Internal relative potency factors based on immunotoxicity for the risk assessment of mixtures of per- and polyfluoroalkyl substances (PFAS) in human biomonitoring

The use of canonical dose-response models for benchmark dose analysis of continuous toxicological data

The benchmark dose (BMD) approach employs dose-response modeling to determine the dose associated with a small change in response relative to the background response. Here, we introduce a conceptual framework for modeling continuous data that is based on key risk assessment principles and requirements. Based on this framework, we define a class of dose-response models sharing the same four biologically interpretable model parameters, while exhibiting five common properties that are essential from a risk assessment perspective: such models are denoted as "canonical" models. The first two canonical properties are straightforward: property 1. The models should predict positive values only (as measurements of continuous endpoints are typically positive) and property 2. the outcomes should not depend on the measurement unit. Canonical property 3 reflects the observation that toxicological dose-response data related to different subgroups (e.g. species, sexes, and exposure durations) are typically (at least approximately) parallel on a log-dose scale, which is at the same time an implicit assumption in defining fundamental toxicological concepts, such as extrapolation factors, relative potency factors (RPFs), and relative sensitivity factors (RSFs). Property 4 is needed to enable comparisons of the sensitivity of endpoints differing in maximum response. A fifth canonical property reflects our view that choices regarding the dose-response model expression, the assumed distribution for the within-group variation, and the benchmark response (BMR) that is being used should be internally consistent. The canonical models that we discuss are suitable to fit parallel dose-response curves to combined datasets related to different subgroups (e.g. species, sexes, and exposure durations). Doing so provides a tool to check canonical property 3 of the particular data analyzed. We provide a review of empirical evidence indicating that this property has general validity, which is highly fortunate, as this legitimizes the use of extrapolation factors and RPFs in risk assessment. We then evaluate to what extent the approaches in current BMD guidance by European Food Safety Authority (EFSA) or U.S. Environmental Protection Agency (US-EPA) comply with the principles of canonical dose-response modeling, concluding that this is only partly the case. The latter can have unfavorable and sometimes far-reaching consequences. For instance, some of the recommended non-canonical models result in different BMDs when changing the measurement unit (e.g. µg to mg). As another example, the BMD tool recently developed by EFSA implements covariate analysis in such a way that canonical property 3 cannot possibly be represented by any of the models. As another disadvantage, non-canonical models preclude the effective development and use of prior distributions in a Bayesian approach. Finally, we argue that a concomitant but important advantage of only using canonical models is that BMD methodology will be more transparent, so that risk assessors will be better able to understand it, and BMDs with high societal impact can be more easily defended. The present paper may be a helpful tool for toxicologists and risk assessors to critically follow the developments in BMD methodology at the conceptual level.

Observational studies on per- and polyfluoroalkyl substance toxicity in marine species: hints for the extrapolation of a screening value

A statistical procedure has been developed to derive a screening value from an observational study related to the developmental toxicity observed in loggerhead turtle (Caretta caretta) eggs exposed to long chain per- and polyfluoroalkyl substances (PFAS). A dataset of 41 nests in which the hatching rate was inversely correlated with the increase in the PFAS concentration in unhatched eggs was processed via a categorical regression approach. After outliers identification and removal, categorical regression analysis tested the relationships of the outcomes with the following parameters: perfluoro-nonanoic (PFNA), decanoic (PFDA), undecanoic (PFUdA), and dodecanoic (PFDoA) acids; perfluoroctansulfonate (PFOS); polychlorobiphenyls (PCBs) 28, 52, 101, 138, 153, 180; lead (Pb), total mercury (Hgtot), and cadmium (Cd); and other factors, such as "nest site," "clutch size," "incubation duration," and "nest minimum depth," as confounders/modifiers of the hatching rate. Among considered contaminants, PFOS, PFDA, and PFNA only were significant (p ˂ 0.05), as were "nest site," "clutch size," and "incubation duration," confirming their possible role in decreasing the hatching rate of sea turtle eggs. According to a chemical-specific visual strategy, PFOS only showed a typical monotonic dose/response curve, which allowed the identification of provisional hypothetical thresholds of PFOS, 1,386 (CI95 = 1,080-1,692) ng/kg, corresponding to average hatching rates of 93.3% (CI95 = 91.4%-95.2%). Our preliminary results indicate the feasibility of the extrapolation of a screening value from observational studies under the following requirements: (a) individuation of most influencing factors for the outcome; (b) datasets referred to baseline contamination; (c) selection of undisturbed nests; (d) appropriate statistical multivariate methodology. This work aims to contribute to the New Approach Methods (NAMs) to assess PFAS early-stage embriotoxicity in marine biota.

