Bisphenol A exposure and risk of thyroid nodules in Chinese women: A case-control study

Relationship between bisphenol A and autoimmune thyroid disease in women of childbearing age

Background

Autoimmune thyroid disease (AITD) is the main cause of hypothyroidism in women of childbearing age. Bisphenol A (BPA) is an environmental factor affecting AITD. This study aims to investigate relationship between BPA and AITD in women of childbearing age, thereby contributing novel evidence for the prevention of hypothyroidism in this specific demographic.

Methods

A total of 155 women of childbearing age were enrolled in this study, including the euthyroid group comprised 60 women with euthyroidism and thyroid autoantibodies negativity and the AITD group consisted of 95 women with euthyroidism and at least one thyroid autoantibody positivity. The general information, thyroid function, thyroid autoantibodies, and thyroid ultrasound results of the two groups of women of childbearing age were recorded. Urinary BPA and urinary BPA/creatinine were detected. The difference of BPA levels between the two groups was compared. logistic regression was used to analyze the correlation between BPA and AITD.

Results

The proportion of multiparous and serum thyroid stimulating hormone levels were significantly higher in the AITD group compared to the euthyroid group. Logistic regression analysis revealed that BPA levels did not exhibit a statistically significant association with AITD. Spearman correlation analysis revealed a statistically significant correlation between BPA and urinary iodine levels (r=0.30, P < 0.05), as well as a correlation between urinary BPA and free tetraiodothyronine (FT4) levels (r=0.29, P < 0.05).

Conclusion

This study revealed a correlation between urinary BPA levels and FT4 levels. However, it did not establish a relationship between BPA and AITD in women of childbearing age.

Bisphenol and analogues in indoor dust from E-waste recycling sites, neighboring residential homes, and urban residential homes: Implications for human exposure

The compound 4-hydroxyphenyl 4-isoprooxyphenylsulfone (BPSIP) has recently emerged as a novel alternative to bisphenol A (BPA) and has been found in various paper products. However, there is limited information available regarding the identification of BPSIP as a novel contaminant in the e-waste dismantling area. In our research, we conducted a comprehensive analysis of 16 bisphenol analogues (BPs), including BPSIP, within indoor dust samples obtained from a representative e-waste recycling facility, neighboring rural communities, and control urban communities. Out of the 16 target BPs, ten were found in both e-waste and local household dust, while only six BPs were identified in the control urban household dust. Bisphenol A (BPA) remained the predominant compound, followed by bisphenol F (BPF), bisphenol S (BPS), BPSIP and bisphenol AF (BPAF). The total concentrations of BPs in e-waste dust were notably higher compared to both local and urban household dust (p < 0.01), with BPA and BPF, in particular, exhibiting significantly elevated levels. Importantly, BPSIP was first identified in e-waste dust, and its concentration significantly exceeded that of the commonly used BPA alternative, BPAF, which justifiably merits increasing concern. Correlation analysis indicated that BPs were commonly used in the production of electronic products, and e-waste dismantling activities contributed significantly to their widespread emission. The daily intakes of BP through dust ingestion for these three population groups exceeded the recently established tolerable daily intake for BPA, especially among e-waste dismantling workers. This represents the first report indicating that e-waste recycling is causing substantial emissions of multiple bisphenol analogues, including a novel contaminant.

Exploration and validation of key genes associated with early lymph node metastasis in thyroid carcinoma using weighted gene co-expression network analysis and machine learning

Background

Thyroid carcinoma (THCA), the most common endocrine neoplasm, typically exhibits an indolent behavior. However, in some instances, lymph node metastasis (LNM) may occur in the early stages, with the underlying mechanisms not yet fully understood.

Materials and methods

LNM potential was defined as the tumor's capability to metastasize to lymph nodes at an early stage, even when the tumor volume is small. We performed differential expression analysis using the 'Limma' R package and conducted enrichment analyses using the Metascape tool. Co-expression networks were established using the 'WGCNA' R package, with the soft threshold power determined by the 'pickSoftThreshold' algorithm. For unsupervised clustering, we utilized the 'ConsensusCluster Plus' R package. To determine the topological features and degree centralities of each node (protein) within the Protein-Protein Interaction (PPI) network, we used the CytoNCA plugin integrated with the Cytoscape tool. Immune cell infiltration was assessed using the Immune Cell Abundance Identifier (ImmuCellAI) database. We applied the Least Absolute Shrinkage and Selection Operator (LASSO), Support Vector Machine (SVM), and Random Forest (RF) algorithms individually, with the 'glmnet,' 'e1071,' and 'randomForest' R packages, respectively. Ridge regression was performed using the 'oncoPredict' algorithm, and all the predictions were based on data from the Genomics of Drug Sensitivity in Cancer (GDSC) database. To ascertain the protein expression levels and subcellular localization of genes, we consulted the Human Protein Atlas (HPA) database. Molecular docking was carried out using the mcule 1-click Docking server online. Experimental validation of gene and protein expression levels was conducted through Real-Time Quantitative PCR (RT-qPCR) and immunohistochemistry (IHC) assays.

Results

Through WGCNA and PPI network analysis, we identified twelve hub genes as the most relevant to LNM potential from these two modules. These 12 hub genes displayed differential expression in THCA and exhibited significant correlations with the downregulation of neutrophil infiltration, as well as the upregulation of dendritic cell and macrophage infiltration, along with activation of the EMT pathway in THCA. We propose a novel molecular classification approach and provide an online web-based nomogram for evaluating the LNM potential of THCA (http://www.empowerstats.net/pmodel/?m=17617_LNM). Machine learning algorithms have identified ERBB3 as the most critical gene associated with LNM potential in THCA. ERBB3 exhibits high expression in patients with THCA who have experienced LNM or have advanced-stage disease. The differential methylation levels partially explain this differential expression of ERBB3. ROC analysis has identified ERBB3 as a diagnostic marker for THCA (AUC=0.89), THCA with high LNM potential (AUC=0.75), and lymph nodes with tumor metastasis (AUC=0.86). We have presented a comprehensive review of endocrine disruptor chemical (EDC) exposures, environmental toxins, and pharmacological agents that may potentially impact LNM potential. Molecular docking revealed a docking score of -10.1 kcal/mol for Lapatinib and ERBB3, indicating a strong binding affinity.

