Exposure to polyfluoroalkyl chemicals and cholesterol, body weight, and insulin resistance in the general U.S. population

Bayesian benchmark dose assessment of per- and polyfluorinated substances exposure-associated thyroid function disruption during pregnancy

Epidemiological evidence on maternal thyroid function disruption by prenatal exposure to perfluorinated and polyfluorinated substances (PFASs) is limited and inconsistent. The study examined the effects of PFASs exposure during early pregnancy on maternal thyroid function [free thyroxine (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibodies (TPOAb) and FT4/TSH ratio]. The associations were evaluated using both single and mixed pollutant models, statistical analyses were further utilized in benchmark dose (BMD) estimations to offer critical references for human health risk assessment. Linear regression was used and then Bonferroni correction adjustment was set up to correct for multiple comparisons. The results revealed a significant association between PFHxS exposure and TSH (β = 0.473; 95 % CI: 0.180, 0.767). According to BKMR mixed-effects models, PFHxS was significantly positively correlated with TSH at the 25th percentile. PFASs were associated with the FT4/TSH ratio at the 25th to 40th percentile. The BMD value of the increasing FT4 effect induced by PFBA and PFPeA in pregnant women were 6.68 ng/mL and 1.37 ng/mL, respectively. The BMDs were obtained for TSH in the case of PFBA (0.33 ng/mL), PFHxS (0.28 ng/mL). Although BMDL10 is higher than observed for maternal TSH elevation in animal studies, both studies agree that thyroid homeostasis is the sensitive target. The fact that BMD results at this stage are lower than current exposure levels to PFHxS underscores the urgency of prioritizing endocrine end points in PFASs risk assessment.

Toxicokinetics and Perfluorooctanesulfonic Acid-Induced Liver Protein Expression Are Markedly Altered in Mice Lacking Albumin

Perfluorooctanesulfonic acid (PFOS) is a ubiquitous perfluoroalkyl substance (PFAS) linked to liver disease and obesity in humans. Binding studies suggest that albumin is a crucial blood protein influencing PFOS toxicokinetics and hepatotoxicity; however, its role has not been mechanistically tested in vivo. This study used an albumin-deficient mouse model to investigate the relevance of albumin in PFOS tissue distribution and liver disease end points. Adult male C57BL/6J wild-type (Alb+/+) and albumin-deficient (Alb-/-) mice were orally gavaged daily for 7 days with either vehicle or PFOS at 0.5 or 10 mg/kg body weight. The measured PFOS concentrations in plasma were significantly lower in Alb-/- mice compared to those in Alb+/+ mice, while liver concentrations were significantly higher in Alb-/- mice. Binding experiments confirmed these findings, indicating that PFOS toxicokinetics are driven by plasma and tissue binding. Significant changes in liver protein expression did not translate into differences in liver disease end points between genotypes, suggesting the need for chronic exposure studies. Our data imply that disease-related albumin deficiency in humans can influence PFAS toxicokinetics and susceptibility to hepatotoxicity. Our framework using knockout mice can be adapted in future studies to assess the relevance of protein binding and membrane transporters in PFAS distribution and elimination.

In vivo gamete toxicology in the context of in vitro fertilization: a narrative review

IVF as a clinical method to surmount infertility has existed since the 1970s, and yet fertilization, embryo development, pregnancy, and live birth rates remain unacceptably low. Although a multitude of factors may contribute to stagnated success despite substantial advances in basic and applied IVF sciences, gamete quality is inarguably integral to IVF success rates. In this review, the authors will explore the role of environmental toxicology in impairing in vivo fertility and gamete quality prior to starting IVF that will influence downstream IVF success. In vivo contaminants of interest that may affect gamete potential in the context of IVF include heavy metals, per- and polyfluoroalkyl substances (PFAS), persistent organic pollutants (POPs), and airborne contaminants. By evaluating the current literature on reproductive toxicology and how toxic exposures may influence IVF, this review aims to provide a comprehensive reference of potential toxicological exposures for clinicians, to use in vitro and animal data to supplement correlative human studies with potential causative mechanisms, and to strengthen the case for patient assessment of toxicological risk.

Exposure to Legacy Per- and Polyfluoroalkyl Substances from Diet and Drinking Water in California Adults, 2018-2020

People are exposed to per- and polyfluoroalkyl substances (PFAS) through multiple sources, with diet historically considered a major source in general populations. This study characterized legacy PFAS in serum from 700 California adults and examined contributions from diet and drinking water. We applied robust regression to estimate associations between nontransformed serum PFAS concentrations, self-reported food consumption, and drinking water PFAS concentrations measured under the USEPA's third Unregulated Contaminant Monitoring Rule (2013-2015). Detectable drinking water concentrations were associated with increased serum perfluorooctanoic acid (PFOA) (0.26 ng/mL; 95% CI: 0.077, 0.43), perfluorohexanesulfonic acid (PFHxS) (0.64 ng/mL; 95% CI: 0.058, 1.23), and perfluorooctanesulfonic acid (PFOS) (0.39 ng/mL; 95% CI: -0.76, 0.86). Seafood consumption was associated with increased perfluorononanoic acid (PFNA) (0.013 ng/mL; 95% CI: 0.0058, 0.021), perfluorodecanoic acid (PFDeA) (0.0059 ng/mL; 95% CI: 0.0026, 0.0092), and perfluoroundecanoic acid (PFUnDA) (0.010 ng/mL; 95% CI: 0.0054, 0.015), while eggs were associated with increased PFDeA (0.0035 ng/mL; 95% CI: 0.00010, 0.0069) and PFNA (0.0073 ng/mL; 95% CI: 0.00017, 0.014). Findings could indicate that dietary contributions may be less than those in earlier studies conducted in other populations, possibly due to shifts in PFAS production over the past 20 years, and that drinking water remains an important source of exposure to PFOA and PFHxS in this population.

United States Environmental Protection Agency's Perfluorooctanoic Acid, Perfluorooctane Sulfonic Acid, and Related Per- and Polyfluoroalkyl Substances 2024 Drinking Water Maximum Contaminant Level: Part 2 - Fifteen Misconceptions About the Health Hazards

This paper examines widely held beliefs about the six per- and polyfluoroalkyl substances (PFAS) addressed in the final U.S. Environmental Protection Agency's (EPA) rule on PFAS in drinking water (e.g., the Maximum Contaminant Levels - MCLs). Based on our understanding of the scientific literature and the comments submitted by stakeholders regarding the EPA's regulation that was promulgated in April 2024, we identified 15 misconceptions that had a weak scientific foundation. These are now memoralized in the MCLs for the six PFAS but remain debated due to ongoing ambiguous research findings. Many critics of the MCLs found the EPA's systematic review of the published relevant information, particularly the toxicology of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), to be inadequate. The following seven views are among the most important. First, the EPA asserted that the toxicology of these six chemicals was poorly understood and lacked sufficient data to determine a safe daily intake level for chronic health effects; nonetheless, they promulgated what may be the costliest environmental regulation to date. Notably, adverse effects remain difficult to demonstrate in occupationally exposed individuals even at blood concentrations 50-100 times higher than current background PFAS levels. Second, the Agency indicated that the epidemiology data showed that exposure to PFOA and PFOS caused kidney and potentially other cancers, yet the data were equivocal and do not support that assertion. Third, it was stated that specific non-cancer effects, such as heart disease, would be prevented under the promulgated rule; however, the studies that they relied upon do not show an increased incidence of heart disease even in highly exposed populations. Fourth, the Agency relied on animal data to support its views on the likely toxic effects in humans, despite ample toxicology data that animals, particularly rodents, are poor predictors of the human response to PFAS exposures. Fifth, the EPA predicted a reduction in healthcare expenditures that would offset much of the cost of complying with the MCL, but, they did not have adequate data to support this prediction. Sixth, the EPA suggested that these six PFAS act through a shared mechanism of action (i.e., PPARα pathway induction); however, data indicate that PPARα induction in humans may be 80% less than what is observed in rodents. Also, induction of the PPARα pathway is not a cause of systemic disease. Seventh, the Agency failed to disclose that achieving the new MCL would yield negligible reductions in blood PFAS levels even among highly exposed populations, given drinking water accounts for only 20% or less of total PFAS exposure. The survey that could answer that question, the EPA's fifth Unregulated Contaminant Monitoring Rule, was only 25% complete at the time the MCL was promulgated. Overall, our analysis concluded that while the EPA's intent to regulate these chemicals due to their environmental presence was necessary, the derivation of the MCLs and the alleged health effects was based on the application of the precautionary principle rather than robust scientific evidence.

Perfluorooctanoic acid increases serum cholesterol in a PPARα-dependent manner in female mice

Per- and polyfluoroalkyl substances (PFAS) are a large group of persistent chemicals that are pervasive in the environment leading to widespread exposure for humans. Perfluorooctanoic acid (PFOA), one of the most commonly measured PFAS in people, disrupts liver and serum lipid homeostasis as shown in animal toxicity and human epidemiological studies. We tested the hypothesis that the effects of PFOA exposure in mice expressing mouse PPARα (mPPARα) are driven largely through PPARα-dependent mechanisms while non-PPARα dependent mechanisms will be more apparent in mice expressing human PPARα (hPPARα). Female and male mPPARα, hPPARα, and PPARα null mice were exposed to PFOA (0.5, 1.4 or 6.2 mg PFOA/L) via drinking water for 14 weeks. Concurrently, mice consumed an American diet containing human diet-relevant amounts of fat and cholesterol. Here, we focused on the effects in female mice, given the dearth of data reported on PFAS-induced effects in females. Increasing the duration of PFOA exposure reduced weight gain in all genotypes of female mice while end-of-study body fat was lower in PFOA exposed hPPARα and PPARα null mice. Serum cholesterol, but not triacylglyceride, concentrations were increased by PFOA exposure in a PPARα-dependent manner. Hepatic triacylglycerides were higher in vehicle-exposed mPPARα and PPARα null mice than hPPARα mice, and PFOA significantly reduced concentrations in mPPARα and PPARα null mice only. In contrast, PFOA increased hepatic cholesterol content in a PPARα-dependent manner. Changes in liver and serum cholesterol may be explained by a strong, PPARα-dependent downregulation of Cyp7a1 expression. PFOA significantly increased PPARα target gene expression in mPPARα mice. Other nuclear receptors were examined: CAR target gene expression was only induced by PFOA in hPPARα and PPARα null mice. PXR target gene expression was induced by PFOA in all genotypes. Results were similar in male mice with two exceptions: (1) vehicle-exposed male mice of all genotypes were equally susceptible to diet-induced hepatic steatosis; (2) male mice drank less water, resulting in lower serum PFOA levels, which may explain the less significant changes in lipid endpoints. Overall, our results show that PFOA modifies triacylglyceride and cholesterol homeostasis independently and that PPARα plays an important role in PFOA-induced increases in liver and serum cholesterol.