Structure-specific variation in per- and polyfluoroalkyl substances toxicity among genetically diverse Caenorhabditis elegans strains

Per- and polyfluoroalkyl substances (PFAS) are in 99% of humans and are associated with a range of adverse health outcomes. It is impossible to test the >14,500 structurally diverse "forever chemicals" for safety, therefore improved assays to quantify structure-activity relationships are needed. Here, we determined the toxicity of a structurally distinct set of PFAS in twelve genetically diverse strains of the genetic model system Caenorhabditis elegans. Dose-response curves for perfluoroalkyl carboxylic acids (PFNA, PFOA, PFPeA, and PFBA), perfluoroalkyl sulfonic acids (PFOS and PFBS), perfluoroalkyl sulfonamides (PFOSA and PFBSA), fluoroether carboxylic acids (GenX and PFMOAA), fluoroether sulfonic acid (PFEESA), and fluorotelomers (6:2 FTCA and 6:2 FTS) were determined in the C. elegans laboratory reference strain, N2, and eleven genetically diverse wild strains. Body length was quantified after 48 hr of developmental exposure of L1 arrest-synchronized larvae to estimate effective concentration values (EC50). PFAS toxicity ranged by three orders of magnitude. Long-chain PFAS had greater toxicity than short-chain and fluorosulfonamides were more toxic than carboxylic and sulfonic acids. Genetic variation resulted in variation in susceptibility among twelve strains to almost all chemicals. Different C. elegans strains varied in susceptibility to different PFAS, which suggests distinct molecular responses to specific structural attributes. Harnessing the natural genetic diversity of C. elegans and the structural complexity of PFAS is a powerful approach that can be used to investigate mechanisms of toxicity which may identify potentially susceptible individuals or populations and predict toxicity of untested PFAS to inform regulatory policies and improve human and environmental health.

Neurotoxicity of per- and polyfluoroalkyl substances: Evidence and future directions

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals widely used in various products, including food packaging, textiles, and firefighting foam, owing to their unique properties such as amphiphilicity and strong CF bonds. Despite their widespread use, concerns have arisen due to their resistance to degradation and propensity for bioaccumulation in both environmental and human systems. Emerging evidence suggests a potential link between PFAS exposure and neurotoxic effects, spanning cognitive deficits, neurodevelopmental disorders, and neurodegenerative diseases. This review comprehensively synthesizes current knowledge on PFAS neurotoxicity, drawing insights from epidemiological studies, animal experiments, and mechanistic investigations. PFAS, known for their lipophilic nature, tend to accumulate in lipid-rich tissues, including the brain, breaching biological barriers such as the blood-brain barrier (BBB). The accumulation of PFAS within the central nervous system (CNS) has been implicated in a spectrum of neurological maladies. Neurotoxicity induced by PFAS manifests through a multitude of direct and indirect mechanisms. A growing body of research associated PFAS exposure with BBB disruption, calcium dysregulation, neurotransmitter alterations, neuroinflammation, oxidative stress, and mitochondrial dysfunction, all contributing to neuronal impairment. Despite notable strides in research, significant lacunae persist, necessitating further exploration to elucidate the full spectrum of PFAS-mediated neurotoxicity. Prospective research endeavors should prioritize developing biomarkers, delineating sensitive exposure windows, and exploring mitigation strategies aimed at safeguarding neurological integrity within populations vulnerable to PFAS exposure.