Conclusion

In conclusion, our study, utilizing bioinformatics analysis techniques, identified gene modules and hub genes influencing LNM potential in THCA patients. ERBB3 was identified as a key gene with therapeutic implications. We have also developed a novel molecular classification approach and a user-friendly web-based nomogram tool for assessing LNM potential. These findings pave the way for investigations into the mechanisms underlying differences in LNM potential and provide guidance for personalized clinical treatment plans.

Sex-specific association of exposure to a mixture of phenols, parabens, and phthalates with thyroid hormone and antibody levels in US adolescents and adults

Individuals are exposed to multiple phenols, parabens, and phthalates simultaneously since they are important endocrine-disrupting compounds (EDCs) and share common exposure pathways. It is necessary to assess the effects of the co-exposure of these EDCs on thyroid hormones (THs). In this study, data included 704 adolescents and 2911 adults from the 2007-2012 National Health and Nutrition Examination Survey (NHANES). Serum THs measured total triiodothyronine (T3), total thyroxine (T4), free forms of T3 (FT3) and T4 (FT4), thyroid-stimulating hormone (TSH), thyroglobulin (Tg), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb). And 16 EDCs (3 phenols, 2 parabens, and 11 phthalates) were measured from urine. The relationship between single EDCs and single THs was analyzed using generalized linear regression. And results showed that several EDCs were positively associated with serum T3 and FT3 levels in boys but negatively associated with serum T4 and FT4 levels in girls. And in adults, five EDCs were negatively associated with T3, T4, or FT4. The effects of co-exposure to 16 EDCs on THs were calculated using Bayesian kernel machine regression and quantile-based g-computational modeling, confirmed that co-exposure was related to the increase of T3 in adolescents and the decrease of T4 in both adolescents and adults. Besides, nonlinear and linear relationships were identified between co-exposure and the risk of positive TPOAb and TgAb in girls and adult females, respectively. In conclusion, phenols, parabens, and phthalates as a mixture might interfere the concentrations of THs and thyroid autoantibodies, and the interfering effect varies significantly by sex as well as by age. Further prospective research is warranted to investigate the causal effects and underlying mechanisms of co-exposure on thyroid dysfunction.

Bisphenol analogues induce thyroid dysfunction via the disruption of the thyroid hormone synthesis pathway

Bisphenol analogues are widely used in industrial and daily-use consumer products having imperfect thyroid hormones (THs) structures. Widespread exposure interferes with thyroid-related health outcomes in human. The mechanisms of disruption on TH synthesis and subsequent thyroid dysfunction by different bisphenol analogues remain unclear. Here, we evaluated bisphenol-induced thyroid endocrine disruption in C57BL/6 mice at doses of 0.002, 0.02, 2, and 20 mg/kg body weight/day (BW/d) for five consecutive weeks. Administration of 20 mg/kg BW/d bisphenol S (BPS) and 2 mg/kg BW/d tetrabromobisphenol S (TBBPS) significantly increased serum thyrotropin (TSH) levels to 1.21-fold and 1.20-fold of control group, respectively, indicating that bisphenols induced thyroid dysfunction in mice. Height of the thyroid follicle epithelium significantly increased to 1.27-, 1.24-, 1.26-, and 1.36-fold compared to control group with BPA, BPS, TBBPA, and TBBPS at 20 mg/kg BW/d, respectively, indicating impairment of the thyroid gland structure, and TBBPS showed potent effect. Exposure to bisphenol analogues of 0.02 mg/kg BW/d downregulated the protein expression levels of thyrotropin receptor, the sodium/iodide symporter, thyroperoxidase. The TH-dependent effects were further determined using the T-Screen assay at 10-11 M to 10-5 M concentrations. Bisphenol analogues significantly decreased TH-dependent GH3 cell proliferation, indicating the antagonistic activity of bisphenol analogues. The gene responsible for THs synthesis of thyrotropin releasing hormone receptor and TSH were upregulated, but downregulation of thyroid receptor β was observed. Our results suggest that bisphenol analogues distinctly induce thyroid dysfunction via TH synthesis, implying adverse effect of bisphenol analogues on TH homeostasis and subsequent physiological processes.

Thyroid disrupting effects of multiple metals exposure: Comprehensive investigation from the thyroid parenchyma to hormonal function in a prospective cohort study

This study aimed to investigate the thyroid disrupting effects of multiple metals exposure with comprehensive investigation from the thyroid parenchyma to hormonal function. In this prospective cohort study of in-service staff of the Baoding Power Supply, we found that arsenic was negatively associated with total thyroxine (TT4) [βAs = -0.075, 95% confidence interval (CI): -0.129, -0.020, Padj = 0.04]. Similarly, selenium was negatively correlated with TT4 (βSe = -0.134, 95% CI: -0.211, -0.058, Padj < 0.01) and peripheral deiodinase activity (GT) (βSe = -0.133, 95% CI: -0.210, -0.056, Padj = 0.01). With respect to strontium, there were positive associations of strontium with thyroid-stimulating hormone (βSr = 0.263, 95% CI: 0.112, 0.414, Padj = 0.01), and negative associations of strontium with TT4 (βSr = -0.099, 95% CI: -0.150, -0.048, Padj < 0.01) and GT (βSr = -0.102, 95% CI: -0.153, -0.050, Padj < 0.01). We also observed negative associations of metal mixtures with TT4 and GT and potential interactions. Increased risks of thyroid nodule associated with aluminum, cobalt and nickel were also observed. Our findings suggest that multiple metals exposure leads to a multi-pronged assault to thyroid from the thyroid parenchyma to hormonal function. Future large-scale prospective cohort studies of general population and experimental studies were warranted.

