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Gu T, Wang G, van den Oord EJC, Goldman E, Yang C, Xie N, Yao L, Wang CY, Jablonski M, Ray K, Liu F, Pan W, Flores G, Aleya L, Meng X, Jiao Y, Li M, Wang Y, Gu W. A Perspective on Evaluating Life Stage Differences in Drug Dosages for Drug Labeling and Instructions. AAPS J 2024; 26:95. [PMID: 39164430 DOI: 10.1208/s12248-024-00964-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/27/2024] [Indexed: 08/22/2024] Open
Abstract
Drug labeling and instructions provide essential information for patients regarding the usage of drugs. Instructions for the dosage of drug usage are critical for the effectiveness of the drug and the safety of patients. The dosage of many drugs varies depending on the patient's age. However, as our understanding of human biology deepens, we believe that these instructions need to be modified to incorporate different life stages. This is because human biology and metabolism differ significantly among different life stages, and their responses to drugs also vary. Additionally, the same age of different persons may fall into different life stages. Therefore, our group from multiple institutes and countries proposes a reexamination of whether incorporating life stages in all or any drug instructions will greatly enhance drug efficiency and patients' health.
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Affiliation(s)
- Tianshu Gu
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, Tennesse, 38103, USA
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, PR China
| | - Guiying Wang
- General Surgery, The 2nd Hospital of Hebei Medical University, 215 Heping Road, Shijiazhuang, Hebei, China
| | - Edwin J C van den Oord
- Center for Biomarker Research and Precision Medicine (BPM), Virginia Commonwealth University, VCU Health Sciences Research Building, Room 216A, P. O. Box 980533, Richmond, Virgina, 23298-0581, USA
| | - Emanuel Goldman
- Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers University, Newark, New Jersey, 07103, USA
| | - Chengyuan Yang
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Centre, Memphis, Tennesse, 38163, USA
| | - Ning Xie
- College of Business, University of Louisville, Louisville, Kentucky, 40292, USA
| | - Lan Yao
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Centre, Memphis, Tennesse, 38163, USA
- College of Health Management, Harbin Medical University, 157 Baojian Road, Harbin, 150081, Heilongjiang, China
| | - Cong-Yi Wang
- The Centre for Biomedical Research, Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Respiratory Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Monica Jablonski
- Department of Ophthalmology, University of Tennessee Health Sciences Center, Memphis, Tennesse, USA
- Department of Medicine, University of Tennessee Health Sciences Center, Memphis, Tennesse, USA
- Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, Tennesse, USA
- College of Nursing, University of Tennessee Health Science Center, Memphis, Tennesse, 38105, USA
| | - Kunal Ray
- School of Biological Science, Ramkrishna Mission Vivekananda Education & Research Institute, Narendrapur, 700103, West Bengal, India
| | - Fengxia Liu
- Research Center, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, 050011, China
| | - Wensen Pan
- Respiratory Medicine and Intensive Care, The 2, Hospital of Hebei Medical University, 215 Heping Road, Shijiazhuang, Hebei, China
| | - Gonzalo Flores
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, 14 Sur 6301, San Manuel, 72570, Puebla, Mexico
| | - Lotfi Aleya
- Chrono-Environnement Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, 25030, Besançon Cedex, France
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, PR China
| | - Yan Jiao
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Centre, Memphis, Tennesse, 38163, USA
| | - Minghui Li
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, Tennesse, 38103, USA.
- , Memphis, USA.
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, PR China.
- Department of Neurology and Department of Clinical Trial Center, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
| | - Weikuan Gu
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Centre, Memphis, Tennesse, 38163, USA.
- Lt. Col. Luke Weathers, Jr. VA Medical Center, 116 N Pauline St., Memphis, Tennesse, 38105, USA.
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, 956 Court Avenue, Memphis, Tennesse, 38163, USA.