The role of per- and polyfluoroalkyl substances in cognitive impairment and dementia

Per- and polyfluoroalkyl substances (PFAS) are ubiquitous persistent organic pollutants. The neurotoxic and cardiometabolic effects of PFAS are well documented, leading to the hypothesis that exposure increases dementia risk. However, empirical data on PFAS in relation to cognitive impairment and dementia are weak, limited, and inconsistent. This report reviews the literature on PFAS and cognitive impairment and provides a rationale and overview of the PFAS VascCog Longitudinal Study, a new study using the population-based Northern Manhattan Study cohort, to prospectively examine serum concentrations of 13 PFAS in relation to lipids, carotid atherosclerosis, cognitive impairment, and dementia. We hypothesize that PFAS deleteriously impact cognition through a pathway involving hyperlipidemia and atherosclerosis. Rigorous examination of PFAS exposure in relation to dementia is needed to inform public health policies on PFAS-containing products, support regulations to reduce community exposure, and provide new avenues to protect cognitive health and impact dementia at the individual and community levels. HIGHLIGHTS: PFAS exposure increases cardiometabolic risk factors and neurotoxicity. Data on PFAS in relation to cognitive health is limited, weak, and controversial. We hypothesize that PFAS exposure increases dementia risk. We hypothesize a mechanistic pathway involving hyperlipidemia and atherosclerosis. Rigorous study of PFAS exposure and dementia risk can inform public health policy.

Longitudinal association of perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) exposure with lipid traits, in a healthy unselected population

BACKGROUND

Perfluorooctanoic acid (PFOA) and Perfluorooctanesulfonic Acid (PFOS) are synthetic substances with long half-lives. Their presence is widespread and pervasive, and they are noted for their environmental persistence. Research has shown these chemicals to be associated with dyslipidaemia, although few studies have considered the long-term associations in the general population.

OBJECTIVES

The aim of this study was to consider the longitudinal and cross-sectional associations with lipid phenotypes.

METHODS

We investigated the association of these chemicals with total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), and the total cholesterol: high-density lipoprotein ratio (TC:HDL), in a healthy unselected British population of twins (n = 2069), measured at three timepoints between 1996 and 2014.

RESULTS

Serum levels of PFOA and PFOS decreased over time during this period. We demonstrate longitudinal associations across serum levels of both PFOA and PFOS, finding positive associations with TC (PFOA:β = 0.51, p = 1.9e-07; PFOS:β = 0.24, p = 3.8e-05) and LDL (PFOA:β = 0.61, p = 1.7e-11; PFOS:β = 0.42, p = 1.6e-14), and consistent negative associations with HDL and PFOA (β = -0.12, p = 0.003) and PFOS (β = -0.25, p = <2e-16). We also observe cross-sectional associations of PFAS with lipids across all three timepoints.

IMPACT

PFAS remain persistent in the environment, despite regulations, due to their structural properties, leaving humans open to exposure. There is less understanding of how chronic low exposure to these chemicals, particularly within an unselected population, may impact health outcomes. This study reports the longitudinal associations of PFOA and PFOS over an 18-year window with 5 lipid phenotypes, highlighting that despite falling serum levels, PFAS exposure may lead to hyperlipidaemia. We further investigate the cross-sectional associations across three timepoints to understand time-dependent effects, demonstrating associations persist. This work aids our understanding on the long-term effect of chronic PFAS exposure.

Exposure to Sodium p-Perfluorous Nonenoxybenzenesulfonate Induces Renal Fibrosis in Mice by Disrupting Lysine Metabolism

Environmental exposure is one driving factor of chronic kidney disease (CKD), yet the intrinsic molecular mechanisms are largely unexplored. As a persistent chemical, perfluorooctanesulfonate (PFOS) is regulated due to a great potential to induce multiple diseases, including renal fibrosis, a major pathological characteristic of CKD. It is hypothesized that sodium p-perfluorous nonenoxybenzenesulfonate (OBS), a typical alternative to PFOS, may also induce renal fibrosis. We observed distinct renal fibrosis in mice exposed to OBS. Metabolomics analysis showed that Nα-acetyllysine was the primary metabolite biomarker, whose level decreased greatly due to its excessive consumption by lysyloxidase (LOX). This suppressed the miR-140-5p expression, promoting upregulation of fibroblast growth factor 9 (FGF9), which activated the PI3K/Akt signaling pathway through fibroblast growth factor receptor 3 (FGFR3), thereby enhancing proliferation and activation of fibroblasts. Supplement of Nα-acetyllysine upregulated miR-140-5p expression, reduced expressions of FGF9 and FGFR3, and eventually ameliorated OBS-induced renal fibrosis. Similarly, treatment with miR-140-5p agomir and PI3K/Akt signaling pathway inhibitor LY294002 attenuated OBS-induced renal fibrosis. Taken together, OBS caused renal fibrosis through the LOX-Nα-acetyllysine-miR-140-5p-FGF9-FGFR3-PI3K/Akt-Bad-Bcl-2-fibroblast axis. The results of this study reveal a specific molecular axis for OBS to induce renal fibrosis and call for concerns in supervising the application of OBS.

Assessing the Impact of Serum Per- and Polyfluoroalkyl Substance Concentrations on Immune Function in an Industrialized Region of China

This study investigates the presence and health implications of per- and polyfluoroalkyl substances (PFAS) in human serum samples collected from white-collar workers in an industrialized region of China. Our research offers fresh insights into the underexplored area of nonoccupational PFAS exposure among white-collar workers, shedding light on health risks linked to industrial PFAS pollution. Seven PFAS compounds were measured. Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) emerged as predominant pollutants, with Σ7PFAS concentrations averaging 65.486 ng/mL. Gender differences showed higher serum Σ7PFAS levels in males, and age-related analyses suggested PFAS accumulation over time, with higher concentrations in older groups. Additionally, significant correlations were found between PFAS concentrations and biomarkers of oxidative stress and immune interference, specifically malondialdehyde (MDA) and immunoglobulin M (IgM), indicating that PFAS exposure may contribute to oxidative damage and potential immunosuppression. The study highlights regional and international variations in PFAS serum concentrations, underscoring the influence of industrial activities on PFAS exposure and expanding on the established links between PFAS exposure and health outcomes. These findings call for targeted strategies to mitigate PFAS exposure in high-risk regions and warrant further research on PFAS health impacts, especially in regard to immune interference.

Maternal perfluoroalkyl and polyfluoroalkyl substances (PFAS) exposure and preeclampsia: a systematic review and meta-analysis

Polyfluoroalkyl and perfluoroalkyl substances (PFAS) are persistent organic pollutants and exposure have been suggested with the risk of developing preeclampsia. Yet, evidence on the associations of PFAS with preeclampsia is still conflicting. Thus, the current study conducted a systematic review and meta-analysis of the epidemiological evidence linking maternal PFAS exposure to preeclampsia. This research methodology involved searching three electronic databases for epidemiological studies, and then conducting a meta-analysis using a random-effects model to analyse the heterogeneity between the studies. The quality and strength of evidence for each exposure-outcome pair was also evaluated, as well as the risk of bias. The search identified 10 potentially eligible studies related to maternal PFAS blood level with preeclampsia, which 7 were ultimately selected. Meta-analysis demonstrated evidence of association between combined PFAS compounds in pregnant mother with preeclampsia with zero heterogeneity (I2=0.0%, Q= 3.09, df= 6, p=0.798). Preeclampsia was found to have moderate association with maternal perfluorooctanoic acid (PFOA) exposure (Test for overall effect: z=2.2, p=0.03; Test for heterogeneity: I2=0.0%, Q= 3.49, df= 6, p=0.745) as well as maternal perfluorooctane sulfonate (PFOS) exposure (Test for overall effect: z=2.5, p=0.01; Test for heterogeneity: I2=0.0%, Q= 3.70, df= 6, p=0.718). This study showed significant associations between PFOA and PFOS exposure with the risk of preeclampsia. However, in-depth investigation is imperative to elucidate the impact of the different concentration and types of PFAS on preeclampsia risk.

Perfluorohexane Sulfonic Acid Disrupts the Immune Microenvironment for Spermatogenesis by Damaging the Structure of the Blood-Testis Barrier in Mice

Perfluorohexane sulfonic acid (PFHxS) is extensively used in waterproof coatings and fire-fighting foams, and several studies have found it to be a potential health hazard, but there is still unknown about its effects on spermatogenesis. Our results showed that PFHxS-treated mice have significant reproductive toxicity, including a decrease in sperm count and motility, and the levels of sex hormones (P < 0.05). Concurrently, structural abnormalities are observed in sperm, affecting ≈60-75% of those in the PFHxS-treated group. Additionally, it is found that the structure of the blood-testis barrier (BTB) is damaged after PFHxS treatment, leading to higher expression levels of inflammatory cytokines in the microenvironment for spermatogenesis. Moreover, the expression of proteins associated with mitochondrial biogenesis, including PTEN-induced kinase 1 (PINK1) and NADPH oxidase 4 (NOX4), is dysregulated in the testes after PFHxS treatment. Based on metabolome data, the differential metabolite 3-hydroxybutanoic acid is identified in the PFHxS-treated group, which can regulate the histone Kac levels, especially H3K4ac and H3K9ac. In summary, the results of this study suggest that in the testes of PFHxS-treated mice, inflammatory factors disrupt the mitochondrial function and metabolic profiles and hinder the progress of gene transcription through histone Kac, ultimately causing sperm dysfunction.

Suspect and Nontarget Analysis of Per- and Polyfluoroalkyl Substances in Groundwater Underlying Different Land-Use Areas

Groundwater can be contaminated by PFAS emissions, yet research on the presence and associated risks of PFAS in groundwater underlying different land-use areas remains limited. Herein, high-resolution mass spectrometry-based suspect and nontarget analyses were performed to determine PFAS occurrence in groundwater samples obtained from a rural area, a planting region, and the vicinities of a pharmaceutical park, an airport, and an industrial park in Datong City, China. A total of 31 PFAS (16 emerging and 15 legacy PFAS) were identified, and the ΣPFAS concentrations ranged from 0.775 (rural area) to 80.7 ng/L (pharmaceutical park). In terms of the average concentration of ΣPFAS, legacy PFAS were predominant in rural groundwater, whereas emerging PFAS were predominant in the other four land-use areas. PFOA, PFDA, PFUnDA, and 6:2 FTS were detected in all groundwater samples. To further prioritize the risk of identified PFAS in groundwater, the detection frequency; concentration; and persistence, bioaccumulation, and toxicity attributes were adopted, which showed that high-risk compounds varied across different land-use areas. Our results further reveal the ubiquitous contamination of PFAS in groundwater environments, even in areas with limited human activity, and highlight the necessity of suspect and nontarget analysis for assessing PFAS exposure through groundwater.