Association of urinary bisphenols with thyroid function in the general population: a cross-sectional study of an industrial park in China

Bisphenols (BPs) are potential thyroid disruptors that are widely used in many consumer products, leading to their widespread exposure in the general population. Current cross-sectional and case-control studies have found associations between exposure to BPs and serum thyroid function, but the results were contradictory. The objectives of this study are to describe demographic characteristics, BP exposure levels, and thyroid function measurements in potentially exposed and control districts and to investigate the association of urinary BPs with thyroid function. Data were collected from a general population aged 3-79 years (N = 281) recruited by the Zhejiang Human Biomonitoring Program (ZJHBP). The concentrations of 10 kinds of BPs in urine and serum free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), thyroid-stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibodies (TgAb), thyroid peroxidase antibodies (TPOAb), and thyrotropin receptor antibody (TRAb) in serum were measured. Multiple linear regression and weighted quantile sum (WQS) regression were used to estimate the relationship between single and mixed exposure of BPs and thyroid function. Bisphenol A (BPA), bisphenol S (BPS), and bisphenol P (BPP) were detected, respectively, in 82.73%, 94.24%, and 55.40% of the population in the exposed area and 81.69%, 61.27%, and 43.66% of the population in the control area. Among adult females, serum TT3 was negatively associated with urinary BPA (β = -0.033, 95% CI = -0.071, -0.008, P = 0.021). Among minor females, FT4 and Tg levels were negatively associated with the urinary BPA (β = -0.026, 95% CI = -0.051, -0.002, P = 0.032 for FT4; β = -0.129, 95% CI = -0.248, -0.009, P = 0.035 for Tg), and TPOAb was positively associated with urinary BPA (β = 0.104, 95% CI = 0.006, 0.203, P = 0.039). In WQS models, BPs mixture was positively associated with FT3 (βWQS = 0.022, 95% CI = 0.002, 0.042) and TT3 (βWQS = 0.033, 95% CI = 0.004, 0.062), and negatively associated with FT4 (βWQS = -0.024, 95% CI = -0.044, 0.004). We found widespread exposure to BPA, BPS, and BPP in the general population of Zhejiang province and found an association between BPA and thyroid hormones. This association is gender- and age-dependent and needs to be confirmed in further studies.

Association of polycyclic aromatic hydrocarbon internal exposure and urinary iodine concentration with thyroid volume in children

Thyroid volume was proposed as a factor for malignancy in evaluating thyroid nodules. Previous studies have demonstrated the endocrine disrupting effect of polycyclic aromatic hydrocarbons (PAHs), but studies on the association between internal exposure of PAHs and thyroid volume are still scarce. In this work, we evaluated the association of polycyclic aromatic hydrocarbon internal exposure and urinary iodine concentration with thyroid volume in 590 school-age children without thyroid disease in Guangzhou, China. Urinary hydroxylated polycyclic aromatic hydrocarbons (OH-PAHs), urinary iodine concentrations, and thyroid volumes were measured. The mean concentrations of urinary iodine and ΣOH-PAHs were 271.1 μg/L and 3.27 μg/L, respectively, and the mean thyroid volume was 2.4 mL. The associations of urinary iodine and OH-PAH concentrations with thyroid volume were investigated by multivariable linear regression and the Bayesian kernel machine regression models. Urinary ΣOH-PAHs were observed to be significantly positively associated with thyroid volume in multivariable linear regression models. The increase in each unit in the log-transformed concentration of ΣOH-PAHs caused 3.88% change in thyroid volume. The Bayesian kernel machine regression model demonstrated a positive joint effect of increased urinary ΣOH-PAHs on thyroid volume. Moreover, urinary ΣOH-PAHs were statistically significant linked to urinary iodine, and iodine mediated the relationship between urinary OH-PAHs and thyroid volume with the mediated proportions of 15.2.

Human Exposure to Bisphenols, Parabens, and Benzophenones, and Its Relationship with the Inflammatory Response: A Systematic Review

Bisphenols, parabens (PBs), and benzophenones (BPs) are widely used environmental chemicals that have been linked to several adverse health effects due to their endocrine disrupting properties. However, the cellular pathways through which these chemicals lead to adverse outcomes in humans are still unclear, suggesting some evidence that inflammation might play a key role. Thus, the aim of this study was to summarize the current evidence on the relationship between human exposure to these chemicals and levels of inflammatory biomarkers. A systematic review of peer-reviewed original research studies published up to February 2023 was conducted using the MEDLINE, Web of Science, and Scopus databases. A total of 20 articles met the inclusion/exclusion criteria. Most of the reviewed studies reported significant associations between any of the selected chemicals (mainly bisphenol A) and some pro-inflammatory biomarkers (including C-reactive protein and interleukin 6, among others). Taken together, this systematic review has identified consistent positive associations between human exposure to some chemicals and levels of pro-inflammatory biomarkers, with very few studies exploring the associations between PBs and/or BPs and inflammation. Therefore, a larger number of studies are required to get a better understanding on the mechanisms of action underlying bisphenols, PBs, and BPs and the critical role that inflammation could play.

