Glyphosate's Synergistic Toxicity in Combination with Other Factors as a Cause of Chronic Kidney Disease of Unknown Origin

DNA demethylase TET2-mediated reduction of HADHB expression contributes to cadmium-induced malignant progression of colorectal cancer

Environmental exposure to the cadmium (Cd) has been shown to be a risk factor for colorectal cancer (CRC) progression, but the exact mechanism has not been fully elucidated. In this study, we found that chronic Cd (3 μM) exposure promoted the proliferation, adhesion, migration, and invasion of CRC cells in vitro, as well as lung metastasis in vivo. RNA-seq and TCGA-COAD datasets revealed that decreased hydroxyacyl-CoA dehydrogenase trifunctional multienzyme complex subunit beta (HADHB) expression may be a crucial factor in Cd-induced CRC progression. Further analysis using qRT-PCR and tissue microarrays from CRC patients showed that HADHB expression was significantly reduced in CRC tissues compared to adjacent normal tissues, and low HADHB expression was associated with adverse clinical features and poor overall survival, either directly or through TNM stage. Furthermore, HADHB was found to play an important role in the Cd-induced malignant metastatic phenotype of CRC cells and lung metastasis in mice. Mechanistically, we discovered that chronic Cd exposure resulted in hypermethylation of the HADHB promoter region via inhibition of DNA demethylase tet methylcytosine dioxygenase 2 (TET2), which then led to decreased HADHB expression and activation of the FAK signaling pathway, and ultimately contributed to CRC progression. In conclusion, this study provided a new potential insight and evaluable biomarker for Cd exposure-induced CRC progression and treatment.

Effects of glyphosate herbicide ingestion on kidney function in rats on a balanced diet

INTRODUCTION

Glyphosate is the most widely used herbicide worldwide and in Brazil. There is currently increasing concern about the effects of glyphosate on human health. The Brazilian Institute for Consumer Protection showed data on the presence of glyphosate in some of Brazil's most consumed ultra-processed products. Currently, regulations on the upper limit for these residues in ultra-processed foods have yet to be established by the National Health Surveillance, and ultra-processed food consumption is independently associated with an increased risk of incident chronic kidney disease.

METHODS

Since an unbalanced diet can interfere with kidney function, this study aims to investigate the effect of daily intake of 5 mg/kg bw glyphosate in conjunction with a balanced diet and the possible impact on renal function in rats. Kidney function, kidney weight, markers of renal injury, and oxidative stress were evaluated.

RESULTS

There was a decrease in kidney weight. The main histopathological alterations in renal tissues were vacuolation in the initial stage and upregulation of the kidney injury marker KIM-1. Renal injury is associated with increased production of reactive oxygen species in mitochondria.

CONCLUSION

This study showed changes in the kidney of rats exposed to a balanced diet with glyphosate, suggesting a potential risk to human kidney. Presumably, ultra-processed food that contain glyphosate can potentiate this risk. The relevance of these results lies in drawing attention to the need to regulate glyphosate concentration in ultra-processed foods in the future.

Biomonitoring of glyphosate and aminomethylphosphonic acid: Current insights and future perspectives

Glyphosate is one of the most widely used herbicides globally, raising concerns about its potential impact on human health. Biomonitoring studies play a crucial role in assessing human exposure to glyphosate and providing valuable insights into its distribution and metabolism in the body. This review aims to summarize the current trends and future perspectives in biomonitoring of glyphosate and its major degradation product of aminomethylphosphonic acid (AMPA). A comprehensive literature search was conducted, focusing on studies published between January 2000 and December 2022. The findings demonstrated that glyphosate and AMPA have been reported in different human specimens with urine as the dominance. Sample pretreatment techniques of solid-phase and liquid-liquid extractions coupled with liquid/gas chromatography-tandem mass spectrometry have achieved matrix elimination and accurate analysis. We also examined and compared the exposure characteristics of these compounds among different regions and various populations, with significantly higher levels of glyphosate and AMPA observed in Asian populations and among occupational groups. The median urinary concentration of glyphosate in children was 0.54 ng/mL, which was relatively higher than those in women (0.28 ng/mL) and adults (0.12 ng/mL). It is worth noting that children may exhibit increased susceptibility to glyphosate exposure or have different exposure patterns compared to women and adults. A number of important perspectives were proposed in order to further facilitate the understanding of health effects of glyphosate and AMPA, which include, but are not limited to, method standardization, combined exposure assessment, attention for vulnerable populations, long-term exposure effects and risk communication and public awareness.

Pubertal glyphosate-based herbicide exposure aggravates high-fat diet-induced obesity in female mice

Glyphosate-based herbicides (GBH) are the most widely used pesticides globally. Studies have indicated that they may increase the risk of various organic dysfunctions. Herein, we verified whether exposure to GBH during puberty increases the susceptibility of male and female mice to obesity when they are fed a high-fat diet (HFD) in adulthood. From the 4th-7th weeks of age, male and female C57Bl/6 mice received water (CTL group) or 50 mg GBH /kg body weight (BW; GBH group). From the 8th-21st weeks of age, the mice were fed a standard diet or a HFD. It was found that pubertal GBH exposure exacerbated BW gains and hyperphagia induced by HFD, but only in female GBH-HFD mice. These female mice also exhibited high accumulation of perigonadal and subcutaneous fat, as well as reduced lean body mass. Both male and female GBH-HFD displayed hypertrophic white adipocytes. However, only in females, pubertal GBH exposure aggravated HFD-induced fat accumulation in brown adipocytes. Furthermore, GBH increased plasma cortisol levels by 80% in GBH-HFD males, and 180% in GBH-HFD females. In conclusion, pubertal GBH exposure aggravated HFD-induced obesity, particularly in adult female mice. This study provides novel evidence that GBH misprograms lipid metabolism, accelerating the development of obesity when individuals are challenged by a second metabolic stressor, such as an obesogenic diet.

