1
|
Leung M, Weisskopf MG, Modest AM, Hacker MR, Iyer HS, Hart JE, Wei Y, Schwartz J, Coull BA, Laden F, Papatheodorou S. Using Parametric g-Computation for Time-to-Event Data and Distributed Lag Models to Identify Critical Exposure Windows for Preterm Birth: An Illustrative Example Using PM2.5 in a Retrospective Birth Cohort Based in Eastern Massachusetts (2011-2016). ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:77002. [PMID: 38995210 PMCID: PMC11243950 DOI: 10.1289/ehp13891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 04/18/2024] [Accepted: 06/20/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Parametric g-computation is an attractive analytic framework to study the health effects of air pollution. Yet, the ability to explore biologically relevant exposure windows within this framework is underdeveloped. OBJECTIVES We outline a novel framework for how to incorporate complex lag-responses using distributed lag models (DLMs) into parametric g-computation analyses for survival data. We call this approach "g-survival-DLM" and illustrate its use examining the association between PM 2.5 during pregnancy and the risk of preterm birth (PTB). METHODS We applied the g-survival-DLM approach to estimate the hypothetical static intervention of reducing average PM 2.5 in each gestational week by 20% on the risk of PTB among 9,403 deliveries from Beth Israel Deaconess Medical Center, Boston, Massachusetts, 2011-2016. Daily PM 2.5 was taken from a 1 -km grid model and assigned to address at birth. Models were adjusted for sociodemographics, time trends, nitrogen dioxide, and temperature. To facilitate implementation, we provide a detailed description of the procedure and accompanying R syntax. RESULTS There were 762 (8.1%) PTBs in this cohort. The gestational week-specific median PM 2.5 concentration was relatively stable across pregnancy at ∼ 7 μ g / m 3 . We found that our hypothetical intervention strategy changed the cumulative risk of PTB at week 36 (i.e., the end of the preterm period) by - 0.009 (95% confidence interval: - 0.034 , 0.007) in comparison with the scenario had we not intervened, which translates to about 86 fewer PTBs in this cohort. We also observed that the critical exposure window appeared to be weeks 5-20. DISCUSSION We demonstrate that our g-survival-DLM approach produces easier-to-interpret, policy-relevant estimates (due to the g-computation); prevents immortal time bias (due to treating PTB as a time-to-event outcome); and allows for the exploration of critical exposure windows (due to the DLMs). In our illustrative example, we found that reducing fine particulate matter [particulate matter (PM) with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 )] during gestational weeks 5-20 could potentially lower the risk of PTB. https://doi.org/10.1289/EHP13891.
Collapse
Affiliation(s)
- Michael Leung
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Anna M Modest
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Michele R Hacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Hari S Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Stefania Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, New Brunswick, New Jersey, USA
| |
Collapse
|
2
|
Hicks PM, Lin G, Newman-Casey PA, Niziol LM, Lu MC, Woodward MA, Elam AR, Musch DC, Mehdipanah R, Ehrlich JR, Rein DB. Place-Based Measures of Inequity and Vision Difficulty and Blindness. JAMA Ophthalmol 2024; 142:540-546. [PMID: 38722650 PMCID: PMC11082749 DOI: 10.1001/jamaophthalmol.2024.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/26/2024] [Indexed: 05/12/2024]
Abstract
Importance Known social risk factors associated with poor visual and systemic health in the US include segregation, income inequality, and persistent poverty. Objective To investigate the association of vision difficulty, including blindness, in neighborhoods with measures of inequity (Theil H index, Gini index, and persistent poverty). Design, Setting, and Participants This cross-sectional study used data from the 2012-2016 American Community Survey and 2010 US census tracts as well as Theil H index, Gini index, and persistent poverty measures from PolicyMap. Data analysis was completed in July 2023. Main Outcomes and Measures The main outcome was the number of census tract residents reporting vision difficulty and blindness (VDB) and the association with the Theil H index, Gini index, or persistent poverty, assessed using logistic regression. Results In total, 73 198 census tracts were analyzed. For every 0.1-unit increase in Theil H index and Gini index, there was an increased odds of VDB after controlling for census tract-level median age, the percentage of the population that identified as female sex, the percentage of the population that identified as a member of a racial or ethnic minority group, state, and population size (Theil H index: odds ratio [OR], 1.14 [95% CI, 1.14-1.14; P < .001]; Gini index: OR, 1.15 [95% CI, 1.15-1.15; P < .001]). Persistent poverty was associated with an increased odds of VDB after controlling for census tract-level median age, the percentage of the population that identified as female sex, the percentage of the population that identified as a member of a racial or ethnic minority group, state, and population size compared with nonpersistent poverty (OR, 1.36; 95% CI, 1.35-1.36; P < .001). Conclusions and Relevance In this cross-sectional study, residential measures of inequity through segregation, income inequality, or persistent poverty were associated with a greater number of residents living with VDB. It is essential to understand and address how neighborhood characteristics can impact rates of VDB.
