In vitro activation of cord blood mononuclear cells and cytokine production in a remote coastal population exposed to organochlorines and methyl mercury

Expression levels and network analysis of inflammamiRs in peripheral blood mononuclear cells exposed to DDE "in vitro"

Recent studies have demonstrated that dichlorodiphenyldichloroethylene (DDE) induced a pro-inflammatory condition in peripheral blood mononuclear cells (PBMC). However, the molecular mechanisms implicated in this condition are poorly understood. Therefore, this study aimed to evaluate miR-155, miR-126, and miR-21 expression levels in PBMC exposed "in vitro" to DDE. PBMC were dosed with increasing concentrations of DDE (10-80 µg mL^-1) at different treatment times (0-24 h). The results showed an up-regulation in the expression levels of assessed miRNAs (miR-155, miR-146, and miR-21) after PBMCs were exposed to DDE. Besides, bioinformatic analysis was performed to understand the biological roles of assessed miRNAs. The bioinformatic analysis shows that assessed miRNAs are associated with regulating signaling pathways involved in cancer, apoptosis, cell cycle, inflammation, metabolism, etc. These findings offer new insights into the molecular mechanisms related to the inflammatory processes and their regulation induced by DDE in PBMC exposed "in vitro".

Gene×environment interactions in autism spectrum disorders

There is credible evidence that environmental factors influence individual risk and/or severity of autism spectrum disorders (hereafter referred to as autism). While it is likely that environmental chemicals contribute to the etiology of autism via multiple mechanisms, identifying specific environmental factors that confer risk for autism and understanding how they contribute to the etiology of autism has been challenging, in part because the influence of environmental chemicals likely varies depending on the genetic substrate of the exposed individual. Current research efforts are focused on elucidating the mechanisms by which environmental chemicals interact with autism genetic susceptibilities to adversely impact neurodevelopment. The goal is to not only generate insights regarding the pathophysiology of autism, but also inform the development of screening platforms to identify specific environmental factors and gene×environment (G×E) interactions that modify autism risk. Data from such studies are needed to support development of intervention strategies for mitigating the burden of this neurodevelopmental condition on individuals, their families and society. In this review, we discuss environmental chemicals identified as putative autism risk factors and proposed mechanisms by which G×E interactions influence autism risk and/or severity using polychlorinated biphenyls (PCBs) as an example.

An overview of organic contaminants in indoor dust, their health impact, geographical distribution and recent extraction/analysis methods

People spend a substantial proportion of their time indoors; therefore, exposure to contaminants in indoor dust is persistent and profuse. According to the findings of recent studies, contaminants such as flame retardants (FRs), organochlorines (OCs), and phthalate esters (PAEs) are more prevalent in indoor dust. The discrepancy in the geographical distribution of these chemicals indicates country-specific applications. However, many studies have revealed that chlorophosphates, polychlorinated biphenyls (PCBs) and di-2-ethylhexyl phthalate are frequently detected in indoor dust throughout the world. Although some chemicals (e.g., OCs) were banned/severely restricted decades ago, they have still been detected in indoor dust. These organic contaminants have shown clear evidence of carcinogenic, neurotoxic, immunogenic, and estrogenic activities. Recent extraction methods have shown their advantages, such as high recoveries, less solvent consumption, less extraction time and simplicity of use. The latest separation techniques such as two-dimensional gas/liquid chromatography, latest ionization techniques (e.g., matrix-assisted laser desorption/ionization (MALDI)), and modern techniques of mass spectrometry (e.g., tandem mass spectrometry (MS/MS), time-of-flight (TOF) and high-resolution mass spectrometry (HRMS)) improve the detection limits, accuracy, reproducibility and simultaneous detection of organic contaminants. For future perspectives, it is suggested that the importance of the study of dust morphology for comprehensive risk analysis, introducing standard reference materials to strengthen the analytical methods, adopt common guidelines for comparison of research findings and the importance of dust analysis in the developing world since lack of records on the production and usage of hazardous substances. Such measures will help to evaluate the effectiveness of prevailing legislations and to set up new regulations.

Serum cytokines are associated with n-3 polyunsaturated fatty acids and not with methylmercury measured in infant cord blood in the Seychelles child development study

BACKGROUND

Maternal fish consumption increases infant methylmercury (MeHg) exposure and polyunsaturated fatty acid (PUFA) concentrations. The n-3 PUFA are regulators of inflammation while MeHg may impact the cord cytokine profile and, subsequently, contribute to immune mediated outcomes. This study aimed to investigate associations between infant MeHg exposure and cord cytokine concentrations while adjusting for cord PUFA.

METHODS

We studied participants in the Seychelles Child Development Study (SCDS) Nutrition Cohort 2 (NC2), a large birth cohort in a high fish-eating population. Whole blood MeHg, serum PUFA and serum cytokine concentrations (IFN-γ, IL-1β, IL-2, IL-12p70, TNF-α, IL-4, IL-10, IL-13, IL-6 and IL-8) were measured in cord blood collected at delivery (n = 878). Linear regression examined associations between infant MeHg exposure and cord cytokines concentrations, with and without adjustment for cord PUFA. An interaction model examined cord MeHg, cytokines and tertiles of the n-6:n-3 ratio (low/medium/high).

RESULTS

There was no overall association between cord MeHg (34.08 ± 19.98 μg/L) and cytokine concentrations, with or without adjustment for PUFA. Increased total n-3 PUFA (DHA, EPA and ALA) was significantly associated with lower IL-10 (β = -0.667; p = 0.007) and lower total Th2 (IL-4, IL-10 and IL-13) (β = -0.715; p = 0.036). In the interaction model, MeHg and IL-1β was positive and significantly different from zero in the lowest n-6:n-3 ratio tertile (β = 0.002, p = 0.03).

CONCLUSION

Methylmercury exposure from fish consumption does not appear to impact markers of inflammation in cord blood. The association of cord n-3 PUFA with lower IL-10 and total Th2 cytokines suggests that they may have a beneficial influence on the regulation of the inflammatory milieu. These findings are important for public health advice and deserve to be investigated in follow up studies.

