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Li X, Li Z, Ye J, Ye W. Association Between Urinary Phthalate Metabolites and Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study. Int J Chron Obstruct Pulmon Dis 2024; 19:1421-1431. [PMID: 38948906 PMCID: PMC11212814 DOI: 10.2147/copd.s459435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024] Open
Abstract
Objective To determine the association of urinary phthalate metabolites with chronic obstructive pulmonary disease (COPD), airflow obstruction, lung function and respiratory symptoms. Methods Our study included a total of 2023 individuals aged ≥ 40 years old in the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression was conducted to explore the correlation of eleven urinary phthalate metabolites (MCNP, MCOP, MECPP, MnBP, MCPP, MEP, MEHHP, MEHP, MiBP, MEOHP, and MBzP) with COPD, airflow obstruction and respiratory symptoms. Linear regression analyses were used to evaluate the relationship between urinary phthalate metabolites and lung function. Results When compared to the first tertile, the third tertile of MEHHP was associated with the risk of COPD [OR: 2.779; 95% confidence interval (CI): 1.129-6.840; P = 0.026]. Stratified analysis showed that MEHHP increased the risk of COPD by 7.080 times in male participants. Both MCPP and MBzP were positively correlated with the risk of airflow obstruction. The third tertile of MBzP increased the risk of cough by 1.545 (95% CI: 1.030-2.317; P = 0.035) times. Both FEV1 and FVC were negatively associated with MEHHP, MECPP, MnBP, MEP, MiBP and MEOHP. Conclusion Higher levels of MEHHP are associated with increased risk of COPD, and lower measures of FEV1 and FVC. MBzP is positively related to airflow obstruction and cough.
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Affiliation(s)
- Xuefang Li
- Department of Infectious Diseases, Zhejiang Hospital, Hangzhou, People’s Republic of China
| | - Zhijun Li
- Department of Respiratory Diseases, Zhejiang Hospital, Hangzhou, People’s Republic of China
| | - Jian Ye
- Department of Respiratory Diseases, Zhejiang Hospital, Hangzhou, People’s Republic of China
| | - Wu Ye
- Department of Respiratory Diseases, Zhejiang Hospital, Hangzhou, People’s Republic of China
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Yu Y, Wang JQ. Phthalate exposure and lung disease: the epidemiological evidences, plausible mechanism and advocacy of interventions. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 39:37-45. [PMID: 36151703 DOI: 10.1515/reveh-2022-0077] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Phthalates are a kind of synthetic plasticizers, which extensively used as plastic productions to improve their plasticity and flexibility. However, exposure to phthalates has been proved an increased risk of respiratory disease, because by they affect the development and functions of the lung and immune system. Here, we attempt to review respiratory health of phthalate exposure. Firstly, we describe the relationship between phthalates and lung function and airway inflammation. Then, the role of phthalates in asthma, lung cancer, rhinitis, and respiratory tract infections and the possible mechanisms of action are discussed. Finally, possible effective measures to reduce exposure to phthalates are proposed, and health care workers are called upon to provide educational resources and advocate for informed public health policies. Overall, the evidence for association between phthalate exposure and respiratory disease is weak and inconsistent. Therefore, thorough implementation in large populations is needed to produce more consistent and robust results and to enhance the overall understanding of the potential respiratory health risks of phthalate in long-term exposure.
