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Dang T, Sehgal N, Barr DB, Panuwet P, Liang D, Smarr M, Naksen W, Fiedler N, Promkam N, Prapamontol T, Suttiwan P, Sittiwang S, Eick SM. Association of prenatal chlorpyrifos exposure with sexually dimorphic differences in anogenital distance among Thai farmworker children. ENVIRONMENTAL RESEARCH 2024; 248:118325. [PMID: 38286251 PMCID: PMC11023773 DOI: 10.1016/j.envres.2024.118325] [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: 11/06/2023] [Revised: 12/18/2023] [Accepted: 01/26/2024] [Indexed: 01/31/2024]
Abstract
Organophosphate (OP) insecticides are some of the most abundantly used insecticides, and prenatal exposures have been linked to adverse maternal and child health outcomes. Anogenital distance (AGD) has emerged as an early marker of androgen activity, and later reproductive outcomes, that is sensitive to alteration by environmental chemicals. Here, we examined associations between prenatal exposure to chlorpyrifos, an OP insecticide, with AGD. Pregnant farmworkers were enrolled in the Study of Asian Women and their Offspring's Development and Environmental Exposures (SAWASDEE; N = 104) between 2017 and 2019 in Northern Thailand. Concentrations of 3,5,6-trichloro-2-pyridinol (TCPy), a specific metabolite of chlorpyrifos, were measured in composited urine samples obtained from each trimester of pregnancy. AGD was measured at 12 months of age. Sex-specific adjusted linear regression models were used to examine associations between average and trimester-specific TCPy levels and AGD. In adjusted models for females and males, increasing TCPy was consistently associated with a modest, non-significant reduction in AGD. Across both strata of sex, associations were greatest in magnitude for trimester 3 (females: β = -2.17, 95 % confidence interval (CI) = -4.99, 0.66; males: β = -3.02, 95 % CI = -6.39, 0.35). In the SAWASDEE study, prenatal chlorpyrifos exposure was not strongly associated with AGD at 12 months of age.
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Affiliation(s)
- Thomas Dang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Neha Sehgal
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dana Boyd Barr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Parinya Panuwet
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Melissa Smarr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Warangkana Naksen
- Chiang Mai University, Faculty of Public Health, Chiang Mai, Thailand
| | - Nancy Fiedler
- Rutgers University, Environmental and Occupational Health Science Institute, Piscataway, NJ, USA
| | - Nattawadee Promkam
- Chiang Mai University, Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Tippawan Prapamontol
- Chiang Mai University, Research Institute for Health Sciences, Chiang Mai, Thailand
| | | | | | - Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Lismer A, Shao X, Dumargne MC, Lafleur C, Lambrot R, Chan D, Toft G, Bonde JP, MacFarlane AJ, Bornman R, Aneck-Hahn N, Patrick S, Bailey JM, de Jager C, Dumeaux V, Trasler JM, Kimmins S. The Association between Long-Term DDT or DDE Exposures and an Altered Sperm Epigenome-a Cross-Sectional Study of Greenlandic Inuit and South African VhaVenda Men. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:17008. [PMID: 38294233 PMCID: PMC10829569 DOI: 10.1289/ehp12013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/26/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND The organochlorine dichlorodiphenyltrichloroethane (DDT) is banned worldwide owing to its negative health effects. It is exceptionally used as an insecticide for malaria control. Exposure occurs in regions where DDT is applied, as well as in the Arctic, where its endocrine disrupting metabolite, p , p ' -dichlorodiphenyldichloroethylene (p , p ' -DDE) accumulates in marine mammals and fish. DDT and p , p ' -DDE exposures are linked to birth defects, infertility, cancer, and neurodevelopmental delays. Of particular concern is the potential of DDT use to impact the health of generations to come via the heritable sperm epigenome. OBJECTIVES The objective of this study was to assess the sperm epigenome in relation to p , p ' -DDE serum levels between geographically diverse populations. METHODS In the Limpopo Province of South Africa, we recruited 247 VhaVenda South African men and selected 50 paired blood serum and semen samples, and 47 Greenlandic Inuit blood and semen paired samples were selected from a total of 193 samples from the biobank of the INUENDO cohort, an EU Fifth Framework Programme Research and Development project. Sample selection was based on obtaining a range of p , p ' -DDE serum levels (mean = 870.734 ± 134.030 ng / mL ). We assessed the sperm epigenome in relation to serum p , p ' -DDE levels using MethylC-Capture-sequencing (MCC-seq) and chromatin immunoprecipitation followed by sequencing (ChIP-seq). We identified genomic regions with altered DNA methylation (DNAme) and differential enrichment of histone H3 lysine 4 trimethylation (H3K4me3) in sperm. RESULTS Differences in DNAme and H3K4me3 enrichment were identified at transposable elements and regulatory regions involved in fertility, disease, development, and neurofunction. A subset of regions with sperm DNAme and H3K4me3 that differed between exposure groups was predicted to persist in the preimplantation embryo and to be associated with embryonic gene expression. DISCUSSION These findings suggest that DDT and p , p ' -DDE exposure impacts the sperm epigenome in a dose-response-like manner and may negatively impact the health of future generations through epigenetic mechanisms. Confounding factors, such as other environmental exposures, genetic diversity, and selection bias, cannot be ruled out. https://doi.org/10.1289/EHP12013.