Collapse
Affiliation(s)
- Patrice M. Hicks
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
- Housing Solutions for Health Equity, University of Michigan, Ann Arbor
| | - George Lin
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
| | - Paula Anne Newman-Casey
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor
| | - Leslie M. Niziol
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
| | - Ming-Chen Lu
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
| | - Maria A. Woodward
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor
| | - Angela R. Elam
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor
| | - David C. Musch
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor
| | - Roshanak Mehdipanah
- Housing Solutions for Health Equity, University of Michigan, Ann Arbor
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor
| | - Joshua R. Ehrlich
- Department of Ophthalmology & Visual Sciences, Medical School, University of Michigan, Ann Arbor
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor
- Institute for Social Research, University of Michigan, Ann Arbor
| | | |
Collapse
|
3
|
Goodrich AJ, Kleeman MJ, Tancredi DJ, Ludeña YJ, Bennett DH, Hertz-Picciotto I, Schmidt RJ. Ultrafine particulate matter exposure during second year of life, but not before, associated with increased risk of autism spectrum disorder in BKMR mixtures model of multiple air pollutants. ENVIRONMENTAL RESEARCH 2024; 242:117624. [PMID: 37956751 PMCID: PMC10872511 DOI: 10.1016/j.envres.2023.117624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023]
Abstract
Prenatal and early postnatal air pollution exposures have been shown to be associated with autism spectrum disorder (ASD) risk but results regarding specific air pollutants and exposure timing are mixed and no study has investigated the effects of combined exposure to multiple air pollutants using a mixtures approach. We aimed to evaluate prenatal and early life multipollutant mixtures for the drivers of associations of air pollution with ASD. This study examined 484 typically developing (TD) and 660 ASD children from the CHARGE case-control study. Daily air concentrations for NO2, O3, ultrafine (PM0.1), fine (PM0.1-2.5), and coarse (PM2.5-10) particles were predicted from chemical transport models with statistical bias adjustment based on ground-based monitors. Daily averages were calculated for each exposure period (pre-pregnancy, each trimester of pregnancy, first and second year of life) between 2000 and 2016. Air pollution variables were natural log-transformed and then standardized. Individual and joint effects of pollutant exposure with ASD, and potential interactions, were evaluated for each period using hierarchical Bayesian Kernel Machine Regression (BKMR) models, with three groups: PM size fractions (PM0.1, PM0.1-2.5, PM2.5-10), NO2, and O3. In BKMR models, the PM group was associated with ASD in year 2 (group posterior inclusion probability (gPIP) = 0.75), and marginally associated in year 1 (gPIP = 0.497). PM2.5-10 appeared to drive the association (conditional PIP (cPIP) = 0.64) in year 1, while PM0.1 appeared to drive the association in year 2 (cPIP = 0.76), with both showing a moderately strong increased risk. Pre-pregnancy O3 showed a slight J-shaped risk of ASD (gPIP = 0.55). No associations were observed for exposures during pregnancy. Pre-pregnancy O3 and year 2 p.m.0.1 exposures appear to be associated with an increased risk of ASD. Future research should examine ultrafine particulate matter in relation to ASD.
Collapse
Affiliation(s)
- Amanda J Goodrich
- Department of Public Health Sciences, School of Medicine, University of California Davis, Sacramento, CA, USA.
| | - Michael J Kleeman
- Department of Civil and Environmental Engineering, University of California Davis, Sacramento, CA, USA
| | - Daniel J Tancredi
- Department of Pediatrics, University of California Davis, Sacramento, CA, USA
| | - Yunin J Ludeña
- Department of Public Health Sciences, School of Medicine, University of California Davis, Sacramento, CA, USA; Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, School of Medicine, University of California Davis, Sacramento, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, School of Medicine, University of California Davis, Sacramento, CA, USA; Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California Davis, Sacramento, CA, USA; Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, Sacramento, CA, USA
| |
Collapse
|
4
|
Evans SP, Ailes EC, Kramer MR, Shumate CJ, Reefhuis J, Insaf TZ, Yazdy MM, Carmichael SL, Romitti PA, Feldkamp ML, Neo DT, Nembhard WN, Shaw GM, Palmi E, Gilboa SM. Neighborhood Deprivation and Neural Tube Defects. Epidemiology 2023; 34:774-785. [PMID: 37757869 PMCID: PMC10928547 DOI: 10.1097/ede.0000000000001655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND Individual measures of socioeconomic status (SES) have been associated with an increased risk of neural tube defects (NTDs); however, the association between neighborhood SES and NTD risk is unknown. Using data from the National Birth Defects Prevention Study (NBDPS) from 1997 to 2011, we investigated the association between measures of census tract SES and NTD risk. METHODS The study population included 10,028 controls and 1829 NTD cases. We linked maternal addresses to census tract SES measures and used these measures to calculate the neighborhood deprivation index. We used generalized estimating equations to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) estimating the impact of quartiles of census tract deprivation on NTDs adjusting for maternal race-ethnicity, maternal education, and maternal age at delivery. RESULTS Quartiles of higher neighborhood deprivation were associated with NTDs when compared with the least deprived quartile (Q2: aOR = 1.2; 95% CI = 1.0, 1.4; Q3: aOR = 1.3, 95% CI = 1.1, 1.5; Q4 (highest): aOR = 1.2; 95% CI = 1.0, 1.4). Results for spina bifida were similar; however, estimates for anencephaly and encephalocele were attenuated. Associations differed by maternal race-ethnicity. CONCLUSIONS Our findings suggest that residing in a census tract with more socioeconomic deprivation is associated with an increased risk for NTDs, specifically spina bifida.