Prenatal and Perinatal Environmental Influences Shaping the Neonatal Immune System: A Focus on Asthma and Allergy Origins

It is suggested that programming of the immune system starts before birth and is shaped by environmental influences acting during critical windows of susceptibility for human development. Prenatal and perinatal exposure to physiological, biological, physical, or chemical factors can trigger permanent, irreversible changes to the developing immune system, which may be reflected in cord blood of neonates. The aim of this narrative review is to summarize the evidence on the role of the prenatal and perinatal environment, including season of birth, mode of delivery, exposure to common allergens, a farming environment, pet ownership, and exposure to tobacco smoking and pollutants, in shaping the immune cell populations and cytokines at birth in humans. We also discuss how reported disruptions in the immune system at birth might contribute to the development of asthma and related allergic manifestations later in life.

Exposure to DDT from indoor residual spraying and biomarkers of inflammation among reproductive-aged women from South Africa

BACKGROUND

Evidence from animal studies suggests that DDT and DDE can adversely affect immuno-competence while human data are less conclusive. We aimed to assess the association of plasma concentrations of DDT and DDE with biomarkers of inflammation among reproductive-aged women residing in homes sprayed with DDT through Indoor Residual Spraying (IRS).

METHODS

This study included 416 women from the Study of Women and Babies, South Africa (2010-2011). DDT, DDE, and biomarkers of inflammation (immunoglobulins A, G and M, interleukins 1β, 6, and 8, tumor necrosis factor-α, C-reactive protein, serum amyloid-A, intercellular adhesion molecule-1, vascular cell adhesion molecule-1) were quantified in plasma. Linear regression was used to assess associations of DDT and DDE with each natural log-transformed biomarker. Models were adjusted for age, body mass index, parity, income, and season; beta estimates were expressed as percent differences.

RESULTS

Compared to women with the lowest plasma concentrations of DDT and DDE, those with the highest concentrations of both compounds had higher levels IL-1β, IL6, and TNF- α. While associations were statistically significant for both DDT and DDE, the magnitude of the associations was slightly stronger for DDT. Compared to women in the lowest quintile of DDT, women in the highest quintile were estimated to have 53.0% (95%CI: 21.7%, 84.4%), 28.1% (95%CI: 6.4%, 49.8%), and 26.6% (95%CI: 12.0%, 41.1%) higher levels of IL-1β, IL6, and TNF- α, respectively.

CONCLUSIONS

Our results suggest that increased plasma concentrations of DDT and DDE resulting from exposure to IRS may increase concentrations of pro-inflammatory biomarkers among reproductive-aged women in South Africa.

The influence of sex, genotype, and dose on serum and hippocampal cytokine levels in juvenile mice developmentally exposed to a human-relevant mixture of polychlorinated biphenyls

Polychlorinated biphenyls (PCBs) are pervasive environmental contaminants implicated as risk factors for neurodevelopmental disorders (NDDs). Immune dysregulation is another NDD risk factor, and developmental PCB exposures are associated with early life immune dysregulation. Studies of the immunomodulatory effects of PCBs have focused on the higher-chlorinated congeners found in legacy commercial mixtures. Comparatively little is known about the immune effects of contemporary, lower-chlorinated PCBs. This is a critical data gap given recent reports that lower-chlorinated congeners comprise >70% of the total PCB burden in serum of pregnant women enrolled in the MARBLES study who are at increased risk for having a child with an NDD. To examine the influence of PCBs, sex, and genotype on cytokine levels, mice were exposed throughout gestation and lactation to a PCB mixture in the maternal diet, which was based on the 12 most abundant PCBs in sera from MARBLES subjects. Using multiplex array, cytokines were quantified in the serum and hippocampus of weanling mice expressing either a human gain-of-function mutation in ryanodine receptor 1 (T4826I mice), a human CGG premutation repeat expansion in the fragile X mental retardation gene 1 (CGG mice), or both mutations (DM mice). Congenic wildtype (WT) mice were used as controls. There were dose-dependent effects of PCB exposure on cytokine concentrations in the serum but not hippocampus. Differential effects of genotype were observed in the serum and hippocampus. Hippocampal cytokines were consistently elevated in T4826I mice and also in WT animals for some cytokines compared to CGG and DM mice, while serum cytokines were usually elevated in the mutant genotypes compared to the WT group. Males had elevated levels of 19 cytokines in the serum and 4 in the hippocampus compared to females, but there were also interactions between sex and genotype for 7 hippocampal cytokines. Only the chemokine CCL5 in the serum showed an interaction between PCB dose, genotype, and sex. Collectively, these findings indicate differential influences of PCB exposure and genotype on cytokine levels in serum and hippocampal tissue of weanling mice. These results suggest that developmental PCB exposure has chronic effects on baseline serum, but not hippocampal, cytokine levels in juvenile mice.

Cytokine expression and lymphocyte proliferative capacity in diseased harbor porpoises (Phocoena phocoena) - Biomarkers for health assessment in wildlife cetaceans

Harbor porpoises (Phocoena phocoena) in the North and Baltic Seas are exposed to anthropogenic influences including acoustic stress and environmental contaminants. In order to evaluate immune responses in healthy and diseased harbor porpoise cells, cytokine expression analyses and lymphocyte proliferation assays, together with toxicological analyses were performed in stranded and bycaught animals as well as in animals kept in permanent human care. Severely diseased harbor porpoises showed a reduced proliferative capacity of peripheral blood lymphocytes together with diminished transcription of transforming growth factor-β and tumor necrosis factor-α compared to healthy controls. Toxicological analyses revealed accumulation of polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene (DDE), and dichlorodiphenyltrichloroethane (DDT) in harbor porpoise blood samples. Correlation analyses between blood organochlorine levels and immune parameters revealed no direct effects of xenobiotics upon lymphocyte proliferation or cytokine transcription, respectively. Results reveal an impaired function of peripheral blood leukocytes in severely diseased harbor porpoises, indicating immune exhaustion and increased disease susceptibility.

Body Burden of Dichlorodiphenyl Dichloroethene (DDE) and Childhood Pulmonary Function

Longitudinal studies have shown that early life exposure to dichlorodiphenyl dichloroethene (DDE) can lead to growth reduction during childhood and adolescence. In addition, DDE exposure has been linked to respiratory tract infections and an increased risk of asthma in children. Our aim was to understand the relationships between DDE exposure and pulmonary function in children, and, particularly, whether associations are mediated by the height of the children. We used data from an environmental epidemiologic study conducted in central Germany in children aged 8-10 years. The pulmonary function (forced vital capacity, FVC, and forced expiratory volume in one second, FEV1) were measured in three consecutive years. Blood DDE levels were measured at 8 and 10 years. We used linear mixed models for repeated measurements and path analyses to assess the association between blood levels of DDE and pulmonary function measurements. All models were adjusted for confounders. Linear mixed approaches and modelling concurrent effects showed no significant associations. The path analytical models demonstrated that DDE measured at eight years had significant, inverse, indirect, and total effects on FVC at ten years (n = 328; −0.18 L per μg/L of DDE) and FEV1 (n = 328; −0.17 L per μg/L of DDE), mediated through effects of DDE on height and weight. The DDE burden reduces pulmonary function through its diminishing effects on height and weight in children. Further studies are required to test these associations in other samples, preferably from a region with ongoing, high DDT application.