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Affiliation(s)
- Ariane Lismer
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Xiaojian Shao
- Digital Technologies Research Centre, National Research Council Canada, Ottawa, Ontario, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Marie-Charlotte Dumargne
- Department of Animal Science, Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Christine Lafleur
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Romain Lambrot
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
| | - Donovan Chan
- Child Health and Human Development Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Gunnar Toft
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amanda J. MacFarlane
- Agriculture Food and Nutrition Evidence Center, Texas A&M University, Fort Worth, Texas, USA
| | - Riana Bornman
- Environmental Chemical Pollution and Health Research Unit, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Natalie Aneck-Hahn
- University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Sean Patrick
- University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Janice M. Bailey
- Research Centre on Reproduction and Intergenerational Health, Department of Animal Sciences, Université Laval, Quebec, Quebec, Canada
| | - Christiaan de Jager
- Environmental Chemical Pollution and Health Research Unit, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Vanessa Dumeaux
- Department of Anatomy and Cell Biology, Western University, London, Ontario, Canada
- Department of Oncology, Western University, London, Ontario, Canada
| | - Jacquetta M. Trasler
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Child Health and Human Development Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sarah Kimmins
- Department of Pharmacology and Therapeutics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Department of Pathology and Cell Biology, Faculty of Medicine, University of Montreal, Quebec, Canada
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García-Villarino M, Signes-Pastor AJ, Riaño-Galán I, Rodríguez-Dehli AC, Vizcaíno E, Grimalt JO, Fernández-Somoano A, Tardón A. Serum concentrations of persistent organic pollutants mixture during pregnancy and anogenital distance in 8-year-old children from the INMA-Asturias cohort. ENVIRONMENTAL RESEARCH 2022; 213:113607. [PMID: 35690090 DOI: 10.1016/j.envres.2022.113607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND During pregnancy, women are commonly exposed to several endocrine-disrupting chemicals, including persistent organic pollutants (POPs). These compounds can transfer to the fetus through the placenta. Prenatal POP exposure is related to altered fetal genital and reproductive tract development. However, the relationship between exposure to POP mixtures and anogenital distance (AGD) is poorly investigated. This study investigated the association between prenatal exposure to POP mixtures and AGD in 8-year-old children. METHODS Data were collected from the INMA-Asturias cohort. Maternal serum POP concentrations were measured during the first trimester of pregnancy. Anoscrotal distance (AGDAS) and anopenile distance (AGDAP) in males and anofourchetal distance (AGDAF) and anoclitoral distance (AGDAC) in females were recorded in 362 8-years-olds. Conventional linear regression, and the novel weighted quantile sum regression (WQSR) and Bayesian kernel machine regression (BKMR) models were applied to assess the relationships between AGD and POPs exposure stratified by sex. RESULTS Among males, in the linear regression, b-hexachlorocyclohexane, PCB138, PCB153, and PCB180 were inversely associated with the anogenital index (AGI)AS (-0.06 mm/kg (95% confidence interval [CI]: -0.11, -0.02), -0.07 mm/kg (95% CI: -0.14, -0.01), -0.07 mm/kg (95% CI: -0.13, -0.01), and -0.08 mm/kg (95% CI: -0.14, -0.02), respectively). Among females, polybrominated diphenyl ether (PBDE)47 and PBDE154 were positively associated with increased AGIAF (0.02 mm/kg (95% CI: 0.00, 0.03) and 0.09 mm/kg (95% CI: 0.01, 0.17), respectively). BKMR confirmed these associations. WQSR found a negative combined effect of the POP mixture on AGD, and PCB138, PCB153, and PCB180 (weighted 0.18, 0.13, and 0.09, respectively) were identified as the most impacting chemicals. In females, WQSR found a positive combined effect and determined PBDE47 (weighted 0.35) as the most impacting. CONCLUSIONS Maternal exposure to a POP mixture was negatively associated with AGD in male children and positively associated with AGD in female children, thus providing evidence of the adverse effects of POPs on genital development.
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Affiliation(s)
- Miguel García-Villarino
- Spanish Consortium for Reseaiologrch on Epidemy and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unidad de Epidemiología Molecular del Cáncer, Instituto Universitario de Oncología del Principado de Asturias (IUOPA) - Departamento de Medicina, Universidad de Oviedo, Julián Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain
| | - Antonio J Signes-Pastor
- Spanish Consortium for Reseaiologrch on Epidemy and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Spain
| | - Isolina Riaño-Galán
- Spanish Consortium for Reseaiologrch on Epidemy and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain; Servicio de Pediatría, Endocrinología Pediátrica, HUCA, Roma Avenue s/n, 33001, Oviedo, Asturias, Spain
| | - Ana Cristina Rodríguez-Dehli
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain; Servicio de Pediatría, Hospital San Agustín, Heros Street, 4, 33410, Avilés, Asturias, Spain
| | - Esther Vizcaíno
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Jordi Girona Street, 18-26, 08034, Barcelona, Cataluña, Spain
| | - Joan O Grimalt
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Jordi Girona Street, 18-26, 08034, Barcelona, Cataluña, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Reseaiologrch on Epidemy and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unidad de Epidemiología Molecular del Cáncer, Instituto Universitario de Oncología del Principado de Asturias (IUOPA) - Departamento de Medicina, Universidad de Oviedo, Julián Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain.