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Affiliation(s)
- Yun Yu
- The Fourth Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Jian Qing Wang
- The Fourth Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
- School of Pharmacy, Anhui Medical University, Hefei, Anhui, China
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Boissiere-O'Neill T, Lee WR, Blake TL, Sly PD, Vilcins D. Exposure to endocrine-disrupting plasticisers and lung function in children and adolescents: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2024; 243:117751. [PMID: 38061586 DOI: 10.1016/j.envres.2023.117751] [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: 07/25/2023] [Revised: 09/21/2023] [Accepted: 11/20/2023] [Indexed: 02/06/2024]
Abstract
Exposure to endocrine-disrupting plasticisers (EDPs), such as phthalates and bisphenols, has been associated with reduced lung function in children and adolescents. However, the existing literature yields conflicting results. This systematic review and meta-analysis aimed to assess the epidemiologic evidence investigating the association between EDP exposure and lung function in children and adolescents. A comprehensive search of five databases identified 25 relevant studies. We employed a random-effects meta-analysis on spirometry measures. The effect size of interest was the change in lung function in standard deviation (SD) units resulting from a two-fold increase in exposure levels. We found that certain phthalates marginally reduced lung function in children. Forced expiratory volume in 1 s (FEV1) was reduced by a two-fold increase in mono-benzyl phthalate (MBzP) (β = -0.025 SD, 95%CI: 0.042, -0.008), mono-ethyl-oxo-hexyl phthalate (MEOHP) (β = -0.035 SD, 95%CI: 0.057, -0.014) and mono-carboxy-nonyl phthalate (MCNP) (β = -0.024 SD, 95%CI: 0.05, -0.003). Forced vital capacity (FVC) was decreased by a two-fold increase in MBzP (β = -0.022 SD, 95%CI: 0.036, -0.008) and MEOHP (β = -0.035 SD, 95%CI: 0.057, -0.014) levels. A two-fold increase in MCNP levels was associated with lower FEV1/FVC (β = -0.023 SD, 95%CI: 0.045, -0.001). Furthermore, a two-fold increase in MEOHP levels reduced forced mid-expiratory flow (FEF25-75) (β = -0.030 SD, 95%CI: 0.055, -0.005) and peak expiratory flow (PEF) (β = -0.056 SD, 95%CI: 0.098, -0.014). Notably, associations were more pronounced in males. Given the potential for reverse causation bias, the association between childhood exposure to EDPs and lung function remains uncertain. Overall, our meta-analysis showed small reductions in lung function with higher phthalate exposure. However, future studies are warranted in younger age groups.
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Affiliation(s)
- Thomas Boissiere-O'Neill
- Child Health Research Centre, The University of Queensland, Centre for Children's Health Research, South Brisbane, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Australia.
| | - Wen R Lee
- Child Health Research Centre, The University of Queensland, Centre for Children's Health Research, South Brisbane, Australia
| | - Tamara L Blake
- Child Health Research Centre, The University of Queensland, Centre for Children's Health Research, South Brisbane, Australia
| | - Peter D Sly
- Child Health Research Centre, The University of Queensland, Centre for Children's Health Research, South Brisbane, Australia
| | - Dwan Vilcins
- Child Health Research Centre, The University of Queensland, Centre for Children's Health Research, South Brisbane, Australia
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Yi J, Shin HS, Han MY, Choi HJ, Lee MS, Sung M. Associations Between Phthalate, Eosinophil, and Aeroallergen Sensitization in Schoolchildren. J Korean Med Sci 2023; 38:e391. [PMID: 37987110 PMCID: PMC10659924 DOI: 10.3346/jkms.2023.38.e391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/17/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Phthalates and bisphenol A (BPA) are endocrine-disrupting chemicals and may cause immunological disorders in children. Therefore, according to the region, we investigated urinary phthalates and BPA levels and the relationship between urinary phthalate, aeroallergen sensitization, and eosinophil count during the coronavirus disease 2019 pandemic. METHODS In total, 203 schoolchildren (134 residential and 69 industrial) aged 7-10 years were enrolled between July 2021 and July 2022. The BPA, metabolites of four high-molecular-weight phthalates (Σ4HMWP) and three low-molecular-weight phthalates (Σ3LMWP), were measured in the urine samples. Total eosinophil count and transepidermal water loss (TEWL) were also measured along with the skin prick test. RESULTS The two groups had no differences in terms of BPA. The industrial group had significantly more plastic container usage, and there was a difference in the Σ3LMWP (P < 0.001) between the two groups but no difference in the Σ4HMWP (P = 0.234). The quartiles of urinary Σ4HMWP and Σ3LMWP (P < were not associated with the total eosinophil count, vitamin D level, or TEWL. After adjusting for cofactors, the quartiles of urinary Σ4HMWP and Σ3LMWP were significantly associated with total eosinophil count (P < 0.001) but not with aeroallergen sensitization or vitamin D. CONCLUSION Exposure to phthalates was significantly associated with eosinophil count but not with aeroallergen sensitization or vitamin D. Therefore, reducing the use of plastic containers may effectively prevent exposure to phthalates and reduce Th2 cell-mediated inflammation in children.
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Affiliation(s)
- Jeongsik Yi
- Department of Emergency Medicine, Gumi CHA Medical Center, CHA University, Gumi, Korea
| | - Ho-Sang Shin
- Department of Environmental Education, Kongju National University, Gongju, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hee Jin Choi
- Department of Biostatistics, Soonchunhyang University Gumi Hospital, Gumi, Korea
| | - Mi Seon Lee
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Gumi, Korea
| | - Myongsoon Sung
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Gumi, Korea.