Exposure to specific polyfluoroalkyl chemicals is associated with cardiovascular disease in US adults: a population-based study

Background

Polyfluoroalkyl chemicals (PFCs) present potential health risks due to their persistence and bioaccumulation. However, there is currently insufficient evidence regarding their impact on cardiovascular disease (CVD). Consequently, it is imperative to investigate the correlation between PFCs and CVD.

Methods

The data was collected from National Health and Nutrition Examination Survey in 2005-2012. Logistic regression models were employed to assess the association between single PFC and CVD. Generalized additive model (GAM) was used for evaluating nonlinear relationships. Subgroup analyses were conducted to explore interaction effects. Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) models were used to evaluate the joint effect of PFC exposures on CVD.

Results

In logistic regression, PFDE, MPAH, and PFUA were positively associated with CVD. In the GAM, there was a significant nonlinear relationship between MPAH and CVD. Subgroup analysis revealed the interaction of gender and race in the effects of PFCs and CVD. PFUA was positively correlated with CVD in males but show no significant difference in females. PFDE was positively associated with CVD among non-Hispanic white individual. The results of BKMR indicated that the impact of mixed PFCs on CVD increased initially and then weakened, showing an overall positive trend. The results of WQS suggested that PFDO contributed most to the effect.

Conclusion

Our study showed that serum PFDE, MPAH, and PFUA levels were positively correlated with CVD. PUFA was found to interact with gender and race in relation to CVD. A general positive correlation exists between mixed exposure to PFCs and CVD, with PFDO being the most contributory PFC. Our study provided important evidence for probing the impact of PFCs on CVD and laid a foundation for further mechanism research.

Per- and polyfluoroalkyl substances, apolipoproteins and the risk of coronary heart disease in US men and women

BACKGROUND

Existing evidence for associations of per- and polyfluoroalkyl substances (PFASs) with blood lipids, lipoproteins and apolipoproteins (apo), and coronary heart disease (CHD) risk is limited and inconsistent. This study aims to explore associations between plasma PFASs, blood lipoprotein subspecies defined by apolipoproteins, and CHD risk.

METHODS

A case-control study of CHD was conducted in the Health Professionals Follow-Up Study (HPFS) and Nurses' Health Study (NHS). Among participants initially free of cardiovascular disease at blood collection in 1994 (HPFS) or 1990 (NHS), 101 participants who developed non-fatal myocardial infarction or fatal CHD were identified and confirmed. A healthy control was matched to each case for age, smoking status, and date of blood draw. Plasma levels of perfluorohexane sulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), total perfluorooctane sulfonic acid (PFOS), branched PFOS (brPFOS), linear PFOS (nPFOS), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) were measured. Conditional logistic regression and cubic spline regression models were used to examine associations between baseline PFASs and CHD risk. Linear regression models were applied to study PFAS associations with lipids and their subfractions.

RESULTS

After multivariate adjustments, total PFOS, brPFOS and nPFOS were significantly associated with increased risk of developing CHD, and HRs (95% CIs) per log(ng/mL) increment of PFASs were 3.66 (1.36-9.89), 3.68 (1.55-8.76), and 3.01 (1.16-7.86), respectively. Significant positive dose-response relationships were identified for these PFASs (Plinearity = 0.01, 0.002, 0.02, respectively). Other PFASs were not associated with CHD risk. PFNA and PFDA were positively associated with total apoE levels among HDL particles with or without apoC-III. No associations were observed for other PFASs with blood lipid subspecies. Blood lipid subfractions did not explain the association between PFOS and CHD risk.

CONCLUSIONS

Plasma PFOS and its isomers were positively associated with CHD risk. These findings suggest that PFOS exposure causes public health risks that are greater than hitherto believed.

Systemic and immunotoxicity induced by topical application of perfluoroheptane sulfonic acid (PFHpS) or perfluorooctane sulfonic acid (PFOS) in a murine model

Per- and polyfluoroalkyl substances (PFAS) are a large group of synthetic surfactants of over 12,000 compounds that are incorporated into numerous products for their chemical and physical properties. Studies have associated PFAS with adverse health effects. Although there is a high potential for dermal exposure, these studies are lacking. The present study evaluated the systemic and immunotoxicity of subchronic 28- or 10-days of dermal exposure, respectively, to PFHpS (0.3125-2.5% or 7.82-62.5 mg/kg/dose) or PFOS (0.5% or 12.5 mg/kg/dose) in a murine model. Elevated levels of PFHpS were detected in the serum and urine, suggesting that absorption is occurring through the dermal route. PFHpS induced significantly increased relative liver weight, significantly decreased relative spleen and thymus weight, altered serum chemistries, and altered histopathology. Additionally, PFHpS significantly reduced the humoral immune response and altered immune subsets in the spleen, suggesting immunosuppression. Gene expression changes were observed in the liver, skin, and spleen of genes involved in fatty acid metabolism, necrosis, and inflammation. Immune-cell phenotyping identified significant decreases in B-cells and CD11b+ monocyte and/or macrophages in the spleen along with decreases in eosinophils and dendritic cells in the skin. These findings support PFHpS absorption through the skin leading to liver damage and immune suppression.

Per- and polyfluoroalkyl substances (PFAS) and cancer: Detection methodologies, epidemiological insights, potential carcinogenic mechanisms, and future perspectives

Per- and polyfluoroalkyl substances (PFAS), known as "forever chemicals," are synthetic chemicals which have been used since the 1940s. Given their remarkable thermostability and chemical stability, PFAS have been widely utilized in commercial products, including textiles, surfactants, food packages, nonstick coatings, and fire-fighting foams. Thus, PFAS are widely distributed worldwide and have been detected in human urine, blood, breast milk, tissues and other substances. Growing concerns over the risks of PFAS, including their toxicity and carcinogenicity, have attracted people's attention. Recent reviews have predominantly emphasized advancements in the detection, adsorption, and degradation of PFAS through their chemical structures and toxic properties; however, further examination of the literature is needed to determine the link between PFAS exposure and cancer risk. Here, we introduced different PFAS detection methods based on sensors and liquid chromatography-mass spectrometry (LC-MS). Then, we discussed epidemiological investigations on PFAS levels and cancer risks in recent years, as well as the mechanisms underlying the carcinogenesis. Finally, we proposed the "4C principles" for ongoing exploration and refinement in this field. This review highlights PFAS-cancer associations to fill knowledge gaps and provide evidence-based strategies for future research.

Exploring the sources, occurrence, transformation, toxicity, monitoring, and remediation strategies of per- and polyfluoroalkyl substances: a review

Per- and polyfluoroalkyl substances (PFAS), a class of man-made chemicals, possess unique properties that have rendered them indispensable in various industries and consumer goods. However, their extensive use and persistence in the environment have raised concerns about their potential repercussions on human health and the ecosystem. This review provides insights into the sources, occurrence, transformation, impacts, fate, monitoring, and remediation strategies for PFAS. Once released into the environment, these chemicals undergo intricate transformation processes, such as degradation, bioaccumulation, and biomagnification, which result in their far-reaching distribution and persistence. Their chemical stability results in persistent pollution, with far-reaching ecological and human health implications. Remediation strategies for PFAS are still in their infancy, and researchers are exploring innovative and sustainable methods for treating contaminated environments. Promising technologies such as adsorption, biodegradation, and electrochemical oxidation have shown the potential to remove PFAS from contaminated sites, yet the search for more efficient and sustainable solutions continues. In conclusion, this review emphasizes the urgent need for continued research and innovation to address the global environmental challenge posed by PFAS. As we move forward, it is imperative to prioritize sustainable solutions that minimize the detrimental consequences of these substances on human health and the environment.

Relationship between per-fluoroalkyl and polyfluoroalkyl substance exposure and insulin resistance in nondiabetic adults: Evidence from NHANES 2003-2018

BACKGROUND

Studies have linked per- and polyfluoroalkyl substances (PFAS) to chronic metabolic diseases. However, the relationship between PFAS exposure and insulin resistance (IR), a key pathophysiological basis of these metabolic diseases, in nondiabetic individuals have yet to be determined.

METHODS

This study analyzed data from 3909 participants (aged ≥20) from the NHANES 2003-2018 to investigate the associations between serum levels of seven PFAS and and IR indicators, including including HOMA-IR, HOMA-β, fasting insulin, QUICKI, and TyG index. Linear and logistic regression models were used, along with a restricted cubic spline to assess dose-response. Weighted quantile sum (WQS) regression and quantile g-computation (qgcomp) models were used to assess the association between mixed PFAS exposure and IR.

RESULTS

Linear regression revealed that elevated exposure to PFOS [β (95 % CI): 0.04 (0.02, 0.06)], PFOA [0.04 (0.01, 0.06)], and Me_PFOSA_AcOH [0.04 (0.02, 0.06)] was associated with a higher TyG index in adults. Notably, Me_PFOSA_AcOH was negatively associated with IR when assessed by HOMA-IR >2.6 [OR (95 % CI): 0.88 (0.79, 0.98)], although this was not supported by linear regression findings. When IR was defined by a TyG index >8.6, exposure to the highest quartiles of PFOS, PFOA, and Me_PFOSA_AcOH was associated with an increased risk of IR by 63 %, 42 %, and 85 %, respectively [1.63 (1.21, 2.20); 1.42 (1.06, 1.92); 1.85 (1.37, 2.50)]. PFOS, PFOA, and Me_PFOSA_AcOH demonstrated a nonlinear dose-response relationship with IR risk. The WQS and qgcomp models revealed significant positive correlations with the TyG index.

CONCLUSION

Mixed PFAS exposure in US nondiabetic adults was positively associated with IR, as indicated by the TyG index, particularly for PFOS, PFOA, and Me_PFOSA_AcOH. Further research is needed to establish causality, and reinforcing environmental risk mitigation strategies to reduce PFAS exposure is recommended.

Comparing the obesogenic effect and regulatory mechanisms of long-term exposure to per/polyfluoroalkyl substances with different terminal groups in Caenorhabditis elegans

Per/polyfluoroalkyl substances (PFASs) are ubiquitous, bioaccumulative, and recalcitrant contaminants, posing global exposure and health risks. The effects of chemical structures on toxicities and the mechanisms of their obesogenic effects were largely unclear. This study used the model organism Caenorhabditis elegans to assess the impact of long-term exposure to different PFASs (PFNA, PFOSA, PFBS, PFHxS, 6:2 FTS, 4:2 FTS, PFOA, and PFOS) on growth and lipid metabolism and discussed the obesogenic mechanisms of selected PFASs. The growth assays indicated longer carbon-fluorine (-CF) chains and total fluorine atoms increased developmental toxicity of PFASs, while at 8 -CF chain-length, PFNA (-COOH terminal), PFOS (-SO3 terminal), and PFOSA (-SO2NH2 terminal) exhibited differential growth inhibition. With the toxicity ranking of PFNA > PFOS > PFOSA, all PFASs significantly induced total lipid accumulation and perturbed the lipid composition in C. elegans. All three PFASs significantly induced lipogenesis gene expression and partially suppressed lipolysis genes. The results suggested that the disruption of lipid metabolism of PFOSA depends on sbp-1, while PFNA and PFOS depend on nhr-49. In conclusion, long-term exposure to PFNA, PFOSA, and PFOS triggers obesogenic effects in organisms by distinct molecular mechanisms.