| | - Adonina Tardón
- Spanish Consortium for Reseaiologrch on Epidemy and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unidad de Epidemiología Molecular del Cáncer, Instituto Universitario de Oncología del Principado de Asturias (IUOPA) - Departamento de Medicina, Universidad de Oviedo, Julián Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain
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Amerstorfer EE, Schmiedeke E, Samuk I, Sloots CEJ, van Rooij IALM, Jenetzky E, Midrio P. Clinical Differentiation between a Normal Anus, Anterior Anus, Congenital Anal Stenosis, and Perineal Fistula: Definitions and Consequences—The ARM-Net Consortium Consensus. CHILDREN 2022; 9:children9060831. [PMID: 35740768 PMCID: PMC9221870 DOI: 10.3390/children9060831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 11/16/2022]
Abstract
In the past, an anteriorly located anus was often misdiagnosed and treated as an anorectal malformation (ARM) with a perineal fistula (PF). The paper aims to define the criteria for a normal anus, an anterior anus (AA) as an anatomic variant, and milder types of ARM such as congenital anal stenosis (CAS) and PF. An extensive literature search was performed by a working group of the ARM-Net Consortium concerning the subject “Normal Anus, AA, and mild ARM”. A consensus on definitions, clinical characteristics, diagnostic management, and treatment modalities was established, and a diagnostic algorithm was proposed. The algorithm enables pediatricians, midwives, gynecologists, and surgeons to make a timely correct diagnosis of any abnormally looking anus and initiate further management if needed. Thus, the routine physical inspection of a newborn should include the inspection of the anus and define its position, relation to the external sphincter, and caliber. A correct diagnosis and use of the presented terminology will avoid misclassifications and allow the initiation of correct management. This will provide a reliable comparison of different therapeutic management and outcomes of these patient cohorts in the future.
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Affiliation(s)
- Eva E. Amerstorfer
- Department for Pediatric and Adolescent Surgery, Medical University of Graz, 8036 Graz, Austria;
| | - Eberhard Schmiedeke
- Clinic for Paediatric Surgery and Paediatric Urology, Klinikum Bremen Mitte, 28205 Bremen, Germany;
| | - Inbal Samuk
- Department of Pediatric and Adolescent Surgery, Schneider Children’s Medical Center of Israel, 4920235 Petach Tikva, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel
| | - Cornelius E. J. Sloots
- Pediatric Surgery Department, Erasmus MC-Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands;
| | - Iris A. L. M. van Rooij
- Department for Health Evidence, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Ekkehart Jenetzky
- Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany;
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes-Gutenberg-University, 55131 Mainz, Germany
| | - Paola Midrio
- Pediatric Surgery Unit, Cà Foncello Hospital, 31100 Treviso, Italy
- Correspondence: ; Tel.: +39-0422-322298
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Koelmel JP, Lin EZ, DeLay K, Williams AJ, Zhou Y, Bornman R, Obida M, Chevrier J, Godri Pollitt KJ. Assessing the External Exposome Using Wearable Passive Samplers and High-Resolution Mass Spectrometry among South African Children Participating in the VHEMBE Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:2191-2203. [PMID: 35089017 DOI: 10.1021/acs.est.1c06481] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Children in low- and middle-income countries are often exposed to higher levels of chemicals and are more vulnerable to the health effects of air pollution. Little is known about the diversity, toxicity, and dynamics of airborne chemical exposures at the molecular level. We developed a workflow employing state-of-the-art wearable passive sampling technology coupled with high-resolution mass spectrometry to comprehensively measure 147 children's personal exposures to airborne chemicals in Limpopo, South Africa, as part of the Venda Health Examination of Mothers, Babies, and Their Environment (VHEMBE). 637 environmental exposures were detected, many of which have never been measured in this population; of these 50 airborne chemical exposures of concern were detected, including pesticides, plasticizers, organophosphates, dyes, combustion products, and perfumes. Biocides detected in wristbands included p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT), p,p'-dichlorodiphenyldichloroethane (p,p'-DDD), p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), propoxur, piperonyl butoxide, and triclosan. Exposures differed across the assessment period with 27% of detected chemicals observed to be either higher or lower in the wet or dry seasons.
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Affiliation(s)
- Jeremy P Koelmel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
| | - Elizabeth Z Lin
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
| | - Kayley DeLay
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
| | - Antony J Williams
- Center for Computational Toxicology and Exposure, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, North Carolina 27711, United States
| | - Yakun Zhou
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
| | - Riana Bornman
- University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa
| | - Muvhulawa Obida
- University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria 0028, South Africa
| | - Jonathan Chevrier
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec H3A 1A2, Canada
| | - Krystal J Godri Pollitt
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut 06520, United States
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Fuhrimann S, Wan C, Blouzard E, Veludo A, Holtman Z, Chetty-Mhlanga S, Dalvie MA, Atuhaire A, Kromhout H, Röösli M, Rother HA. Pesticide Research on Environmental and Human Exposure and Risks in Sub-Saharan Africa: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:259. [PMID: 35010520 PMCID: PMC8750985 DOI: 10.3390/ijerph19010259] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/11/2021] [Accepted: 12/14/2021] [Indexed: 12/16/2022]
Abstract
On the African continent, ongoing agriculture intensification is accompanied by the increasing use of pesticides, associated with environmental and public health concerns. Using a systematic literature review, we aimed to map current geographical research hotspots and gaps around environmental and public health risks research of agriculture pesticides in Sub-Saharan Africa (SSA). Studies were included that collected primary data on past and current-used agricultural pesticides and assessed their environmental occurrence, related knowledge, attitude and practice, human exposure, and environmental or public health risks between 2006 and 2021. We identified 391 articles covering 469 study sites in 37 countries in SSA. Five geographical research hotspots were identified: two in South Africa, two in East Africa, and one in West Africa. Despite its ban for agricultural use, organochlorine was the most studied pesticide group (60%; 86% of studies included DDT). Current-used pesticides in agriculture were studied in 54% of the study sites (including insecticides (92%), herbicides (44%), and fungicides (35%)). Environmental samples were collected in 67% of the studies (e.g., water, aquatic species, sediment, agricultural produce, and air). In 38% of the studies, human subjects were investigated. Only few studies had a longitudinal design or assessed pesticide's environmental risks; human biomarkers; dose-response in human subjects, including children and women; and interventions to reduce pesticide exposure. We established a research database that can help stakeholders to address research gaps, foster research collaboration between environmental and health dimensions, and work towards sustainable and safe agriculture systems in SSA.