The Emerging Role of Epigenetics in Metabolism and Endocrinology

Each cell in a multicellular organism has its own phenotype despite sharing the same genome. Epigenetics is a somatic, heritable pattern of gene expression or cellular phenotype mediated by structural changes in chromatin that occur without altering the DNA sequence. Epigenetic modification is an important factor in determining the level and timing of gene expression in response to endogenous and exogenous stimuli. There is also growing evidence concerning the interaction between epigenetics and metabolism. Accordingly, several enzymes that consume vital metabolites as substrates or cofactors are used during the catalysis of epigenetic modification. Therefore, altered metabolism might lead to diseases and pathogenesis, including endocrine disorders and cancer. In addition, it has been demonstrated that epigenetic modification influences the endocrine system and immune response-related pathways. In this regard, epigenetic modification may impact the levels of hormones that are important in regulating growth, development, reproduction, energy balance, and metabolism. Altering the function of the endocrine system has negative health consequences. Furthermore, endocrine disruptors (EDC) have a significant impact on the endocrine system, causing the abnormal functioning of hormones and their receptors, resulting in various diseases and disorders. Overall, this review focuses on the impact of epigenetics on the endocrine system and its interaction with metabolism.

A case-control study of urinary concentrations of bisphenol A, bisphenol F, and bisphenol S and the risk of papillary thyroid cancer

The incidence of thyroid cancer (TC), especially papillary thyroid cancer (PTC), has dramatically increased globally. Whereas some endocrine disruptors have been linked to neoplastic processes, the associations between human exposure to bisphenol analogs and the risk of TC remain unclear. This present case-control study examined the associations between the urinary concentrations of bisphenol A (BPA) and other bisphenols, namely bisphenol F (BPF) and bisphenol S (BPS), and the risk of PTC. After adjusting for confounders and creatinine standardization, significantly positive associations were observed for BPF (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.27-2.54), but negative associations observed for BPA (OR = 0.38, 95% CI = 0.19-0.77) and BPS (OR = 0.63, 95% CI = 0.43-0.93), in the total population. However, after stratification by age and smoking, statistical significance was retained only in non-smoking women, suggesting the adverse effects of BPF exposure on PTC risk, especially in women. These findings require replication and confirmation in further research.

Iodine as a potential endocrine disruptor-a role of oxidative stress

PURPOSE

Iodine is an essential micronutrient required for thyroid hormone biosynthesis. However, overtreatment with iodine can unfavorably affect thyroid physiology. The aim of this review is to present the evidence that iodine-when in excess-can interfere with thyroid hormone synthesis and, therefore, can act as a potential endocrine-disrupting chemical (EDC), and that this action, as well as other abnormalities in the thyroid, occurs-at least partially-via oxidative stress.

METHODS

We reviewed published studies on iodine as a potential EDC, with particular emphasis on the phenomenon of oxidative stress.

RESULTS

This paper summarizes current knowledge on iodine excess in the context of its properties as an EDC and its effects on oxidative processes.

CONCLUSION

Iodine does fulfill the criteria of an EDC because it is an exogenous chemical that interferes-when in excess-with thyroid hormone synthesis. However, this statement cannot change general rules regarding iodine supply, which means that iodine deficiency should be still eliminated worldwide and, at the same time, iodine excess should be avoided. Universal awareness that iodine is a potential EDC would make consumers more careful regarding their diet and what they supplement in tablets, and-what is of great importance-it would make caregivers choose iodine-containing medications (or other chemicals) more prudently. It should be stressed that compared to iodine deficiency, iodine in excess (acting either as a potential EDC or via other mechanisms) is much less harmful in such a sense that it affects only a small percentage of sensitive individuals, whereas the former affects whole populations; therefore, it causes endemic consequences.

Environmental endocrine disruptor concentrations in urine samples from Mexican Indigenous women

The Indigenous communities in Mexico show significant degrees of vulnerability to pollution due to the lack of knowledge of health risks, traditions, low levels of support, and restricted access to healthcare. As a result, exposure to environmental endocrine disruptors increases in these populations through plastic components or indoor air pollution. Therefore, the aim of the study was to evaluate the exposure to phthalate metabolites, 1-hydroxypyrene, and bisphenol A through biomonitoring data from indigenous Mexican women. A total of 45 women from the Tocoy community in San Luis Potosí, Mexico, were included. Urine samples were analyzed for Bisphenol A and 4 phthalate metabolites by ultra-performance liquid chromatography couples to tandem mass spectrometry; additionally, the 1-hydroxypyrene concentrations were evaluated by high-performance liquid chromatography coupled to a fluorescence detector. Among the main pollution sources were the use of plastic containers and burning garbage (98-100%). Indigenous women presented an exposure of 100% to mono-2-ethyl phthalate, mono-n-butyl phthalate, and 1-hydroxypyrene, with a median (25th-75th percentiles) of 17,478 (11,362-37,355), 113.8 (61.7-203.5), and 1.2 (0.9-1.7) µg/g creatinine, respectively. The major findings show urinary mono-2-ethyl phthalate concentrations higher than those measured from other studies. Therefore, these results show an impressive exposure to di(2-ethylhexyl) phthalate in Indigenous women. The current study reflects the absence of regulatory policies in marginalized populations. It highlights the need to design strategies that mitigate exposure and the importance of biological monitoring to evaluate and prevent health risk associated with exposure to environmental endocrine disruptors.

Lipidomic biomarkers: Potential mediators of associations between urinary bisphenol A exposure and colorectal cancer

Previous research reported associations between bisphenol A (BPA) exposure and some malignant tumor incidences, yet the underlying mechanism remains largely uncertain. This investigation was aimed to explore the association of BPA exposure burden with colorectal cancer (CRC) and the role of tumor tissue lipid metabolism in the associations between BPA and CRC using lipidomic approach. Urinary BPA levels in CRC cases were significantly higher than those in controls (P value < 0.05). BPA was positively correlated with all three serum CRC biomarkers, with an estimated odds ratio (OR) of 4.45 (95% confidence interval (95% CI): [1.31, 15.14]) between the highest and lowest tertiles of exposure. Lipidomic screening of tumor samples suggested significant perturbation in the glycerophospholipid metabolism pathway, of which phosphatidylcholine (PC 34:0), phosphatidylcholine (PC 37:1), phosphatidylethanolamine (PE 34:2), triacylglycerol (TG 56:4) demonstrated mediation contribution of 21.9%, 18.7%, 18.4% and 27.39%, respectively, in the association between BPA exposure and CRC. Our work provides novel findings that cancer tissue metabolites may be playing vital mediating roles in the associations between BPA exposure burden and CRC risk. These findings contribute to better understanding of the etiology of CRC induced by environmental stressors.