In utero exposure to DDT and incidence of diarrhea among boys from tropical Mexico

BACKGROUND

A higher incidence rate (IR) of acute gastrointestinal (GI) infections associated with prenatal exposure to p,p'-DDE was suggested by the results in two studies. Given the high mortality rate due to childhood diarrhea in some countries with ongoing use of DDT, additional data on this association is relevant for those making decisions about vector-borne disease control.

OBJECTIVE

To evaluate whether higher levels of prenatal exposure to p,p'-DDE and p,p'-DDT increase the risk of having diarrhea in a birth cohort of boys from tropical Mexico.

METHODS

Our analysis was based on 747 boys whose exposure was measured in maternal serum collected at delivery (2002-2003). Mothers reported the number of diarrhea episodes of their children during in-person interviews. The median age of the children at their last interview was 21.4 months. Poisson regression models were fitted to estimate adjusted incidence rate ratios (aIRR) of diarrhea by levels of p,p'-DDE and p,p'-DDT.

RESULTS

Overall, there were 1.7 episodes of diarrhea per child-year. Among those in the highest category of exposure (> 9µg DDE/g serum lipid), the aIRR for diarrhea was 1.14 (95% CI: 0.94, 1.30) compared to those in the lowest category of exposure (≤ 3µg/g). Among boys living in the urban area, the corresponding aIRR was 1.39 (95% CI: 1.07-1.80). Among rural boys, no associations emerged.

CONCLUSION

Although the results were consistent with a small positive association, the overall estimate was not precise. While urban boys in this study appeared to be more susceptible to DDE-associated diarrhea, a ready explanation for such increased susceptibility was not apparent.

Effects of Postnatal Exposure to a Mixture of Polychlorinated Biphenyls, p,p′-dichlorodiphenyltrichloroethane, and p-p′-dichlorodiphenyldichloroethene in Prepubertal and Adult Female Sprague-Dawley Rats

The postnatal period is a critical phase of development and a time during which humans are exposed to higher levels of persistent organic pollutants (POPs), than during subsequent periods of life. There is a paucity of information describing effects of postnatal exposure to environmentally relevant mixtures of POPs, such as polychlorinated biphenyls (PCBs), p,p′-dichlorodiphenyltrichloroethane (DDT), and p,p′-dichlorodiphenyldichloroethene (DDE). To provide data useful for the risk assessment of postnatal exposure to POPs, mixtures containing 19 PCBs, DDT, and DDE were prepared according to their concentrations previously measured in the milk of Canadian women, and dose-response effects were tested on the proliferation of MCF7-E3 cells in vitro, and in vivo experiments. Female neonates were exposed by gavage at postnatal days (PNDs) 1, 5, 10, 15, and 20 with dosages equivalent to 10, 100, and 1000 times the estimated human exposure level over the first 24 days of life. The MCF7-E3 cells showed a 227% increase in the AlamarBlue proliferation index, suggesting estrogen-like properties of the mixture, but this was not confirmed in vivo, given the absence of uterotrophic effects at PND21. An increase (511%) in hepatic ethoxyresorufin- o-deethylase activity at the dose 100 × was the most sensitive endpoint among those measured at PND21 (organ weight, mammary gland and ovarian morphometry, hepatic enzyme inductions, serum thyroxine and pituitary hormones). In liver samples from older female rats (previously involved in a mammary tumor study [Desaulniers et al., Toxicol. Sci. 75:468–480, 2001]), hepatic metabolism of 14C-estradiol-17 β (E2) at PND55 to PND62 was significantly higher in the 1000 × compared to the control group, but hepatic detoxification enzyme activities had already returned to control values. The production of hepatic 2-hydroxy-E2 decreased, whereas that of estrone increased with age. In conclusion, the smallest dose of the mixture to induce significant effects was 100×, and mixture-induced changes in the hepatic metabolism of estrogens might be a sensitive indicator of persistent effects.

Early-life Exposure to Widespread Environmental Toxicants and Health Risk: A Focus on the Immune and Respiratory Systems

Evidence has accumulated that exposure to widespread environmental toxicants, such as heavy metals, persistent organic pollutants, and tobacco smoke adversely affect fetal development and organ maturation, even after birth. The developing immune and respiratory systems are more sensitive to environmental toxicants due to their long-term physical development, starting from the early embryonic stage and persisting into early postnatal life, which requires complex signaling pathways that control proliferation and differentiation of highly heterogeneous cell types. In this review, we summarize the effect of early-life exposure to several widespread environmental toxicants on immune and lung development before and after birth, including the effects on immune cell counts, baseline characteristics of cell-mediated and humoral immunity, and alteration of lung structure and function in offspring. We also review evidence supporting the association between early-life exposure to environmental toxicants and risk for immune-related diseases and lung dysfunction in offspring in later life.

Can exposure to environmental chemicals increase the risk of diabetes type 1 development?

Type 1 diabetes mellitus (T1DM) is an autoimmune disease, where destruction of beta-cells causes insulin deficiency. The incidence of T1DM has increased in the last decades and cannot entirely be explained by genetic predisposition. Several environmental factors are suggested to promote T1DM, like early childhood enteroviral infections and nutritional factors, but the evidence is inconclusive. Prenatal and early life exposure to environmental pollutants like phthalates, bisphenol A, perfluorinated compounds, PCBs, dioxins, toxicants, and air pollutants can have negative effects on the developing immune system, resulting in asthma-like symptoms and increased susceptibility to childhood infections. In this review the associations between environmental chemical exposure and T1DM development is summarized. Although information on environmental chemicals as possible triggers for T1DM is sparse, we conclude that it is plausible that environmental chemicals can contribute to T1DM development via impaired pancreatic beta-cell and immune-cell functions and immunomodulation. Several environmental factors and chemicals could act together to trigger T1DM development in genetically susceptible individuals, possibly via hormonal or epigenetic alterations. Further observational T1DM cohort studies and animal exposure experiments are encouraged.