Identification and quantification of novel per- and polyfluoroalkyl substances (PFAS) contamination in a Great Lakes urban-dominated watershed

Per- and polyfluoroalkyl substances (PFAS) are a large group of synthetic organic fluoro-compounds that are oil-, water-, and flame-resistant, making them useful in a wide range of commercial and consumer products, as well as resistant to environmental degradation. To assess the impact of urbanization and wastewater treatment processes, surface water and sediment samples were collected at 27 sites within the Great Lakes in the Lake Huron to Lake Erie corridor (HEC), an international waterway including the highly urbanized Detroit and Rouge Rivers. Samples were analyzed for 92 PFAS via UHPLC-MS/MS. Our previous data in the HEC found the highest amount of PFAS contamination at the Rouge River mouth. In addition to evaluating the input of the Rouge River into the HEC, we evaluated the transport of PFAS into the HEC from other major tributaries. PFAS were detected in both surface water and sediment at all sites in this study, with a total of 10 congeners quantified in all surface water samples and 16 congeners quantified in all sediment samples, indicating ubiquitous contamination. Perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) were pervasive in the HEC as these two compounds were detected in all sites and matrices, often at concentrations above the US EPA's recommended lifetime interim updated health advisories. Surface water samples contained more perfluorohexanoic acid (PFHxA) than any other congener, with average aqueous PFHxA across all surface water samples exceeding the average concentration previously reported in the Great Lakes. Sediment samples were dominated by PFOS, but novel congeners, notably 3-Perfluoropentyl propanoic acid (FPePA), were also quantified in sediment. The Rouge River and other tributaries contribute significantly to the PFAS burden in the HEC including Lake Erie. Overall, our results indicate the need for expanding toxicological research and risk assessment focused on congeners such as PFHxA and PFAS mixtures, as well as regulation that is tighter at the onset of production and encompasses PFAS as a group at a national level.

Developmental PFOS exposure alters lung inflammation and barrier integrity in juvenile mice

Emerging epidemiological evidence indicates perfluorooctane sulfonic acid (PFOS) is increasingly associated with asthma and respiratory viral infections. Animal studies suggest PFOS disrupts lung development and immuno-inflammatory responses, but little is known about the potential consequences on respiratory health and disease risk. Importantly, PFOS exposure during the critical stages of lung development may increase disease risk later in life. Thus, we hypothesized that developmental PFOS exposure will affect lung inflammation and alveolar/airway development in a sex-dependent manner. To address this knowledge gap, timed pregnant Balb/cJ dams were orally dosed with a PFOS (1.0 or 2.0 mg/kg/d) injected mealworm or a vehicle control daily from gestational day (GD) 0.5 to postnatal day (PND) 21, and offspring were sacrificed at PND 22-23. PFOS-exposed male offspring displayed increased alveolar septa thickness. Occludin was also downregulated in the lungs after PFOS exposure in mice, indicative of barrier dysfunction. BALF macrophages were significantly elevated at 2.0 mg/kg/d PFOS in both sexes compared with vehicles, whereas BALF cytokines (TNF-α, IL-6, KC, MIP-1α, MIP-1β, and MCP-1) were suppressed in PFOS-exposed male offspring compared with vehicle controls. Multiplex nucleic acid hybridization assay showed male-specific downregulation of cytokine gene expression in PFOS-exposed mice compared with vehicle mice. Overall, these results demonstrate PFOS exposure exhibits male-specific adverse effects on lung development and inflammation in juvenile offspring, possibly predisposing them to later-in-life respiratory disease. Further research is required to elucidate the mechanisms underlying the sex-differentiated pulmonary toxicity of PFOS.

A novel molecular pathway of lipid accumulation in human hepatocytes caused by PFOA and PFOS

Exposed to ubiquitously perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) has been associated with non-alcoholic fatty liver disease (NAFLD), yet the underlying molecular mechanism remains elusive. The extrapolation of empirical studies correlating per- and polyfluoroalkyl substance (PFAS) exposure with NAFLD occurrence to real-life exposure was hindered by the limited availability of mechanistic data at environmentally relevant concentrations. Herein, a novel pathway mediating hepatocyte lipid accumulation by PFOA and PFOS at human-relevant dose (<10 μM) was identified by integrating CRISPR-Cas9 genome screening, concentration-dependent transcriptional assay in HepG2 cell and epidemiological data mining. 1) At genetic level, nudt7 showed the highest enriched potency among 569 NAFLD-related genes, and the transcription of nudt7 was significantly downregulated by PFOA and PFOS exposure (<7 μM). 2) At molecular pathway, upon exposure to ≤10-4 μM PFOA and PFOS, the downregulation of nudt7 transcriptional expression triggered the reduction of Ace-CoA hydrolase activity. 3) At cellular level, increased lipids were measured in HepG2 cells with PFOA and PFOS (<2 μM). Overall, we identified a novel mechanism mediated by transcriptional downregulation of nudt7 gene in hepatocellular lipid increase treated with PFOA and PFOS, which could potentially explain the NAFLD occurrence associated with exposure to PFASs in humans.

Exposure of Ldlr-/- Mice to a PFAS Mixture and Outcomes Related to Circulating Lipids, Bile Acid Excretion, and the Intestinal Transporter ASBT

BACKGROUND

Previous epidemiological studies have repeatedly found per- and polyfluoroalkyl substances (PFAS) exposure associated with higher circulating cholesterol, one of the greatest risk factors for development of coronary artery disease. The main route of cholesterol catabolism is through its conversion to bile acids, which circulate between the liver and ileum via enterohepatic circulation. Patients with coronary artery disease have decreased bile acid excretion, indicating that PFAS-induced impacts on enterohepatic circulation may play a critical role in cardiovascular risk.

OBJECTIVES

Using a mouse model with high levels of low-density and very low-density lipoprotein (LDL and VLDL, respectively) cholesterol and aortic lesion development similar to humans, the present study investigated mechanisms linking exposure to a PFAS mixture with increased cholesterol.

METHODS

Male and female L d l r - / - mice were fed an atherogenic diet (Clinton/Cybulsky low fat, 0.15% cholesterol) and exposed to a mixture of 5 PFAS representing legacy, replacement, and emerging subtypes (i.e., PFOA, PFOS, PFHxS, PFNA, GenX), each at a concentration of 2 mg / L , for 7 wk. Blood was collected longitudinally for cholesterol measurements, and mass spectrometry was used to measure circulating and fecal bile acids. Transcriptomic analysis of ileal samples was performed via RNA sequencing.

RESULTS

After 7 wk of PFAS exposure, average circulating PFAS levels were measured at 21.6, 20.1, 31.2, 23.5, and 1.5 μ g / mL in PFAS-exposed females and 12.9, 9.7, 23, 14.3, and 1.7 μ g / mL in PFAS-exposed males for PFOA, PFOS, PFHxS, PFNA, and GenX, respectively. Total circulating cholesterol levels were higher in PFAS-exposed mice after 7 wk (352 mg / dL vs. 415 mg / dL in female mice and 392 mg / dL vs. 488 mg / dL in male mice exposed to vehicle or PFAS, respectively). Total circulating bile acid levels were higher in PFAS-exposed mice (2,978  pg / μ L vs. 8,496  pg / μ L in female mice and 1,960  pg / μ L vs. 4,452  pg / μ L in male mice exposed to vehicle or PFAS, respectively). In addition, total fecal bile acid levels were lower in PFAS-exposed mice (1,797  ng / mg vs. 682  ng / mg in females and 1,622  ng / mg vs. 670  ng / mg in males exposed to vehicle or PFAS, respectively). In the ileum, expression levels of the apical sodium-dependent bile acid transporter (ASBT) were higher in PFAS-exposed mice.

DISCUSSION

Mice exposed to a PFAS mixture displayed higher circulating cholesterol and bile acids perhaps due to impacts on enterohepatic circulation. This study implicates PFAS-mediated effects at the site of the ileum as a possible critical mediator of increased cardiovascular risk following PFAS exposure. https://doi.org/10.1289/EHP14339.

Legacy and alternative per- and polyfluoroalkyl substances (PFAS) alter the lipid profile of HepaRG cells

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals used in various industrial and consumer products. They have gained attention due to their ubiquitous occurrence in the environment and potential for adverse effects on human health, often linked to immune suppression, hepatotoxicity, and altered cholesterol metabolism. This study aimed to explore the impact of ten individual PFAS, 3 H-perfluoro-3-[(3-methoxypropoxy) propanoic acid] (PMPP/Adona), ammonium perfluoro-(2-methyl-3-oxahexanoate) (HFPO-DA/GenX), perfluorobutanoic acid (PFBA), perfluorobutanesulfonic acid (PFBS), perfluorodecanoic acid (PFDA), perfluorohexanoic acid (PFHxA), perfluorohexanesulfonate (PFHxS), perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), and perfluorooctanesulfonic acid (PFOS) on the lipid metabolism in human hepatocyte-like cells (HepaRG). These cells were exposed to different concentrations of PFAS ranging from 10 µM to 5000 µM. Lipids were extracted and analyzed using liquid chromatography coupled with mass spectrometry (LC- MS-QTOF). PFOS at 10 µM and PFOA at 25 µM increased the levels of ceramide (Cer), diacylglycerol (DAG), N-acylethanolamine (NAE), phosphatidylcholine (PC), and triacylglycerol (TAG) lipids, while PMPP/Adona, HFPO-DA/GenX, PFBA, PFBS, PFHxA, and PFHxS decreased the levels of these lipids. Furthermore, PFOA and PFOS markedly reduced the levels of palmitic acid (FA 16.0). The present study shows distinct concentration-dependent effects of PFAS on various lipid species, shedding light on the implications of PFAS for essential cellular functions. Our study revealed that the investigated legacy PFAS (PFOS, PFOA, PFBA, PFDA, PFHxA, PFHxS, and PFNA) and alternative PFAS (PMPP/Adona, HFPO-DA/GenX and PFBS) can potentially disrupt lipid homeostasis and metabolism in hepatic cells. This research offers a comprehensive insight into the impacts of legacy and alternative PFAS on lipid composition in HepaRG cells.