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Affiliation(s)
- Samuel Fuhrimann
- Swiss Tropical and Public Health Institute (Swiss TPH), 4002 Basel, Switzerland; (A.V.); (S.C.-M.); (M.R.)
- Faculty of Science, University of Basel, 4002 Basel, Switzerland
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CM Utrecht, The Netherlands; (E.B.); (H.K.)
| | - Chenjie Wan
- Department of Environmental Systems Science, ETH Zurich, 8092 Zurich, Switzerland;
| | - Elodie Blouzard
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CM Utrecht, The Netherlands; (E.B.); (H.K.)
| | - Adriana Veludo
- Swiss Tropical and Public Health Institute (Swiss TPH), 4002 Basel, Switzerland; (A.V.); (S.C.-M.); (M.R.)
- Faculty of Science, University of Basel, 4002 Basel, Switzerland
| | - Zelda Holtman
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7729, South Africa; (Z.H.); (M.A.D.); (H.-A.R.)
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7729, South Africa
| | - Shala Chetty-Mhlanga
- Swiss Tropical and Public Health Institute (Swiss TPH), 4002 Basel, Switzerland; (A.V.); (S.C.-M.); (M.R.)
- Faculty of Science, University of Basel, 4002 Basel, Switzerland
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7729, South Africa; (Z.H.); (M.A.D.); (H.-A.R.)
| | - Aggrey Atuhaire
- Uganda National Association of Community and Occupational Health (UNACOH), Kampala 12590, Uganda;
| | - Hans Kromhout
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CM Utrecht, The Netherlands; (E.B.); (H.K.)
| | - Martin Röösli
- Swiss Tropical and Public Health Institute (Swiss TPH), 4002 Basel, Switzerland; (A.V.); (S.C.-M.); (M.R.)
- Faculty of Science, University of Basel, 4002 Basel, Switzerland
| | - Hanna-Andrea Rother
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7729, South Africa; (Z.H.); (M.A.D.); (H.-A.R.)
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7729, South Africa
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Cargnelutti F, Di Nisio A, Pallotti F, Sabovic I, Spaziani M, Tarsitano MG, Paoli D, Foresta C. Effects of endocrine disruptors on fetal testis development, male puberty, and transition age. Endocrine 2021; 72:358-374. [PMID: 32757113 PMCID: PMC8128728 DOI: 10.1007/s12020-020-02436-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/23/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Endocrine disruptors (EDs) are exogenous substances able to impair endocrine system; consequently, they may cause numerous adverse effects. Over the last years, particular focus has been given to their harmful effects on reproductive system, but very little is known, especially in males. The aim of this review is to discuss the detrimental effects of EDs exposure on fetal testis development, male puberty, and transition age. METHODS A search for the existing literature focusing on the impact of EDs on fetal testis development, male puberty, andrological parameters (anogenital distance, penile length, and testicular volume), and testicular cancer with particular regard to pubertal age provided the most current information available for this review. Human evidence-based reports were given priority over animal and in vitro experimental results. Given the paucity of available articles on this subject, all resources were given careful consideration. RESULTS Information about the consequences associated with EDs exposure in the current literature is limited and often conflicting, due to the scarcity of human studies and their heterogeneity. CONCLUSIONS We conclude that current evidence does not clarify the impact of EDs on human male reproductive health, although severe harmful effects had been reported in animals. Despite controversial results, overall conclusion points toward a positive association between exposure to EDs and reproductive system damage. Further long-term studies performed on wide number of subjects are necessary in order to identify damaging compounds and remove them from the environment.
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Affiliation(s)
- Francesco Cargnelutti
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Andrea Di Nisio
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
| | - Francesco Pallotti
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Iva Sabovic
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
| | - Matteo Spaziani
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Maria Grazia Tarsitano
- Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Donatella Paoli
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Carlo Foresta
- Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy
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Sharma S, Perumal V, Sharma K, Gupta DK. Varied parameters and utility of the anal position index: a systematic review and meta-analysis. Pediatr Surg Int 2021; 37:469-477. [PMID: 33511448 DOI: 10.1007/s00383-020-04839-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The anal position index (API) was described in 1984 by Reisner et al. Since then, it has been measured in different ethnic populations and its utility in various medical conditions have been explored. We aimed to review the literature regarding the various values reported analytically. METHOD A Pubmed Search was carried out with the terms Anal Position Index. There were 158 articles hit by the search. The description of the API was uniform in all studies, described as ratio of anus-fourchette distance in girls and anus-scrotum distance in boys to the distance between coccyx and fourchette/scrotum. 18 relevant studies were included describing the values in different ethnic groups and describing its utility. One study was excluded from statistics due to different landmark for measurement. The studies were grouped into 4. Group A:B:C:D comprised of Newborns:Infants:All age groups:Constipated children. We carried out meta-analysis to estimate effect size (mean difference) using STATA software version 16.0. RESULTS The different ethnic populations in which API were measured, and were Indian (2), Turkish (3), Israel (2), Taiwanese, Thai, Iranian, Spanish, Italian, and Mexican. The API was higher by 0.129 in boys. The mean API in males was 0.53:0.54:0.48:0.52 in Group A:B:C:D with an overall mean (SD) API of 0.51 (0.04). The mean API in females was 0.40:0.40:0.38:0.37 in Group A:B:C:D with an overall mean (SD) API of 0.40(0.03). Two studies were done in mice and showed the relation of API to intrauterine exposure to androgens. In children, API was mostly used to diagnose an anterior ectopic anus and see correlation with constipation. The abnormal values varied from less than 0.30-0.34 in girls and less than 0.41-0.46 in boys. The effect size by regions showed that the estimated effect size for all the regions were within 95% Confidence limits of overall estimate (0.13: 95% CI: 0.13-0.14). Therefore, it can be inferred that there was no significant ethnic variation in the study parameter. The anal position in relation to genitalia was measured in nulliparous women, menopause women, and women with levator deficiency. It was affected in vulvovaginal atrophy. Dichlorodiphenyldichloroethylene exposure during the first trimester of pregnancy was reported to alter the anal position in male infants. CONCLUSION The anteriorly positioned anus has been associated with constipation. API been measured in various ethnic populations with insignificant variations. The API is significantly (p < 0.05) higher in males. The presence of constipation does not seem to alter API. One should adopt a single method for measurement. API should not be considered at the sole indication for any surgical intervention.