Concentrations of persistent organic pollutants (POPs) and heavy metals in soil from San Luis Potosí, México

The aim of this study was to assess the levels of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), p,p'-dichlorodiphenyltrichloroethane (DDT), p,p'-dichlorodiphenyldichloroethylene (DDE), and four heavy metals (arsenic, cadmium, lead, and mercury) in soil from the city of San Luis Potosí in Mexico. In order to confirm the presence of the previously mentioned compounds, outdoor surface soil samples were collected and analyzed by gas chromatography/mass spectrometer for PBDEs, PCBs, DDT, and DDE. Meanwhile, heavy metals were quantified using the atomic absorption spectrophotometry technique. The total PBDEs levels ranged from 5.0 to 134 μg/kg dry weight (dw), with a total mean PBDEs level of 22.0 ± 32.5 μg/kg dw (geometric mean ± standard deviation). For PCBs, the total mean level in the studied soil was 21.6 ± 24.7 μg/kg dw (range, <LOD to 80.5). An important finding in our study was that all soil samples (100 %) had detectable levels of the metabolite DDE. Moreover, the total mean DDT level (∑ DDT and DDE) was approximately 5.50 ± 4.50 μg/kg dw. The mean levels for arsenic, mercury, cadmium, and lead in soil samples were 7.20 ± 10.7 (range, 15.0 to 265 mg/kg dw), 0.45 ± 0.48 (range, <LOD to 2.50 mg/kg dw), 3.00 ± 3.00 (range, 1.00-13.0 mg/kg dw), and 108 ± 105 (range, 25.0 to 435 mg/kg dw), respectively. This screening study provides us with concentration data for the occurrence of persistent organic pollutants (POPs) and four heavy metals in soil samples from the city of San Luis Potosí, Mexico, and considering that soil is an important pathway of exposure for people, a biomonitoring program for the surveillance of the general population in the city of San Luis Potosi is necessary.

Persistent organic pollutants and children's respiratory health: the role of cytokines and inflammatory biomarkers

Evidence of adverse effects of persistent organic pollutants (POPs) on the developmental respiratory and immune systems in children is still limited, and the biological mechanisms behind such effects are not fully understood. The aim of the present study is to evaluate the effects of prenatal DDE, HCB and ΣPCB exposure on children's respiratory health from birth to 14 years and to evaluate the role of immune biomarkers in these associations. We measured prenatal DDE, HCB and ΣPCB levels in 405 participants of the INMA-Menorca birth cohort (Spain) and collected information on wheeze, chest infections, atopy and asthma from birth until the age of 14 years. At age 4 years, 275 children provided serum samples and IL6, IL8, IL10, TNFα and C-reactive protein were measured. We applied linear and logistic regression models and generalized estimating equations. Prenatal DDE was associated with wheeze at age 4 years [RR (95% CI) per doubling of concentration=1.35 (1.07, 1.71)], but not thereafter. Prenatal HCB was associated with wheeze [1.58 (1.04, 2.41)] and chest infections [1.89 (1.10, 3.25)] at age 10years. No associations were found with ΣPCBs. IL10 levels increased with increasing POP concentration, with HCB showing the strongest association [β (95% CI)=0.22 (0.02, 0.41)]. IL8, IL10 and TNFα were associated with wheeze and/or chest infections and IL10 was associated with asthma. Prenatal DDE and HCB exposure was associated with respiratory health of children at different ages. This study further suggests a possible role of IL10, but not of the other immune biomarkers examined, as an early marker of chronic immune-related health effects of POPs.

Effects of persistent organic pollutants on the developing respiratory and immune systems: a systematic review

BACKGROUND

Disruption of developing immune and respiratory systems by early-life exposure to persistent organic pollutants (POPs) could result into reduced capacity to fight infections and increased risk to develop allergic manifestations later in life.

OBJECTIVES

To systematically review the epidemiologic literature on the adverse effects of early-life exposure to POPs on respiratory health, allergy and the immune system in infancy, childhood and adolescence.

METHODS

Based on published guidelines for systematic reviews, two independent researchers searched for published articles in MEDLINE and SCOPUS using defined keywords on POPs and respiratory health, immune function and allergy. Study eligibility criteria were defined to select the articles.

RESULTS

This review of 41 studies finds limited evidence for prenatal exposure to DDE, PCBs and dioxins and risk of respiratory infections. Evidence was limited also for postnatal exposure to PCBs, specifically ndl-PCBs, and reduced immune response after vaccination in childhood. The review indicates lack of association between postnatal exposure to PCBs/ndl-PCBs and risk of asthma-related symptoms. For the other exposure-outcome associations reviewed evidence was inadequate.

DISCUSSION AND CONCLUSION

Current epidemiological evidence suggests that early-life exposure to POPs can adversely influence immune and respiratory systems development. Heterogeneity between studies in exposure and outcome assessment and the small number of studies for any given exposure-outcome relationship currently make comparisons difficult and meta-analyses impossible. Also, mechanisms remain largely unexplored. Recommendations for significantly improving our understanding thus include harmonization of exposure and outcome assessment between studies, conduct of larger studies, long-term assessment of respiratory infections and asthma symptoms in order to identify critical periods of susceptibility, integration of the potential immunotoxic mechanisms of POPs, and use of new statistical tools to detangle the role of multiple exposures on multiple outcomes.

Assessment of the levels of DDT and DDE in soil and blood samples from Tabasco, Mexico

In Mexico, 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) was used until the year 2000, principally in agriculture and anti-paludal program health campaigns. The southeastern region of Mexico was an important area of malaria, and from 1957 DDT was applied indoors every 6 months, with a coverage of 2 g/m(2). The current study was performed in Tabasco, a Mexican state located in the southeastern region of Mexico. DDT and 1,1-dichloro-2,2-bis(4-chlorophenyl)ethene (DDE) were analyzed by gas chromatography/mass spectrometry. In general, low levels were found in household outdoor samples; the levels of DDT ranged from not detectable to 0.048 mg/kg, and of DDE from 0.001 to 0.068 mg/kg. An important finding was that, in all communities where DDT in blood was analyzed, exposure to DDT was found, indicating both past and present exposure. Although the levels found in this study were lower than other studies in Mexico, there is a need to evaluate whether the people living in the study area are at risk.