Collapse
Affiliation(s)
- Shannon Pruitt Evans
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
- Eagle Global Scientific LLC, San Antonio, TX
| | - Elizabeth C. Ailes
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Charles J. Shumate
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX
| | - Jennita Reefhuis
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Tabassum Z. Insaf
- New York State Department of Health, Albany, NY
- School of Public Health, University at Albany, Rensselaer, NY
| | - Mahsa M. Yazdy
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA
| | - Suzan L. Carmichael
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Paul A. Romitti
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Marcia L. Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - Dayna T. Neo
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Wendy N. Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Gary M. Shaw
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Elizabeth Palmi
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Suzanne M. Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | | |
Collapse
|
5
|
Payne-Sturges DC, Taiwo TK, Ellickson K, Mullen H, Tchangalova N, Anderko L, Chen A, Swanson M. Disparities in Toxic Chemical Exposures and Associated Neurodevelopmental Outcomes: A Scoping Review and Systematic Evidence Map of the Epidemiological Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:96001. [PMID: 37754677 PMCID: PMC10525348 DOI: 10.1289/ehp11750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2023] [Accepted: 08/10/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Children are routinely exposed to chemicals known or suspected of harming brain development. Targeting Environmental Neuro-Development Risks (Project TENDR), an alliance of > 50 leading scientists, health professionals, and advocates, is working to protect children from these toxic chemicals and pollutants, especially the disproportionate exposures experienced by children from families with low incomes and families of color. OBJECTIVE This scoping review was initiated to map existing literature on disparities in neurodevelopmental outcomes for U.S. children from population groups who have been historically economically/socially marginalized and exposed to seven exemplar neurotoxicants: combustion-related air pollution (AP), lead (Pb), mercury (Hg), organophosphate pesticides (OPs), phthalates (Phth), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs). METHODS Systematic literature searches for the seven exemplar chemicals, informed by the Population, Exposure, Comparator, Outcome (PECO) framework, were conducted through 18 November 2022, using PubMed, CINAHL Plus (EBSCO), GreenFILE (EBSCO), and Web of Science sources. We examined these studies regarding authors' conceptualization and operationalization of race, ethnicity, and other indicators of sociodemographic and socioeconomic disadvantage; whether studies presented data on exposure and outcome disparities and the patterns of those disparities; and the evidence of effect modification by or interaction with race and ethnicity. RESULTS Two hundred twelve individual studies met the search criteria and were reviewed, resulting in 218 studies or investigations being included in this review. AP and Pb were the most commonly studied exposures. The most frequently identified neurodevelopmental outcomes were cognitive and behavioral/psychological. Approximately a third (74 studies) reported investigations of interactions or effect modification with 69% (51 of 74 studies) reporting the presence of interactions or effect modification. However, less than half of the studies presented data on disparities in the outcome or the exposure, and fewer conducted formal tests of heterogeneity. Ninety-two percent of the 165 articles that examined race and ethnicity did not provide an explanation of their constructs for these variables, creating an incomplete picture. DISCUSSION As a whole, the studies we reviewed indicated a complex story about how racial and ethnic minority and low-income children may be disproportionately harmed by exposures to neurotoxicants, and this has implications for targeting interventions, policy change, and other necessary investments to eliminate these health disparities. We provide recommendations on improving environmental epidemiological studies on environmental health disparities. To achieve environmental justice and health equity, we recommend concomitant strategies to eradicate both neurotoxic chemical exposures and systems that perpetuate social inequities. https://doi.org/10.1289/EHP11750.
Collapse
Affiliation(s)
| | | | - Kristie Ellickson
- Minnesota Pollution Control Agency, St. Paul, Minnesota, USA
- Union of Concerned Scientists, Cambridge, Massachusetts, USA
| | - Haley Mullen
- Department of Geographical Sciences, University of Maryland, College Park, Maryland, USA
| | | | - Laura Anderko
- M. Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Aimin Chen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | |
Collapse
|
6
|
Leung M, Modest AM, Hacker MR, Wylie BJ, Wei Y, Schwartz J, Iyer HS, Hart JE, Coull BA, Laden F, Weisskopf MG, Papatheodorou S. Traffic-Related Air Pollution and Ultrasound Parameters of Fetal Growth in Eastern Massachusetts. Am J Epidemiol 2023; 192:1105-1115. [PMID: 36963378 PMCID: PMC10893850 DOI: 10.1093/aje/kwad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/30/2022] [Accepted: 03/23/2023] [Indexed: 03/26/2023] Open
Abstract
Previous studies have examined the association between prenatal nitrogen dioxide (NO2)-a traffic emissions tracer-and fetal growth based on ultrasound measures. Yet, most have used exposure assessment methods with low temporal resolution, which limits the identification of critical exposure windows given that pregnancy is relatively short. Here, we used NO2 data from an ensemble model linked to residential addresses at birth to fit distributed lag models that estimated the association between NO2 exposure (resolved weekly) and ultrasound biometric parameters in a Massachusetts-based cohort of 9,446 singleton births from 2011-2016. Ultrasound biometric parameters examined included biparietal diameter (BPD), head circumference, femur length, and abdominal circumference. All models adjusted for sociodemographic characteristics, time trends, and temperature. We found that higher NO2 was negatively associated with all ultrasound parameters. The critical window differed depending on the parameter and when it was assessed. For example, for BPD measured after week 31, the critical exposure window appeared to be weeks 15-25; 10-parts-per-billion higher NO2 sustained from conception to the time of measurement was associated with a lower mean z score of -0.11 (95% CI: -0.17, -0.05). Our findings indicate that reducing traffic emissions is one potential avenue to improving fetal and offspring health.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Stefania Papatheodorou
- Correspondence to Dr. Stefania Papatheodorou, Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115 (e-mail: )
| |
Collapse
|
7
|
Strathearn L, Momany A, Kovács EH, Guiler W, Ladd-Acosta C. The intersection of genome, epigenome and social experience in autism spectrum disorder: Exploring modifiable pathways for intervention. Neurobiol Learn Mem 2023; 202:107761. [PMID: 37121464 PMCID: PMC10330448 DOI: 10.1016/j.nlm.2023.107761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 02/22/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
The number of children diagnosed with autism spectrum disorder (ASD) has increased substantially over the past two decades. Current research suggests that both genetic and environmental risk factors are involved in the etiology of ASD. The goal of this paper is to examine how one specific environmental factor, early social experience, may be correlated with DNA methylation (DNAm) changes in genes associated with ASD. We present an innovative model which proposes that polygenic risk and changes in DNAm due to social experience may both contribute to the symptoms of ASD. Previous research on genetic and environmental factors implicated in the etiology of ASD will be reviewed, with an emphasis on the oxytocin receptor gene, which may be epigenetically altered by early social experience, and which plays a crucial role in social and cognitive development. Identifying an environmental risk factor for ASD (e.g., social experience) that could be modified via early intervention and which results in epigenetic (DNAm) changes, could transform our understanding of this condition, facilitate earlier identification of ASD, and guide early intervention efforts.