Bisphenol A drives di(2-ethylhexyl) phthalate promoting thyroid tumorigenesis via regulating HDAC6/PTEN and c-MYC signaling

Bisphenol A (BPA) and di-(2-ethylhcxyl) phthalate (DEHP) are exist widespread in the environment and produce adverse effect to human as environmental disruptors (EDCs). Epidemiological studies have found that the exposure of DEHP and BPA could increase the susceptibility to thyroid diseases including thyroid cancer and benign thyroid nodules. Due to the existence of multiple pollutants in our daily life, the mixed toxic effects of exposure and their interrelationships may distinguish from the exposure to a single chemical, so it is of great significance to explore the mixed toxic effect of DEHP and BPA co-exposure. Thyroid, as one of the target organs of EDCs, is prone to tumor occurrence, however, whether the mixture of BPA and DEHP will affect the occurrence of thyroid cancer is still obscure. We aim to investigate the effect of single or combined exposure to BPA and DEHP on the occurrence of thyroid cancer. An animal model of exposure to BPA and DEHP was firstly established to evaluate their effect on DMD-induced thyroid cancer. Additionally, human thyroid cancer cells BCPAP and thyroid cells Nthy-ori3-1 were used to further clarify some possible mechanisms of BPA and MEHP, the main metabolite of DEHP. Consequently, we found that BPA alone could increase the incidence of thyroid tumors in female rats compared with DEHP, and DEHP enhanced the effect of BPA on cancer promotion. BPA alone and in combination with DEHP mainly induced the expression of HDAC6, inhibited tumor suppressor gene PTEN upregulated the expression of oncogene c-MYC, and eventually elevate the susceptibility to thyroid tumors. Mechanistically, BPA alone and in combination with MEHP could significantly induce the proliferation of BCPAP cells depending on HDAC6, which could modulate H3K9ac to inhibit PTEN, activate AKT signaling pathway, and simultaneously upregulate the expression of c-MYC. Interestingly, we found that BPA alone and in combination with MEHP could significantly induce the proliferation of Nthy-ori3-1 cells independent on HDAC6 via activating ERK signaling pathway. Taken together, these findings not only provide new evidence of the promoting effect of BPA and DEHP on thyroid cancer but also discusses some possible mechanisms underlying these effects.

Lack of Association Between Helicobacter pylori Infection and the Risk of Thyroid Nodule Types: A Multicenter Case-Control Studyin China

The prevalence of Helicobacter pylori infection is high worldwide, while numerous research has focused on unraveling the relationship between H. pylori infection and extragastric diseases. Although H. pylori infection has been associated with thyroid diseases, including thyroid nodule (TN), the relationship has mainly focused on potential physiological mechanisms and has not been validated by large population epidemiological investigations. Therefore, we thus designed a case-control study comprising participants who received regular health examination between 2017 and 2019. The cases and controls were diagnosed via ultrasound, while TN types were classified according to the guidelines of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). Moreover, H. pylori infection was determined by C14 urea breath test, while its relationship with TN type risk and severity was analyzed using binary and ordinal logistic regression analyses. A total of 43,411 participants, including 13,036 TN patients and 30,375 controls, were finally recruited in the study. The crude odds ratio (OR) was 1.07 in Model 1 (95% CI = 1.03-1.14) without adjustment compared to the H. pylori non-infection group. However, it was negative in Model 2 (OR = 1.02, 95% CI = 0.97-1.06) after being adjusted for gender, age, body mass index (BMI), and blood pressure and in Model 3 (OR = 1.01, 95% CI = 0.97-1.06) after being adjusted for total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein on the basis of Model 2. Control variables, including gender, age, BMI, and diastolic pressure, were significantly correlated with the risk of TN types. Additionally, ordinal logistic regression results revealed that H. pylori infection was positively correlated with malignant differentiation of TN (Model 1: OR = 1.06, 95% CI = 1.02-1.11), while Model 2 and Model 3 showed negative results (Model 2: OR = 1.01, 95% CI = 0.96-1.06; Model 3: OR = 1.01, 95% CI = 0.96-1.05). In conclusion, H. pylori infection was not significantly associated with both TN type risk and severity of its malignant differentiation. These findings provide relevant insights for correcting possible misconceptions regarding TN type pathogenesis and will help guide optimization of therapeutic strategies for thyroid diseases.

Internal exposure of Chinese children from a typical coastal city to bisphenols and possible association with thyroid hormone levels

Bisphenols (BPs) are widely used in consumer products, and human exposure to BPs is nearly ubiquitous. However, human biomonitoring data are scarce, especially for children. In this study, we quantified eight BPs in the serum of 345 children from a typical coastal city in China. Bisphenol A (BPA), bisphenol F (BPF), and bisphenol S (BPS) were frequently detected (63% BPA, 68% BPF, 43% BPS), with geometric mean (GM) concentrations of 1.6, 0.08, and 0.04 ng/mL, respectively. The other five BPs had low detection frequencies (<5%). The distribution of BPA, BPF, and BPS in children's serum samples was independent of sex whereas the concentrations of BPS and BPF both significantly increased with age (P < 0.01). The GM values of estimated daily intake for BPA and BPS were 0.61 and 0.014 μg/kg body weight (bw)/day, respectively, indicating a relatively higher exposure risk of BPA in comparison with BPS. Compared with the population with euthyroid or nonhyperthyroid thyroid dysfunction, children with hyperthyroidism suffered higher exposure to BPA. By multiple linear regression analysis, thyroid-stimulating hormone showed a significantly negative relationship with log₁₀-BPA concentration for euthyroid children (R² = 0.477, P < 0.001), whereas a significantly positive correlation (R² = 0.753, P = 0.033) was found for hyperthyroid children.