Higher urinary glyphosate exposure is associated with increased risk of liver dysfunction in adults: An analysis of NHANES, 2013-2016

Glyphosate (GLY) exposure, both exogenous and endogenous, is a global concern. Multiple studies of model systems in vitro and in vivo have demonstrated the potential toxic effects of GLY exposure on human organs, particularly the liver and renal system. However, there is currently limited epidemiological evidence establishing a link between GLY exposure and hepatorenal function in the general population. In this study, a multivariable linear regression model and forest plots were employed to evaluate the connection between urinary GLY and biomarkers of hepatorenal function in 2241 participants from the National Health and Nutrition Examination Survey 2013-2016. Additionally, subgroup analyses were conducted based on age, gender, race, BMI, and chronic kidney disease (CKD). Alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ALT and fibrosis 4 score (FIB-4) all increased with elevated urinary GLY concentrations after adjusting for potential confounders, while albumin (ALB) exhibited the opposite trend, particularly among younger, female, non-Hispanic white, overweight, and CKD participants. Furthermore, individuals in the third tertile had a greater risk of liver dysfunction than those in the first tertile after categorizing urinary GLY concentrations. However, our study showed no proof that GLY exposure affects the ratio of urine albumin to creatinine (ACR) or serum creatinine levels. Overall, these results imply that GLY exposure may have adverse effects on human liver function.

Design and Experiment of a Biomimetic Duckbill-like Vibration Chain for Physical Weed Control during the Rice Tillering Stage

The widespread use of chemical herbicides has jeopardized concerns about food safety and ecological consequences. To address these issues and reduce reliance on chemical herbicides, a physical weed control device was developed for the tillering stage in paddy fields. This device features a biomimetic duckbill-like vibration chain that effectively controls weed outbreaks. The chain penetrates the soft surface soil of the paddy field under gravity and rapidly stirs the soil through vibration, leading to the detachment of the weed roots anchored in the surface layer. Simultaneously, the device avoids mechanical damage to rice seedlings rooted in deeper soil. This study aimed to investigate the effects of chain structural parameters (the number of chain rows, vibration amplitude, and length of chains) and operational parameters (vibration frequency and working velocity) on weed control efficiency and rice seedling damage. Through a central composite regression field test, the optimal device structure and operational parameters were determined. The optimization results demonstrated that a vibration amplitude of 78.8 mm, a chain length of 93.47 cm, and 3.4 rows of chains, along with a vibration frequency and working velocity ranging from 0.5 to 1.25 m/s, achieved an optimal weeding effect. Under the optimal parameter combination, field test results demonstrated that approximately 80% of the weeds in the field were effectively cleared. This indicates that the design of the biomimetic duckbill-like vibration chain weeding device exhibits a relatively superior weeding performance, offering a practical solution for the management of weeds in rice fields.

Underestimation of glyphosate intake by the methods currently used by regulatory agencies

The acceptable daily intake (ADI) is an estimate of the amount of a substance in food or beverages that can be consumed daily over a lifetime without presenting an appreciable risk to health. To assess the risk of ingesting glyphosate, regulatory agencies compare glyphosate daily intake to ADI. Based on published data on urine glyphosate levels measured according to known quantities of ingested glyphosate, our objectives were to test the robustness of the mathematical model currently used to calculate glyphosate daily intake, and to propose alternative models based on urinary excretion kinetics. Our results support that the quantity of ingested glyphosate is systematically underestimated by the model currently used by regulatory agencies, whereas the other models evaluated showed better estimations, with differences according to gender. Our results also show a great variability between individuals, leading to some uncertainties notably with regards to the ADI, and further support that glyphosate excretion varies significantly among individuals who follow a similar dosing regimen. In conclusion, our study highlights the lack of reliability of assessment processes carried out by regulatory agencies for glyphosate in particular, and pesticides in general, and questions the relevance of such processes supposed to safeguard human health and the environment.

Pollutants, including Organophosphorus and Organochloride Pesticides, May Increase the Risk of Cardiac Remodeling and Atrial Fibrillation: A Narrative Review

Atrial fibrillation (AF) is the most common type of cardiac rhythm disorder. Recent clinical and experimental studies reveal that environmental pollutants, including organophosphorus-organochloride pesticides and air pollution, may contribute to the development of cardiac arrhythmias including AF. Here, we discussed the unifying cascade of events that may explain the role of pollutant exposure in the development of AF. Following ingestion and inhalation of pollution-promoting toxic compounds, damage-associated molecular pattern (DAMP) stimuli activate the inflammatory response and oxidative stress that may negatively affect the respiratory, cognitive, digestive, and cardiac systems. Although the detailed mechanisms underlying the association between pollutant exposure and the incidence of AF are not completely elucidated, some clinical reports and fundamental research data support the idea that pollutant poisoning can provoke perturbed ion channel function, myocardial electrical abnormalities, decreased action potential duration, slowed conduction, contractile dysfunction, cardiac fibrosis, and arrhythmias including AF.

