Endocrine disrupting chemicals and ovulation: Is there a relationship?

Empowering Student Pharmacists to Counsel Patients on Endocrine Disrupting Chemicals through Interactive Role-Play

Preparing the next generation of pharmacists to succeed in practice and provide premier care starts with ensuring pharmacy education standards are met and align with innovative practices and that education incorporates topics that are important to promoting health. For example, recent reports link endocrine disrupting chemicals (EDCs) to numerous diseases such as reproductive disorders, metabolic diseases, and developmental abnormalities. Considering the suboptimal awareness and knowledge about EDCs, it is imperative to provide public health education through a pharmacy curriculum. The objective of this study was to evaluate student pharmacists' perceptions of the impact of a role play activity on their knowledge of EDCs and counseling skills. A secondary objective was to explore student pharmacists' perceptions of how role play might impact their future career as a pharmacist. A retrospective qualitative study consisting of a lecture, a pre-brief, a low-fidelity simulation centered on role-play, and debrief to develop knowledge of EDCs to practice counseling skills, and a post reflection was implemented to explore this aim. Third year student pharmacists who were enrolled on the public health elective course were eligible to participate in the study. All reflections were de-identified, imported into a qualitative software, Dedoose®, Version 9.2.6 and thematically analyzed using an inductive approach. Thematic analysis revealed three master themes, which tell the story of an initial lack of familiarity with EDCs that was rectified by the lecture and low-fidelity simulation. In the first theme, we can see that all of the participants noted their positive perceptions of the low-fidelity simulation, especially the role playing on a topic they lacked familiarity with. In the second theme, participants revealed the activity's impact on their performance or behaviors. Finally, the third theme explores the future implications of a pharmacist's impact on public health. This novel study contributes to a growing body of literature on the impact of pharmacy education practices and instruction on public health. The findings suggest that pharmacy educators might consider incorporating role playing instruction for public health topics, EDCs, or topics not traditionally taught in the pharmacy curriculum.

Combining computational tools and experimental studies towards endocrine disruptors mitigation: A review of biocatalytic and adsorptive processes

The endocrine disruptors (EDCs) are an important group of emerging contaminants, and their mitigation has been a huge challenge due to their chemistry complexity and variety of these compounds. The traditional treatments are inefficient to completely remove EDCs, and adsorptive processes are the major alternative investigated on their removal. Also, the use of EDCs degrading enzymes has been encouraged due to ecofriendly approach of biocatalytic processes. This paper highlights the occurrence, classification, and toxicity of EDCs with special focus in the use of enzyme-based and adsorptive technologies in the elimination of EDCs from ambiental matrices. Numerous prior reviews have focused on the discussions toward these technologies. However, the literature lacks theoretical discussions about important aspects of these methods such as the mechanisms of EDCs adsorption on the adsorbent surface or the interactions between degrading enzymes - EDCs. In this sense, theoretical calculations combined to experimental studies may help in the development of more efficient technologies to EDCs mitigation. In this review, we point out how computational tools such as molecular docking and molecular dynamics have to contribute to the design of new adsorbents and efficient catalytic processes towards endocrine disruptors mitigation.

Exposure of Akwesasne Mohawk women to polychlorinated biphenyls and hexachlorobenzene is associated with increased serum levels of thyroid peroxidase autoantibodies

Persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB), and dichlorodiphenyltrichloroethane (p,p'-DDT) were reported to influence immunological activity. As endocrine-disrupting chemicals (EDC), these pollutants may disrupt normal thyroid function and act as catalysts for development of autoimmune thyroid disease by directly and indirectly affecting levels of thyroid peroxidase antibodies (TPOAbs). Native American communities are disproportionately exposed to harmful toxicants and are at an increased risk of developing an autoimmune disease. The aim of this study was to determine the association between POPs and TPOAbs in serum obtained from Native American women. This assessment was used to measure whether increased risk of autoimmune thyroid disease occurred as a result of exposure to POPs. Data were collected from 183 Akwesasne Mohawk women, 21-38 years of age, between 2009 and 2013. Multivariate analyses were conducted to determine the association between toxicant exposure and levels of TPOAbs. In multiple logistic regression analyses, exposure to PCB congener 33 was related to elevated risk of individuals possessing above normal levels of TPOAbs. Further, HCB was associated with more than 2-fold higher risk of possessing above normal levels of TPOAbs compared to women with normal levels of TPOAbs. p,p'-DDE was not associated with TPOAb levels within this study. Exposure to PCB congener 33 and HCB was correlated with above normal levels of TPOAbs, a marker of autoimmune thyroid disease. Additional investigations are needed to establish the causes and factors surrounding autoimmune thyroid disease which are multiple and complex.