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New evidence for deleterious effects of environmental contaminants on the male gamete. Anim Reprod Sci 2022; 246:106886. [PMID: 34774338 DOI: 10.1016/j.anireprosci.2021.106886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 12/14/2022]
Abstract
The decreasing trend in human and domestic animal fertility in recent decades has resulted in the question of whether reduced sperm quality is associated with changes in global climate and the environment. Proposed causes for reduced sperm quality include environmental contaminants, which enter into the body of animals through the food chain and are transported to the reproductive tract, where contaminating agents can have effects on fertilization capacities of gametes. In this review, there is a focus on various environmental contaminants and potential effects on male fertility. Human-derived contaminants, particularly endocrine-disrupting phthalates and the pesticide atrazine, are discussed. Naturally occurring toxins are also addressed, in particular mycotoxins such as aflatoxin which can be components in food consumed by humans and animals. Mechanisms by which environmental contaminants reduce male fertility are not clearly defined; however, are apparently multifactorial (i.e., direct and indirect effects) with there being diverse modes of action. Results from studies with humans, rodents and domestic animals indicate there are deleterious effects of contaminants on male gametes at various stages of spermatogenesis (i.e., in the testis) during passage through the epididymis, and in mature spermatozoa, after ejaculation and during capacitation. Considering there is never detection of a single contaminant, this review addresses synergistic or additive effects of combinations of contaminants. There is new evidence highlighted for the long-lasting effects of environmental contaminants on spermatozoa and developing embryos. Understanding the risk associated with environmental contaminants for animal reproduction may lead to new management strategies, thereby improving reproductive processes.
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Zarean M, Keikha M, Poursafa P, Khalighinejad P, Amin M, Kelishadi R. A systematic review on the adverse health effects of di-2-ethylhexyl phthalate. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:24642-24693. [PMID: 27714658 DOI: 10.1007/s11356-016-7648-3] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 09/07/2016] [Indexed: 05/23/2023]
Abstract
Di (ethylhexyl) phthalate (DEHP) is a global environmental pollutant. This study aims to systematically review the literature on health effects of exposure to DEHP including effects on reproductive health, carcinogenesis, pregnancy outcome, and respiratory system. The literature search was done through Scopus, ISI Web of Science, Google Scholar, PubMed, Medline, and the reference lists of previous review articles to identify relevant articles published to June 2016 in each subject area. The inclusion criteria were as follows: original research, cross-sectional studies, case-control studies, cohort studies, interventional studies, and review articles. Both human and animal studies were included. The search was limited to English language papers. Conference papers, editorials, and letters were not included. The systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Overall, 152 of the 407 papers met the inclusion criteria. We provided an up-to-date comprehensive and critical assessment of both human and animal studies undertaken to explore the effects of DEHP. It revealed that in experimental studies, exposure to DEHP mainly targeted the reproductive, neurodevelopment, and respiratory systems. Human studies reported that exposure to this contaminant had carcinogenic effects and influenced neurodevelopment in early life. This systematic review underscored the adverse health effects of DEHP for pregnant women and the pediatric age group. It summarizes different response of humans and experimental animals to DEHP exposure, and some suggested underlying mechanisms.
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Affiliation(s)
- Maryam Zarean
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Environmental Health Department, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Keikha
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parinaz Poursafa
- Environmental Health Department, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
- Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Pooyan Khalighinejad
- Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Kimia Gostar Saba, Isfahan, Iran
| | - Mohammadmehdi Amin
- Environmental Health Department, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Huang LP, Lee CC, Hsu PC, Shih TS. The association between semen quality in workers and the concentration of di(2-ethylhexyl) phthalate in polyvinyl chloride pellet plant air. Fertil Steril 2011; 96:90-4. [PMID: 21621774 DOI: 10.1016/j.fertnstert.2011.04.093] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 04/06/2011] [Accepted: 04/26/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate potential associations between semen quality in workers and the concentrations of di(2-ethylhexyl) phthalate (DEHP) in personal air collected from polyvinyl chloride (PVC) plants. DESIGN Cross-sectional study. SETTING PVC plants in Taiwan. PATIENT(S) Forty-five male workers employed in two PVC pellet plants. INTERVENTION(S) None. MAIN OUTCOME MEASUREMENT(S) Sperm concentration, motility, morphology, and chromatin DNA integrity were accessed. RESULT(S) The workers were divided into low- and high-DEHP-exposed groups in accordance with the median levels of DEHP (23.7 μg/m(3)) in personal air. In the high-DEHP-exposed group, significant increases were found in the tendency for sperm DNA denaturation (αT) induction, the DNA fragmentation index (DFI), and propensity for coffee drinking. After adjusting for coffee drinking, cigarette smoking, and age, personal air concentrations of DEHP showed positive associations with αT (β = 0.038) and DFI (β = 0.140) and negative associations with sperm motility (β = -0.227). CONCLUSION(S) This is the first study to demonstrate a link between DEHP concentration in ambient air and the adverse effects in sperm motility and chromatin DNA integrity. Given the current wide use of these PVC products, the implications for phthalates toxicity and occupational health could be considerable.