Assessment of the impact of glyphosate and 2,4-D herbicides on the kidney injury and transcriptome changes in obese mice fed a Western diet

The development of chronic kidney disease has been associated with comorbidities resulting from the consumption of Westernized dietary (WD) patterns, including obesity and other metabolic dysfunctions. Kidneys also have a crucial role in the metabolism and excretion of xenobiotics, including herbicides. There is limited knowledge regarding the simultaneous exposure to WD and glyphosate (glypho) and 2,4-D, the most used herbicides globally. Thus, this study examined whether exposure to glypho and/or 2,4-D, either individually or in mixed, could impact the early effects of WD intake on kidney histology and gene expression in a rodent model. Male C57BL6J mice were fed a WD containing 20% lard, 0.2% cholesterol, 20% sucrose, and high sugar solution with 23.1 and 18.9 g/L of D-fructose and D-glucose for six months. During this period, the mice also received glypho (0.05 or 5 mg/kg/day), 2,4-D (0.02 or 2 mg/kg/day), or a mixture of both (0.05 +0.02, 5 +2 mg/kg/day) via intragastric administration five times per week. The doses were within or below the established regulatory limits. While single or mixed exposures did not alter WD-induced obesity, tubular lipid vacuolation, or increased serum creatinine levels; the exposure to higher doses of the mixture (5 +2) reduced the mesangial matrix area and tubular cell proliferation, while increasing the density of F4/80 macrophages in the renal interstitium. In terms of transcriptomic analysis, the herbicide mixture altered the expression of 415 genes in the kidney, which were found to be associated with immune response processes, particularly those related to phagocyte activity. While discrete, findings indicate that herbicide mixtures, rather than single exposures, might induce minor deleterious effects on the kidneys of obese mice under WD intake.

Chronic Kidney Disease of Unknown Origin: Think Beyond Common Etiologies

Chronic kidney disease has an increased health impact on a global scale, with the most common etiologies being hypertension and diabetes. It is most frequently linked to noncommunicable conditions, including diabetes and hypertension, among high-income nations. However, it has a couple of new potential etiologies in low- and middle-income countries, many of which are yet unknown, including viral infections and environmental toxins. The phrase "CKD of unknown etiology" (CKDu) has been used to refer to CKD that is not caused by a typical risk factor such as diabetes, high blood pressure, or HIV. Environmental variables have been investigated as potential contributors to CKDu, including heavy metal exposure, elevated seasonal temperatures, pesticide use, mycotoxins, contamination of water supplies, and snake bites. Furthermore, the underlying causes have not been definitively established in the majority of areas and identifying serious health consequences across different international contexts and populations may be crucial for comprehending and avoiding CKDu.

Effects of glyphosate on the growth, development, and physiological functions of silkworm, Bombyx mori

Glyphosate is an herbicide widely used worldwide, but whether it is safe to nontarget organisms is controversial. In this study, the lepidopteran model insect silkworm was used to investigate the effects of glyphosate residues. The LC50 (72 h) of glyphosate on silkworm was determined to be 14875.98 mg/L, and after exposure to glyphosate at 2975.20 mg/L (a concentration comparable to that used for weed control in mulberry fields), silkworm growth was inhibited by 9.00%, total cocoon weight was lowered by 10.53%, feed digestibility was decreased by 7.56%, and the activities of alpha-amylase and trypsin were reduced by 10.41% and 21.32%, respectively. Pathological analysis revealed that glyphosate exposure led to significantly damaged midgut, along with thinner basal layer, shedding microvilli, blurred cytoplasmic membrane, and appearance of vacuoles. Exposure to glyphosate also led to accumulation of peroxides in the intestinal tissue; the messenger RNA transcription of SOD, Cu/Zn-SOD, and Mn-SOD was all significantly upregulated by glyphosate treatment for 24 h, while CAT transcription was increased at 24, 48, and 72 h. The activity of SOD was increased significantly at 24 h, while significant activity changes were observed for CAT at 72 and 96 h. These results indicated that exposure to glyphosate caused oxidative stress in the midgut of silkworm and affected the midgut's physiological function. This study provides important insights in evaluating the impact of glyphosate residues in the environment on nontarget organisms.

Acute Kidney Failure among Brazilian Agricultural Workers: A Death-Certificate Case-Control Study

Recent evidence suggests that pesticides may play a role in chronic kidney disease. However, little is known about associations with acute kidney failure (AKF). We investigated trends in AKF and pesticide expenditures and associations with agricultural work in two Brazilian regions with intense use of pesticides, in the south and midwest. Using death certificate data, we investigated trends in AKF mortality (1980-2014). We used joinpoint regression to calculate annual percent changes in AKF mortality rates by urban/rural status and, in rural municipalities, by tertiles of per capita pesticide expenditures. We then compared AKF mortality in farmers and population controls from 2006 to 2014 using logistic regression to estimate odds ratios and 95% confidence intervals adjusted by age, sex, region, education, and race. AKF mortality increased in both regions regardless of urban/rural status; trends were steeper from the mid-1990s to 2000s, and in rural municipalities, they were higher by tertiles of pesticide expenditures. Agricultural workers were more likely to die from AKF than from other causes, especially at younger ages, among females, and in the southern municipalities. We observed increasing AKF mortality in rural areas with greater pesticide expenditures and an association of AKF mortality with agricultural work, especially among younger workers.

A review of molecular mechanisms linked to potential renal injury agents in tropical rural farming communities

The chronic kidney disease of unknown etiology (CKDu) is a global health concern primarily impacting tropical farming communities. Although the precise etiology is debated, CKDu is associated with environmental exposures including heat stress and chemical contaminants such as fluoride, heavy metals, and herbicide glyphosate. However, a comprehensive synthesis is lacking on molecular networks underpinning renal damage induced by these factors. Addressing this gap, here we present key molecular events associated with heat and chemical exposures. We identified that caspase activation and lipid peroxidation are common endpoints of glyphosate exposure, while vasopressin and polyol pathways are associated with heat stress and dehydration. Heavy metal exposure is shown to induce lipid peroxidation and endoplasmic reticulum stress from ROS activated MAPK, NFĸB, and caspase. Collectively, we identify that environmental exposure induced increased cellular oxidative stress as a common mechanism mediating renal cell inflammation, apoptosis, and necrosis, likely contributing to CKDu initiation and progression.