Research advances in identification procedures of endocrine disrupting chemicals

Endocrine disrupting chemicals (EDCs) are increasingly concerned substance endangering human health and environment. However, there is no unified standard for identifying chemicals as EDCs, which is also controversial internationally. In this review, the procedures for EDC identification in different organizations/countries were described. Importantly, three aspects to be considered in identifying chemical substances as EDCs were summarized, which were mechanistic data, animal experiments, and epidemiological information. The relationships between them were also discussed. To elaborate more clearly on these three aspects of evidence, scientific data on some chemicals including bisphenol A, 1,2-dibromo-4-(1,2 dibromoethyl) cyclohexane and perchlorate were collected and evaluated. Altogether, the above three chemicals were assessed for interfering with hormones and elaborated their health hazards from macroscopic to microscopic. This review is helpful for standardizing the identification procedure of EDCs.

Mixture Effects of Polychlorinated Biphenyls (PCBs) and Three Organochlorine Pesticides on Cognitive Function in Mohawk Adults at Akwesasne

The Mohawks at Akwesasne have been highly exposed to polychlorinated biphenyls (PCBs), via releases from three aluminum foundries located near the reserve. They are also exposed to organochlorine pesticides, namely hexachlorobenzene (HCB), dichlorodiphenyldichloroethylene (DDE), and mirex. Previous studies have demonstrated reduced cognition in relation to total PCBs, but the effects of the mixtures of different PCB congener groups, HCB, DDE, and mirex on cognitive function have not been studied. Therefore, cognitive performance for executive function, scored via the digit symbol substitution test (DSST), in Mohawk adults aged 17-79 years (n = 301), was assessed in relation to serum concentrations of low-chlorinated PCBs, high-chlorinated PCBs, total PCBs, HCB, DDE, and mirex. We used mixture models employing the quantile-based g-computation method. The mixture effects of low-chlorinated PCBs, high-chlorinated PCBs, HCB, DDE, and mirex were significantly associated with 4.01 DSST scores decrements in the oldest age group, 47-79 years old. There were important contributions to mixture effects from low-chlorinated PCBs, high-chlorinated PCBs, and total PCBs, with smaller contributions of HCB and DDE. Our findings indicate that exposures to both low- and high-chlorinated PCBs increase the risk of cognitive decline in older adults, while DDE and HCB have less effect.

An evidence map of polychlorinated biphenyl exposure and health outcome studies among residents of the Akwesasne Mohawk Nation

From the 1950s to the 1970s, three Superfund sites discharged polychlorinated biphenyl (PCB)-contaminated waste upstream of the Mohawk Nation at Akwesasne, resulting in PCB contamination of groundwater, soil, and sediment in the surrounding area. Given the persistence of PCBs in the environment and in human tissues, there are continued concerns regarding PCB exposures and the potential for adverse health effects in the community. We developed an evidence map of PCB research at Akwesasne in order to characterize the available data and to highlight potential research needs. Human health and exposure biomarker studies were identified from a literature search based on population, exposure, comparator, and outcome (PECO) criteria. Data extracted from references that met the inclusion criteria after full-text review included study characteristics (e.g., sample size, study design, sampling years), details on PCB measurements (e.g., analytical method, number of congeners analyzed, method detection limits), and results (e.g., PCB levels and summary of study conclusions). We identified 33 studies, conducted between 1986 and 2013, that examined PCB exposure characteristics and health effects in residents of the Akwesasne Mohawk Nation. Organizing this literature into an evidence map including information on study cohort, congener groupings, exposure biomarker characteristics, and health effects allowed us to identify research gaps and to suggest future research priorities for the community. We identified current PCB exposure levels and PCB source characterization as major uncertainties, both of which could be addressed by new studies of PCB concentrations in environmental media.

Associations between autoimmune dysfunction and pollutants in Akwesasne Mohawk women: Dichlorodiphenyltrichloroethane and polychlorinated biphenyl exposure

BACKGROUND

Pollutant exposures, including polychlorinated biphenyls (PCBs) and dichlorodiphenyltrichloroethane (DDT), have been found to disrupt normal immune function. Native American communities are disproportionately affected by autoimmune dysfunction and are more likely to be exposed to harmful pollutants than the general population.

OBJECTIVE

To determine the association between autoimmune dysfunction and pollutant exposure levels, this study evaluates the statistical relationship between the presence of autoimmune dysfunction and pollutant exposure.