Current status of the epidemiologic evidence linking polychlorinated biphenyls and non-hodgkin lymphoma, and the role of immune dysregulation

BACKGROUND

Although case-control studies conducted to date have largely affirmed the relationship between polychlorinated biphenyls (PCBs) and non-Hodgkin lymphoma (NHL), occupational cohort studies of PCB-exposed workers have been generally interpreted as negative, thereby raising doubts about a potential causal association. A common theme of immune dysregulation unifies many of NHL's strongest risk factors, and several authors have posited that subclinical immune dysregulation may increase NHL risk by decreasing host resistance, reducing control of cellular proliferation and differentiation, and diminishing tumor surveillance mechanisms.

OBJECTIVES

The goals of this review were a) to evaluate the epidemiological research examining the association between PCB exposure and NHL and discuss the contribution to the weight of evidence of case-control studies and occupational cohort studies; and b) to summarize the evidence for immune dysregulation as a means by which PCBs may cause NHL.

METHODS

We performed a literature search using PubMed and seven additional online biomedical and toxicological referencing libraries to identify literature published through August 2011.

DISCUSSION AND CONCLUSIONS

Overall, we conclude that the weight of evidence supports a causal role of PCBs in lymphomagenesis. The strongest epidemiological evidence for the relationship between PCBs and NHL comes from case-control studies conducted among the general population. Epidemiological and toxicological data demonstrating immunosuppressive and inflammatory effects of PCBs further contribute to the weight of evidence by providing a plausible explanation for how PCBs can cause NHL through immune dysregulation.

Evidence on the human health effects of low-level methylmercury exposure

BACKGROUND

Methylmercury (MeHg) is a known neuro-toxicant. Emerging evidence indicates it may have adverse effects on the neuro-logic and other body systems at common low levels of exposure. Impacts of MeHg exposure could vary by individual susceptibility or be confounded by beneficial nutrients in fish containing MeHg. Despite its global relevance, synthesis of the available literature on low-level MeHg exposure has been limited.

OBJECTIVES

We undertook a synthesis of the current knowledge on the human health effects of low-level MeHg exposure to provide a basis for future research efforts, risk assessment, and exposure remediation policies worldwide.

DATA SOURCES AND EXTRACTION

We reviewed the published literature for original human epidemiologic research articles that reported a direct biomarker of mercury exposure. To focus on high-quality studies and those specifically on low mercury exposure, we excluded case series, as well as studies of populations with unusually high fish consumption (e.g., the Seychelles), marine mammal consumption (e.g., the Faroe Islands, circumpolar, and other indigenous populations), or consumption of highly contaminated fish (e.g., gold-mining regions in the Amazon).

DATA SYNTHESIS

Recent evidence raises the possibility of effects of low-level MeHg exposure on fetal growth among susceptible subgroups and on infant growth in the first 2 years of life. Low-level effects of MeHg on neuro-logic outcomes may differ by age, sex, and timing of exposure. No clear pattern has been observed for cardio-vascular disease (CVD) risk across populations or for specific CVD end points. For the few studies evaluating immunologic effects associated with MeHg, results have been inconsistent.

CONCLUSIONS

Studies targeted at identifying potential mechanisms of low-level MeHg effects and characterizing individual susceptibility, sexual dimorphism, and non-linearity in dose response would help guide future prevention, policy, and regulatory efforts surrounding MeHg exposure.

Assessment of DDT and DDE levels in soil, dust, and blood samples from Chihuahua, Mexico

The aim of this study was to assess levels of DDT and DDE in two environmental matrices (soil and dust) and to investigate the blood levels of these insecticides in exposed children living in a north Mexican state (Chihuahua) where DDT was sprayed several years ago during (1) health campaigns for the control of malaria and (2) agricultural activities. DDT and DDE were analyzed by gas chromatography/mass spectrometry. In general, lower levels were found in household outdoor samples. The levels in outdoor samples ranged from 0.001 to 0.788 mg/kg for DDT and from 0.001 to 0.642 mg/kg for DDE. The levels in indoor samples ranged from 0.001 to 15.47 mg/kg for DDT and from 0.001 to 1.063 mg/kg for DDE. Similar results to those found in indoor soil were found in dust, in which the levels ranged from 0.001 to 95.87 mg/kg for DDT and from 0.001 to 0.797 mg/kg for DDE. Moreover, blood levels showed that all of the communities studied had been exposed to DDT and/or DDE, indicating a general past or present exposure to DDT. It is important to note that the quotient DDT/DDE in all matrices was always >1. Whether the people living in our study area are at risk is an issue that deserves further analysis. However, applying precautionary principles, it is important to initiate a risk-reduction program to decrease exposure to DDT and its metabolites in people living in this area.

Effect of polychlorinated biphenyls 118 and 153 on Th1/Th2 cells differentiation

The objective of this study was evaluate the effect of coplanar polychlorinated biphenyls (PCB) 118-congener (PCB like-dioxin) and noncoplanar PCB 153-congener (PCB no like-dioxin) on differentiation of humans T-CD4+ lymphocytes into Th1 or Th2 subpopulations. Peripheral blood mononuclear cells (PBMC) were isolated from healthy volunteers (aged 25-30 years); T-CD4+ lymphocytes were separated from PBMC. Then, the differentiation of T-CD4+ cells into Th1 or Th2 subpopulation was performed and the intracellular cytokines analyses were assessed. No effect on IFNγ (produced by Th1 cells) production was observed when the cells were treated with both PCBs congeners. However, the PCB 118-congener induced an increase of IL-4-producing T-CD4 cells (produced by Th2 cells), PCB153 not exerted any effect on IL-4 production. The clinical significance of our data is uncertain, therefore, more studies are necessary in order to elucidate the effects generated in exposed human individual.