Collapse
Affiliation(s)
- Lane Strathearn
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, 51 Newton Road 2-471 Bowen Science Building, Iowa City, IA 52241, USA; Interdisciplinary Graduate Program in Neuroscience, University of Iowa, 356 Medical Research Center, Iowa City, IA 52242, USA; Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, 100 Hawkins Drive, Iowa City, IA 52242, USA; Hawkeye Intellectual and Developmental Disabilities Research Center (Hawk-IDDRC), University of Iowa, 100 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Allison Momany
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Hawkeye Intellectual and Developmental Disabilities Research Center (Hawk-IDDRC), University of Iowa, 100 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Emese Hc Kovács
- Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, 51 Newton Road 2-471 Bowen Science Building, Iowa City, IA 52241, USA.
| | - William Guiler
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, 356 Medical Research Center, Iowa City, IA 52242, USA.
| | - Christine Ladd-Acosta
- Department of Epidemiology and the Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| |
Collapse
|
8
|
Smith CJ, Rendina DN, Kingsbury MA, Malacon KE, Nguyen DM, Tran JJ, Devlin BA, Raju RM, Clark MJ, Burgett L, Zhang JH, Cetinbas M, Sadreyev RI, Chen K, Iyer MS, Bilbo SD. Microbial modulation via cross-fostering prevents the effects of pervasive environmental stressors on microglia and social behavior, but not the dopamine system. Mol Psychiatry 2023; 28:2549-2562. [PMID: 37198262 PMCID: PMC10719943 DOI: 10.1038/s41380-023-02108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/25/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
Environmental toxicant exposure, including air pollution, is increasing worldwide. However, toxicant exposures are not equitably distributed. Rather, low-income and minority communities bear the greatest burden, along with higher levels of psychosocial stress. Both air pollution and maternal stress during pregnancy have been linked to neurodevelopmental disorders such as autism, but biological mechanisms and targets for therapeutic intervention remain poorly understood. We demonstrate that combined prenatal exposure to air pollution (diesel exhaust particles, DEP) and maternal stress (MS) in mice induces social behavior deficits only in male offspring, in line with the male bias in autism. These behavioral deficits are accompanied by changes in microglial morphology and gene expression as well as decreased dopamine receptor expression and dopaminergic fiber input in the nucleus accumbens (NAc). Importantly, the gut-brain axis has been implicated in ASD, and both microglia and the dopamine system are sensitive to the composition of the gut microbiome. In line with this, we find that the composition of the gut microbiome and the structure of the intestinal epithelium are significantly shifted in DEP/MS-exposed males. Excitingly, both the DEP/MS-induced social deficits and microglial alterations in males are prevented by shifting the gut microbiome at birth via a cross-fostering procedure. However, while social deficits in DEP/MS males can be reversed by chemogenetic activation of dopamine neurons in the ventral tegmental area, modulation of the gut microbiome does not impact dopamine endpoints. These findings demonstrate male-specific changes in the gut-brain axis following DEP/MS and suggest that the gut microbiome is an important modulator of both social behavior and microglia.
Collapse
Affiliation(s)
- Caroline J Smith
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Danielle N Rendina
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Marcy A Kingsbury
- Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital, Lurie Center for Autism, Charlestown, MA, USA
| | - Karen E Malacon
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Dang M Nguyen
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Jessica J Tran
- Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital, Lurie Center for Autism, Charlestown, MA, USA
| | - Benjamin A Devlin
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Ravikiran M Raju
- Department of Pediatrics, Division of Newborn Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
- Massachusetts Institute of Technology, Picower Institute for Learning and Memory, Cambridge, MA, USA
| | - Madeline J Clark
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Neurobiology, Duke University Medical School, Durham, NC, USA
| | - Lauren Burgett
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Jason H Zhang
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Murat Cetinbas
- Department of Molecular Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Genetics, Massachusetts General Hospital, Boston, MA, USA
| | - Ruslan I Sadreyev
- Department of Molecular Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin Chen
- Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital, Lurie Center for Autism, Charlestown, MA, USA
| | - Malvika S Iyer
- Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital, Lurie Center for Autism, Charlestown, MA, USA
| | - Staci D Bilbo
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.
- Department of Neurobiology, Duke University Medical School, Durham, NC, USA.
| |
Collapse
|
9
|
Liu H, Ding L, Qu G, Guo X, Liang M, Ma S, Sun Y. Particulate matter exposure during pregnancy and infancy and risks of autism spectrum disorder in children: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 855:158830. [PMID: 36150594 DOI: 10.1016/j.scitotenv.2022.158830] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/13/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE This meta-analysis aimed to clarify the relationship between particulate matter (PM) and autism spectrum disorder (ASD) in detail. METHODS A systematic literature search was performed using eight databases before April 9, 2022. The estimated effects were combined separately according to the PM type. Subgroup analyses were conducted in terms of the study design type, study location, exposure window, birth year, and sex. RESULTS PM2.5 was associated with an increased risk of ASD, while PM10 was not. PMc, PM1, and diesel particulate matter (DPM) were also associated with an increased risk of ASD. Specifically, a 10 μg/m3 increase in PM2.5 was associated with a 1.337-fold increased risk of ASD in children, and a 10 μg/m3 increase in PMc and PM1 may increase the risk of ASD by 1.062 and 3.643 times, respectively. PM2.5 exposure may increase the risk of ASD in boys. Exposure to PMc might increase the risk of ASD in children born after the year 2000. The combined results of different PM differed between studies with continuous and non-continuous data for different study design type, study location, and birth year. The sensitive window for PM2.5 exposure to increase the risk of ASD may be from the first, second, and third trimesters to the first year of the postnatal period. Exposure to PMc during pregnancy was significantly associated with ASD. CONCLUSION Exposure to PM2.5 may increase the risk of ASD in boys. Exposure to PM2.5 during the first, second, and third trimesters and postnatally increased the risk of ASD.