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Affiliation(s)
- Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Vanamail Perumal
- Statistics & Demography, Department of Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Kanika Sharma
- Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Devendra K Gupta
- Department of Pediatric Surgery, Super Specialty Pediatric Hospital and Post Graduate Teaching Institute, Noida, India
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9
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Luan M, Ji H, Miao M, Liang H, Wang Z, Chen Y, Chen A, Cao W, Yuan W. Association between prenatal exposure to polybrominated diphenyl ethers and anogenital distance in girls at ages 0-4 years. Int J Hyg Environ Health 2021; 233:113706. [PMID: 33582604 DOI: 10.1016/j.ijheh.2021.113706] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Abstract
Anogenital distance (AGD) is a sensitive marker for the effect of in utero hormonal disturbance. However, studies on the associations between prenatal exposure to polybrominated diphenyl ethers (PBDEs), a group of endocrine disruptors, and AGD are limited. We examined the associations between prenatal PBDE exposure and AGD in girls at ages 0-4 years in the Shanghai-Minhang Birth Cohort Study. We measured PBDE in cord plasma collected from 148 girls at birth. Of them, two AGD metrics (AGDAC: from the anterior surface of the clitoral hood to the center of the anus; AGDAF: from the posterior end of the fourchette to the center of the anus) were measured in 142, 114, 104 and 120 of girls at birth, 6, 12, and 48 months of age, respectively. Linear regression models and linear mixed models were used to evaluate the associations between PBDE exposure and AGD at ages 0-4 years. We found positive associations of PBDE exposure with AGDAF and AGDAC in linear regression models, although some associations only reached significance at 6 and 48 months of age. For AGDAF, the associations were statistically significant for BDE-47, -99, and -100 at 6 months of age (β = 2.34, 95% CI (0.21, 4.48) for BDE-47; β = 2.21, 95% CI (0.05, 4.36) for BDE-99; β = 2.12, 95% CI (0.01, 4.23) for BDE-100), and for BDE-99 and -100 at 48 months of age (β = 4.49, 95% CI (1.27, 7.71) for BDE-99; β = 5.04, 95% CI (1.87, 8.22) for BDE-100), while statistically significant associations with AGDAC were only observed for BDE-99, -100, -153, and ∑5PBDEs at 48 months of age (β = 7.62, 95% CI (2.59, 12.64) for BDE-99; β = 7.04, 95% CI (2.01, 12.07) for BDE-100; β = 5.41, 95% CI (0.45, 10.38) for BDE-153; β = 5.05 mm, 95% CI (0.09, 10.01 for ∑5PBDEs). A consistent pattern of positive associations between prenatal exposure to PBDEs and AGD was also observed in linear mixed models. The finding provided further insights into the adverse effects of PBDEs on reproductive development at low dose exposure.
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Affiliation(s)
- Min Luan
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, Shanghai, China
| | - Honglei Ji
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Maohua Miao
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Hong Liang
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Ziliang Wang
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Yafei Chen
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, Shanghai, China
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Wencheng Cao
- National Reference Laboratory of Dioxin, Institute of Health Inspection and Detection, Hubei Provincial Academy of Preventive Medicine, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Wei Yuan
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China.
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10
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Rodprasert W, Toppari J, Virtanen HE. Endocrine Disrupting Chemicals and Reproductive Health in Boys and Men. Front Endocrinol (Lausanne) 2021; 12:706532. [PMID: 34690925 PMCID: PMC8530230 DOI: 10.3389/fendo.2021.706532] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/17/2021] [Indexed: 12/15/2022] Open
Abstract
Male reproductive health has declined as indicated by increasing rates of cryptorchidism, i.e., undescended testis, poor semen quality, low serum testosterone level, and testicular cancer. Exposure to endocrine disrupting chemicals (EDCs) has been proposed to have a role in this finding. In utero exposure to antiandrogenic EDCs, particularly at a sensitive period of fetal testicular development, the so-called 'masculinization programming window (MPW)', can disturb testicular development and function. Low androgen effect during the MPW can cause both short- and long-term reproductive disorders. A concurrent exposure to EDCs may also affect testicular function or damage testicular cells. Evidence from animal studies supports the role of endocrine disrupting chemicals in development of male reproductive disorders. However, evidence from epidemiological studies is relatively mixed. In this article, we review the current literature that evaluated relationship between prenatal EDC exposures and anogenital distance, cryptorchidism, and congenital penile abnormality called hypospadias. We review also studies on the association between early life and postnatal EDC exposure and semen quality, hypothalamic-pituitary-gonadal axis hormone levels and testicular cancer.