Predictors of adipose tissue concentrations of organochlorine pesticides in a general Danish population

Organochlorine pesticides are ubiquitously present in the environment and suspected of carcinogenic, neurological and immunological effects. Our objective was to identify determinants of adipose tissue levels of organochlorine pesticides experienced by a general Danish population. Adipose tissue was collected upon enrolment of 245 randomly selected persons from a prospective cohort of 57,053 persons enrolled between 1993 and 1997. We examined geography, gender, age, lactation, body mass index (BMI) and intake of nine dietary groups and tap water drinks, as potential determinants of dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene, hexachlorocyclohexane, dieldrin, hexachlorobenzene, cis-nonachlor, trans-nonachlor and oxychlordane. Living in Copenhagen city and age at enrolment showed positive associations with all compounds. BMI was positively associated with all compounds except cis-nonachlor. Fatty-fish consumption showed positive associations with cis-nonachlor, trans-nonachlor, DDT and dieldrin and fruit and vegetables were inversely associated with dieldrin. Determinant estimates of trans-nonachlor were similar to estimates of total chlordanes while cis-nonachlor and oxychlordane seemed to differ. This is one of the first studies of organochlorine pesticides predictors in adipose tissue and contributes to the ongoing debate about exposure sources of these compounds. Single determinants varied among the individual compounds, even within related chlordane residues, suggesting that organochlorine pesticides should not be treated as a homogenous group.

Organochlorine concentrations in breast milk and prevalence of allergic disorders in Japanese women

Persistent organic pollutants have been shown to have immunomodulating effects in humans. However, epidemiological evidence regarding the relationships between organochlorine compound exposure and allergic disorders coming from studies of children has been limited and inconsistent. The current cross-sectional study examined the associations between the concentrations of β-hexachlorocyclohexane (HCH), hexachlorobenzene (HCB), p,p'-dichlorodiphenyldichloroethylene (DDE), and trans-nonachlordane in breast milk and the prevalence of allergic disorders in 124 adult Japanese women. The definition of wheeze and asthma was based on criteria from the European Community Respiratory Health Survey whereas that of eczema and rhinoconjunctivitis was based on criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age, smoking, family history of allergic disorders, and education. The prevalence values of wheeze, asthma, eczema, and rhinoconjunctivitis in the past 12 months were 9.7%, 4.8%, 13.7%, and 29.8%, respectively. The median concentrations of β-HCH, HCB, p,p'-DDE, and trans-nonachlordane in breast milk were 28.3, 7.0, 71.6, and 23.9 ng g(-1) lipid, respectively (range, 4.5-253, 2.1-14.5, 7.5-362, and 1.8-130 ng g(-1) lipid, respectively). When the exposures were treated as continuous variables, no significant associations were found between concentrations of HCB, β-HCH, p,p'-DDE, or trans-nonachlordane and the prevalence of wheeze, asthma, eczema, or rhinoconjunctivitis. Our results suggest that concentrations of β-HCH, HCB, p,p'-DDE, and trans-nonachlordane in breast milk are not evidently associated with the prevalence of wheeze, asthma, eczema, or rhinoconjunctivitis in young female Japanese adults.

Serum concentrations of antibodies against vaccine toxoids in children exposed perinatally to immunotoxicants

BACKGROUND

Polychlorinated biphenyls (PCBs) may cause immunotoxic effects, but the detailed dose-response relationship and possible vulnerable time windows of exposure are uncertain. In this study we applied serum concentrations of specific antibodies against childhood vaccines as sentinels of immunotoxicity.

OBJECTIVES

The main objective was to assess the possible dependence of antibody concentrations against diphtheria and tetanus toxoids in children with regard to prenatal and postnatal PCB exposures.

METHODS

From a cohort of 656 singleton births formed in the Faroe Islands during 1999-2001, children were invited for examination with assessment of serum antibody concentrations at 5 years (before and after a booster vaccination) and at 7 years of age. Total PCB concentrations were determined in serum from ages 5 and 7 years, and data were also available on PCB concentrations in maternal pregnancy serum, maternal milk, and, for a subgroup, the child's serum at 18 months of age.

RESULTS

A total of 587 children participated in the examinations at ages 5 and/or 7 years. At age 5 years, before the booster vaccination, the antidiphtheria antibody concentration was inversely associated with PCB concentrations in milk and 18-month serum. Results obtained 2 years later showed an inverse association of concentrations of antibodies against both toxoids with PCB concentrations at 18 months of age. The strongest associations suggested a decrease in the antibody concentration by about 20% for each doubling in PCB exposure. At age 5 years, the odds of an antidiphtheria antibody concentration below a clinically protective level of 0.1 IU/L increased by about 30% for a doubling in PCB in milk and 18-month serum.

CONCLUSIONS

Developmental PCB exposure is associated with immunotoxic effects on serum concentrations of specific antibodies against diphtheria and tetanus vaccinations. The immune system development during the first years of life appears to be particularly vulnerable to this exposure.

Allergy and sensitization during childhood associated with prenatal and lactational exposure to marine pollutants

BACKGROUND

Breast-feeding may affect the risk of developing allergy during childhood and may also cause exposure to immunotoxicants, such as polychlorinated biphenyls (PCBs), which are of concern as marine pollutants in the Faroe Islands and the Arctic region.

OBJECTIVES

The objective was to assess whether sensitization and development of allergic disease is associated with duration of breast-feeding and prenatal or postnatal exposures to PCBs and methylmercury.

METHODS

A cohort of 656 singleton births was formed in the Faroe Islands during 1999-2001. Duration of breast-feeding and history of asthma and atopic dermatitis were recorded at clinical examinations at 5 and 7 years of age. PCB and mercury concentrations were determined in blood samples obtained at parturition and at follow-up. Serum from 464 children (71%) at 7 years of age was analyzed for total immunoglobulin E (IgE) and grass-specific IgE.

RESULTS

The total IgE concentration in serum at 7 years of age was positively associated both with the concomitant serum PCB concentration and with the duration of breast-feeding. However, the effect only of the latter was substantially attenuated in a multivariate analysis. A raised grass-specific IgE concentration compatible with sensitization was positively associated with the duration of breast-feeding and inversely associated with prenatal methylmercury exposure. However, a history of asthma or atopic dermatitis was not associated with the duration of breast-feeding, although children with atopic dermatitis had lower prenatal PCB exposures than did nonallergic children.

CONCLUSIONS

These findings suggest that developmental exposure to immunotoxicants may both increase and decrease the risk of allergic disease and that associations between breast-feeding and subsequent allergic disease in children may, at least in part, reflect lactational exposure to immunotoxic food contaminants.