Bisphenol A as a Factor in the Mosaic of Autoimmunity

The population worldwide is largely exposed to bisphenol A (BPA), a commonly used plasticizer, that has a similar molecular structure to endogenous estrogens. Therefore, it is able to influence physiological processes in human body, taking part in the pathophysiology of various endocrinopathies, as well as, cardiovascular, neurological and oncological diseases. BPA has been found to affect the immune system, leading to the development of autoimmunity and allergies, too. In the last few decades, the prevalence of autoimmune diseases has significantly increased, that could be explained by a rising exposure of the population to environmental factors, such as BPA. BPA has been found to play a role in the pathogenesis of systemic autoimmune diseases and also organ-specific autoimmunity (thyroid autoimmunity, diabetes mellitus type 1, myocarditis, inflammatory bowel disease, multiple sclerosis, encephalomyelitis etc), but the results of some studies remain still controversial, so further research is needed.

A comprehensive review on the carcinogenic potential of bisphenol A: clues and evidence

Bisphenol A [BPA; (CH₃)₂C(C₆H₄OH)₂] is a synthetic chemical used as a precursor material for the manufacturing of plastics and resins. It gained attention due to its high chances of human exposure and predisposing individuals at extremely low doses to diseases, including cancer. It enters the human body via oral, inhaled, and dermal routes as leach-out products. BPA may be anticipated as a probable human carcinogen. Studies using in vitro cell lines, rodent models, and epidemiological analysis have convincingly shown the increasing susceptibility to cancer at doses below the oral reference dose set by the Environmental Protection Agency for BPA. Furthermore, BPA exerts its toxicological effects at the genetic and epigenetic levels, influencing various cell signaling pathways. The present review summarizes the available data on BPA and its potential impact on cancer and its clinical outcome.

Urinary Biomarkers of Phthalates Exposure, Blood Lead Levels, and Risks of Thyroid Nodules

Thyroid nodules (TNs) are becoming increasingly prevalent. However, few studies have reported the effects of phthalates and lead (Pb) on TNs. In this study, we aimed to explore the associations of phthalates and Pb with the risks of TN. We sex-age-matched 220 TNs patients and 220 healthy controls from Zhejiang Shangyu, China. We measured 13 phthalate metabolites in spot urine samples. Blood lead levels (BLLs) were determined by atomic absorption spectrometry. The multivariable logistic regression models were used to assess the associations between urinary phthalate metabolites and BLLs and the risks of TNs. We found BLLs were associated with increased risk of TNs in total population. Female-specific positive associations of mono-2-ethyl-5-carboxypentylphthalate (MECPP), mono-2-ethyl-5-hydroxyhexylphthalate (MEHHP), mono-2-ethyl-5-oxohexylphthalate (MEOHP), mono-2-carboxymethyl-hexyl phthalate (MCMHP), and mono-isononyl phthalate (MiNP) with increased risk of TNs were also observed. Moreover, the positive association between phthalates and TNs was modified by BLLs. At the highest tertile of BLLs, monoethylphthalate (MEP), MECPP, MEHHP, MEOHP, and MiNP were significantly associated with increased risk of TNs. Our results indicated that certain phthalate metabolites and BLLs may contribute to increased risks of TNs.

Serum concentration of bisphenol A in elderly cats and its association with clinicopathological findings

OBJECTIVES

Bisphenol A (BPA) has been mentioned as a possible factor contributing to feline hyperthyroidism. Nevertheless, there are no previous studies reporting on the concentration of BPA in feline serum and its association with thyroid function. The objectives of this study were to measure serum BPA concentration in cats aged ⩾7 years, considered as healthy by their owners, and to compare the results with clinicopathological findings.

METHODS

Sixty-nine cats aged ⩾7 years considered as healthy by their owners were enrolled in the study. The concentration of BPA in feline serum was measured using liquid chromatography-tandem mass spectrometry. In all cats, signalment, living environment, diet history, and the results of haematological and biochemical analysis, including thyroxine levels, were available.

RESULTS

The mean serum BPA concentration in feline serum was 1.06 ± 0.908 ng/ml. Significant correlation was found between BPA concentration and haemoglobin (r = 0.3397; P = 0.0043), haematocrit (r = 0.3245; P = 0.0065) and the number of red blood cells (r = 0.2916; P = 0.0151), concentration of total protein (r = 0.2383; P = 0.0486), concentration of calcium (r = 0.3915; P = 0.0009) and level of bilirubin (r = 0.3848; P = 0.0011). No other significant correlations were found. Significant differences (P <0.01) were found between mature (1.28 ± 0.994 ng/ml) and geriatric cats (0.420 ± 0.240 ng/ml), between strictly indoor cats (1.27 ± 0.992 ng/ml) and cats with outdoor access (0.660 ± 0.529 ng/ml), and between cats fed canned food (1.23 ± 0.935 ng/ml) and cats fed non-canned food (0.774 ± 0.795 ng/ml).

CONCLUSIONS AND RELEVANCE

Measurable serum BPA levels were found in all examined samples. The age of the cats was revealed as a significant factor affecting BPA concentration and mature cats had the highest levels. A significantly higher concentration of BPA was found in cats living strictly indoors and in cats fed canned food. No association was found between BPA and thyroid function. Further studies are needed that focus on hyperthyroid cats for better evaluation of this relationship.

Six Air Pollutants Associated With Increased Risk of Thyroid Nodules: A Study of 4.9 Million Chinese Adults

BACKGROUND

Thyroid nodules has become a significant public health issue worldwide with a rapidly increasing prevalence. However, its association with outdoor air pollution remains poorly understood. We aim to investigate the relationship between six outdoor air pollutants (PM_2.5, PM₁₀, NO₂, SO₂, CO, and O₃) and the risk of thyroid nodules.