Tissue-specific distribution and fatty acid content of PFAS in the northern Bohai Sea fish: Risk-benefit assessment of legacy PFAS and emerging alternatives

This study aimed to examine the distribution of poly- and perfluoroalkyl substances (PFAS) in 15 marine fish species from the northern Bohai Sea, investigate their sources of contamination, and evaluate the benefits-risks associated with the concurrent consumption of fish fatty acids and PFAS. The ∑PFAS concentrations in fish ranged from 9.38 to 262.92 ng·g-1 (dry weight). The highest PFAS levels were found in the viscera and gills, while the lowest levels were found in the muscles. Industrial effluents and sewage treatment plant discharges were the primary sources of PFAS contamination. The individual PFAS concentrations in fish were insignificantly correlated with their trophic levels (p > 0.05). However, the concentrations of hexafluoropropylene oxide dimer acid (HFPO-DA) or long-chain PFAS (C > 8) significantly increased with fish size (e.g., total length, weight) and lipid content (p < 0.001). The benefit-risk analysis suggests that HPFO-DA poses a higher health risk than perfluorooctanoic acid (PFOA) in fish (p < 0.05). Long-term consumption of contaminated fish may significantly increase human serum PFOA concentration and kidney cancer risk (p < 0.05). Daily consumption of 5 g (wet weight) muscle from Ditrema temmincki and Konosirus punctatus is recommended to meet the requirements for fatty acid supplementation without posing health risks.

Advancing toxicity studies of per- and poly-fluoroalkyl substances (pfass) through machine learning: Models, mechanisms, and future directions

Perfluorinated and perfluoroalkyl substances (PFASs), encompassing a vast array of isomeric chemicals, are recognized as typical emerging contaminants with direct or potential impacts on human health and the ecological environment. With the complex and elusive toxicological profiles of PFASs, machine learning (ML) has been increasingly employed in their toxicity studies due to its proficiency in prediction and data analytics. This integration is poised to become a predominant trend in environmental toxicology, propelled by the swift advancements in computational technology. This review diligently examines the literature to encapsulate the varied objectives of employing ML in the toxicity studies of PFASs: (1) Utilizing ML to establish Quantitative Structure-Activity Relationship (QSAR) models for PFASs with diverse toxicity endpoints, facilitating the targeted toxicity prediction of unidentified PFASs; (2) Investigating and substantiating the Adverse Outcome Pathway (AOP) through the synergy of ML and traditional toxicological methods, with this refining the toxicity assessment framework for PFASs; (3) Dissecting and elucidating the features of established ML models to advance Open Research into the toxicity of PFASs, with a primary focus on determinants and mechanisms. The discourse extends to an in-depth examination of ML studies, segregating findings based on their distinct application trajectories. Given that ML represents a nascent paradigm within PFASs research, this review delineates the collective challenges encountered in the ML-mediated study of PFAS toxicity and proffers strategic guidance for ensuing investigations.

Advances in perfluoro-alkylated compounds (PFAS) detection in seafood and marine environments: A comprehensive review on analytical techniques and global regulations

Per- and poly-fluoroalkyl substances (PFAS) are persistent organic pollutants that severely threaten the environment and human health due to their distinct chemical composition, extensive production, widespread distribution, bioaccumulation in nature, and long-term persistence. This review focuses on the occurrence and sources of PFAS in seafood, with a particular emphasis on advanced detection methods viz. nanoparticle-based, biosensor-based, and metal-organic frameworks-based, and mass spectrometric techniques. The challenges associated with these advanced detection technologies are also discussed. Recent research and regulatory updates about PFAS, including hazardous and potential health effects, epidemiological studies, and various risk assessment models, have been reviewed. In addition, the need for global monitoring programs and regulations on PFAS are critically reviewed by underscoring their crucial role in protecting human health and the environment. Further, approaches for reducing PFAS in seafood are highlighted with future innovative remediation directions. Although advanced PFAS analytical methods are available, selectivity, sample preparation, and sensitivity are still significant challenges associated with detection of PFAS in seafood matrices.  Moreover, crucial research gaps and solutions to essential concerns are critically explored in this review.