Quantifiable urine glyphosate levels detected in 99% of the French population, with higher values in men, in younger people, and in farmers

France is the first pesticide-consuming country in Europe. Glyphosate is the most used pesticide worldwide and glyphosate is detected in the general population of industrialized countries, with higher levels found in farmers and children. Little data was available concerning exposure in France. Our objective was to determine glyphosate levels in the French general population and to search for an association with seasons, biological features, lifestyle status, dietary habits, and occupational exposure. This study includes 6848 participants recruited between 2018 and 2020. Associated data include age, gender, location, employment status, and dietary information. Glyphosate was quantified by a single laboratory in first-void urine samples using ELISA. Our results support a general contamination of the French population, with glyphosate quantifiable in 99.8% of urine samples with a mean of 1.19 ng/ml + / - 0.84 after adjustment to body mass index (BMI). We confirm higher glyphosate levels in men and children. Our results support glyphosate contamination through food and water intake, as lower glyphosate levels are associated with dominant organic food intake and filtered water. Higher occupational exposure is confirmed in farmers and farmers working in wine-growing environment. Thus, our present results show a general contamination of the French population with glyphosate, and further contribute to the description of a widespread contamination in industrialized countries.

Fluorescence determination of glyphosate based on a DNA-templated copper nanoparticle biosensor

A rapid and convenient fluorescence glyphosate (GLYP) biosensor was developed based on DNA-templated copper nanoparticles (DNA-CuNPs). In the absence of GLYP, the DNA-CuNPs were formed through the reduction of Cu2+ by vitamin C (Vc). The DNA-CuNPs emitted intense fluorescence at 615 nm when being excited at 340 nm. In the presence of GLYP, GLYP can strongly chelate with Cu2+ by the phosphate and carboxyl groups to decrease the amount of free Cu2+. Due to the lack of free Cu2+, DNA-CuNPs cannot be formed, which caused the fluorescence to decrease. The whole detection process of this proposed GLYP biosensor can be completed within 14 min. Titration experiments showed that this biosensor had a linear relationship for GLYP in the range 1 to 18 µM with a limit of detection (LOD) of 0.47 µM. This biosensor showed obvious selectivity among other pesticides, even between GLYP and organophosphorus pesticides. This biosensor performed well for GLYP detection in real samples with recoveries of 88.0-104.0%.

Glyphosate and AMPA exposure in relation to markers of biological aging in an adult population-based study

BACKGROUND/AIM

Glyphosate, a broad-spectrum herbicide, and its main metabolite aminomethylphosphonic acid (AMPA) are persistent in the environment. Studies showed associations between glyphosate or AMPA exposure and several adverse cellular processes, including metabolic alterations and oxidative stress.

OBJECTIVE

To determine the association between glyphosate and AMPA exposure and biomarkers of biological aging.

METHODS

We examined glyphosate and AMPA exposure, mtDNA content and leukocyte telomere length in 181 adults, included in the third cycle of the Flemish Environment and Health Study (FLEHSIII). DNA was isolated from leukocytes and the relative mtDNA content and telomere length were determined using qPCR. Urinary glyphosate and AMPA concentrations were measured by Gas Chromatography-Tandem Mass Spectrometry (GC-MS-MS). We used multiple linear regression models to associate mtDNA content and leukocyte telomere length with glyphosate or AMPA exposure while adjusting for confounding variables.

RESULTS

A doubling in urinary AMPA concentration was associated with 5.19% (95% CI: 0.49 to 10.11; p = 0.03) longer leukocyte telomere length, while no association was observed with urinary glyphosate concentration. No association between mtDNA content and urinary glyphosate nor AMPA levels was observed.

CONCLUSIONS

This study showed that AMPA exposure may be associated with telomere biology in adults.

Chronic kidney disease of unknown etiology in India: a comparative study with Mesoamerican and Sri Lankan nephropathy

Chronic kidney disease of unknown etiology [CKDu] is a condition characterized by decline in kidney function and is not associated with diabetic nephropathy or hypertensive nephropathy. In this review, we have done a detailed literature analysis on CKDu in India, and then had a comparison with that of Mesoamerica and Sri Lanka. In India, CKDu became the second most common type of CKD after diabetic nephropathy. Silica was seen in the groundwater of both India and Sri Lanka, whereas in Mesoamerica silica exposure through particulate matter was seen among CKDu communities. DDE is a common agrochemical seen in both India and Sri Lanka. The risk factors vary from region to region and it is important to categorize CKDu population based on the risk factors to avoid misinterpretation of the condition as non-CKDu category and to evade further complications. More studies have to be conducted to reveal the detailed pathophysiological mechanisms and its relation with irrational exploitation of environmental resources.

Histologic characterization and risk factors for persistent albuminuria in adolescents in a region of highly prevalent end-stage renal failure of unknown origin

Background

End-stage renal failure of unknown origin (ESRD-UO) is a public health problem in Mexico and many regions of the world. The prevalence of ESRD-UO in Aguascalientes Mexico is one of the highest worldwide, particularly in adults between 20 and 40 years of age.

Aim

To screen adolescents for chronic kidney disease (CKD), identify risk factors, and histologically characterize adolescents with persistent albuminuria (pACR).