METHODS

We utilized a database including 4,920,536 participants who attended the annual physical examinations in the Meinian HealthCare Screening Center in 157 Chinese cities in 2017. City-specific concentrations of six pollutants (PM_2.5, PM₁₀, NO₂, SO₂, CO, and O₃) from 2015 to 2017 were estimated based on the China's National Urban Air Quality Real Time Publishing Platform. Thyroid nodule was measured with ultrasound. Multivariable Logistic regression was used to examine the associations between air pollutants and thyroid nodules with adjustment for age, sex, education, smoking, body mass index, fasting blood glucose, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, urine iodine, gross domestic product, and thyroid stimulating hormone. We conducted stratified analyses to investigate potential effect modification by sex, age, and urine iodine groups.

RESULTS

Approximately 38% of the participants (1,869,742) were diagnosed with thyroid nodules. Each of the six air pollutants was significantly and linearly associated with the risk for thyroid nodules. The adjusted odds ratios [95% CI] for every increase of 10 μg/m³ for PM_2.5, PM₁₀, NO₂, SO₂, and O₃ were 1.062 [1.061, 1.064], 1.04 [1.03, 1.04], 1.10 [1.09, 1.10], 1.11 [1.11, 1.12], and 1.151 [1.149, 1.154], respectively; The odds ratio for each increase of 1 mg/m³ for CO was 1.50 [1.49 to 1.52]. Furthermore, these associations were significantly higher in the participants who were men, younger, or having lower urine iodine level (p <0.001).

CONCLUSION

The six air pollutants may contribute to the high prevalence of thyroid nodules in China.

Urinary Iodine and Genetic Predisposition to Hashimoto's Thyroiditis in a Chinese Han Population: A Case-Control Study

Background: We aimed to examine the association of urinary iodine concentration with Hashimoto's thyroiditis (HT) risk, and particularly, to investigate whether the HT-related genetic variations might modify the effects of urinary iodine on HT in the Chinese Han population. Methods: We conducted a case-control study with 1723 Chinese (731 cases, 992 controls). The associations between urinary iodine concentration and HT risk were analyzed using logistic regression models. The effects of interactions between the genetic risk scores (GRSs) and urinary iodine on HT risk were assessed by including the respective interaction terms in the models. We also applied restricted cubic spline regression to estimate the possible nonlinear relationship. The multinomial logistic regression models were performed to determine the associations of urinary iodine with euthyroid-HT and hypothyroidism-HT. Results: After controlling for potential confounders, the odds of HT increased with increasing quartiles of urinary iodine concentration: adjusted odds ratios (ORs) and 95% confidence intervals [CIs] were 1.45 [1.06-1.99], 1.66 [1.17-2.34], and 2.07 [1.38-3.10] for the quartiles 2, 3, and 4, respectively, compared with the first quartile (p for trend <0.001). Multivariable restricted cubic spline regression analysis further demonstrated that there was a near-linear association between urinary iodine concentration and HT risk (p-overall <0.001; p-nonlinear = 0.074). However, we did not find significant interactions between urinary iodine and GRSs on the risk of HT (all p for interaction >0.05). Interestingly, we found that each increment of urinary iodine was associated with a more than twofold increase in the odds of hypothyroidism-HT (adjusted OR = 2.64 [CI = 1.73-4.05]), but not with euthyroid-HT (p > 0.05). Conclusions: Higher urinary iodine concentration was associated with increased risk of HT, and this association was near linear, indicating that increased urinary iodine has a continuous and graded impact on HT risk. Moreover, the iodine-HT association was not modified by genetic predisposition to HT. Interestingly, urinary iodine concentration was significantly associated with increased risk of hypothyroidism.

New Insights into Mechanisms of Endocrine-Disrupting Chemicals in Thyroid Diseases: The Epigenetic Way

In recent years, the presence in the environment of chemical compounds with thyroid-disrupting effects is progressively increased. This phenomenon has risen concern for human health as the preservation of thyroid system homeostasis is essential for fetal development and for maintaining psychological and physiological wellbeing. An increasing number of studies explored the role of different classes of toxicants in the occurrence and severity of thyroid diseases, but large epidemiological studies are limited and only a few animal or in vitro studies have attempted to identify the mechanisms of chemical action. Recently, epigenetic changes such as alteration of methylation status or modification of non-coding RNAs have been suggested as correlated to possible deleterious effects leading to different thyroid disorders in susceptible individuals. This review aims to analyze the epigenetic alterations putatively induced by chemical exposures and involved in the onset of frequent thyroid diseases such as thyroid cancer, autoimmune thyroiditis and disruption of fetal thyroid homeostasis.

Association of bisphenol A or bisphenol S exposure with oxidative stress and immune disturbance among unexplained recurrent spontaneous abortion women

Human exposure to environmental chemicals might play a role in the pathogenesis of unexplained recurrent spontaneous abortion (URSA). Bisphenol A (BPA) and bisphenol S (BPS) have been suggested to affect reproductive health. However, the mechanism remains unclear. To explore the association between BPA and BPS exposure and oxidative stress and immune homeostasis, we conducted a cross-sectional study and revealed BPA and BPS levels in relation to these two factors which were supposed to be implicated in miscarriage. 111 URSA patients were recruited and we analyzed urinary BPA and BPS concentrations, oxidative stress biomarkers (8-hydroxydeoxyguanosine and 8-isoprostane) and serum immune balance biomarkers (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, TNF-α, TGF-β and IFN-γ). Multivariable linear regression models were used to evaluate the correlation between bisphenols exposure and outcome biomarkers. After adjustment for age, BMI, menstrual cycle, and parity history, creatinine-adjusted BPA was significantly associated with increases in 8-isoprostane (β = 0.74, 95% CI = 0.07, 1.41; p = 0.031) and IFN-γ (β = 0.18, 95% CI = 0.00, 0.36; p = 0.046). No statistical correlation between BPS and biomarkers of oxidative stress or immune balance was observed when all participants were analyzed. Further analysis revealed that in the subgroup of BPS > limit of detection (0.01 ng/ml), creatinine-adjusted BPS was significantly associated with increases in IL-10 (β = 0.22, 95% CI = 0.00, 0.45; p = 0.048). Our findings suggested that BPA and BPS exposure might be related to oxidative stress and immune imbalance in URSA patients. Overall, our work might suggest potential pathogenic and aetiological associations among the bisphenols, biomarkers and URSA, which offers hypotheses for further studies.