Per- and polyfluoroalkyl substances (PFAS) in homegrown crops: Accumulation and human risk assessment

Homegrown crops can present a significant exposure source of per- and polyfluoroalkyl substances (PFAS) to humans. Field studies studying PFAS accumulation in multiple vegetable food categories and examining the potential influence of soil characteristics on vegetable bioavailability under realistic exposure conditions are very scarce. Crop PFAS accumulation depends on a complex combination of factors. The physicochemical differences among the numerous PFAS makes risk assessment very challenging. Thus, simplification of this complexity into key factors that govern crop PFAS accumulation is critical. This study analyzed 29 targeted legacy, precursor and emerging PFAS in the vertical soil profile (0-45 cm depth), rainwater and edible crop parts of 88 private gardens, at different distances from a major fluorochemical plant. Gardens closer to the plant site showed higher soil concentrations which could be linked with historical and recent industrial emissions. Most compounds showed little variation along the soil depth profile, regardless of the distance from the plant site, which could be due to gardening practices. Annual crops consistently accumulated higher sum PFAS concentrations than perennials. Highest concentrations were observed in vegetables, followed by fruits and walnuts. Single soil-crop relationships were weak, which indicated that other factors (e.g., porewater) may be better measures of bioavailability in homegrown crop accumulation. Regression models, which additionally considered soil characteristics showed limited predictive power (all R2 ≤ 35%), possibly due to low variability in crop concentrations. Human intake estimations revealed that the PFAS exposure risk via crop consumption was similar nearby and remotely from the plant site, although the contribution to the overall dietary exposure can be relatively large. The tolerable weekly intake was frequently exceeded with respect to fruit and vegetable consumption, thus potential health risks cannot be ruled out.

Perfluoroalkyl substances and immunotoxicity: An in vitro structure-activity relationship study in THP-1-derived monocytes and macrophages

Recently, PFASs toxicity for the human immune system has become a growing concern. However, there is currently limited information on PFASs immunotoxicity beyond PFHxS, PFOA, PFOS, and PFNA. Therefore, it is urgent to close the present knowledge gap by testing a wider range of compounds. In the present study, twelve compounds were tested for a relationship between the chain-length and headgroup of a PFAS and its cytotoxic for THP-1. As such, THP-1, either as monocytes or differentiated macrophages, were exposed to PFASs in a concentration range of 0-800 μM for either 3 or 24 h. After that, cell viability and reactive oxygen species (ROS) generation were assessed using MTT and DCFH assay, respectively. PFASs' cytotoxicity is dependent on both their chain-length and headgroups. Cell viability decreased with increasing chain-length, and FTOHs displayed markedly higher toxicity than PFCAs and PFSAs. PFASs were ranked based on their calculated Relative Potency Factor. The ranking for the cytotoxicity data on monocytes appears to be 6:2 FTOH ≫ PFNA > PFDA > PFOS > PFOA >4: 2 FTOH > PFHxS = PFHxA > PFBA. For macrophages, this ranking was as follows: 6:2 FTOH >4:2 FTOH > PFOS > PFDA > PFNA > PFOA > PFHxS. The results observed for the ROS generating potential differed as FTOHs generated no ROS. Here, the ranking in monocytes was PFOA > PFNA > PFOS > PFHxS > PFDA > PFHxA = PFBS = PFBA. The ranking for macrophages was PFNA > PFDA ≥ PFOA > PFOS > PFHxA > PFHxS > PFBA = PFBS. In conclusion, the carbon chain-length and functional headgroup of a PFAS are major determinants for their toxicity to THP-1 cells. Furthermore, our study demonstrates the most potent cytotoxic effect for FTOHs in vitro, which has not been observed before to the authors' knowledge.

Effects of Perfluorohexane Sulfonate Exposure on Immune Cell Populations in Naive Mice