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Affiliation(s)
- Wiwat Rodprasert
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Jorma Toppari
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Helena E. Virtanen
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- *Correspondence: Helena E. Virtanen,
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García-Peñarrubia P, Ruiz-Alcaraz AJ, Martínez-Esparza M, Marín P, Machado-Linde F. Hypothetical roadmap towards endometriosis: prenatal endocrine-disrupting chemical pollutant exposure, anogenital distance, gut-genital microbiota and subclinical infections. Hum Reprod Update 2020; 26:214-246. [PMID: 32108227 DOI: 10.1093/humupd/dmz044] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 11/08/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Endometriosis is a gynaecological hormone-dependent disorder that is defined by histological lesions generated by the growth of endometrial-like tissue out of the uterus cavity, most commonly engrafted within the peritoneal cavity, although these lesions can also be located in distant organs. Endometriosis affects ~10% of women of reproductive age, frequently producing severe and, sometimes, incapacitating symptoms, including chronic pelvic pain, dysmenorrhea and dyspareunia, among others. Furthermore, endometriosis causes infertility in ~30% of affected women. Despite intense research on the mechanisms involved in the initial development and later progression of endometriosis, many questions remain unanswered and its aetiology remains unknown. Recent studies have demonstrated the critical role played by the relationship between the microbiome and mucosal immunology in preventing sexually transmitted diseases (HIV), infertility and several gynaecologic diseases. OBJECTIVE AND RATIONALE In this review, we sought to respond to the main research question related to the aetiology of endometriosis. We provide a model pointing out several risk factors that could explain the development of endometriosis. The hypothesis arises from bringing together current findings from large distinct areas, linking high prenatal exposure to environmental endocrine-disrupting chemicals with a short anogenital distance, female genital tract contamination with the faecal microbiota and the active role of genital subclinical microbial infections in the development and clinical progression of endometriosis. SEARCH METHODS We performed a search of the scientific literature published until 2019 in the PubMed database. The search strategy included the following keywords in various combinations: endometriosis, anogenital distance, chemical pollutants, endocrine-disrupting chemicals, prenatal exposure to endocrine-disrupting chemicals, the microbiome of the female reproductive tract, microbiota and genital tract, bacterial vaginosis, endometritis, oestrogens and microbiota and microbiota-immune system interactions. OUTCOMES On searching the corresponding bibliography, we found frequent associations between environmental endocrine-disrupting chemicals and endometriosis risk. Likewise, recent evidence and hypotheses have suggested the active role of genital subclinical microbial infections in the development and clinical progression of endometriosis. Hence, we can envisage a direct relationship between higher prenatal exposure to oestrogens or estrogenic endocrine-disrupting compounds (phthalates, bisphenols, organochlorine pesticides and others) and a shorter anogenital distance, which could favour frequent postnatal episodes of faecal microbiota contamination of the vulva and vagina, producing cervicovaginal microbiota dysbiosis. This relationship would disrupt local antimicrobial defences, subverting the homeostasis state and inducing a subclinical inflammatory response that could evolve into a sustained immune dysregulation, closing the vicious cycle responsible for the development of endometriosis. WIDER IMPLICATIONS Determining the aetiology of endometriosis is a challenging issue. Posing a new hypothesis on this subject provides the initial tool necessary to design future experimental, clinical and epidemiological research that could allow for a better understanding of the origin of this disease. Furthermore, advances in the understanding of its aetiology would allow the identification of new therapeutics and preventive actions.
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Affiliation(s)
- Pilar García-Peñarrubia
- Departamento de Bioquímica, Biología Molecular (B) e Inmunología. Facultad de Medicina, IMIB and Regional Campus of International Excellence "Campus Mare Nostrum", Universidad de Murcia, 30100 Murcia, Spain
| | - Antonio J Ruiz-Alcaraz
- Departamento de Bioquímica, Biología Molecular (B) e Inmunología. Facultad de Medicina, IMIB and Regional Campus of International Excellence "Campus Mare Nostrum", Universidad de Murcia, 30100 Murcia, Spain
| | - María Martínez-Esparza
- Departamento de Bioquímica, Biología Molecular (B) e Inmunología. Facultad de Medicina, IMIB and Regional Campus of International Excellence "Campus Mare Nostrum", Universidad de Murcia, 30100 Murcia, Spain
| | - Pilar Marín
- Servicio de Ginecología y Obstetricia, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, Murcia, Spain
| | - Francisco Machado-Linde
- Servicio de Ginecología y Obstetricia, Hospital Clínico Universitario Reina Sofía, CARM, Murcia, Spain