Positive correlation between human exposure to organophosphate esters and gastrointestinal cancer in patients from Wuhan, China

As kinds of endocrine disruptors, organophosphate esters (OPEs) pollution in the environment had received increasing attention recently. Food and water intake were two important exposure pathways for OPEs. However, the studies about the potential association between OPEs and gastrointestinal cancer were limited. This study investigated the possible association between OPEs and gastrointestinal cancer. All cancer patients were diagnosed with gastrointestinal cancer from a Grade 3 A hospital in Wuhan, China, while the control group was non-cancer healthy persons. The results showed that 6 OPEs were found in the control samples, while 8 in the samples from patients with gastrointestinal cancer. The detection frequencies of OPEs in gastrointestinal cancer patients were significantly higher than those in the control group (p < 0.05 or p < 0.01), except for triethyl phosphate (TEP) and tris (methylphenyl) phosphate (TMPP) in the gastric cancer group. The concentrations of OPEs in the control group were significantly lower than those in the gastric cancer group and colorectal cancer group (p < 0.01). In the control group and gastrointestinal cancer group, TEP was the dominant pollutant. Correlation analysis found that concentrations of TEP, tris(2-chloroisopropyl) phosphate (TCIPP), triphenyl phosphate (TPHP), TMPP, tris(2-ethylhexyl) phosphate (TEHP), and 2-ethylhexyl diphenyl phosphate (EHDPP) were associated with gastric cancer (p < 0.01), and concentrations of TEP, TCIPP, TPHP, TMPP and TEHP were associated with colorectal cancer (p < 0.01). A cluster analysis divided the 34 patients with gastric cancer and 40 patients with colorectal cancer in four groups. The results showed that the elderly male patients with gastric cancer were more sensitive to the exposure of EHDPP, while the TEP exposure was more sensitive to the relatively young gastrointestinal cancer patients. These findings indicated that OPEs might play a role in developing gastrointestinal cancer.

Interference on Iodine Uptake and Human Thyroid Function by Perchlorate-Contaminated Water and Food

Background: Perchlorate-induced natrium-iodide symporter (NIS) interference is a well-recognized thyroid disrupting mechanism. It is unclear, however, whether a chronic low-dose exposure to perchlorate delivered by food and drinks may cause thyroid dysfunction in the long term. Thus, the aim of this review was to overview and summarize literature results in order to clarify this issue. Methods: Authors searched PubMed/MEDLINE, Scopus, Web of Science, institutional websites and Google until April 2020 for relevant information about the fundamental mechanism of the thyroid NIS interference induced by orally consumed perchlorate compounds and its clinical consequences. Results: Food and drinking water should be considered relevant sources of perchlorate. Despite some controversies, cross-sectional studies demonstrated that perchlorate exposure affects thyroid hormone synthesis in infants, adolescents and adults, particularly in the case of underlying thyroid diseases and iodine insufficiency. An exaggerated exposure to perchlorate during pregnancy leads to a worse neurocognitive and behavioral development outcome in infants, regardless of maternal thyroid hormone levels. Discussion and conclusion: The effects of a chronic low-dose perchlorate exposure on thyroid homeostasis remain still unclear, leading to concerns especially for highly sensitive patients. Specific studies are needed to clarify this issue, aiming to better define strategies of detection and prevention.

Bisphenols as Environmental Triggers of Thyroid Dysfunction: Clues and Evidence

Bisphenols (BPs), and especially bisphenol A (BPA), are known endocrine disruptors (EDCs), capable of interfering with estrogen and androgen activities, as well as being suspected of other health outcomes. Given the crucial role of thyroid hormones and the increasing incidence of thyroid carcinoma in the last few decades, this review analyzes the effects of BPS on the thyroid, considering original research in vitro, in vivo, and in humans published from January 2000 to October 2019. Both in vitro and in vivo studies reported the ability of BPs to disrupt thyroid function through multiple mechanisms. The antagonism with thyroid receptors (TRs), which affects TR-mediated transcriptional activity, the direct action of BPs on gene expression at the thyroid and the pituitary level, the competitive binding with thyroid transport proteins, and the induction of toxicity in several cell lines are likely the main mechanisms leading to thyroid dysfunction. In humans, results are more contradictory, though some evidence suggests the potential of BPs in increasing the risk of thyroid nodules. A standardized methodology in toxicological studies and prospective epidemiological studies with individual exposure assessments are warranted to evaluate the pathophysiology resulting in the damage and to establish the temporal relationship between markers of exposure and long-term effects.

Bisphenols and Thyroid Hormone

In recent decades, attention has been directed toward the effects of bisphenol A (BPA) on human health. BPA has estrogenic activity and is regarded as a representative endocrine disruptor. In addition, mounting evidence indicates that BPA can disrupt thyroid hormone and its action. This review examined human epidemiological studies to investigate the association between BPA exposure and thyroid hormone levels, and analyzed in vivo and in vitro experiments to identify the causal relationship and its mechanism of action. BPA is involved in thyroid hormone action not only as a thyroid hormone receptor antagonist, but also through several other mechanisms. Since the use of bisphenols other than BPA has recently increased, we also reviewed the effects of other bisphenols on thyroid hormone action.