Perfluorohexane sulfonate (PFHxS) is a member of the per- and polyfluoroalkyls (PFAS) superfamily of molecules, characterized by their fluorinated carbon chains and use in a wide range of industrial applications. PFHxS and perfluorooctane sulfonate are able to accumulate in the environment and in humans with the approximated serum elimination half-life in the range of several years. More recently, some PFAS compounds have also been suggested as potential immunosuppressants. In this study, we analyze immune cell numbers in mice following 28-d repeated oral exposure to potassium PFHxS at 12, 120, 1,200, and 12,000 ng/kg/d, with resulting serum levels ranging up to ∼1,600 ng/ml, approximating ranges found in the general population and at higher levels in PFAS workers. The immunosuppressant cyclophosphamide was analyzed as a positive control. B cells, T cells, and granulocytes from the bone marrow, liver, spleen, lymph nodes, and thymus were evaluated. We found that at these exposures, there was no effect of PFHxS on major T or B cell populations, macrophages, dendritic cells, basophils, mast cells, eosinophils, neutrophils, or circulating Ab isotypes. By contrast, mice exposed to cyclophosphamide exhibited depletion of several granulocyte and T and B cell populations in the thymus, bone marrow, and spleen, as well as reductions in IgG1, IgG2b, IgG2c, IgG3, IgE, and IgM. These data indicate that exposures of up to 12,000 ng/kg of PFHxS for 28 d do not affect immune cell numbers in naive mice, which provides valuable information for assessing the risks and health influences of exposures to this compound.

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

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

Placental inflammatory injury induced by chlorinated polyfluorinated ether sulfonate (F-53B) through NLRP3 inflammasome activation

Chlorinated polyfluorinated ether sulfonate, commercially known as F-53B, has been associated with adverse birth outcomes. However, the reproductive toxicology of F-53B on the placenta remains poorly understood. To address this gap, we examined the impact of F-53B on placental injury and its underlying molecular mechanisms in vivo. Pregnant C57BL/6 J female mice were randomly allocated to three groups: the control group, F-53B 0.8 µg/kg/day group, and F-53B 8 µg/kg/day group. After F-53B exposure through free drinking water from gestational day (GD) 0.5-14.5, the F-53B 8 µg/kg/day group exhibited significant increases in placental weights and distinctive histopathological alterations, including inflammatory cell infiltration, heightened syncytiotrophoblast knots, and a loosened trophoblastic basement membrane. Within the F-53B 8 µg/kg/day group, placental tissue exhibited increased apoptosis, as indicated by increased caspase3 activation. Furthermore, F-53B potentially induced the NF-κB signaling pathway activation through IκB-α phosphorylation. Subsequently, this activation upregulated the expression of inflammatory cytokines and components of the NLRP3 inflammasome, including activated caspase1, IL-1β, IL-18, and cleaved gasdermin D (GSDMD), ultimately leading to pyroptosis in the mouse placenta. Our findings reveal a pronounced inflammatory injury in the placenta due to F-53B exposure, suggesting potential reproductive toxicity at concentrations relevant to the human population. Further toxicological and epidemiological investigations are warranted to conclusively assess the reproductive health risks posed by F-53B.

The "forever" per- and polyfluoroalkyl substances (PFAS): A critical accounting of global research on a major threat under changing regulations

The European Commission's current efforts to launch the largest proposal to restrict per- and polyfluoroalkyl substances (PFAS) in history reflect the dire global plight of PFAS accumulation in the environment and their health impacts. While there are existing studies on PFAS research, there is a lack of comprehensive analysis that both covers the entire research period and provides deep insights into global research patterns, incentives, and barriers based on various parameters. We have been able to demonstrate the increasing interest in PFAS research, although citation numbers are declining prematurely. Policy regulations based on proving and establishing the toxicity of PFASs have stimulated research in developed countries and vice versa, with increasing emphasis on ecological aspects. China, in particular, is investing increasingly in PFAS research, but without defining or implementing regulations - with devastating effects. The separation of industrial and environmental research interests is clear, with little involvement of developing countries, even though their exposure to PFAS is devastating. It, therefore, requires increased globally networked and multidisciplinary approaches to address PFAS contamination challenges.

Determination of in vitro immunotoxic potencies of a series of perfluoralkylsubstances (PFASs) in human Namalwa B lymphocyte and human Jurkat T lymphocyte cells