METHODS

Information was collected from Akwesasne Mohawk women (n = 182), 21-39 years of age, between 2009 and 2013. Data collection included anthropometric measurements, medical diagnoses of autoimmune disease and symptoms of autoimmune dysfunction in the medical record, and blood draws for measurement of pollutants. Multivariate analyses determined the association between toxicant exposure and autoimmune dysfunction.

RESULTS

Toxicant p,p'-DDE was positively associated with an almost two-fold risk of autoimmune dysfunction. p,p'-DDE and PCB congeners 32, 136, and 138 were positively associated in a multivariate analysis with an autoimmune diagnosis.

CONCLUSIONS

Pollutant exposures, specifically to p,p'-DDE and some PCB congeners, are common exposures that are associated with autoimmune dysfunction and autoimmune disease, although there are other factors and causes related to autoimmune dysfunction incidence.

A review on advances in removal of endocrine disrupting compounds from aquatic matrices: Future perspectives on utilization of agri-waste based adsorbents

In the recent past, a class of emerging contaminants particularly endocrine disrupting compounds (EDCs) in the aquatic environment have gained a lot of attention. This is due to their toxic behaviour, affecting endocrine activities in humans as well as among aquatic animals. Presently, there are no regulations and discharge limits for EDCs to preclude their negative impact. Furthermore, the conventional treatment processes fail to remove EDCs efficiently. This necessitates the need for more research aimed at development of advanced alternative treatment methods which are economical, efficient, and sustainable. This paper focusses on the occurrence, fate, toxicity, and various treatment processes for removal of EDCs. The treatment processes (physical, chemical, biological and hybrid) have been comprehensively studied highlighting their advantages and disadvantages. Additionally, the use of agri-waste based adsorption technologies has been reviewed. The aim of this review article is to understand the prospect of application of agri-waste based adsorbents for efficient removal of EDCs. Interestingly, research findings have indicated that the use of these low-cost and abundantly available agri-waste based adsorbents can efficiently remove the EDCs. Furthermore, the challenges and future perspectives on the use of agri-waste based adsorbents have been discussed.

Comparative transcriptomic analysis reveals reproductive impairments caused by PCBs and OH-PCBs through the dysregulation of ER and AR signaling

Reports have highlighted the presence of PCBs and their metabolites, OH-PCBs, in human serum as well as their endocrine-disrupting effects on reproductive function through direct interactions with the androgen receptor (AR) and estrogen receptor (ER). However, the molecular mechanisms directly linking the actions of PCBs and OH-PCBs on the AR and ER to induce reproductive impairment remain poorly understood. In this study, we characterized the cellular response to PCBs and OH-PCBs acting on AR and ER transactivation at the transcriptome level coupled with bioinformatics analysis to identify the downstream pathways of androgen and estrogen signaling that leads to reproductive dysfunction. We first confirmed the agonistic and antagonistic effects of several PCBs and OH-PCBs on AR- and ER-mediated reporter gene activity using the androgen-responsive LNCaP and estrogen-responsive MCF-7 cell lines, respectively. Anti-estrogenic activity was not detected among the tested compounds; however, we found that in addition to anti-androgenic and estrogenic activity, PCB 28 and PCB 138 exhibited androgenic activity, while most of the tested OH-PCBs showed a synergistic effect on DHT-mediated transactivation of the AR. Bioinformatics analysis of transcriptome profiles from selected PCBs and OH-PCBs revealed various pathways that were dysregulated depending on their agonistic, antagonistic, or synergistic effects. The OH-PCBs with estrogenic activity affected pathways including vitamin metabolism and calcium transport. Other notable dysregulated pathways include cholesterol transport in response to androgenic PCBs, thyroid hormone metabolism in response to anti-androgenic PCBs, and antioxidant pathways in response to androgen-synergistic OH-PCBs. Our results demonstrate that PCBs and OH-PCBs directly alter specific pathways through androgen- or estrogen-mediated signaling, thereby providing additional insights into the mechanisms by which these compounds cause reproductive dysfunction.

Implications of environmental toxicants on ovarian follicles: how it can adversely affect the female fertility?