Collapse
Affiliation(s)
- Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Liu Ding
- Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, Anhui, China; University of Science and Technology of China, Hefei 230026, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - MingMing Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, Hefei 238000, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, Hefei 230032, Anhui, China.
| |
Collapse
|
10
|
Block CL, Eroglu O, Mague SD, Smith CJ, Ceasrine AM, Sriworarat C, Blount C, Beben KA, Malacon KE, Ndubuizu N, Talbot A, Gallagher NM, Chan Jo Y, Nyangacha T, Carlson DE, Dzirasa K, Eroglu C, Bilbo SD. Prenatal environmental stressors impair postnatal microglia function and adult behavior in males. Cell Rep 2022; 40:111161. [PMID: 35926455 PMCID: PMC9438555 DOI: 10.1016/j.celrep.2022.111161] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 05/18/2022] [Accepted: 07/13/2022] [Indexed: 12/14/2022] Open
Abstract
Gestational exposure to environmental toxins and socioeconomic stressors is epidemiologically linked to neurodevelopmental disorders with strong male bias, such as autism. We model these prenatal risk factors in mice by co-exposing pregnant dams to an environmental pollutant and limited-resource stress, which robustly activates the maternal immune system. Only male offspring display long-lasting behavioral abnormalities and alterations in the activity of brain networks encoding social interactions. Cellularly, prenatal stressors diminish microglial function within the anterior cingulate cortex, a central node of the social coding network, in males during early postnatal development. Precise inhibition of microglial phagocytosis within the anterior cingulate cortex (ACC) of wild-type (WT) mice during the same critical period mimics the impact of prenatal stressors on a male-specific behavior, indicating that environmental stressors alter neural circuit formation in males via impairing microglia function during development. Block et al. show that combined exposure to air pollution and maternal stress during pregnancy activates the maternal immune system and induces male-specific impairments in social behavior and circuit connectivity in offspring. Cellularly, prenatal stressors diminish microglia phagocytic function, and inhibition of microglia phagocytosis phenocopies behavioral deficits from prenatal stressors.
Collapse
Affiliation(s)
- Carina L Block
- Department of Psychology and Neuroscience, Trinity College of Arts and Sciences, Duke University, Durham, NC 27710, USA
| | - Oznur Eroglu
- Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA
| | - Stephen D Mague
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Caroline J Smith
- Department of Psychology and Neuroscience, Trinity College of Arts and Sciences, Duke University, Durham, NC 27710, USA
| | - Alexis M Ceasrine
- Department of Psychology and Neuroscience, Trinity College of Arts and Sciences, Duke University, Durham, NC 27710, USA
| | | | - Cameron Blount
- Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Kathleen A Beben
- Department of Psychology and Neuroscience, Trinity College of Arts and Sciences, Duke University, Durham, NC 27710, USA
| | - Karen E Malacon
- Department of Psychology and Neuroscience, Trinity College of Arts and Sciences, Duke University, Durham, NC 27710, USA
| | - Nkemdilim Ndubuizu
- Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Austin Talbot
- Department of Statistical Science, Duke University, Durham, NC 27710, USA
| | - Neil M Gallagher
- Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Young Chan Jo
- Department of Psychology and Neuroscience, Trinity College of Arts and Sciences, Duke University, Durham, NC 27710, USA
| | - Timothy Nyangacha
- Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA
| | - David E Carlson
- Department of Civil and Environmental Engineering, Duke University, Durham, NC 27710, USA; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA
| | - Kafui Dzirasa
- Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA; Duke Institute for Brain Sciences, Durham, NC 27710, USA; Howard Hughes Medical Institute, Duke University, Durham, NC 27710, USA.
| | - Cagla Eroglu
- Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA; Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA; Duke Institute for Brain Sciences, Durham, NC 27710, USA; Howard Hughes Medical Institute, Duke University, Durham, NC 27710, USA.