Association of co-exposure to organophosphate esters and per- and polyfluoroalkyl substances and mixture with cardiovascular-kidney-liver-metabolic biomarkers among Chinese adults

BACKGROUND

Organophosphate esters (OPEs) and Per- and polyfluoroalkyl substances (PFAS) are ubiquitous environmental contaminants with common exposure sources, leading to their widespread presence in human body. However, evidence on co-exposure to OPEs and PFAS and its impact on cardiovascular-kidney-liver-metabolic biomarkers remains limited.

METHODS

In this cross-sectional study, 467 adults were enrolled from January to May 2022 during physical visits in Shijiazhuang, Hebei province. Eleven types of OPEs and twelves types of PFAS were detected, among which eight OPEs and six PFAS contaminants were detected in more than 60% of plasma samples. Seventeen biomarkers were assessed to comprehensively evaluate the cardiovascular-kidney-liver-metabolic function. Multiple linear regression, multipollutant models with sparse partial least squares, and Bayesian kernel machine regression (BKMR) models were applied to examine the associations of individual OPEs and PFAS and their mixtures with organ function and metabolism, respectively.

RESULTS

Of the over 400 exposure-outcome associations tested when modelling, we observed robust results across three models that perfluorohexanoic acid (PFHxS) was significantly positively associated with alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and indirect bilirubin (IBIL). Perfluorononanoic acid was significantly associated with decreased AST/ALT and increased very-low-density lipoprotein cholesterol levels. Besides, perfluorodecanoic acid was correlated with increased high lipoprotein cholesterol and perfluoroundecanoic acid was consistently associated with lower glucose level. BKMR analysis showed that OPEs and PFAS mixtures were positively associated with IBIL and TBIL, among which PFHxS was the main toxic chemicals.

CONCLUSIONS

Our findings suggest that exposure to OPEs and PFAS, especially PFHxS and PFNA, may disrupt organ function and metabolism in the general population, providing insight into the potential pathophysiological mechanisms of OPEs and PFAS co-exposure and chronic diseases.

Identification and quantification of per- and polyfluorinated alkyl substances (PFAS) migrating from food contact materials (FCM)

Per- and polyfluorinated alkyl substances (PFAS) can be added to food contact materials (FCM) to increase their water and/or grease repellent properties. Some well-known PFAS are perfluoroalkyl carboxylic acids (PFCA), perfluoroalkyl sulfonic acids (PFSA), and polyfluorinated telomer alcohols (FTOH). Due to the strength of the carbon-fluorine bond, PFAS are chemically very stable and highly resistant to biological degradation, posing a risk to human health and the environment. To examine the presence of PFAS in paper-based FCM, various samples were collected, including popcorn bags, muffin cups, and pizza boxes with high total organic fluorine (TOF) content from the Danish and Spanish markets. The FCM composition was characterised by FTIR. Quantification of some well-known PFAS such as PFCA, PFSA, and FTOH was performed in food simulants using LC-MS/MS, and in addition a non-targeted screening approach was performed by LC-Orbitrap-HRMS. Among analysed samples, the highest concentrations of PFAS were found in a muffin cup made of cellulose (PFCA ∼ 1.41 μg kg-1 food, FTOH ∼ 11.5 μg kg-1 food), and the results were used to estimate dietary exposures to PFAS migrated from this FCM. Compared to measured TOF value in this sample, the fluorine from all quantified PFAS accounted for only 0.6%. Thus, a more powerful analytical approach was used to further investigate PFAS occurrence in this sample. Using non-targeted screening, an additional twenty compounds were identified, among them five with confidence level 1 and ten with confidence level 2. Many of them were either fluorotelomer carboxylic acids or sulfonic acids or ether-containing compounds.

Effects of Per- and Polyfluoroalkylated Substances on Female Reproduction

Per- and poly-fluoroalkylated substances (PFAS) are a large group of chemicals that persist both in the environment and in the body. Legacy PFAS, e.g., perfluorooctanoic acid and perfluorooctane sulfonic acid, are implicated as endocrine disruptors and reproductive and developmental toxicants in epidemiological and animal model studies. This review describes female reproductive outcomes of reported studies and includes where associative relationships between PFAS exposures and female reproductive outcomes have been observed as well as where those are absent. In animal models, studies in which PFAS are documented to cause toxicity and where effects are lacking are described. Discrepancies exist in both human and animal studies and are likely attributable to human geographical contamination, developmental status, duration of exposure, and PFAS chemical identity. Similarly, in animal investigations, the model used, exposure paradigm, and developmental status of the female are important and vary widely in documented studies. Taken together, support for PFAS as reproductive and developmental toxicants exists, although the disparity in study conditions and human exposures contribute to the variation in effects noted.

Gradual effects of gradient concentrations of perfluorooctane sulfonate on the antioxidant ability and gut microbiota of red claw crayfish (Cherax quadricarinatus)

Perfluorooctane sulfonate (PFOS) is a typical persistent organic pollutant that is characterized by environmental persistence, bioaccumulation, and toxicity. In this study, we investigated the gut microbial response of the red claw crayfish Cherax quadricarinatus after 28 days of exposure to 0 ng/L, 1 ng/L, 10 μg/L, or 10 mg/L of PFOS as a stressor. We measured oxidative stress-related enzyme activities and expression of molecules related to detoxification mechanisms to evaluate the toxic effects of PFOS. We found that PFOS disturbed microbial homeostasis in the gut of C. quadricarinatus, resulting in increased abundance of the pathogen Shewanella and decreased abundance of the beneficial bacterium Lactobacillus. The latter especially disturbed amino acid transport and carbohydrate transport. We also found that the activities of glutathione S-transferase and glutathione peroxidase were positively correlated with the expression levels of cytochrome P450 genes (GST1-1, GSTP, GSTK1, HPGDS, UGT5), which are products of PFOS-induced oxidative stress and play an antioxidant role in the body. The results of this study provided valuable ecotoxicological data to better understand the biological fate and effects of PFOS in C. quadricarinatus.

Exposure to PFAS chemicals induces sex-dependent alterations in key rate-limiting steps of lipid metabolism in liver steatosis

Toxicants with the potential to bioaccumulate in humans and animals have long been a cause for concern, particularly due to their association with multiple diseases and organ injuries. Per- and polyfluoro alkyl substances (PFAS) and polycyclic aromatic hydrocarbons (PAH) are two such classes of chemicals that bioaccumulate and have been associated with steatosis in the liver. Although PFAS and PAH are classified as chemicals of concern, their molecular mechanisms of toxicity remain to be explored in detail. In this study, we aimed to identify potential mechanisms by which an acute exposure to PFAS and PAH chemicals can induce lipid accumulation and whether the responses depend on chemical class, dose, and sex. To this end, we analyzed mechanisms beginning with the binding of the chemical to a molecular initiating event (MIE) and the consequent transcriptomic alterations. We collated potential MIEs using predictions from our previously developed ToxProfiler tool and from published steatosis adverse outcome pathways. Most of the MIEs are transcription factors, and we collected their target genes by mining the TRRUST database. To analyze the effects of PFAS and PAH on the steatosis mechanisms, we performed a computational MIE-target gene analysis on high-throughput transcriptomic measurements of liver tissue from male and female rats exposed to either a PFAS or PAH. The results showed peroxisome proliferator-activated receptor (PPAR)-α targets to be the most dysregulated, with most of the genes being upregulated. Furthermore, PFAS exposure disrupted several lipid metabolism genes, including upregulation of fatty acid oxidation genes (Acadm, Acox1, Cpt2, Cyp4a1-3) and downregulation of lipid transport genes (Apoa1, Apoa5, Pltp). We also identified multiple genes with sex-specific behavior. Notably, the rate-limiting genes of gluconeogenesis (Pck1) and bile acid synthesis (Cyp7a1) were specifically downregulated in male rats compared to female rats, while the rate-limiting gene of lipid synthesis (Scd) showed a PFAS-specific upregulation. The results suggest that the PPAR signaling pathway plays a major role in PFAS-induced lipid accumulation in rats. Together, these results show that PFAS exposure induces a sex-specific multi-factorial mechanism involving rate-limiting genes of gluconeogenesis and bile acid synthesis that could lead to activation of an adverse outcome pathway for steatosis.

Non-target and target screening and risk assessment of per- and polyfluoroalkyl substances in textile wastewater and receiving river

Textile industry uses varieties of chemicals including per- and polyfluoroalkyl substances (PFAS). PFAS are known to be persistent and incompletely removed in wastewater treatment plants (WWTPs). So far, little is known about what types of PFAS are used in the textile industry and their potential risks. Here we investigated PFAS in two WWTPs and a receiving river of a textile industrial park in Guangxi, China, by using both target and non-target analyses over a two-year period. The target analysis identified 11 specific PFAS, while the non-target analysis revealed a list of 648 different PFAS, including both legacy and emerging substances. Notably, perfluorooctanoic acid (PFOA) was still the most prevalent compound detected. Of particular concern was the finding that the investigated WWTPs, which employs an A/O (Anaerobic/Aerobic) process, exhibited a poor removal efficiency for PFAS. The average removal rate was only 22.0 %, indicating that the current treatment processes are inadequate in effectively mitigating PFAS contamination. Correlation analysis further highlighted the potential for PFAS to be transported from WWTPs to the receiving river, revealing a significant and strong positive correlation between the PFAS in the WWTP effluent and those of the river. Perfluorooctanesulfonic acid (PFOS) and two emerging PFAS (DTXSID30240816 and DTXSID90240817) were identified to have high ecological risks in the receiving river. Notably, these two emerging PFAS are homologues, and their presence in WWTPs has been poorly reported. The findings highlight the wide use and persistence of PFAS in current textile WWTPs, indicating potential long term risks to the receiving environment.

Associations of per- and polyfluoroalkyl substances with maternal metabolic and inflammatory biomarkers in early-to-mid-pregnancy

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) can disrupt metabolism. Early-to-mid pregnancy is characterized by amplified metabolic processes and inflammation to support maternal adaptations and fetal growth. Thus, we cross-sectionally evaluated whether PFAS are individually and jointly associated with these processes in early-to-mid pregnancy.

METHODS

Pregnant Illinois women (n = 452) provided fasted blood samples at median 17 weeks gestation. We quantified serum perfluorononanoic (PFNA), perfluorooctane sulfonic (PFOS), perfluorooctanoic (PFOA), methyl-perfluorooctane sulfonamide acetic acid (Me-PFOSA-AcOH), perfluorohexanesulfonic (PFHxS), perfluorodecanoic (PFDeA), and perfluoroundecanoic (PFUdA) acid. Key outcomes were plasma glucose, insulin, C-peptide, insulin-like growth factor 1 (IGF-1), adiponectin, leptin, triglycerides, free fatty acids, total cholesterol, high-density lipoprotein (HDL) cholesterol, C-reactive protein, tumor necrosis factor alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and interleukin 6. We calculated homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein (LDL) cholesterol, and very low-density lipoprotein (VLDL). We evaluated associations of PFAS with each metabolic/inflammatory biomarker individually using covariate-adjusted linear regression and jointly using quantile-based g-computation.