Exposure to PFASs is associated to several adverse health effects, such as immunotoxicity. Immunotoxic effects of PFOA and PFOS, including a reduced antibody response in both experimental animals and humans, have been reported. However, there is limited understanding of the underlying mechanisms involved. Moreover, there is only a restricted amount of immunotoxicity data available for a limited number of PFASs. In the current study the effects of 15 PFASs, including short- and long-chain perfluorinated carboxylic and sulfonic acids, fluorotelomer alcohols, and perfluoralkyl ether carboxylic acids were studied on the expression of recombinant activating gene 1 (RAG1) and RAG2 in the Namalwa human B lymphoma cell line, and on the human IL-2 promotor activity in Jurkat T-cells. Concentration-response data were subsequently used to derive in vitro relative potencies through benchmark dose analysis. In vitro relative potency factors (RPFs) were obtained for 6 and 9 PFASs based on their effect on RAG1 and RAG2 gene expression in Namalwa B-cells, respectively, and for 10 PFASs based on their inhibitory effect on IL-2 promotor activity in Jurkat T-cells. The most potent substances were HFPO-TA for the reduction of RAG1 and RAG2 gene expression in Namalwa cells (RPFs of 2.1 and 2.3 respectively), and PFDA on IL-2 promoter activity (RPF of 9.1). RAG1 and RAG2 play a crucial role in V (D)J gene recombination, a process for acquiring a varied array of antibodies crucial for antigen recognition. Hence, the effects observed in Namalwa cells might indicate a PFAS-induced impairment of generating a diverse range of B-cells essential for antigen recognition. The observed outcomes in the Jurkat T-cells suggest a possible PFAS-induced reduction of T-cell activation, which may contribute to a decline in the T-cell dependent antibody response. Altogether, the present study provides potential mechanistic insights into the reported PFAS-induced decreased antibody response. Additionally, the presented in vitro models may represent useful tools for assessing the immunotoxic potential of PFASs and prioritization for further risk assessment.

Dietary exposure to per- and polyfluoroalkyl substances: Potential health impacts on human liver

Per- and polyfluoroalkyl substances (PFAS), dubbed "forever chemicals", are widely present in the environment. Environmental contamination and food contact substances are the main sources of PFAS in food, increasing the risk of human dietary exposure. Numerous epidemiological studies have established the link between dietary exposure to PFAS and liver disease. Correspondingly, PFAS induced-hepatotoxicity (e.g., hepatomegaly, cell viability, inflammation, oxidative stress, bile acid metabolism dysregulation and glycolipid metabolism disorder) observed from in vitro models and in vivo rodent studies have been extensively reported. In this review, the pertinent literature of the last 5 years from the Web of Science database was researched. This study summarized the source and fate of PFAS, and reviewed the occurrence of PFAS in food system (natural and processed food). Subsequently, the characteristics of human dietary exposure PFAS (population characteristics, distribution trend, absorption and distribution) were mentioned. Additionally, epidemiologic evidence linking PFAS exposure and liver disease was alluded, and the PFAS-induced hepatotoxicity observed from in vitro models and in vivo rodent studies was comprehensively reviewed. Lastly, we highlighted several critical knowledge gaps and proposed future research directions. This review aims to raise public awareness about food PFAS contamination and its potential risks to human liver health.

An integrated assessment of ecological and human health risks of per- and polyfluoroalkyl substances through toxicity prediction approaches

Per- and polyfluoroalkyl substances (PFAS) are also known as "forever chemicals" due to their persistence and ubiquitous environmental distribution. This review aims to summarize the global PFAS distribution in surface water and identify its ecological and human risks through integrated assessment. Moreover, it provides a holistic insight into the studies highlighting the human biomonitoring and toxicological screening of PFAS in freshwater and marine species using quantitative structure-activity relationship (QSAR) based models. Literature showed that PFOA and PFOS were the most prevalent chemicals found in surface water. The highest PFAS levels were reported in the US, China, and Australia. The TEST model showed relatively low LC50 of PFDA and PFOS for Pimephales promelas (0.36 and 0.91 mg/L) and high bioaccumulation factors (518 and 921), revealing an elevated associated toxicity. The risk quotients (RQs) values for P. promelas and Daphnia magna were found to be 269 and 23.7 for PFOS. Studies confirmed that long-chain PFAS such as PFOS and PFOA undergo bioaccumulation in aquatic organisms and induce toxicological effects such as oxidative stress, transgenerational epigenetic effects, disturbed genetic and enzymatic responses, perturbed immune system, hepatotoxicity, neurobehavioral toxicity, altered genetic and enzymatic responses, and metabolism abnormalities. Human biomonitoring studies found the highest PFOS, PFOA, and PFHxS levels in urine, cerebrospinal fluid, and serum samples. Further, long-chain PFOA and PFOS exposure create severe health implications such as hyperuricemia, reduced birth weight, and immunotoxicity in humans. Molecular docking analysis revealed that short-chain PFBS (-11.84 Kcal/mol) and long-chain PFUnDA (-10.53 Kcal/mol) displayed the strongest binding interactions with human serum albumin protein. Lastly, research challenges and future perspectives for PFAS toxicological implications were also discussed, which helps to mitigate associated pollution and ecological risks.