| | - Staci D Bilbo
- Department of Psychology and Neuroscience, Trinity College of Arts and Sciences, Duke University, Durham, NC 27710, USA; Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA; Duke Institute for Brain Sciences, Durham, NC 27710, USA; Lurie Center for Autism, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
| |
Collapse
|
11
|
Lin LZ, Zhan XL, Jin CY, Liang JH, Jing J, Dong GH. The epidemiological evidence linking exposure to ambient particulate matter with neurodevelopmental disorders: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 209:112876. [PMID: 35134379 DOI: 10.1016/j.envres.2022.112876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/26/2022] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND There has been increasing attention on the associations between ambient particulate matter (PM) in early-life and neurodevelopmental disorders (NDDs). However, the associations remained unclear when considering different types of NDDs and different sizes of PM, and vulnerable exposure windows during early-life were not identified yet. OBJECTIVE To synthesize the published literature on the associations between ambient particulate matter (PM) and risk of different types of neurodevelopmental disorders (NDDs) in a systematic review and meta-analysis. METHODS A systematic search of Medline, Embase, PubMed, Cochrane Library, and Web of Science was performed from inception through 24 January 2022. Two reviewers conducted the study selection, data extraction, and quality appraisal. A random-effects model was used for meta-analyses with two quality-of-evidence assessments (the Grading of Recommendations Assessment, Development, and Evaluation system and the best evidence synthesis system). RESULTS A total of 6554 articles were screened, of which 31 were included in the review, and 20 provided adequate data for meta-analyses. Exposures to particulate matter of 2.5 μm or less (PM2.5) during prenatal periods (OR, 1.32 [95%CI, 1.03-1.69]), the first year after birth (OR, 1.62 [95%CI, 1.22-2.15]) and the second year after birth (OR, 3.13 [95%CI, 1.47-6.67]) were associated with increased risk of autism spectrum disorders (ASD) in children. The quality of evidence for these associations during early postnatal periods was somewhat moderate with limited studies. We found inconsistent evidence when considering other types of NDDs and different sizes of PM. CONCLUSIONS AND RELEVANCE Current evidence indicated that there might be an association between PM2.5 exposure and higher risk of ASD, and early postnatal periods appeared to be the critical exposure window. High-quality studies are needed to assess the evidence for other types of NDDs.
Collapse
Affiliation(s)
- Li-Zi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiao-Ling Zhan
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Chu-Yao Jin
- Department of Maternal and Child Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Jing-Hong Liang
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jin Jing
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| |
Collapse
|
12
|
Yu X, Rahman MM, Wang Z, Carter SA, Schwartz J, Chen Z, Eckel SP, Hackman D, Chen JC, Xiang AH, McConnell R. Evidence of susceptibility to autism risks associated with early life ambient air pollution: A systematic review. ENVIRONMENTAL RESEARCH 2022; 208:112590. [PMID: 34929192 DOI: 10.1016/j.envres.2021.112590] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Many studies have found associations between early life air pollution exposure and subsequent onset of autism spectrum disorder (ASD). However, characteristics that affect susceptibility remain unclear. OBJECTIVE This systematic review examined epidemiologic studies on the modifying roles of social, child, genetic and maternal characteristics in associations between prenatal and early postnatal air pollution exposure and ASD. METHODS A systematic literature search in PubMed and Embase was conducted. Studies that examined modifiers of the association between air pollution and ASD were included. RESULTS A total of 19 publications examined modifiers of the associations between early life air pollution exposures and ASD. In general, estimates of effects on risk of ASD in boys were larger than in girls (based on 11 studies). Results from studies of effects of family education (2 studies) and neighborhood deprivation (2 studies) on air pollution-ASD associations were inconsistent. Limited data (1 study) suggest pregnant women with insufficient folic acid intake might be more susceptible to ambient particulate matter less than 2.5 μm (PM2.5) and 10 μm (PM10) in aerodynamic diameter, and to nitrogen dioxide (NO2). Children of mothers with gestational diabetes had increased risk of ozone-associated ASD (1 study). Two genetic studies reported that copy number variations may amplify the effect of ozone, and MET rs1858830 CC genotype may augment effects of PM and near-roadway pollutants on ASD. CONCLUSIONS Child's sex, maternal nutrition or diabetes, socioeconomic factors, and child risk genotypes were reported to modify the effect of early-life air pollutants on ASD risk in the epidemiologic literature. However, the sparsity of studies on comparable modifying hypotheses precludes conclusive findings. Further research is needed to identify susceptible populations and potential targets for preventive intervention.
Collapse
Affiliation(s)
- Xin Yu
- Spatial Science Institute, University of Southern California, Los Angeles, CA, USA
| | - Md Mostafijur Rahman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zhongying Wang
- Spatial Science Institute, University of Southern California, Los Angeles, CA, USA
| | - Sarah A Carter
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel Hackman
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| |
Collapse
|
13
|
Leung M, Weisskopf MG, Laden F, Coull BA, Modest AM, Hacker MR, Wylie BJ, Wei Y, Schwartz J, Papatheodorou S. Exposure to PM2.5 during Pregnancy and Fetal Growth in Eastern Massachusetts, USA. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:17004. [PMID: 34989624 PMCID: PMC8734565 DOI: 10.1289/ehp9824] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 05/29/2023]
Abstract
BACKGROUND Prior studies have examined the association between fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5)] and fetal growth with either limited spatial or temporal resolution. OBJECTIVES In this study, we examined the association between PM2.5 exposure during pregnancy and fetal growth measures (ultrasound parameters and birth weight) in a pregnancy cohort using spatiotemporally resolved PM2.5 in Eastern Massachusetts, USA. METHODS We used ultrasound measures of biparietal diameter (BPD), head circumference, femur length, and abdominal circumference (AC), in addition to birth weight, from 9,446 pregnancies that were delivered at the Beth Israel Deaconess Medical Center from 2011-2016. We used linear mixed-effects models to examine the associations of PM2.5 in two exposure windows (the first 16 wk of pregnancy and the cumulative exposure up until the assessment of fetal growth) with anatomic scans (ultrasound measures at<24 wk), growth scans (ultrasound measures at≥24wk), and birth weight. All models were adjusted for sociodemographic characteristics, long-term trends, and temperature. RESULTS Higher PM2.5 exposure in the first 16 wk was associated with smaller fetal growth measures, where associations were particularly strong for BPD, AC, and birth weight. For example, a 5-μg/m3 increase in PM2.5 was associated with a lower mean BPD z-score of -0.19 (95% CI: -0.31, -0.06) before 24 wk, a lower mean AC z-score of -0.15 (95% CI: -0.28, -0.01) after 24 wk, and a lower mean birth weight z-score of -0.11 (95% CI: -0.20, -0.01). Analyses examining the associations with cumulative PM2.5 exposure up until the assessment of fetal growth produced attenuated associations. CONCLUSIONS Higher gestational exposure to PM2.5 was associated with smaller fetal growth measures at levels below the current national standards. https://doi.org/10.1289/EHP9824.