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García-Villarino M, Riaño-Galán I, Rodríguez-Dehli AC, Freire C, Vizcaíno E, Grimalt JO, Tardón A, Fernández-Somoano A. Association between pre/perinatal exposure to POPs and children's anogenital distance at age 4 years: A study from the INMA-Asturias cohort. Int J Hyg Environ Health 2020; 229:113563. [PMID: 32559636 DOI: 10.1016/j.ijheh.2020.113563] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 05/08/2020] [Accepted: 05/18/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Prenatal exposure to endocrine-disrupting chemicals may impair genital development and alter reproductive tract anatomy. Anogenital distance (AGD) is a useful biomarker of exposure to chemicals that act as endocrine disruptors. We evaluated associations between prenatal and perinatal exposure to several persistent organic pollutants (POPs) and AGD in 4-year-old children. METHODS Data were drawn from the INMA-Asturias cohort. Pediatricians measured the anofourchetal distance in female children and anoscrotal distance in male children. The anogenital index (AGI) was defined as the AGD divided by the child's weight at age of examination. We measured the levels of two hexachlorocyclohexane isomers, hexachlorobenzene, dichlorodiphenyltrichloroethane (DDT) and its metabolites, six polychlorinated biphenyl (PCB) congeners, and six polybrominated diphenyl ether (PBDE) congeners in maternal serum at 12 gestational weeks (n = 155) and in cord blood serum (n = 229). Anthropometric and parental sociodemographic variables were collected via face-to-face interviews. Linear regression models were used to evaluate the relationship between exposure to POPs and AGI, adjusted for confounders and stratified by sex. RESULTS In male children, we found inverse associations between AGI and maternal concentrations of PCB-138 (ß = -0.041, 95% confidence interval [CI]: -0.074, -0.008, second tertile), PCB-153 (ß = -0.052, 95% CI: -0.085, -0.020, second tertile), PCB-180 ß = -0.065, 95% CI: -0.096, -0.035, second tertile; ß = -0.042, 95% CI: -0.073, -0.011, third tertile), PBDE-209 (ß = -0.031, 95% CI: -0.058, -0.006), cord serum concentrations of PCB-153 (ß = -0.029, 95% CI: -0.059, -0.000, second tertile; ß = -0.047, 95% CI: -0.085, -0.008, third tertile), and PCB-180 (ß = -0.041, 95% CI: -0.078, -0.005, third tertile). In female children, AGI was positively associated with maternal serum concentrations of PCB-101 (ß = 0.039, 95% CI: 0.002, 0.076, second tertile), and higher cord serum levels of 4,4'-DDT (ß = 0.032, 95% CI: 0.003, 0.061, third tertile) and 4,4'-DDE (ß = 0.040, 95% CI: 0.011, 0.069, third tertile). CONCLUSIONS Our findings provide evidence of associations between specific POPs and AGI in boys and girls aged 4 years, and suggest that pre/perinatal exposure to POPs has a feminizing effect in males and a masculinizing effect in females.
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Affiliation(s)
- Miguel García-Villarino
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain.
| | - Isolina Riaño-Galán
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain; Servicio de Pediatría, Endocrinología, HUCA, Roma Avenue s/n. 33001, Oviedo, Asturias, Spain
| | - Ana Cristina Rodríguez-Dehli
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain; Servicio de Pediatría. Hospital San Agustín, Heros Street, 4, 33410, Avilés, Asturias, Spain
| | - Carmen Freire
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Avenida de Madrid 15, 18010, Granada, Spain
| | - Esther Vizcaíno
- Department of environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Jordi Girona Street, 18-26, 08034, Barcelona, Cataluña, Spain
| | - Joan O Grimalt
- Department of environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Jordi Girona Street, 18-26, 08034, Barcelona, Cataluña, Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain
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Nelson W, Liu DY, Yang Y, Zhong ZH, Wang YX, Ding YB. In utero exposure to persistent and nonpersistent endocrine-disrupting chemicals and anogenital distance. A systematic review of epidemiological studies†. Biol Reprod 2019; 102:276-291. [DOI: 10.1093/biolre/ioz200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/18/2019] [Accepted: 10/09/2019] [Indexed: 12/24/2022] Open
Abstract
Abstract
Anti-androgenic endocrine-disrupting chemicals (EDCs) can cross the placenta to modify early offspring sexual dimorphic markers. These changes are linked to anogenital distance (AGD), which is an androgen-sensitive anthropometric parameter used as a biomarker of perineal growth and caudal migration of the genital tubercle. This review aimed to summarize strength of evidence for associations of in utero exposure to EDCs with AGD and to identify gaps and limitations in the literature so as to inform future research. We performed an electronic search of English literature in September 2019 in medical literature analysis and retrieval system online (MEDLINE), Web of Science and Toxline. We included epidemiological studies that examined in utero exposure to persistent and nonpersistent EDCs and considered AGD in offspring as an outcome. Our review contained 16 investigations examining exposure to persistent EDCs (nine studies) and nonpersistent EDCs (seven studies). Some individual studies reported an inverse association between exposure to bisphenol A (BPA), dioxins, perfluoroalkyl substances, and organochlorides and AGD in both male and female offspring. Meta-analysis of three studies found a small reduction of AGD in female offspring exposed to BPA. The number of studies per chemical is small, and number of subjects examined is limited; so, replication of these results is needed. To achieve more specificity and better replication of results, future studies should establish the association of nonpersistent EDCs using multiple urine samples, evaluate the cumulative impact of exposure to a mixture of anti-androgenic chemicals, and offer adequate consideration of more maternal- and children-related confounding factors.