Methodology

This is a cross-sectional, observational, and comparative study of adolescents in whom serum creatinine and the albumin creatinine ratio (ACR) were determined when screening for CKD. A clinical evaluation and risk factor survey were conducted. Patients with an abnormal ACR (≥ 30 mg/gr) or a low glomerular filtration rate (GFR) (≤75 ml/min/1.73 m2) were reevaluated and a renal ultrasound was obtained (rUS). A kidney biopsy was performed in patients with pACR.

Results

Five-hundred and thirteen (513) students were included, 19 had pACR and 494 were controls. The prevalence of pACR was 3.7% (95%CI 2.1 – 5.3). Only one patient had a decreased GRF. None of the patients with pACR had anatomical abnormalities of the urinary tract by rUS. Patients with pACR had a decreased total renal volume in comparison with the control group (150 vs 195 ml/m2, p <0.01). Eighteen (18) kidney biopsies were performed, 72% had glomerulomegaly, and only one patient had mild fibrosis. Podocyte abnormalities were evident on electron microscopy: partial fusion (100%), microvillous degeneration (80%), and increased organelles (60%). Risk factors for pACR were: homestead proximity to maize crops, the use of pesticides at the father´s workplace, a family history of CKD, and blood pressure abnormalities. The body mass index and breastfeeding were protective factors.

Conclusions

The prevalence of pACR in adolescents in Aguascalientes is high, and histologic compromise is characterized by podocyte injury in the absence of fibrosis. The renal volume of pACR patients was decreased, suggesting oligonephronia. Exposure to environmental toxins such as pesticides, even prenatally, may be responsible for this pathological entity. Screening programs in adolescents by determining ACR are necessary in our milieu.

Pleiotropic Outcomes of Glyphosate Exposure: From Organ Damage to Effects on Inflammation, Cancer, Reproduction and Development

Glyphosate is widely used worldwide as a potent herbicide. Due to its ubiquitous use, it is detectable in air, water and foodstuffs and can accumulate in human biological fluids and tissues representing a severe human health risk. In plants, glyphosate acts as an inhibitor of the shikimate pathway, which is absent in vertebrates. Due to this, international scientific authorities have long-considered glyphosate as a compound that has no or weak toxicity in humans. However, increasing evidence has highlighted the toxicity of glyphosate and its formulations in animals and human cells and tissues. Thus, despite the extension of the authorization of the use of glyphosate in Europe until 2022, several countries have begun to take precautionary measures to reduce its diffusion. Glyphosate has been detected in urine, blood and maternal milk and has been found to induce the generation of reactive oxygen species (ROS) and several cytotoxic and genotoxic effects in vitro and in animal models directly or indirectly through its metabolite, aminomethylphosphonic acid (AMPA). This review aims to summarize the more relevant findings on the biological effects and underlying molecular mechanisms of glyphosate, with a particular focus on glyphosate's potential to induce inflammation, DNA damage and alterations in gene expression profiles as well as adverse effects on reproduction and development.

Risk factors for endemic chronic kidney disease of unknown etiology in Sri Lanka: Retrospect of water security in the dry zone

The prevalence of chronic kidney disease of unknown etiology (CKDu) is receiving considerable attention due to the serious threat to human health throughout the world. However, the roles of geo-socio-environmental factors in the prevalence of the CKDu endemic areas are still unknown. Sri Lanka is one of the countries most seriously affected by CKDu, where 10 out of 25 districts have been identified as the areas with the high prevalence of CKDu (10-20%). This review summarizes the geographical distribution of CKDu and its probable geochemical, behavioral, sociological, and environmental risk factors based on research related to hydrogeochemical influences on CKDu in Sri Lanka. More than 98% of CKDu patients have consumed groundwater as their primary water source in daily life, indicating the interactions of geogenic contaminants (such as F^-, total dissolved solids, Hofmeister ions) in groundwater is responsible for the disease. Apart from the hydrogeochemical factors, mycotoxins, cyanotoxins, use of some herbal medicines, dehydration, and exposure to agrochemicals were alleged as risk factors. Sociological factors, including poverty, living habits and anthropogenic activities, may also provoke the emergence of CKDu. Therefore, the interaction of geo-socio environmental risk factors should be sociologically and scientifically considered to prevent the prevalence of CKDu. Future in-depth studies are required to reveal the individual role of each of the postulated etiological factors, possibly using machine learning and advanced statistics.

Environmental risk factors for reduced kidney function due to undetermined cause in India: an environmental epidemiologic analysis

BACKGROUND

An epidemic of chronic kidney disease is occurring in rural communities in low-income and middle-income countries that do not share common kidney disease risk factors such as diabetes and hypertension. This chronic kidney disease of unknown etiology occurs primarily in agricultural communities in Central America and South Asia. Consequently, environmental risk factors including heat stress, heavy metals exposure, and low altitude have been hypothesized as risk factors. We conducted an environmental epidemiological analysis investigating these exposures in India which reports the disease.

METHODS

We used a random sample population in rural and urban sites in Northern and Southern India in 2010, 2011, and 2014 (n = 11,119). We investigated associations of the heat index, altitude, and vicinity to cropland with estimated glomerular filtration rate (eGFR) using satellite-derived data assigned to residential coordinates. We modeled these exposures with eGFR using logistic regression to estimate the risk of low eGFR, and linear mixed models (LMMs) to analyze site-specific eGFR-environment associations.