Collapse
Affiliation(s)
- Michael Leung
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Marc G. Weisskopf
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Brent A. Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Anna M. Modest
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Michele R. Hacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Blair J. Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joel Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Stefania Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
14
|
Influence of the Aryl Hydrocarbon Receptor Activating Environmental Pollutants on Autism Spectrum Disorder. Int J Mol Sci 2021; 22:ijms22179258. [PMID: 34502168 PMCID: PMC8431328 DOI: 10.3390/ijms22179258] [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: 05/10/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
Autism spectrum disorder (ASD) is an umbrella term that includes many different disorders that affect the development, communication, and behavior of an individual. Prevalence of ASD has risen exponentially in the past couple of decades. ASD has a complex etiology and traditionally recognized risk factors only account for a small percentage of incidence of the disorder. Recent studies have examined factors beyond the conventional risk factors (e.g., environmental pollution). There has been an increase in air pollution since the beginning of industrialization. Most environmental pollutants cause toxicities through activation of several cellular receptors, such as the aryl hydrocarbon receptor (AhR)/cytochrome P450 (CYPs) pathway. There is little research on the involvement of AhR in contributing to ASD. Although a few reviews have discussed and addressed the link between increased prevalence of ASD and exposure to environmental pollutants, the mechanism governing this effect, specifically the role of AhR in ASD development and the molecular mechanisms involved, have not been discussed or reviewed before. This article reviews the state of knowledge regarding the impact of the AhR/CYP pathway modulation upon exposure to environmental pollutants on ASD risk, incidence, and development. It also explores the molecular mechanisms involved, such as epigenesis and polymorphism. In addition, the review explores possible new AhR-mediated mechanisms of several drugs used for treatment of ASD, such as sulforaphane, resveratrol, haloperidol, and metformin.
Collapse
|
15
|
Imbriani G, Panico A, Grassi T, Idolo A, Serio F, Bagordo F, De Filippis G, De Giorgi D, Antonucci G, Piscitelli P, Colangelo M, Peccarisi L, Tumolo MR, De Masi R, Miani A, De Donno A. Early-Life Exposure to Environmental Air Pollution and Autism Spectrum Disorder: A Review of Available Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031204. [PMID: 33572907 PMCID: PMC7908547 DOI: 10.3390/ijerph18031204] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 12/13/2022]
Abstract
The number of children diagnosed with Autism Spectrum Disorder (ASD) has rapidly increased globally. Genetic and environmental factors both contribute to the development of ASD. Several studies showed linkage between prenatal, early postnatal air pollution exposure and the risk of developing ASD. We reviewed the available literature concerning the relationship between early-life exposure to air pollutants and ASD onset in childhood. We searched on Medline and Scopus for cohort or case-control studies published in English from 1977 to 2020. A total of 20 articles were selected for the review. We found a strong association between maternal exposure to particulate matter (PM) during pregnancy or in the first years of the children’s life and the risk of the ASD. This association was found to be stronger with PM2.5 and less evident with the other pollutants. Current evidence suggest that pregnancy is the period in which exposure to environmental pollutants seems to be most impactful concerning the onset of ASD in children. Air pollution should be considered among the emerging risk factors for ASD. Further epidemiological and toxicological studies should address molecular pathways involved in the development of ASD and determine specific cause–effect associations.
Collapse
Affiliation(s)
- Giovanni Imbriani
- Department of Biological and Environmental Sciences and Technology, University of Salento, via Monteroni 165, 73100 Lecce, Italy; (G.I.); (A.P.); (A.I.); (F.S.); (F.B.); (A.D.D.)
| | - Alessandra Panico
- Department of Biological and Environmental Sciences and Technology, University of Salento, via Monteroni 165, 73100 Lecce, Italy; (G.I.); (A.P.); (A.I.); (F.S.); (F.B.); (A.D.D.)
| | - Tiziana Grassi
- Department of Biological and Environmental Sciences and Technology, University of Salento, via Monteroni 165, 73100 Lecce, Italy; (G.I.); (A.P.); (A.I.); (F.S.); (F.B.); (A.D.D.)
- Correspondence:
| | - Adele Idolo
- Department of Biological and Environmental Sciences and Technology, University of Salento, via Monteroni 165, 73100 Lecce, Italy; (G.I.); (A.P.); (A.I.); (F.S.); (F.B.); (A.D.D.)
- Local Health Authority ASL Le, 73100 Lecce, Italy; (G.D.F.); (D.D.G.); (G.A.); (P.P.); (L.P.); (R.D.M.)
| | - Francesca Serio
- Department of Biological and Environmental Sciences and Technology, University of Salento, via Monteroni 165, 73100 Lecce, Italy; (G.I.); (A.P.); (A.I.); (F.S.); (F.B.); (A.D.D.)
| | - Francesco Bagordo
- Department of Biological and Environmental Sciences and Technology, University of Salento, via Monteroni 165, 73100 Lecce, Italy; (G.I.); (A.P.); (A.I.); (F.S.); (F.B.); (A.D.D.)
| | - Giovanni De Filippis
- Local Health Authority ASL Le, 73100 Lecce, Italy; (G.D.F.); (D.D.G.); (G.A.); (P.P.); (L.P.); (R.D.M.)
- Medical Professional Association (OMCEO), 73100 Lecce, Italy
| | - Donato De Giorgi
- Local Health Authority ASL Le, 73100 Lecce, Italy; (G.D.F.); (D.D.G.); (G.A.); (P.P.); (L.P.); (R.D.M.)