Assessment of DDT levels in selected environmental media and biological samples from Mexico and Central America

Taking into account the environmental persistence and the toxicity of DDT, the Pan American Health Organization (PAHO) organized a surveillance program in Mesoamerica which included the detection of residual DDT in environmental (soil) and biological samples (fish tissue and children's blood). This program was carried out in communities from Mexico, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica and Panama. This paper presents the first report of that program. As expected, the results show that the levels for [summation operator] DDT in soil (outdoor or indoor) and fish samples in the majority of the locations studied are below guidelines. However, in some locations, we found children with high concentrations of DDT as in Mexico (mean level 50.2 ng/mL). Furthermore, in some communities and for some matrices, the DDT/DDE quotient is higher than one and this may reflect a recent DDT exposure. Therefore, more efforts are needed to avoid exposure and to prevent the reintroduction of DDT into the region. In this regard it is important to know that under the surveillance of PAHO and with the support of UNEP, a regional program in Mesoamerica for the collection and disposal of DDT and other POPs stockpiles is in progress.

Exposure assessment of persistent organic pollutants and metals in Mexican children

Environmental policies in Mexico have contributed to the reduction in the production or use of some persistent organic pollutants (POPs) and metals. However, monitoring of POPs concentrations in humans living in hot spots is lacking. Therefore, the objective of this study was to conduct a screening for POPs and metals first in Mexican children living in high-risk areas. During the year 2004, we analyzed a total of 229 healthy children (aged 6-12 years old) who resided in communities located in nine Mexican states. Organochlorine insecticides, PCBs and metals were quantified in plasma and urine samples. We detected p'p-DDE in all the children; moreover, p'p-DDT, lindane and hexachlorobenzene were detected respectively in 14%, 85% and 10% of the children studied. Measurable levels of PCBs were recorded in only one community, where six of 14 PCB congeners assayed were detected (numbers 52, 118, 138, 153, 170 and 180). All the children had detectable levels of lead in their blood (mean level, 4.6 microg dL(-1)); furthermore, 57% of the children studied had levels higher than 5.0 microg/dL. The mean level of urinary arsenic (UAs) for all the children was 22.35 microg g(-1) creatinine and 15% of those children had concentrations of UAs above 50 microg g(-1) creatinine. For cadmium, the mean urinary level was 0.78 microg g(-1) creatinine, and only one percent of the children had values above 2.0 microg g(-1) creatinine. The results cannot be generalized since the communities selected are not representative of the Mexican population; however, they indicate that Mexican children are exposed to chemicals and some at risk levels.

Effects of PCBs 52 and 77 on Th1/Th2 Balance in Mouse Thymocyte Cell Cultures

Polychlorinated biphenyls (PCBs) are industrial chemicals that have been released into the environment, resulting in widespread and persistent contamination. PCBs exist as 209 different congeners depending on the chlorine substitution on the biphenyl rings, and the physical properties and toxic effects of different PCB congeners are structure-dependent. We have tested an ortho-substituted, noncoplanar congener, 2,2',5,5'-tetrachlorobiphenyl (PCB 52), and a non-ortho-substituted coplanar congener, 3,3',4,4'-tetrachlorobiphenyl (PCB 77), for their effects on the T helper 1 (Th1) and T helper 2 (Th2) lymphocyte balance. The experiments were performed in 10 microg/ml concanavalin A (Con A)-stimulated and nonstimulated thymocytes for determination of cytokine production profiles. Interferon-gamma (produced by Th1 cells) and interleukin (IL)-10 (produced by Th2 cells) concentrations were measured in the supernatants at 12 and 24 hr after treatment with PCBs. PCBs 52 and 77 caused significant increases in interferon-gamma levels at 12 and 24 hr in both Con A-stimulated and nonstimulated media. IL-10 levels were significantly reduced at two interval periods by PCBs 52 and 77 in cultures with and without Con A. Our results show that the cytokine production profile was significantly shifted to Th1 by both ortho-substituted and coplanar PCB congeners in mouse thymocyte cultures.

Cytokines and other immunological biomarkers in children's environmental health studies

Environmental exposures (e.g. pesticides, air pollution, and environmental tobacco smoke) during prenatal and early postnatal development have been linked to a growing number of childhood diseases including allergic disorders and leukemia. Because the immune response plays a critical role in each of these diseases, it is important to study the effects of toxicants on the developing immune system. Children's unique susceptibility to environmental toxicants has become an important focus of the field of immunotoxicology and the use of immune biomarkers in molecular epidemiology of children's environmental health is a rapidly expanding field of research. In this review, we discuss how markers of immune status and immunotoxicity are being applied to pediatric studies, with a specific focus on the various methods used to analyze T-helper-1/2 (Th1/Th2) cytokine profiles. Furthermore, we review recent data on the effects of children's environmental exposures to volatile organic compounds, metals, and pesticides on Th1/Th2 cytokine profiles and the associations of Th1/Th2 profiles with adverse health outcomes such as pediatric respiratory diseases, allergies, cancer and diabetes. Although cytokine profiles are increasingly used in children's studies, there is still a need to acquire distribution data for different ages and ethnic groups of healthy children. These data will contribute to the validation and standardization of cytokine biomarkers for future studies. Application of immunological markers in epidemiological studies will improve the understanding of mechanisms that underlie associations between environmental exposures and immune-mediated disorders.

Multiple cytokine and acute-phase protein gene transcription in West Greenland sledge dogs (Canis familiaris) dietary exposed to organic environmental pollutants

Exposure levels of persistent organic pollutants, such as polychlorinated biphenyls and DDTs, are high in Arctic apex predators and Inuit peoples and are suspected to have negative impacts on their immune systems. We conducted a controlled generational study on liver tissue and ethylenediaminetetraacetic acid blood cytokine and acute-phase protein (APP) mRNA expressions using reverse transcriptionase-polymerase chain reaction in West Greenland sledge dogs (Canis familiaris); contaminated minke whale (Balaenoptera acutorostrata) blubber serves as dietary pollutant source. Two of seven blood cytokine expressions (IL-6 and IL-12) and three of five APP expressions (haptoglobin [HP], heat shock protein, and fatty acid-binding protein [FABP]) were lowest in the exposed group, whereas the remaining five blood cytokine expressions (IL-2, IL-10, IFN-gamma, TNF-alpha, and TGF-beta) and two APP expressions (MT1 and MT2) were highest in the exposed group. In liver tissue, three cytokine expressions (IL-10, IFN-gamma, and TNF-alpha) and two APP expressions (MT1 and MT2) were highest in the exposed group, and the remaining cytokine and APP expressions were lowest in the exposed group. Of these, the liver tissue expression of HP and FABP was significantly lowest in the exposed group (both p < 0.05). As a consequence of our findings, we suggest that a daily intake of 50 to 200 g polluted whale blubber is associated with a genotoxic decrease in HP and FABP gene expression in the liver of sledge dog and possibly of other top mammalian marine predators and consumers in the Arctic, indicating a restricted acute-phase reaction and insufficient immune response. Finally, HP and FABP liver expression appear to be new and sensitive biomarkers of organohalogen compound exposure.