The pool of primordial follicles formed in the ovaries during early development determines the span and quality of fertility in the reproductive life of a woman. As exposure to occupational and environmental toxicants (ETs) has become inevitable, consequences on female fertility need to be established. This review focuses on the ETs, especially well-studied prototypes of the classes endocrine disrupting chemicals (EDCs), heavy metals, agrochemicals, cigarette smoke, certain chemicals used in plastic, cosmetic and sanitary product industries etc that adversely affect the female fertility. Many in vitro, in vivo and epidemiological studies have indicated that these ETs have the potential to affect folliculogenesis and cause reduced fertility in women. Here, we emphasize on four main conditions: polycystic ovary syndrome, primary ovarian insufficiency, multioocytic follicles and meiotic defects including aneuploidies which can be precipitated by ETs. These are considered main causes for reduced female fertility by directly altering the follicular recruitment, development and oocytic meiosis. Although substantial experimental evidence is drawn with respect to the detrimental effects, it is clear that establishing the role of one ET as a risk factor in a single condition is difficult as multiple conditions have common risk factors. Therefore, it is important to consider this as a matter of public and wildlife health.

Endocrine disrupting chemicals (EDCs) and sex steroid receptors

Sex-steroid receptors (SSRs) are essential mediators of estrogen, progestin, and androgen signaling that are critical in vast aspects of human development and multi-organ homeostasis. Dysregulation of SSR function has been implicated in numerous pathologies including cancers, obesity, Type II diabetes mellitus, neuroendocrine disorders, cardiovascular disease, hyperlipidemia, male and female infertility, and other reproductive disorders. Endocrine disrupting chemicals (EDCs) modulate SSR function in a wide variety of cell and tissues. There exists strong experimental, clinical, and epidemiological evidence that engagement of EDCs with SSRs may disrupt endogenous hormone signaling leading to physiological abnormalities that may manifest in disease. In this chapter, we discuss the molecular mechanisms by which EDCs interact with estrogen, progestin, and androgen receptors and alter SSR functions in target cells. In addition, the pathological consequences of disruption of SSR action in reproductive and other organs by EDCs is described with an emphasis on underlying mechanisms of receptors dysfunction.

Effects of Prepubertal Exposure to Aroclor-1221 on Reproductive Development and Transcriptional Gene Expression in Female Rats

Polychlorinated biphenyls (PCBs), as persistent organic pollutants, are environmental endocrine-disrupting chemicals (EDCs). We aim to investigate the effects of prepubertal exposure to PCBs on the reproductive development and expression and regulation of related genes in rats. Female rats were treated with Aroclor-1221 (A-1221) (4 mg/kg/day, 0.4 mg/kg/day) or castor oil daily from postnatal day (PND) 28 for 2 weeks by gavage. Morphological, histological, hormonal, and biochemical parameters were studied. Lower weight and relative weight of hypothalamus, earlier puberty onset, a longer length of the estrous cycle, lower serum estradiol and progesterone levels, accelerated ovarian folliculogenesis, and higher apoptotic index in the ovary were found. The in vitro fertilization study showed a lower fertilization rate and cleavage rate. The genetic study revealed higher expression of Kiss-1 mRNA and lower expression of GnRH mRNA in the hypothalamus and higher expression of AMH mRNA and lower expression of C-myc mRNA in the ovary. These confirmed the reproductive damage of A-1221 in rats.

A Systematic Review of Environmental Health Outcomes in Selected American Indian and Alaska Native Populations

BACKGROUND

Economic and social marginalization among American Indians and Alaska Natives (AI/ANs) results in higher chronic disease prevalence. Potential causal associations between toxic environmental exposures and adverse health outcomes within AI/AN communities are not well understood.

OBJECTIVES

This review examines epidemiological literature on exposure to toxicants and associated adverse health outcomes among AI/AN populations.

METHODS

PubMed, Embase, Cochrane, Environment Complete, Web of Science Plus, DART, and ToxLine were searched for English-language articles. The following data were extracted: lead author's last name, publication year, cohort name, study location, AI/AN tribe, study initiation and conclusion, sample size, primary characteristic, environmental exposure, health outcomes, risk estimates, and covariates.

RESULTS

About 31 articles on three types of environmental exposures met inclusion criteria: persistent organic pollutants (POPs), heavy metals, and open dumpsites. Of these, 17 addressed exposure to POPs, 10 heavy metal exposure, 2 exposure to both POPs and heavy metals, and 2 exposure to open dumpsites. Studies on the Mohawk Nation at Akwesasne; Yupik on St. Lawrence Island, Alaska; Navajo Nation; Gila River Indian Community; Cheyenne River Sioux; 197 Alaska Native villages; and 13 tribes in Arizona, Oklahoma, North Dakota, and South Dakota that participated in the Strong Heart Study support associations between toxicant exposure and various chronic conditions including cardiovascular conditions, reproductive abnormalities, cancer, autoimmune disorders, neurological deficits, and diabetes.