- Medical Professional Association (OMCEO), 73100 Lecce, Italy
| | - Gianfranco Antonucci
- Local Health Authority ASL Le, 73100 Lecce, Italy; (G.D.F.); (D.D.G.); (G.A.); (P.P.); (L.P.); (R.D.M.)
- Medical Professional Association (OMCEO), 73100 Lecce, Italy
| | - Prisco Piscitelli
- Local Health Authority ASL Le, 73100 Lecce, Italy; (G.D.F.); (D.D.G.); (G.A.); (P.P.); (L.P.); (R.D.M.)
- Medical Professional Association (OMCEO), 73100 Lecce, Italy
| | - Manuela Colangelo
- Italian Association of Health, Environment and Society (AISAS), via De Gasperi 22, Lizzanello, 73023 Lecce, Italy;
| | - Luigi Peccarisi
- Local Health Authority ASL Le, 73100 Lecce, Italy; (G.D.F.); (D.D.G.); (G.A.); (P.P.); (L.P.); (R.D.M.)
- Medical Professional Association (OMCEO), 73100 Lecce, Italy
| | - Maria Rosaria Tumolo
- Research Unit of Brindisi, c/o ex Osp. Di Summa, Institute for Research on Population and Social Policies, National Research Council, Piazza Di Summa, 72100 Brindisi, Italy;
- c/o Campus Ecotekne via Monteroni, Branch of Lecce, Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy
| | - Roberto De Masi
- Local Health Authority ASL Le, 73100 Lecce, Italy; (G.D.F.); (D.D.G.); (G.A.); (P.P.); (L.P.); (R.D.M.)
- Multiple Sclerosis Centre, Laboratory of Neuroproteomics, “Francesco Ferrari” Hospital, 73042 Casarano, Italy
| | - Alessandro Miani
- Italian Society of Environmental Medicine, 02100 Milan, Italy;
- Department of Environmental Science and Policy, University of Milan, 02100 Milan, Italy
| | - Antonella De Donno
- Department of Biological and Environmental Sciences and Technology, University of Salento, via Monteroni 165, 73100 Lecce, Italy; (G.I.); (A.P.); (A.I.); (F.S.); (F.B.); (A.D.D.)
| |
Collapse
|
16
|
Pagliaccio D, Herbstman JB, Perera F, Tang D, Goldsmith J, Peterson BS, Rauh V, Margolis AE. Prenatal exposure to polycyclic aromatic hydrocarbons modifies the effects of early life stress on attention and Thought Problems in late childhood. J Child Psychol Psychiatry 2020; 61:1253-1265. [PMID: 31907931 PMCID: PMC7338249 DOI: 10.1111/jcpp.13189] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/15/2019] [Accepted: 12/04/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Risk for childhood psychopathology is complex and multifactorial, implicating direct and interacting effects of familial and environmental factors. The role of environmental neurotoxicants in psychiatric risk is of growing concern, including polycyclic aromatic hydrocarbons (PAH), common in air pollution. Prenatal PAH exposure is linked to adverse physical, behavioral, and cognitive outcomes as well as increasing psychiatric risk. It is unclear whether environmental exposures, like PAH, magnify the effects of exposure to early life stress (ELS), a critical risk factor for psychopathology. The current work aimed to test potential interactions between prenatal PAH exposure and psychosocial/socioeconomic stress on psychiatric symptoms in school-age children. METHODS Data were from the Columbia Center for Children's Environmental Health Mothers and Newborns longitudinal birth cohort study. Prenatal PAH exposure was ascertained though air monitoring during pregnancy and maternal PAH-DNA adducts at delivery. Mothers reported on ELS (child age 5) and on child psychiatric symptoms across childhood (child age 5, 7, 9, and 11) using the Child Behavior Checklist (CBCL). RESULTS Significant prenatal airborne PAH × ELS interactions (FDR-corrected) predicted CBCL Attention (β = 0.22, t(307) = 3.47, p < .001, pfdr = .003) and Thought Problems T-scores (β = 0.21, t(307) = 3.29, p = .001, pfdr = .004) at age 11 (n = 319). Relative to those with lower exposure, children with higher prenatal PAH exposure exhibited stronger positive associations between ELS and CBCL Attention and Thought Problem T-scores. This interaction was also significant examining convergent ADHD measures (Conners, DuPaul) and examining maternal PAH-DNA adducts (β = 0.29, t(261) = 2.48, p = .01; n = 273). A three-way interaction with assessment wave indicated that the PAH × ELS interaction on Attention Problems was stronger later in development (β = 0.03, t(1,601) = 2.19, p = .03; n = 477). CONCLUSIONS Prenatal exposure to PAH, a common neurotoxicant in air pollution, may magnify or sustain the effects of early life psychosocial/socioeconomic stress on psychiatric outcomes later in child development. This work highlights the critical role of air pollution exposure on child mental health.
Collapse
Affiliation(s)
- David Pagliaccio
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA;,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA;,Columbia Center for Children’s Environmental Health, Department of Environmental Health Sciences, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Frederica Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA;,Columbia Center for Children’s Environmental Health, Department of Environmental Health Sciences, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Deliang Tang
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA;,Columbia Center for Children’s Environmental Health, Department of Environmental Health Sciences, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jeff Goldsmith
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Bradley S. Peterson
- Department of Psychiatry, Keck School of Medicine University of Southern California, Los Angeles, CA, USA
| | - Virginia Rauh
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA;,Columbia Center for Children’s Environmental Health, Department of Environmental Health Sciences, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Amy E. Margolis
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA;,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| |
Collapse
|