RESULTS

In linear regression, all PFAS (except Me-PFOSA-AcOH) were negatively associated with insulin, HOMA-IR, and leptin, whereas all PFAS were positively associated with HDL cholesterol. We also observed negative associations of some PFAS with TNF-α and MCP-1; positive associations with adiponectin and total cholesterol also emerged. Additionally, PFOS was positively, whereas Me-PFOSA-AcOH was negatively, associated with triglycerides and VLDL. Each 25% increase in the PFAS mixture was associated with -31.3% lower insulin (95%CI: -45.8, -12.9), -31.9% lower HOMA-IR (95%CI: -46.4, -13.4), and -9.4% lower leptin (95%CI: -17.3, -0.8), but 7.4% higher HDL cholesterol (95%CI: 4.6, 10.3). For most outcomes, the major contributors to the PFAS mixture often differed compared to single-PFAS analyses.

IMPLICATIONS

Individual and joint PFAS exposures were associated with markers of maternal metabolism and inflammation in pregnancy. Further investigation is needed to elucidate possible mechanisms and consequences of these findings.

Total and Class-Specific Determination of Fluorinated Compounds in Consumer and Food Packaging Samples Using Fluorine-19 Solid-State Nuclear Magnetic Resonance Spectroscopy

Hamburger wrapping paper, coated with water-based barrier coatings, used in the food packaging industry was studied by using the total organic fluorine (TOF) method based on combustion ion chromatography and fluorine-19 solid-state nuclear magnetic resonance (19F ss-NMR) spectroscopy. Although the TOF method is a fast and affordable method used to screen for per- and polyfluoroalkyl substances (PFAS), the amount of fluorine it measures is heavily dependent on the extraction step and, therefore could lead to inaccurate results. Fluorine-19 ss-NMR spectroscopy can differentiate between organic and inorganic fluorinated sources, eliminating the need for sample clean up. To illustrate this, the 19F ss-NMR spectra of clean coated paper samples that contained naturally occurring F- ions from the talc raw material and spiked samples containing perfluorooctanoic acid were compared. A range of experimental conditions was explored to improve sensitivity for low PFAS concentrations (in the order of 10-20 mg/kg). Despite the disadvantages of ss-NMR spectroscopy, such as the low limit of detection and resolution, the results demonstrate it can be a viable tool to directly detect PFAS moieties in consumer and food packaging. Therefore, 19F solid-state NMR spectroscopy challenges and complements current methods, which only provide indirect evidence of the presence of PFAS.

An Atomic and Molecular Insight into How PFOA Reduces α-Helicity, Compromises Substrate Binding, and Creates Binding Pockets in a Model Globular Protein

Per- and polyfluoroalkyl substances (PFAS) pose significant health risks due to their widespread presence in various environmental and biological matrices. However, the molecular-level mechanisms underlying the interactions between PFAS and biological constituents, including proteins, carbohydrates, lipids, and DNA, remain poorly understood. Here, we investigate the interactions between a legacy PFAS, viz. perfluorooctanoic acid (PFOA), and the milk protein β-lactoglobulin (BLG) obtained using a combination of experimental and computational techniques. Circular dichroism studies reveal that PFOA perturbs the secondary structure of BLG, by driving a dose-dependent loss of α-helicity and alterations in its β-sheet content. Furthermore, exposure of the protein to PFOA attenuates the on-rate constant for the binding of the hydrophobic probe 8-anilino-1-naphthalene sulfonic acid (ANS), suggesting potential functional impairment of BLG by PFOA. Steered molecular dynamics and umbrella sampling calculations reveal that PFOA binding leads to the formation of an energetically favorable novel binding pocket within the protein, when residues 129-142 are steered to unfold from their initial α-helical structure, wherein a host of intermolecular interactions between PFOA and BLG's residues serve to insert the PFOA into the region between the unfolded helix and beta-sheets. Together, the data provide a novel understanding of the atomic and molecular mechanism(s) by which PFAS modulates structure and function in a globular protein, leading to a beginning of our understanding of altered biological outcomes.

Temporal Trend of Serum Perfluorooctanoic Acid and Perfluorooctane Sulfonic Acid among U.S. Adults with or without Comorbidities in NHANES 1999-2018

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are associated with adverse health effects. This study examined the trend of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) levels in individuals with and without pre-existing comorbidities. We analyzed the characteristics of 13,887 participants across nine U.S. NHANES cycles (1999-2000 to 2017-2018) and calculated the geometric mean (GM) of PFOA and PFOS levels, standardized by sex and age. A joinpoint regression model was used to analyze the temporal trends of serum PFOA and PFOS levels. We observed declining PFOA and PFOS serum levels among adults in NHANES from 1999-2000 to 2017-2018. Serum PFOA and PFOS concentrations were higher in men, smokers, and individuals with pre-existing CKD, hyperlipidemia, CVD, and cancer. We observed faster decline rates in PFOA levels among individuals with diabetes and CKD and faster decline rates in PFOS levels among individuals with diabetes and those without CKD. This study provided evidence of varying levels and changing trends of PFOA and PFOS between groups with and without established chronic disease, highlighting the role of environmental chemicals in the onset and development of chronic diseases.

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

Conservative estimates by the World Health Organization suggest that at least a quarter of global cardiovascular diseases are attributable to environmental exposures. Associations between air pollution and cardiovascular risk have garnered the most headlines and are strong, but less attention has been paid to other omnipresent toxicants in our ecosystem. Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are man-made chemicals that are extensively used in industrial and consumer products worldwide and in aqueous film-forming foam utilized in firefighting. As such, our exposure to PFAS is essentially ubiquitous. Given the long half-lives of these degradation-resistant chemicals, virtually, all people are carrying a body burden of PFAS. Health concerns related to PFAS are growing such that the National Academies of Sciences, Engineering and Medicine has recommended standards for clinical follow-up of individuals with high PFAS blood levels, including prioritizing screening for dyslipidemia. The link between PFAS and dyslipidemia has been extensively investigated, and evidence for associations is compelling. However, dyslipidemia is not the only cardiovascular risk factor with which PFAS is associated. Here, we review the epidemiological evidence for links between PFAS of concern identified by the National Academies of Sciences, Engineering and Medicine and risk factors for cardiovascular disease, including overweight/obesity, glucose intolerance, hypertension, dyslipidemia, and hyperuricemia. Moreover, we review the potential connections of PFAS with vascular disease and atherosclerosis. While observational data support associations between the National Academies of Sciences, Engineering and Medicine PFAS and selected cardiac risk factors, additional research is needed to establish causation and better understand how exposure to PFAS leads to the development of these conditions.

All-cause, cardiovascular disease and cancer mortality in the population of a large Italian area contaminated by perfluoroalkyl and polyfluoroalkyl substances (1980-2018)

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are associated with many adverse health conditions. Among the main effects is carcinogenicity in humans, which deserves to be further clarified. An evident association has been reported for kidney cancer and testicular cancer. In 2013, a large episode of surface, ground and drinking water contamination with PFAS was uncovered in three provinces of the Veneto Region (northern Italy) involving 30 municipalities and a population of about 150,000. We report on the temporal evolution of all-cause mortality and selected cause-specific mortality by calendar period and birth cohort in the local population between 1980 and 2018.

METHODS

The Italian National Institute of Health pre-processed and made available anonymous data from the Italian National Institute of Statistics death certificate archives for residents of the provinces of Vicenza, Padua and Verona (males, n = 29,629; females, n = 29,518) who died between 1980 and 2018. Calendar period analysis was done by calculating standardised mortality ratios using the total population of the three provinces in the same calendar period as reference. The birth cohort analysis was performed using 20-84 years cumulative standardised mortality ratios. Exposure was defined as being resident in one of the 30 municipalities of the Red area, where the aqueduct supplying drinking water was fed by the contaminated groundwater.

RESULTS

During the 34 years between 1985 (assumed as beginning date of water contamination) and 2018 (last year of availability of cause-specific mortality data), in the resident population of the Red area we observed 51,621 deaths vs. 47,731 expected (age- and sex-SMR: 108; 90% CI: 107-109). We found evidence of raised mortality from cardiovascular disease (in particular, heart diseases and ischemic heart disease) and malignant neoplastic diseases, including kidney cancer and testicular cancer.

CONCLUSIONS

For the first time, an association of PFAS exposure with mortality from cardiovascular disease was formally demonstrated. The evidence regarding kidney cancer and testicular cancer is consistent with previously reported data.

Exposure to per- and polyfluoroalkyl substance and metabolic syndrome: A nationally representative cross-sectional study from NHANES, 2003-2018

Per- and polyfluoroalkyl substances(PFAS) are widespread organic pollutants with endocrine-disrupting effects on human health, but the association of PFAS exposure with metabolic syndrome remains conflicting. National Health and Nutrition Examination Survey(NHANES) program was utilized to evaluate the association of individual PFAS exposure and metabolic disorders and further determined the joint effect of PFAS co-exposures. 13921 participants and five PFAS exposures(PFHxS, MPAH, PFDE, PFNA, and PFUA) were included for analysis. The association between individual PFAS and metabolic syndrome varied in the specific PFAS and the specific metabolic disorder examined. PFHxS was negatively associated with obesity(Q4; OR = 0.75; P < 0.001), but positively associated with hyperlipidemia (Q3; OR = 1.2; P = 0.013). PFUA was negatively associated with obesity (Q4; OR = 0.6; P < 0.001), hyperlipidemia (Q3; OR = 0.85; P = 0.03), and non-alcoholic fatty liver disease (NAFLD, Q4; OR = 0.64; P = 0.015), but positively associated with hyperglycemia(Q3; OR = 1.27; P = 0.004). Furthermore, PFAS co-exposures were negatively associated with obesity(OR = 0.63; P < 0.001) and NAFLD(OR = 0.85; P = 0.021), and positively associated with hyperlipidemia(OR = 1.05; P = 0.022), but not significantly associated with hyperglycemia or hypertension. Overall, there was a negative association between PFAS co-exposures and metabolic severity score(β = -0.15; P < 0.001). Subgroup analysis stratified by gender and obesity consistently showed the negative association of PFAS co-exposures with metabolic severity score, and the positive association with hyperlipidemia. However, subgroup analysis showed a negative association with NAFLD in females but not in males, and a negative association with hyperglycemia in the obesity group, but not in the non-obesity group. Collectively, our study showed a negative association of PFAS co-exposures with metabolic syndrome severity score, but did not support a consistent association between PFAS co-exposures and individual components of metabolic syndrome. Additionally, there were gender-specific as well as BMI-specific differences in these associations. Further studies are needed to rule out the reverse causality and clarify the relationship of PFAS co-exposures with the specific metabolic disorder.

