide an updated narrative review of the known mediators of human luteal progesterone and highlight new observations regarding this important process, focusing on studies published within the last five years. We will also review recent evidence suggesting that this complex system of progesterone production is sensitive to disruption by exogenous environmental chemicals that can mimic or interfere with the activities of endogenous hormones.
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Affiliation(s)
- Natalie A DeWitt
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Shannon Whirledge
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Amanda N Kallen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
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Gan Y, Yang D, Yang S, Wang J, Wei J, Chen J. Di-2-ethylhexyl phthalate (DEHP) induces apoptosis and autophagy of mouse GC-1 spg cells. ENVIRONMENTAL TOXICOLOGY 2020; 35:292-299. [PMID: 31675140 DOI: 10.1002/tox.22866] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/13/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
As a widely used plasticizer in industry, di-2-ethylhexylphthalate (DEHP) can cause testicular toxicity, yet little is known about the potential mechanism. In this study, DEHP exposure dramatically inhibited cellviability and induced apoptosis of mouse GC-1 spg cells. Furthermore, DEHP significantly increased the levels of autophagy proteins LC3-II, Beclin1 and Atg5, as well as the ratio ofLC3-II/LC3-I. Transmission electron microscopy (TEM) further confirmed that DEHP induced autophagy of mouse GC-1 spg cells. DEHP was also shown to induceoxidative stress; while inhibition of oxidative stress with NAC could increase cell viability and inhibit DEHP-induced apoptosis and autophagy. These results suggested that DEHP induced apoptosis and autophagy of mouse GC-1 spg cells via oxidative stress. 3-MA, an inhibitor of autophagy, could rescue DEHP-induced apoptosis. In summary, DEHP induced apoptosis and autophagy of mouse GC-1 spg cells via oxidative stress, and autophagy might exert a cytotoxic effect on DEHP-induced apoptosis.
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Affiliation(s)
- Yu Gan
- Department of Physiology, Medical College of Nanchang University, Nanchang, China
| | - Dan Yang
- Department of Physiology, Medical College of Nanchang University, Nanchang, China
| | - Si Yang
- Department of Physiology, Medical College of Nanchang University, Nanchang, China
| | - Jinglei Wang
- Department of Physiology, Medical College of Nanchang University, Nanchang, China
| | - Jie Wei
- Department of Physiology, Medical College of Nanchang University, Nanchang, China
| | - Jiaxiang Chen
- Department of Physiology, Medical College of Nanchang University, Nanchang, China
- Jiangxi Provincial Key Laboratory of Reproductive Physiology and Pathology, Nanchang, China
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