RESULTS

Being over 55 years of age, male, and living in proximity to cropland was associated with increased risk of low eGFR [odds ratio (OR) (95% confidence interval (CI) = 2.24 (1.43, 3.56), 2.32 (1.39, 3.88), and 1.47 (1.16, 2.36)], respectively. In LMMs, vicinity to cropland was associated with low eGFR [-0.80 (-0.44, -0.14)]. No associations were observed with temperature or altitude.

CONCLUSIONS

Older age, being male, and living in proximity to cropland were negatively associated with eGFR. These analyses are important in identifying subcommunities at higher risk and can help direct future environmental investigations.

Development of a sensitive direct injection LC-MS/MS method for the detection of glyphosate and aminomethylphosphonic acid (AMPA) in hard waters

Glyphosate is currently the most widely used herbicide in the world; however, the zwitterionic and highly polar properties of glyphosate make current pesticide analysis methods unsuitable for its trace analysis in natural waters. Additionally, current glyphosate analysis methods do not account for waters of varying hardness, which is vital as glyphosate can complex with cationic species such as Ca2+ and Mg2+ in the environment. We detail here a robust LC-MS/MS method for the quantitation of glyphosate and its primary transformation product aminomethylphosphonic acid (AMPA) in environmental waters of varying water hardness. Chromatographic separation was achieved with a reversed-phase and weak anion-exchange mixed-mode column. We found that the addition of EDTA into hard water samples increases the response of both glyphosate and AMPA in the mass spectrometer. Limits of detection of 0.23 and 0.30 μg L-1 for glyphosate and AMPA in EDTA-amended hard water were achieved, respectively. We have demonstrated that the accuracy of the method was consistent over a wide range of water hardness levels up to a maximum of ~340 mg mL-1 CaCO3 hardness. We validated the method using matrix fortification of uncontaminated environmental samples from US river water. We then demonstrated that the method was successful at quantifying glyphosate and AMPA across surface and drinking water samples of varying water hardness from North Carolina and Sri Lanka. Measured concentrations of glyphosate and AMPA ranged from 1.6 to 13 μg L-1 and 0.50 to 2.5 μg L-1, respectively. This study represents a significant increase in sensitivity for LC-MS/MS analysis of glyphosate in hard water systems. Graphical abstract.

A Systematic Review of Renal Pathology in Chronic Kidney Disease of Uncertain Etiology

INTRODUCTION

Despite much research on chronic kidney disease of uncertain etiology (CKDu) in Sri Lanka and the Mesoamerican nephropathy, the etiology and pathogenesis of this disease remains elusive. The pathology has broadly been described as chronic tubulointerstitial nephritis and no specific signature lesions have been identified.

METHODS

A scoping review was conducted through MEDLINE and Google Scholar databases for peer-reviewed publications on biopsy studies related to CKDu - Sri Lanka and Mesoamerican nephropathy to develop a comparative and critical analysis of the renal pathology found in these patients.

RESULTS

Thirteen studies met the selection criteria. Interstitial fibrosis was the predominant lesion in all the studies. Tubulointerstitial and glomerular abnormalities showed a more variable distribution. No characteristic histopathological feature was reported other than a proximal tubular lysosomal inclusion body which was claimed to indicate a toxic etiology. Three main pathogenetic mechanisms were postulated: repeated acute insults leading to scarring, low-grade chronic insults leading to non-inflammatory fibrosis, and tubulointerstitial damage in combination with glomerular injury. The main limitations in the interpretation and comparative analysis of these studies were the heterogeneity in case selection and biopsy reporting.

CONCLUSIONS

Although no characteristic histopathological feature could be found in CKDu-Sri Lanka or Mesoamerican nephropathy, there are noticeable differences between these two groups in the frequency and severity of the glomerular and tubulointerstitial changes which warrant more explorative studies preferably on kidneys in early stages of the disease. Future strategies should ensure that more uniform selection criteria and reporting methods are used.

Adverse Health Effects in Women Farmers Indirectly Exposed to Pesticides

Farmers are among the most vulnerable populations because of the exposure to low levels of pesticides. Acetylcholinesterase and butyrylcholinesterase activities are considered as biomarkers of pesticides poisoning. However, biomarkers of oxidative stress are also playing an important role in toxicity of these contaminants. Further, increased activities of gamma-glutamyltransferase, alanine aminotransferase, urea and creatinine have been linked with hepatic and nephrotoxic cell damage, respectively. The aim of this study was to ascertain if the indirect exposure to pesticides leads to some biochemical parameter changes. Thus, cholinesterase activities, oxidative stress status (lipid and protein oxidation), hepatic function (AST and ALT levels), hormonal function (TSH, T4, FSH, LH and AMH), renal function (serum creatinine and urea), as well as possible subclinical kidney damage (urinary proteins and biomarkers of early kidney damage) were evaluated in farmer women who collect fruits and vegetables comparing with a group of women non-occupational exposed to pesticides but living in the same rural environment. Samples were taken periodically along one year to relate the observed effects to a chronic exposure. Our main results showed for the first time a subclinical kidney damage in a rural setting with indirect chronic exposure to pesticides.