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Affiliation(s)
- William Nelson
- Joint International Research Laboratory of Reproduction and Development, Department of Reproductive Biology, School of Public Health, Chongqing Medical University, Chongqing, 400016, P.R. China
- Department of Environmental and Occupational Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Ding-Yuan Liu
- Joint International Research Laboratory of Reproduction and Development, Department of Reproductive Biology, School of Public Health, Chongqing Medical University, Chongqing, 400016, P.R. China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, 400016, P.R. China
| | - Zhao-Hui Zhong
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, 400016, P.R. China
| | - Ying-Xiong Wang
- Joint International Research Laboratory of Reproduction and Development, Department of Reproductive Biology, School of Public Health, Chongqing Medical University, Chongqing, 400016, P.R. China
| | - Yu-bin Ding
- Joint International Research Laboratory of Reproduction and Development, Department of Reproductive Biology, School of Public Health, Chongqing Medical University, Chongqing, 400016, P.R. China
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Schwartz CL, Christiansen S, Vinggaard AM, Axelstad M, Hass U, Svingen T. Anogenital distance as a toxicological or clinical marker for fetal androgen action and risk for reproductive disorders. Arch Toxicol 2018; 93:253-272. [PMID: 30430187 DOI: 10.1007/s00204-018-2350-5] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/08/2018] [Indexed: 11/30/2022]
Abstract
Male reproductive development is intricately dependent on fetal androgen action. Consequently, disrupted androgen action during fetal life can interfere with the development of the reproductive system resulting in adverse effects on reproductive function later in life. One biomarker used to evaluate fetal androgen action is the anogenital distance (AGD), the distance between the anus and the external genitalia. A short male AGD is strongly associated with genital malformations at birth and reproductive disorders in adulthood. AGD is therefore used as an effect readout in rodent toxicity studies aimed at testing compounds for endocrine activity and anti-androgenic properties, and in human epidemiological studies to correlate fetal exposure to endocrine disrupting chemicals to feminization of new-born boys. In this review, we have synthesized current data related to intrauterine exposure to xenobiotics and AGD measurements. We discuss the utility of AGD as a retrospective marker of in utero anti-androgenicity and as a predictive marker for male reproductive disorders, both with respect to human health and rodent toxicity studies. Finally, we highlight four areas that need addressing to fully evaluate AGD as a biomarker in both a regulatory and clinical setting.
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Affiliation(s)
- Camilla Lindgren Schwartz
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - Sofie Christiansen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - Anne Marie Vinggaard
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - Marta Axelstad
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - Ulla Hass
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - Terje Svingen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, 2800, Kongens Lyngby, Denmark.
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Araki A, Miyashita C, Mitsui T, Goudarzi H, Mizutani F, Chisaki Y, Itoh S, Sasaki S, Cho K, Moriya K, Shinohara N, Nonomura K, Kishi R. Prenatal organochlorine pesticide exposure and the disruption of steroids and reproductive hormones in cord blood: The Hokkaido study. ENVIRONMENT INTERNATIONAL 2018; 110:1-13. [PMID: 29055783 DOI: 10.1016/j.envint.2017.10.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/10/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Abstract
Certain organochlorine pesticides (OCPs) are designated as persistent organic pollutants and are regulated in many countries. The effects of OCPs on pediatric endocrinology are a concern; however, only limited data exist from human studies on maternal OCP exposure and its effects on infants' hormone levels. This study was conducted as part of the Hokkaido Study Sapporo Cohort, a prospective birth cohort study in Japan. Participants included 514 women who enrolled at 23-35weeks of gestation between 2002 and 2005; maternal blood samples were collected in late pregnancy, and 29 OCPs were measured. Reproductive and steroid hormone levels in cord blood were also determined. Characteristics of mothers and their infants were obtained from self-administered questionnaires and medical records. Ultimately, 232 samples with both OCP and hormone data were analyzed. Fifteen of 29 investigated OCPs were detected in over 80% of the samples, with p,p'-dichlorodiphenyldichloroethylene showing the highest concentration (median value: 619pg/g-wet). The association between OCPs and sex hormone levels varied by sex. Linear regression models after sex stratification showed that chlordanes, cis-hexachlorobenzene, heptachlor epoxide, Mirex, and toxaphenes in maternal blood were inversely associated with testosterone, cortisol, cortisone, sex hormone-binding globin, prolactin, and androstenedione-dehydroepiandrosterone (DHEA) and testosterone-androstenediones ratios among boys. Furthermore, these OCPs were positively correlated with DHEA, follicle stimulating hormone (FSH), and adrenal androgen-glucocorticoid and FSH-inhibin B ratios among boys. In categorical quartile models, testosterone and DHEA were inversely and positively associated with OCPs, respectively. Estradiol-testosterone and adrenal androgen-glucocorticoid ratios tended to increase with increasing OCP concentrations in the higher quartile, while the testosterone-androstenedione ratio tended to decrease. Sex hormone-binding globulin and prolactin showed an inverse association with OCPs. Among girls, the linear regression model showed that only p,p'-dichlorodiphenyltrichloroethane was inversely associated with the level of DHEA and the adrenal androgen-glucocorticoid ratio, but was positively associated with cortisone levels. However, no associations were observed using the quartile categorical model. These results suggest that prenatal exposure to OCPs disrupt reproductive hormones of fetuses in utero among boys, even at relatively low levels.
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Affiliation(s)
- Atsuko Araki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Sapporo, Hokkaido, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Sapporo, Hokkaido, Japan
| | - Takahiko Mitsui
- Department of Urology, Hokkaido University Hospital, Kita 15, Nishi 7, Sapporo, Hokkaido, Japan; Yamanashi University, 1110, Shimogato, Chuo, Yamanashi, Japan
| | - Houman Goudarzi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Sapporo, Hokkaido, Japan; Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, Hokkaido, Japan
| | - Futoshi Mizutani
- Institute of Environmental Ecology, IDEA Consultants, Inc., 1334-5 Riemon, Yaizu, Shizuoka, Japan
| | - Youichi Chisaki
- Institute of Environmental Ecology, IDEA Consultants, Inc., 1334-5 Riemon, Yaizu, Shizuoka, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Sapporo, Hokkaido, Japan
| | - Seiko Sasaki
- Department of Public Health, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, Hokkaido, Japan
| | - Kazutoshi Cho
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Kita 15, Nishi 7, Sapporo, Hokkaido, Japan
| | - Kimihiko Moriya
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, Hokkaido, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, Hokkaido, Japan
| | - Katsuya Nonomura
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo, Hokkaido, Japan; Kushiro Rosai Hospital, 13-23, Nakazono-cho, Kushiro, Hokkaido, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Sapporo, Hokkaido, Japan.
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