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Kostorz-Nosal S, Jastrzębski D, Błach A, Skoczyński S. Window of opportunity for respiratory oscillometry: A review of recent research. Respir Physiol Neurobiol 2023; 316:104135. [PMID: 37536553 DOI: 10.1016/j.resp.2023.104135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/19/2023] [Accepted: 07/30/2023] [Indexed: 08/05/2023]
Abstract
Oscillometry has been around for almost 70 years, but there are still many unknowns. The test is performed during tidal breathing and is therefore free from patient-dependent factors that could influence the results. The Forced Oscillation Technique (FOT), which requires minimal patient cooperation, is gaining ground, particularly with elderly patients and children. In pulmonology, it is a valuable tool for assessing obstructive conditions (with a distinction between central and peripheral obstruction) and restrictive disorders (intrapulmonary and extrapulmonary). Its sensitivity allows the assessment of bronchodilator and bronchoconstrictor responses. Different lung diseases show different patterns of changes in FOT, especially studied in asthma and chronic obstructive pulmonary disease. Because of these differences, many studies have analysed the usefulness of this technique in different areas of medicine. In this paper, the authors would like to present the basics of oscillometry with the areas of its most recent clinical applications.
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Affiliation(s)
- Sabina Kostorz-Nosal
- Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-803 Zabrze, Poland.
| | - Dariusz Jastrzębski
- Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-803 Zabrze, Poland
| | - Anna Błach
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Szymon Skoczyński
- Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-803 Zabrze, Poland
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Yavuz ST, Kalayci Ö, Eigenmann PA. Editorial to the special issue "Environmental influences on childhood asthma". Pediatr Allergy Immunol 2022; 33:e13828. [PMID: 35871455 DOI: 10.1111/pai.13828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Süleyman Tolga Yavuz
- Department of Pediatric Allergy, Children's Hospital, University of Bonn, Bonn, Germany
| | - Ömer Kalayci
- Hacettepe University School of Medicine, Ankara, Turkey
| | - Philippe A Eigenmann
- Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
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Liu Z, Lu Y, Zhong K, Wang C, Xu X. The associations between endocrine disrupting chemicals and markers of inflammation and immune responses: A systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 234:113382. [PMID: 35276610 DOI: 10.1016/j.ecoenv.2022.113382] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Exposure to endocrine disrupting chemicals (EDCs) may lead to dysregulated inflammatory responses, however, the detailed relationship between different EDCs and inflammation remains unclear. A systematic review and meta-analysis was conducted to evaluate the associations between four types of EDCs (bisphenol A (BPA), phthalates (PAEs), organochlorine pesticides (OCPs), and polychlorinated biphenyls (PCBs)) and markers of inflammation and immune responses in humans. Three databases were searched, and 36 studies with a total of 22055 participants were included. The associations between EDCs and 26 inflammation-related acute phase proteins and cytokines were analyzed. The results demonstrated that exposure to BPA was positively associated with circulating levels of C-reactive protein (CRP) and interleukin (IL)-6. Exposure to PAEs was associated with elevated levels of CRP, IL-6 and IL-10. Subgroup analysis found that three PAE metabolites mono-benzyl phthalate (MBzP), mono-isobutyl phthalate (MiBP), and mono-n-butyl phthalate (MnBP) were directly associated with a higher level of CRP, and two other PAE metabolites mono-carboxyisononyl phthalate (MCNP) and mono-3-carboxypropyl phthalate (MCPP) were positively associated with IL-6. The positive associations between PAEs and CRP, IL-6 and IL-10 were significant in the high-molecular-weight phthalate (HMWP) exposure group, not the low-molecular-weight phthalate (LMWP) exposure group. Exposure to OCPs was positively associated with CRP, IL-1β, IL-2, and IL-10. No significant association was found between PCBs and inflammatory markers. These findings demonstrate that exposure to EDCs is closely linked to dysregulated inflammatory responses. More studies should be conducted in the future to get a comprehensive view of the associations between different EDCs and inflammation, and investigations on the underlying mechanisms are needed.
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Affiliation(s)
- Zhiqin Liu
- School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing 210094, PR China
| | - Yao Lu
- School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing 210094, PR China
| | - Kunxia Zhong
- School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing 210094, PR China
| | - Chenchen Wang
- School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing 210094, PR China
| | - Xi Xu
- School of Environmental and Biological Engineering, Nanjing University of Science and Technology, Nanjing 210094, PR China.
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