Protective effect of melatonin against herbicides-induced hepatotoxicity in rats

Exposure to the herbicides Paraquat and Roundup® may cause cell lesions due to an increase in oxidative stress levels in different biological systems, even in the liver. The aim of this study was to analyze the effect of melatonin on liver of rats exposed to herbicides. A total of 35 rats were randomly divided into seven equal-sized groups: control, Paraquat, Roundup®, Paraquat + Roundup®, Paraquat + melatonin, Roundup® + melatonin, and Paraquat + Roundup® + melatonin. Samples of blood and hepatic tissue were collected at the end of the seventh day of exposure and treatment with melatonin. Body weight, hematological parameters, and histopathological, biochemical analyses and determination of oxidative stress levels in liver were evaluated. Body weight was compromised (P < 0.01). Alterations of hematologic parameters were significant when compared to control (P < 0.001). Biochemically, serum levels of albumin decreased (P < 0.001), but serum levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase increased (P < 0.001). Histopathology revealed necrotic hepatocytes, portal and central-lobular inflammatory infiltrate, congestion of capillaries. Serum levels of thiobarbituric acid reactive substances were found to be significantly elevated (P < 0.05; P < 0.001), and serum level of reduced glutathione was significantly lower (P < 0.05; P < 0.001). The groups treated concomitantly with melatonin revealed results similar to those of the control. However, melatonin acted as a protective agent for the liver against experimentally induced hepatic toxicity, promoting prevention of body weight, oxidative stress, and normalization of hematological and biochemical parameters.

A comparative review: Chronic Kidney Disease of unknown etiology (CKDu) research conducted in Latin America versus Asia

INTRODUCTION

The incidence of chronic kidney disease of unknown or uncertain etiology (CKDu) is recognized as a global non-communicable health crisis. The goal of this work is to compare the types of research studies in Latin America and Asia, two regions with increasing CKDu incidence.

METHODS

A comparative literature review was conducted to evaluate the CKDu research design for peer-reviewed articles published from 2015 to 2019. Full texts were reviewed to identify study location, study type, study design, risk factors evaluated, and if applicable, sample type and number.

RESULTS

In Asia and Latin America, 82 and 65 articles were identified in total, respectively, with 55 field studies in Asia versus 34 in Latin America. In Asia, research was focused on drinking water (34), heavy metals (20), and agrochemical product usage (19) as potential risk factors. In Latin America, research focused mostly on heat stress/dehydration (36) and agrochemical product usage (18) as potential CKDu risk factors. Biological samples were collected more frequently than environmental samples, especially in Latin America.

DISCUSSION

Research to pinpoint the risk factors associated with CKDu to date is not standardized and typically limited in geographical scope. The emphasis of CKDu research varies by geographic region, with a greater priority placed on water quality and chemical exposure in Asia, versus dehydration and heat stress in Latin America. Using a harmonized approach to CKDu research would yield improved understanding of the risk factors associated with CKDu and how they compare across affected regions.

Using water quality and isotope studies to inform research in chronic kidney disease of unknown aetiology endemic areas in Sri Lanka

Chronic Kidney Disease of unknown aetiology (CKDu) is a major public health concern in dry climatic, agricultural regions of Sri Lanka. The chemistry of groundwater (the main source of drinking water) in the area has been studied extensively, in relation to the occurrence of CKDu. This paper investigates water quality studies published in CKDu affected areas of Sri Lanka and also presents a new data set of 27 hydrochemical and isotopic samples collected from groundwater wells in selected CKDu endemic areas in Sri Lanka. The study outcomes do not provide evidence of pollutants such as heavy metals in groundwater. However, the study identifies elevated concentrations of silica which requires further investigation. Two groups of groundwater have been identified based on the isotopic results suggesting different sources or origins. The available water quality data, including the data from this study, is not sufficient to answer questions on whether the chemistry of groundwater is related to the CKDu occurrence. However, this study identifies the importance of detailed investigation into degradation products of agrochemicals, the organic matter content and the influence of elevate silica concentration in groundwater. The study also provides research directions in the form of isotopic tracers and the frequency of sampling that is needed to capture potential pollutants in future groundwater quality studies in CKDu endemic areas in Sri Lanka.

Kidney developmental effects of metal-herbicide mixtures: Implications for chronic kidney disease of unknown etiology

Chronic kidney disease of unknown etiology (CKDu) is an emerging global concern affecting several agricultural communities in the Americas and South Asia. Environmental contaminants such as heavy metals (e.g., Cd, As, Pb, and V) and organic pesticides (e.g., glyphosate) in the drinking water have been hypothesized to play a role in childhood onset and progression of this disease. However, a comprehensive analysis of chemical contaminants in the drinking water and effects of these compounds and their mixtures on kidney development and function remains unknown. Here, we conducted targeted and non-targeted chemical analyses of sediment and drinking water in CKDu affected regions in Sri Lanka, one of the most affected countries. Using zebrafish Danio rerio, a toxicology and kidney disease model, we then examined kidney developmental effects of exposure to (i) environmentally derived samples from CKDu endemic and non-endemic regions and (ii) Cd, As, V, Pb, and glyphosate as individual compounds and in mixtures. We found that drinking water is contaminated with various organic chemicals including nephrotoxic compounds as well as heavy metals, but at levels considered safe for drinking. Histological studies and gene expression analyses examining markers of kidney development (pax2a) and kidney injury (kim1) showed novel metal and glyphosate-metal mixture specific effects on kidney development. Mitochondrial dysfunction is directly linked to kidney failure, and examination of mixture specific mitochondrial toxicity showed altered mitochondrial function following treatment with environmental samples from endemic regions. Collectively, we show that metals in drinking water, even at safe levels, can impede kidney development at an early age, potentiating increased susceptibility to other agrochemicals such as glyphosate. Drinking water contaminant effects on mitochondria can further contribute to progression of kidney dysfunction and our mitochondrial assay may help identify regions at risk of CKDu.

Effect of Occupational Exposure to Herbicides on Oxidative Stress in Sprayers

Background

Herbicides such as glyphosate, paraquat, and 2,4-dichlorophenoxyacetic acid have been reported to cause adverse side effects through production of reactive oxygen species. However, there were no data representing the adverse effects of a mixture herbicide usage in farmers, especially the changes in oxidative marker and antioxidant defense. This study aimed to determine the urinary malondialdehyde (MDA) and glutathione (GSH) level in farmers using mixed herbicides.