Combined chronic dietary exposure to four nephrotoxic metals exceeds tolerable intake levels in the adult population of 10 European countries

A mixture risk assessment (MRA) for four metals relevant to chronic kidney disease (CKD) was performed. Dietary exposure to cadmium or lead alone exceeded the respective reference values in the majority of the 10 European countries included in our study. When the dietary exposure to those metals and inorganic mercury and inorganic arsenic was combined following a classical or personalised modified reference point index (mRPI) approach, not only high exposure (95th percentile) estimates but also the mean exceeded the tolerable intake of the mixture in all countries studied. Cadmium and lead contributed most to the combined exposure, followed by inorganic arsenic and inorganic mercury. The use of conversion factors for inorganic arsenic and inorganic mercury from total arsenic and total mercury concentration data was a source of uncertainty. Other uncertainties were related to the use of different principles to derive reference points. Yet, MRA at the target organ level, as performed in our study, could be used as a way to efficiently prioritise assessment groups for higher-tier MRA. Since the combined exposure to the four metals exceeded the tolerable intake, we recommend a refined MRA based on a common, specific nephrotoxic effect and relative potency factors (RPFs) based on a similar effect size.

Dose additive maternal and offspring effects of oral maternal exposure to a mixture of three PFAS (HFPO-DA, NBP2, PFOS) during pregnancy in the Sprague-Dawley rat

Simultaneous exposure to multiple per- and polyfluoroalkyl substances (PFAS) is common in humans across the globe. Individual PFAS are associated with adverse health effects, yet the nature of mixture effects after exposure to two or more PFAS remains unclear. Previously we reported that oral administration of hexafluoropropylene oxide-dimer acid (HFPO-DA, or GenX), Nafion byproduct 2 (NBP2), or perfluorooctane sulfonate (PFOS) individually during pregnancy produced maternal and F1 effects. Here, we hypothesized that responses to the combined exposure to these three PFAS would be dose additive. Pregnant Sprague-Dawley rats were exposed to a fixed-ratio equipotent mixture where the top dose contained each PFAS at their ED50 for neonatal mortality (100 % dose = PFOS 3 mg/kg; NBP2 10 mg/kg; HFPO-DA 110 mg/kg), followed by a dilution series (33.3, 10, 3.3, and 1 %) and vehicle controls (0 % dose). Consistent with the single chemical studies, dams were exposed from gestation day (GD)14-18 or from GD8-postnatal day (PND2). Fetal and maternal livers on GD18 displayed multiple significantly upregulated genes associated with lipid and carbohydrate metabolism at all dose levels, while dams displayed significantly increased liver weight (≥3.3 % dose) and reduced serum thyroid hormones (≥33.3 % dose). Maternal exposure from GD8-PND2 significantly reduced pup bodyweights at birth (≥33.3 % dose) and PND2 (all doses), increased neonatal liver weights (≥3.3 % dose), increased pup mortality (≥3.3 % dose), and reduced maternal bodyweights and weight gain at the top dose. Echocardiography of adult F1 males and females identified significantly increased left ventricular anterior wall thickness (~10 % increase), whereas other cardiac morphological, functional, and transcriptomic measures were unaffected. Mixture effects in maternal and neonatal animals conformed to dose addition using a relative potency factor (RPF) analysis. Results support dose addition-based cumulative assessment approaches for estimating combined effects of PFAS co-exposure.