Systemic and immunotoxicity induced by topical application of perfluorohexane sulfonic acid (PFHxS) in a murine model

Per- and polyfluoroalkyl substances (PFAS) are a large group of stable synthetic surfactants that are incorporated into numerous products for their water and oil resistance and have been associated with adverse health effects. The present study evaluated the systemic and immunotoxicity of sub-chronic 28- or 10-day dermal exposure of PFHxS (0.625-5% or 15.63-125 mg/kg/dose) in a murine model. Elevated levels of PFHxS were detected in the serum and urine, suggesting that absorption is occurring through the dermal route. Liver weight (% body) significantly increased and spleen weight (% body) significantly decreased with PFHxS exposure, which was supported by histopathological changes. Additionally, PFHxS significantly reduced the humoral immune response and altered immune subsets in the spleen, suggesting immunosuppression. Gene expression changes were observed in the liver, skin, and spleen with genes involved in fatty acid metabolism, necrosis, and inflammation. Immune-cell phenotyping identified significant decreases in B-cells, NK cells, and CD11b+ monocyte/macrophages in the spleen along with increases in CD4+ and CD8+ T-cells, NK cells, and neutrophils in the skin. These findings support dermal PFHxS-induced liver damage and immune suppression. Overall, data support PFHxS absorption through the skin and demonstrate immunotoxicity via this exposure route, suggesting the need for further examination.

Dietary intake of Perfluorooctanesulfonic acid (PFOS) and glucose homeostasis parameters in a non-diabetic senior population

BACKGROUND

Endocrine disruptors (EDs) have emerged as potential contributors to the development of type-2 diabetes. Perfluorooctane sulfonate (PFOS), is one of these EDs linked with chronic diseases and gathered attention due to its widespread in food.

OBJECTIVE

To assess at baseline and after 1-year of follow-up associations between estimated dietary intake (DI) of PFOS, and glucose homeostasis parameters and body-mass-index (BMI) in a senior population of 4600 non-diabetic participants from the PREDIMED-plus study.

METHODS

Multivariable linear regression models were conducted to assess associations between baseline PFOS-DI at lower bound (LB) and upper bound (UB) established by the EFSA, glucose homeostasis parameters and BMI.

RESULTS

Compared to those in the lowest tertile, participants in the highest tertile of baseline PFOS-DI in LB and UB showed higher levels of HbA1c [β-coefficient(CI)] [0.01 %(0.002 to 0.026), and [0.06 mg/dL(0.026 to 0.087), both p-trend ≤ 0.001], and fasting plasma glucose in the LB PFOS-DI [1.05 mg/dL(0.050 to 2.046),p-trend = 0.022]. Prospectively, a positive association between LB of PFOS-DI and BMI [0.06 kg/m2(0.014 to 0.106) per 1-SD increment of energy-adjusted PFOS-DI was shown. Participants in the top tertile showed an increase in HOMA-IR [0.06(0.016 to 0.097), p-trend = 0.005] compared to participants in the reference tertile after 1-year of follow-up.

DISCUSSION

This is the first study to explore the association between DI of PFOS and glucose homeostasis. In this study, a high baseline DI of PFOS was associated with a higher levels of fasting plasma glucose and HbA1c and with an increase in HOMA-IR and BMI after 1-year of follow-up.

Biotransformation of 6:2 fluorotelomer sulfonate and microbial community dynamics in water-saturated one-dimensional flow-through columns

Nearly all per- and polyfluoroalkyl substances (PFAS) biotransformation studies reported to date have been limited to laboratory-scale batch reactors. The fate and transport of PFAS in systems that more closely represent field conditions, i.e., in saturated porous media under flowing conditions, remain largely unexplored. This study investigated the biotransformation of 6:2 fluorotelomer sulfonate (6:2 FTS), a representative PFAS of widespread environmental occurrence, in one-dimensional water-saturated flow-through columns packed with soil obtained from a PFAS-contaminated site. The 305-day column experiments demonstrated that 6:2 FTS biotransformation was rate-limited, where a decrease in pore-water velocity from 3.7 to 2.4 cm/day, resulted in a 21.7-26.1 % decrease in effluent concentrations of 6:2 FTS and higher yields (1.0-1.4 mol% vs. 0.3 mol%) of late-stage biotransformation products (C4C7 perfluoroalkyl carboxylates). Flow interruptions (2 and 7 days) were found to enhance 6:2 FTS biotransformation during the 6-7 pore volumes following flow resumption. Model-fitted 6:2 FTS column biotransformation rates (0.039-0.041 cmw3/gs/d) were ∼3.5 times smaller than those observed in microcosms (0.137 cmw3/gs/d). Additionally, during column experiments, planktonic microbial communities remained relatively stable, whereas the composition of the attached microbial communities shifted along the flow path, which may have been attributed to oxygen availability and the toxicity of 6:2 FTS and associated biotransformation products. Genus Pseudomonas dominated in planktonic microbial communities, while in the attached microbial communities, Rhodococcus decreased and Pelotomaculum increased along the flow path, suggesting their potential involvement in early- and late-stage 6:2 FTS biotransformation, respectively. Overall, this study highlights the importance of incorporating realistic environmental conditions into experimental systems to obtain a more representative assessment of in-situ PFAS biotransformation.

Comparison of Serum Per- and Polyfluoroalkyl Substances Concentrations in Incumbent and Recruit Firefighters and Longitudinal Assessment in Recruits

OBJECTIVE

Firefighters are occupationally exposed to per- and polyfluoroalkyl substances (PFAS). This study objective was to compare serum PFAS concentrations in incumbent and recruit firefighters and evaluate temporal trends among recruits.

METHODS

Serum PFAS concentrations were measured in 99 incumbent and 55 recruit firefighters at enrollment in 2015-2016, with follow-up 20 to 37 months later for recruits. Linear and logistic regression and linear mixed-effects models were used for analyses. Fireground exposure impact on PFAS concentrations was investigated using adjusted linear and logistic regression models.

RESULTS

Incumbents had lower n-PFOA and PFNA than recruits and most PFAS significantly decreased over time among male recruits. No significant links were found between cumulative fireground exposures and PFAS concentrations.

CONCLUSIONS

Serum PFAS concentrations were not increased in incumbent firefighters compared with recruits and were not associated with cumulative fireground exposures.

PFOS exposure destroys the integrity of the blood-testis barrier (BTB) through PI3K/AKT/mTOR-mediated autophagy

Perfluorooctanesulfonate or perfluorooctane sulfonic acid (PFOS), a type of perfluorinated compound, is mainly found in consumer products. Exposure to PFOS could cause male reproductive toxicity by causing injury to the blood-testis barrier (BTB). However, the specific mechanisms through which PFOS affects male reproduction remain unclear. The mammalian target of rapamycin (mTOR) is a vital protein kinase that is believed to be a central regulator of autophagy. In this study, we established in vivo and in vitro models to explore the effects of PFOS on the BTB, autophagy, and the regulatory role of the mTOR signaling pathway. Adult mice were developmentally exposed to 0, 0.5, 5, and 10 mg/kg/day PFOS for five weeks. Thereafter, their testicular morphology, sperm counts, serum testosterone, expression of BTB-related proteins, and autophagy-related proteins were evaluated. Additionally, TM4 cells (a mouse Sertoli cell line) were used to delineate the molecular mechanisms that mediate the effects of PFOS on BTB. Our results demonstrated that exposure to PFOS induced BTB injury and autophagy, as evidenced by increased expression of autophagy-related proteins, accumulation of autophagosomes, observed through representative electron micrographs, and decreased activity of the PI3K/AKT/mTOR pathway. Moreover, treatment with chloroquine, an autophagy inhibitor, alleviated the effects of PFOS on the integrity of TM4 cells in the BTB and the PI3K/AKT/mTOR pathway. Overall, this study highlights that exposure to PFOS destroys the integrity of the BTB through PI3K/AKT/mTOR-mediated autophagy.

Association between prenatal perfluorinated compounds exposure and risk of pregnancy complications: A meta-analysis

BACKGROUND AND OBJECTIVE

Per- and polyfluoroalkyl substances (PFASs) have been shown to be persistent and bioaccumulative. An elevated danger of pregnancy complications perhaps connected with exposure to PFASs, but the potential effects remain elusive. The objective of this study is to investigate the possible association between PFASs exposure and pregnancy complications, drawing upon existing evidence.

METHODS

Electronic databases of PubMed, Qvid Medline, Embase, and Web of Science were searched thoroughly to identify eligible research published prior to November 28, 2023, examining the relationship between PFASs and pregnancy-related complications. To evaluate the quality of observational studies incorporated into the article, the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) tool was utilized. The main outcomes assessed in this study included gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), gestational hypertension (GH), and preeclampsia (PE).

RESULTS

Twenty-five relevant studies involving 30079 participants were finally selected from four databases. The combined estimates indicate that prenatal exposure to perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorobutane sulfonic acid (PFBS), and perfluoroenanthic acid (PFHpA) is associated with gestational diabetes mellitus (GDM) (PFOA: OR = 1.45, 95%CI: 1.07-1.94, P = 0.015; PFHxS: OR = 1.16, 95%CI: 1.00-1.36, P = 0.055; PFBS: OR = 1.44, 95%CI: 1.16-1.79, P = 0.001; PFHpA: OR = 1.41, 95%CI: 1.10-1.82, P = 0.008). The exposure to PFBS is positively associated with HDP (OR = 1.27, 95%CI: 1.14-1.41, P < 0.001), while both PFOA and PFHpA demonstrate statistically significant positive correlations with GH (PFOA: OR = 1.09, 95%CI: 1.00-1.19, P = 0.049; PFHpA: OR = 1.43, 95%CI: 1.15-1.78, P = 0.001). Negative correlations were observed for prenatal perfluorododecanoic acid (PFDoA) exposure and GH (OR = 0.71, 95%CI: 0.57-0.87, P = 0.001). However, no compelling evidence was identified to link PFASs exposure with the risk of PE.

CONCLUSION

According to the meta-analysis findings, exposure to PFASs may be linked to GDM, HDP, and GH, but it does not significantly raise the risk of PE alone. Further research with larger sample size is required to verify this potential association and explore the biological mechanisms.