Methods

Ninety-three farmers were recruited, and two spot urine samples (before and after work) were collected. The urinary MDA level was evaluated by thiobarbituric acid reactive substance assay, and the urinary GSH level was determined using the enzymatic recycling method.

Results

Sixty-two percent of the participants were men, and 59% of the participants worked in a farm for 20–40 years. The common combinations of herbicide usage were glyphosate with 2,4-dichlorophenoxyacetic acid (36.5%). There was no significant difference between pre- and post-work urinary MDA and GSH levels among the 3 groups of herbicides. However, the urinary MDA levels in farmers using the combination of glyphosate and paraquat were significantly higher than those found in farmers using glyphosate alone. The associated factors with changes in MDA levels found that the exposure intensity index (B = 0.154), the cumulative exposure intensity index (B = 0.023), and wearing gloves while working (B = −2.347) were found to be significantly associated with MDA level.

Conclusion

The results suggest that the combined use of glyphosate and paraquat caused a significant increase in urinary MDA levels. Moreover, intensity of exposure to herbicide and wearing gloves were associated with the level of MDA.

Separating the Empirical Wheat From the Pseudoscientific Chaff: A Critical Review of the Literature Surrounding Glyphosate, Dysbiosis and Wheat-Sensitivity

The prevalence of digestive disorders has increased globally, as countries have adopted a more "Westernized" diet pattern. A Western diet, characterized as high in fat and refined carbohydrates, can also be defined as a product of increased technology and industrialization. Modern farmers rely on agrochemicals to meet the needs of a growing population, and these chemicals have shifted the Western diet's chemical composition. While the number of individuals choosing to live a wheat-free lifestyle without a celiac disease diagnosis has increased, clinical trials have shown that gluten from wheat is not responsible for causing symptoms in healthy individuals suggesting that something else is inducing symptoms. The herbicide, glyphosate, is applied to wheat crops before harvest to encourage ripening resulting in higher glyphosate residues in commercial wheat products within North America. Glyphosate inhibits the shikimate pathway, a pathway exclusive to plants and bacteria. Glyphosate's effect on dysbiosis was not considered when making safety recommendations. Here, we evaluate the literature surrounding glyphosate's effects on the gut microbiome and conclude that glyphosate residues on food could cause dysbiosis, given that opportunistic pathogens are more resistant to glyphosate compared to commensal bacteria. However, research on glyphosate's effects on the microbiome suffers from numerous methodological weaknesses, and these limitations make it impossible to draw any definitive conclusions regarding glyphosate's influence on health through alterations in the gut microbiome. In this review, we critically evaluate the evidence currently known and discuss recommendations for future studies.

A comprehensive analysis of the animal carcinogenicity data for glyphosate from chronic exposure rodent carcinogenicity studies

Since the introduction of glyphosate-tolerant genetically-modified plants, the global use of glyphosate has increased dramatically making it the most widely used pesticide on the planet. There is considerable controversy concerning the carcinogenicity of glyphosate with scientists and regulatory authorities involved in the review of glyphosate having markedly different opinions. One key aspect of these opinions is the degree to which glyphosate causes cancer in laboratory animals after lifetime exposure. In this review, twenty-one chronic exposure animal carcinogenicity studies of glyphosate are identified from regulatory documents and reviews; 13 studies are of sufficient quality and detail to be reanalyzed in this review using trend tests, historical control tests and pooled analyses. The analyses identify 37 significant tumor findings in these studies and demonstrate consistency across studies in the same sex/species/strain for many of these tumors. Considering analyses of the individual studies, the consistency of the data across studies, the pooled analyses, the historical control data, non-neoplastic lesions, mechanistic evidence and the associated scientific literature, the tumor increases seen in this review are categorized as to the strength of the evidence that glyphosate causes these cancers. The strongest evidence shows that glyphosate causes hemangiosarcomas, kidney tumors and malignant lymphomas in male CD-1 mice, hemangiomas and malignant lymphomas in female CD-1 mice, hemangiomas in female Swiss albino mice, kidney adenomas, liver adenomas, skin keratoacanthomas and skin basal cell tumors in male Sprague-Dawley rats, adrenal cortical carcinomas in female Sprague-Dawley rats and hepatocellular adenomas and skin keratocanthomas in male Wistar rats.

The Introduction of Thousands of Tonnes of Glyphosate in the food Chain-An Evaluation of Glyphosate Tolerant Soybeans

Glyphosate-tolerant (GT) soybeans dominate the world soybean market. These plants have triggered increased use of, as well as increased residues of, glyphosate in soybean products. We present data that show farmers have doubled their glyphosate applications per season (from two to four) and that residues of late season spraying of glyphosate (at full bloom of the plant) result in much higher residues in the harvested plants and products. GT soybeans produced on commercial farms in the USA, Brazil and Argentina accumulate in total an estimated 2500-10,000 metric tonnes of glyphosate per year, which enter global food chains. We also review studies that have compared the quality of GT soybeans with conventional and organic soybeans. Feeding studies in Daphnia magna have shown dose-related adverse effects (mortality, reduced fecundity and delayed reproduction) of glyphosate residues in soybeans, even at glyphosate concentrations below allowed residue levels. We argue that GT soybeans need to be tested in fully representative and realistic contexts. However, the current risk assessment system has only required and received data from field trials with beans that were sprayed with much lower doses of glyphosate as compared to contemporary commercial farms. This has left knowledge gaps and a potentially serious underestimation of health risks to consumers.