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Affiliation(s)
- Li-Ping Huang
- Department of Safety, Health and Environmental Engineering, National Kaohsiung First University of Science and Technology, Kaohsiung, Taiwan
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Spjuth L, Gil MA, Caballero I, Cuello C, Almiñana C, Martínez EA, Lundeheim N, Rodríguez-Martínez H. Pre-pubertal Di(2-ethylhexyl) Phthalate (DEHP) Exposure of Young Boars Did Not Affect SpermIn vitroPenetration Capacity of Homologous Oocytes Post-puberty. ACTA ACUST UNITED AC 2009; 53:141-7. [PMID: 17612872 DOI: 10.1080/01485010701271778] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Di(2-ethylhexyl) phthalate (DEHP), a plastic softener used in polyvinylchloride (PVC) products (e.g., plastic bags and medical equipment), has been reported to have toxic effects on animal reproduction and is considered an environmental hazard based, mostly, on rodent studies. However, the doses used in these studies are often considerably higher than that presumed in human exposure. In the present study we used young boars as model animals to assess the effects of pre-pubertal DEHP exposure on the ability of spermatozoa to penetrate homologous oocytes in vitro. Eight pairs of cross-bred male boar siblings were used. One brother in each pair became, at random, the test animal exposed to DEHP per os, three times a week, from 3 to 7 weeks of age while the other acted as the control, i.e., placebo-exposed. Semen was collected and frozen between 8 and 9 months of age and stored until spermatozoa were evaluated for their ability to in vitro penetrate in vitro-matured homologous oocytes post-thaw. Both the penetration rate and the number of spermatozoa per oocyte were considered within expected ranges for frozen boar semen of good quality. Penetration rate did not significantly differ (p > 0.05) between the groups with DEHP-exposed: 50%; control: 59%, which could be owing to a large variation between boars, and between replicates. The number of spermatozoa in the ooplasm was low and similar (p > 0.05) between the groups with DEHP-exposed: 1.5 and the control: 1.7. Under the conditions of the present experiment, pre-pubertal exposure to DEHP does not seem to cause a deleterious effect on the in vitro fertilizing ability of frozen spermatozoa post-puberty.
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Affiliation(s)
- Linda Spjuth
- Department of Clinical Sciences, Division of Reproduction, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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Spjuth L, Johannisson A, Lundeheim N, Rodríguez-Martínez H. Early pre-pubertal exposure to low-dose oral di(2-ethylhexyl) phthalate does not affect sperm plasma membrane stability, acrosomal integrity or chromatin structure in the post-pubertal boar. Theriogenology 2007; 68:186-95. [PMID: 17543380 DOI: 10.1016/j.theriogenology.2007.04.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 03/25/2007] [Accepted: 04/14/2007] [Indexed: 10/23/2022]
Abstract
This study aimed to determine whether pre-pubertal exposure in boars to di(2-ethylhexyl) phthalate (DEHP), a plasticizer reported to have toxic effects on rodent reproduction, would affect the sperm ability to undergo capacitation and acrosome reaction (AR) in vitro or give rise to a higher degree of chromatin instability associated with acid-induced denaturation. Spermatozoa were collected from 16 boars (n=8/group) 8-9 months of age, exposed to 300mg/kg body weight of DEHP or placebo per os three times a week, from 3 to 7 weeks of age. The spermatozoa were cryopreserved and examined post-thaw by flow cytometry for their ability to capacitate in vitro when exposed to the effector bicarbonate and to acrosome-react when exposed to calcium ionophores, using the lipid stain Merocyanine-540 (m-540), and peanut agglutinin-fluorescein isothiocyanate, respectively, as probes. The ability of the DNA to sustain denaturation in vitro was tested using a sperm chromatin structure assay (SCSA). No significant differences between the DEHP-exposed group and controls were found for any of the sperm attributes examined. Frozen-thawed spermatozoa showed similar rates of non-capacitated cells between groups, and were capacitated at similar rates. Rates of induced ARs were also similar. Values of DNA denaturation were low and showed no differences between groups. In conclusion, pre-pubertal exposure to DEHP does not seem, under the conditions of the present experiment, to affect the ability of frozen-thawed spermatozoa collected post-puberty to capacitate or acrosome-react (the main requisites for fertilization) or to present damage in their nuclear genome.
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Affiliation(s)
- L Spjuth
- Department of Clinical Sciences, Division of Reproduction, Box 7054, Swedish University of Agricultural Sciences (SLU), 750 07 Uppsala, Sweden.
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