Impact of perfluoroalkyl substances (PFAS) and PFAS mixtures on lipid metabolism in differentiated HepaRG cells as a model for human hepatocytes

Per- and polyfluoroalkyl substances (PFAS) are environmental contaminants with various adverse health effects in humans including disruption of lipid metabolism. Aim of the present study was to elucidate the molecular mechanisms of PFAS-mediated effects on lipid metabolism in human cells. Here, we examined the impact of a number of PFAS (PFOS, PFOA, PFNA, PFDA, PFHxA, PFBA, PFHxS, PFBS, HFPO-DA, and PMPP) and of some exposure-relevant PFAS mixtures being composed of PFOS, PFOA, PFNA and PFHxS on lipid metabolism in human HepaRG cells, an in vitro model for human hepatocytes. At near cytotoxic concentrations, the selected PFAS and PFAS mixtures induced triglyceride accumulation in HepaRG cells and consistently affected the expression of marker genes for steatosis, as well as PPARα target genes and genes related to lipid and cholesterol metabolism, pointing to common molecular mechanisms of PFAS in disrupting cellular lipid and cholesterol homeostasis. PPARα activation was examined by a transactivation assay in HEK293T cells, and synergistic effects were observed for the selected PFAS mixtures at sum concentrations higher than 25 µM, whereas additivity was observed at sum concentrations lower than 25 µM. Of note, any effect observed in the in vitro assays occurred at PFAS concentrations that were at least four to five magnitudes above real-life internal exposure levels of the general population.

Environment relevant exposure of perfluorooctanoic acid accelerates the growth of hepatocellular carcinoma cells through mammalian target of rapamycin (mTOR) signal pathway

Perfluorooctanoic acid (PFOA), a synthetic alkyl chain fluorinated compound, has emerged as a persistent organic pollutant of grave concern, casting a shadow over both ecological integrity and humans. Its insidious presence raises alarms due to its capacity to bioaccumulate within the human liver, potentially paving the treacherous path toward liver cancer. Yet, the intricate mechanisms underpinning PFOA's role in promoting the growth of hepatocellular carcinoma (HCC) remain shrouded in ambiguity. Here, we determined the proliferation and transcription changes of HCC after PFOA exposure through integrated experiments including cell culture, nude mice tests, and colony-forming assays. Based on our findings, PFOA effectively promotes the proliferation of HCC cells within the experimental range of concentrations, both in vivo and in vitro. The proliferation efficiency of HCC cells was observed to increase by approximately 10% due to overexposure to PFOA. Additionally, the cancer weight of tumor-bearing nude mice increased by 87.0% (p < 0.05). We systematically evaluated the effects of PFOA on HCC cells and found that PFOA's exposure can selectively activate the PI3K/AKT/mTOR/4E-BP1 signaling pathway, thereby playing a pro-cancer effect on HCC cells Confirmation echoed through western blot assays and inhibitor combination analyses. These insights summon a response to PFOA's dual nature as both an environmental threat and a promoter of liver cancer. Our work illuminates the obscured domain of PFOA-induced hepatoxicity, shedding light on its ties to hepatocellular carcinoma progression.

Association among serum per- and polyfluoroalkyl substances, lipid profile and metabolic syndrome in Czech adults, HBM-EHES survey 2019

OBJECTIVES

Per- and polyfluoroalkyl substances (PFASs) are a large group of persistent synthetic chemicals widely used commercially. They accumulate increasingly in all environmental components and enter the organisms, including humans. Some of them are associated with the risk of harm to health, among others with metabolic disorders. To test the associations between blood serum levels of PFASs and blood lipid profile as well as metabolic syndrome, we linked human biomonitoring with the Czech Health Examination Survey (CZ-EHES) conducted in 2019.

METHODS

A total of 168 participants of the CZ-EHES survey aged 25-64 years were examined including anthropometrical data and analyses for serum PFAS and blood lipid levels. Extended model approach in multiple linear regression models was used for identification of the associations between serum levels of 11 PFASs and lipid profile components. The relation between PFAS serum levels and metabolic syndrome prevalence was tested using a logistic regression model.

RESULTS

Six PFASs were detected over the limit of quantification in at least 40% cases and were examined in subsequent analyses: perfluorodecanoic acid (PFDA), perfluorohexane sulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluoroundecanoic acid (PFUdA). The most dominant was PFOS with the mean value amounting to 4.81 ng/ml. After adjusting for potential confounders, we found a significant positive association between serum PFHxS and blood total cholesterol (p = 0.005) as well as LDL-cholesterol (p = 0.008). Significant positive association was also found between PFDA and HDL-cholesterol levels (p = 0.010). No significant associations were detected between PFASs and triglycerides, and between PFASs and metabolic syndrome.

CONCLUSIONS

We found some evidence of a significant association between blood serum PFAS levels and blood cholesterol levels. Our results did not confirm an association between serum PFASs and the metabolic syndrome prevalence.

Concentrations and association between exposure to mixed perfluoroalkyl and polyfluoroalkyl substances and glycometabolism among adolescents

BACKGROUND

Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are widely used for industrial and commercial purposes and have received increasing attention due to their adverse effects on health.

OBJECTIVE

To examine the relationship of serum PFAS and glycometabolism among adolescents based on the US National Health and Nutrition Examination Survey.

METHODS

General linear regression models were applied to estimate the relationship between exposure to single PFAS and glycometabolism. Weighted quantile sum (WQS) regression models and Bayesian kernel machine regressions (BKMR) were used to assess the associations between multiple PFASs mixture exposure and glycometabolism.

RESULTS

A total of 757 adolescents were enrolled. Multivariable regression model showed that Me-PFOSA-AcOH exposure was negatively associated with fasting blood glucose. WQS index showed that there was marginal negative correlation between multiple PFASs joint exposure and the homeostasis model of assessment for insulin resistance index (HOMA-IR) (β = -0.26, p < .068), and PFHxS had the largest weight. BKMR models showed that PFASs mixture exposure were associated with decreased INS and HOMA-IR, and the exposure-response relationship had curvilinear shape.

CONCLUSIONS

The increase in serum PFASs were associated with a decrease in HOMA-IR among adolescents. Mixed exposure models could more accurately and effectively reveal true exposure.Key MessagesThe detection rates of different PFAS contents in adolescent serum remained diverse.Adolescent serum PFASs had negative curvilinear correlation with INS and HOMA-IR levels.PFHxS had the highest weight in the associations between multiple PFASs and adolescent glycometabolism.

Perfluoroalkyl substances (PFAS) and lead (Pb) as "cardiovascular disruptors" in 9-11-year-old children living in Syracuse, New York, United States

OBJECTIVE

Per- and polyfluoro-alkyl substances (PFAS) and lead (Pb) are ubiquitous environmental toxicants with apparent impact on cardiovascular disease (CVD) risk. As one possible mechanism for this increased risk, we have previously demonstrated an association between Pb exposure and heightened cardiovascular reactivity to acute psychological stress, a CVD risk factor. The present study expands this approach and considers both PFAS and Pb exposures (and the possible interaction).

METHODS

We assessed 14 serum PFAS and whole blood Pb concentrations in a sample of 9-11 year-old children (N = 291; 43.2% White, 56.8% Black; 53.5% female). We measured cardiovascular functioning at rest and during psychological stress as well as multiple indicators of subclinical CVD including resting blood pressure (BP), carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT), and left ventricular mass (LVM). Data analysis included general linear modeling as well as a non-parametric approach to study metal mixtures, specifically Bayesian Kernel Machine Regression (BKMR).

RESULTS

Significant interactions between different PFAS and with Pb suggest the importance of considering toxicant mixtures when assessing potential disruption of the cardiovascular system. The pattern of findings suggests that greater "vascular reactivity" (elevated BP and vascular resistance during acute psychological stress) was associated with higher concentrations of perfluorononanoic acid (PFNA), perfluorohexane sulfonate (PFHxS), and Pb, but only when perfluorooctanoic acid (PFOA) was concurrently elevated. With respect to subclinical outcomes, increasing perfluorodecanoic acid (PFDA) was associated with greater cIMT (β = 0.21, p = 0.010).

CONCLUSION

To our knowledge this is the first study to consider how PFAS exposures might affect cardiovascular functioning and subclinical disease. Although a complex pattern of associations emerged, it does appear that PFAS and Pb can be classified as "cardiovascular disruptors" in children. Further research is needed to replicate these novel findings and determine whether these disruptions produce future cardiovascular disease.

Deficiency of spns1 exacerbates per- and polyfluoroalkyl substances mediated hepatic toxicity and steatosis in zebrafish (Danio rerio)

Per- and polyfluoroalkyl substances (PFAS) are man-made long-lasting chemical compounds that are found in everyday household items. Today they occur in the environment as a major group of pollutants. These compounds are broadly used in commercial product preparation such as, for food packaging, nonstick coatings, and firefighting foam. In humans, PFAS can cause immune disorders, impaired fetal development, abnormal skeletal tissue development, osteoarthritis, thyroid dysfunctions, cholesterol changes, affect insulin regulation and lipid metabolism, and are also involved in the development of fatty liver disease. In the current study, we investigated the effect of low, but physiologically relevant, concentrations of perfluorooctanoic acid (PFOA), heptafluorobutyric acid (HFBA), and perfluorotetradecanoic acid (PFTA) on gene expression markers of an inflammatory response (tnfa, il-1b, il-6, rplp0, edem1, and dnajc3a), unfolded protein response (UPR) (bip, atf4a, atf6, xbp1, and ddit3), senescence (p21, pai1, smp30, mdm2, and baxa), lipogenesis (scd1, acc, srebp1, pparγ, and fasn) and autophagy (p62, atg3, atg7, rab7, lc3b, and becn1) in AB wild-type (+/+), spns1-wt sibling (+/+), (+/-) and spns1 homozygous mutant (-/-) zebrafish embryos. Exposure to PFOA and HFBA (50 and 100 nM) specifically modulated inflammatory, UPR, senescence, lipogenic, and autophagy signaling in spns1-wt (+/+), (+/-), and spns1-mutant (-/-) zebrafish embryos. Furthermore, PFOA, but not HFBA, upregulated lipogenic-related gene expression and enhanced hepatic steatosis in spns1-wt (+/+), (+/-) zebrafish embryos. Combined exposure to PFOA, HFBA, and PFTA differentially expressed inflammatory, senescence, lipogenic, and autophagy-associated gene expression in spns1-mutant (-/-) zebrafish embryos compared with spns1-wt (+/+), (+/-) and AB-wt (+/+) zebrafish embryos. In addition, chronic exposure (∼2 months) to PFOA (120-600 nM) upregulated the expression of hepatic lipogenic and steatosis biomarkers in AB-wt (+/+) zebrafish. Collectively, our data suggest that acute/chronic physiologically relevant concentrations of PFOA upregulate inflammatory, UPR, senescence, and lipogenic signaling in spns1-wt (+/+), (+/-) and spns1-mutant (-/-) zebrafish embryos as well as in two-month-old AB-wt zebrafish, by targeting autophagy and hence induces toxicity that could promote nonalcoholic fatty liver disease.