Diagnostic relevance of the determination of lymphocyte subpopulations in environmental medicine

Earlier hopes that determination of lymphocyte subpopulations might become a strong diagnostic tool in environmental medicine have not been fulfilled in recent years. Analysis of the scientific literature rather shows that there are only few examples for environmental exposures causing reproducible shifts of lymphocyte subpopulations. Moreover, current knowledge suggests that "environmental diseases" are not associated with characteristic changes of subpopulation patterns. If lymphocyte subpopulations are analyzed, each diagnostic step, including indication, sample handling, analytic procedure and data-interpretation, should adhere to good quality criteria. Taking all together, the determination of lymphocyte subpopulations in the context of environmental medicine comes under category IV of the criteria of the Commission for Methods and Quality Assurance in Environmental Medicine of the German federal health authority (Robert Koch-Institute; RKI): "A procedure cannot be recommended because there is not sufficient information to justify it" (here: no solid trends in epidemiological examinations), "and because theoretical considerations speak against an application" (here: high physiological variability and missing exposure or substance specificity).

DDE-induced apoptosis in children exposed to the DDT metabolite

In a preliminary study in children we found a weak positive association between the frequency of apoptosis and the exposure to DDT and DDE (a DDT metabolite). In order to verify this information, more studies were needed with an increased number of children. Thus, the aim of the present work was to see if DDT and its metabolites were able to induce apoptosis of PBMC in exposed children. We performed a study in children living in three communities located in southern Mexico. During the year 2003, we studied a total of 61 healthy children; and during the year 2004, 57 children from the same communities were assessed. Apoptosis frequencies in PBMC in these children ranged from 0.10% to 8.30% during 2003 and from 0.12% to 16.20% during 2004, and although we detected exposure to DDT, DDD and DDE, significant association with apoptosis frequencies was found only with DDE blood levels (p=0.010 and 0.040 for 2003 and 2004 respectively). DNA damage and oxidative DNA damage were also studied in 2004 using the comet assay. The association between exposure to DDT or DDE and DNA damage was significant (p=0.004 and p=0.005 respectively), but the association between DDT or DDE and oxidative DNA damage and that of oxidative damage and apoptosis were not significant. Taking into account that DDE is the most persistent metabolite, it would be important to assess the effects of this DDE-induced apoptosis of PBCM in children living in areas where DDT was sprayed.

Prenatal dichlorodiphenyldichloroethylene (DDE) and asthma in children

Prevalence of asthma increases with increasing dichlorodiphenyldichloroethylene (DDE) levels. However, the effect of early-life exposure, the fundamental window of exposure, is unknown. We assessed the association between prenatal DDE and other organochlorine compounds, and atopy and asthma during infancy. All women presenting for antenatal care in Menorca (Spain) over 12 months starting in mid-1997 were invited to take part in a longitudinal study; 482 children were subsequently enrolled, and 468 (97.1%) provided complete outcome data up to the fourth year of study. Prenatal exposure of organochlorine compounds was measured in cord serum in 405 (83%) children. Asthma was defined on the basis of wheezing at 4 years of age, persistent wheezing, or doctor-diagnosed asthma. We measured specific immunoglobulin-E (IgE) against house dust mite, cat, and grass in sera extracted at 4 years of age. DDE (median = 1.03 ng/mL) was detected in all children, as well as hexachlorobenzene (0.68 ng/mL) and polychlorobiphenyls (0.69 ng/mL). Wheezing at 4 years of age increased with DDE concentration, particularly at the highest quartile [9% in the lowest quartile (< 0.57 ng/mL) vs. 19% in the highest quartile (1.90 ng/mL); relative risk = 2.63 (95% confidence interval 1.19-4.69), adjusting for maternal asthma, breast-feeding, education, social class, or other organochlorines]. The association was not modified by IgE sensitization and occurred with the same strength among nonatopic subjects and among those with persistent wheezing or diagnosed asthma. DDE was not associated with atopy alone. Prenatal exposure to DDE residues may contribute to development of asthma.

Health risks and benefits of bis(4-chlorophenyl)-1,1,1-trichloroethane (DDT)

DDT (bis[4-chlorophenyl]-1,1,1-trichloroethane) is a persistent insecticide that was used worldwide from the mid 1940s until its ban in the USA and other countries in the 1970s. When a global ban on DDT was proposed in 2001, several countries in sub-Saharan Africa claimed that DDT was still needed as a cheap and effective means for vector control. Although DDT is generally not toxic to human beings and was banned mainly for ecological reasons, subsequent research has shown that exposure to DDT at amounts that would be needed in malaria control might cause preterm birth and early weaning, abrogating the benefit of reducing infant mortality from malaria. Historically, DDT has had mixed success in Africa; only the countries that are able to find and devote substantial resources towards malaria control have made major advances. DDT might be useful in controlling malaria, but the evidence of its adverse effects on human health needs appropriate research on whether it achieves a favourable balance of risk versus benefit.

Biomarkers to assess potential developmental immunotoxicity in children

Clinical tests are readily available for assessing severe loss of immune function in children with diseases such as AIDS or primary immunodeficiency. However tests that could reliably identify subtle immune changes, as might be expected to result from exposure to developmental immunotoxic agents, are not readily available. A number of tests are described which we believe have potential applicability for epidemiological studies involving developmental immunotoxicity. Several of the tests, such as T cell receptor rearrangement excision circles (TRECs) and cytokine measurements, while highly relevant from a biological standpoint, may be precluded from use at the current time, for either technical issues or insufficient validation. Immunophenotyping and measurement of serum immunoglobulin levels, on the other hand, are well validated. Yet they may require extraordinary care in experimental design and technical performance in order to obtain data that would consistently detect subtle changes, as these tests are not generally considered highly sensitive. Quantification of the immune response to childhood vaccine, while up to the present used sparingly, may represent an excellent indicator for developmental immunotoxicity when conducted under appropriate conditions.