A multi-tiered hierarchical Bayesian approach to derive toxic equivalency factors for dioxin-like compounds

In 2005, the World Health Organization (WHO) re-evaluated Toxic Equivalency factors (TEFs) developed for dioxin-like compounds believed to act through the Ah receptor based on an updated database of relative estimated potency (REP)(REP2004 database). This re-evalution identified the need to develop a consistent approach for dose-response modeling. Further, the WHO Panel discussed the significant heterogeneity of experimental datasets and dataset quality underlying the REPs in the database. There is a critical need to develop a quantitative, and quality weighted approach to characterize the TEF for each congener. To address this, a multi-tiered approach that combines Bayesian dose-response fitting and meta-regression with a machine learning model to predict REPS' quality categorizations was developed to predict the most likely relationship between each congener and its reference and derive model-predicted TEF uncertainty distributions. As a proof of concept, this 'Best-Estimate TEF workflow' was applied to the REP2004 database to derive TEF point-estimates and characterizations of uncertainty for all congeners. Model-TEFs were similar to the 2005 WHO TEFs, with the data-poor congeners having larger levels of uncertainty. This transparent and reproducible computational workflow incorporates WHO expert panel recommendations and represents a substantial improvement in the TEF methodology.

The EU's Per- and Polyfluoroalkyl Substances (PFAS) Ban: A Case of Policy over Science

The proposal by the European Chemicals Agency (ECHA) to ban over 12,000 per- and polyfluoroalkyl substances (PFAS) has sparked a debate about potential consequences for the economy, industry, and the environment. Although some PFAS are known to be harmful, a blanket ban may lead to significant problems in attempting to replace PFAS-based materials for environmental transition, as well as in medical devices and everyday products. Alternative materials may potentially be less safe, as a rush to replace PFAS would reduce the time needed for toxicological analyses. Studies have shown that PFAS exhibit a diverse range of mechanisms of action, biopersistence, and bioaccumulation potential, and should thus not be treated as a single group. This is particularly true for the class of fluoropolymers. A targeted approach that considers the specific risks and benefits of each chemical may be more effective. Moreover, the proposed ban may also have unintended consequences for the environment as PFAS use is also associated with benefits such as reducing greenhouse-gas emissions and improving energy efficiency. Policymakers must carefully weigh up the potential consequences before making a final decision on the ban.

Consideration of pathways for immunotoxicity of per- and polyfluoroalkyl substances (PFAS)

BACKGROUND

Per- and polyfluoroalkyl substances (PFAS) are of public health concern, because of their ubiquitous and extremely persistent occurrence, and depending on their structure, their bio-accumulative, mobile and toxic properties. Human health effects associated with exposure to PFAS include adverse effects on the immune system. In 2020, EFSA (the European Food Safety Authority) defined adverse effects on the immune system as the most critical effect for human health risk assessment, based on reduced antibody responses to childhood vaccines and similar effects observed in experimental animal studies. Likewise, the U.S. EPA (Environmental Protection Agency) considers PFAS-induced immunotoxicity, especially in children, as the critical effect for risk assessment. However, the mechanisms by which antibody concentrations are impacted are not completely understood. Furthermore, other targets of the immune system functions have been reported in the literature.

OBJECTIVE

The aim of this review is to explore PFAS-associated immune-related effects. This includes, relevant mechanisms that may underlie the observed effects on the immune system, immunosuppression as well as immunoenhancement, such as i) modulation of cell signalling and nuclear receptors, such as NF-κB and PPARs; ii) alteration of calcium signalling and homoeostasis in immune cells; iii) modulation of immune cell populations; iv) oxidative stress and v) impact on fatty acid metabolism & secondary effects on the immune system.

METHODS

A literature research was conducted using three databases (Web of Science, PubMed, and Scopus), which were searched in July 2021 for relevant studies published in the time frame from 2018 to 2021. In total, 487 publications were identified as potentially eligible and following expert-based judgement, articles relevant for mechanisms of PFAS induced immunotoxicity are discussed.

CONCLUSIONS

Taken together, we show that there is substantial evidence from both in vitro and in vivo experimental as well as epidemiological studies, supporting that various PFAS, not only PFOA and PFOS, affect multiple aspects of the immune system. Timing of exposure is critical, because the developing immune system is especially vulnerable to toxic insults, resulting in a higher risk of particularly adverse immune effects but also other organs later in life.