DISCUSSION

The complex interplay of environmental and social factors in disease etiology among AI/ANs is a product of externally imposed environmental exposures, systemic discrimination, and modifiable risk behaviors. The connection between environmental health disparities and adverse health outcomes indicates a need for further study.

Perturbation of Nuclear Hormone Receptors by Endocrine Disrupting Chemicals: Mechanisms and Pathological Consequences of Exposure

Much of the early work on Nuclear Hormone Receptors (NHRs) focused on their essential roles as mediators of sex steroid hormone signaling in reproductive development and function, and thyroid hormone-dependent formation of the central nervous system. However, as NHRs display tissue-specific distributions and activities, it is not surprising that they are involved and vital in numerous aspects of human development and essential for homeostasis of all organ systems. Much attention has recently been focused on the role of NHRs in energy balance, metabolism, and lipid homeostasis. Dysregulation of NHR function has been implicated in numerous pathologies including cancers, metabolic obesity and syndrome, Type II diabetes mellitus, cardiovascular disease, hyperlipidemia, male and female infertility and other reproductive disorders. This review will discuss the dysregulation of NHR function by environmental endocrine disrupting chemicals (EDCs), and the associated pathological consequences of exposure in numerous tissues and organ systems, as revealed by experimental, clinical, and epidemiological studies.

Removal of an Ethoxylated Alkylphenol by Adsorption on Zeolites and Photocatalysis with TiO2/Ag

Two advanced removal methods (adsorption and photocatalysis) were compared for the elimination of an ethoxylated alkylphenol (nonylphenol polyethylene glycol, NPEG). For the adsorption process, zeolites were used in their natural state, and the process was characterized by DRX (X-ray diffraction) and SEM–EDS (Scanning electron microscopy). The analysis of the results of the adsorption kinetics was carried out using different isotherms to interpret the removal capacity of zeolites. The Temkin kinetic model better predicted the experimental data and was satisfactorily adjusted to models of pseudo-second order (PSO). On the other hand, for photocatalysis, nano-particles of Ag (silver) were deposited on titanium oxide (TiO2) Degussa-P25 by photo-deposition, and the catalyst was characterized by diffuse reflectance and SEM–EDS. The data obtained using the two removal techniques were analyzed by UV–Vis (ultraviolet-visible spectrophotometry) and total organic carbon (TOC). The kinetic data were compared. The photocatalytic process showed the highest efficiency in the removal of NPEG, corresponding to >80%, while the efficiency of the adsorption process was <60%. This was attributed to the recalcitrant and surfactant nature of NPEG.

Modern water: A biocultural approach to water pollution at the Akwesasne Mohawk Nation

OBJECTIVES

The goal of this article is to review a body of research around water contamination conducted in the Akwesasne Mohawk Nation between 1995 and 2016, place these findings in a biocultural context, and consider implications for a human biology of water.

METHODS

This review draws on research projects conducted in partnership with the Akwesasne Mohawk Nation living along the St. Lawrence River as well as published research by others on water contamination at Akwesasne. Quantitative and qualitative methods including toxicological and epidemiological methods, surveys, and ethnographic studies are included.

RESULTS

Pollution of a river with polychlorinated biphenyls (PCBs) contaminated local fish, a major, traditional, food source. Following health advisories to avoid consuming local fish, consumption and PCB levels decreased. PCB levels were negatively associated with health outcomes. In adolescents, higher PCB levels were associated with advanced sexual maturation in females, reduced testosterone in males and reduced thyroxine levels in young adults. Avoiding fish consumption altered traditional dietary patterns and social interactions, generational transmission of knowledge, and relations between generations, all of which impacted cultural forms and may have added to the perceived injustices in this Native American community. Items substituted for fish may have contributed to increasing rates of obesity as well.

CONCLUSIONS

Water pollution has immediate direct health consequences as well as cultural impacts related to changed food consumption and altered patterns of social interaction.

Trends in height, weight, BMI, skinfolds, and measures of overweight and obesity from 1979 through 1999 among American Indian Youth: The Akwesasne Mohawk

BACKGROUND/OBJECTIVES

Information on recent changes in overweight, obesity, and adiposity among American Indians is scarce. To assess changes in size and adiposity among American Indian youth, data from two samples of Akwesasne Mohawk youth, were compared.

SUBJECTS/METHODS

Both project 1, conducted in 1979 (n = 75) and Project 2, conducted between 1996 and 1999 (n = 206), sampled youth 10-14 years of age from the Akwesasne Mohawk Reservation (aka St. Regis) that borders New York state, and Ontario and Quebec provinces. Heights, weights, and skinfold thicknesses were converted to z-scores using CDC reference values. BMI status was calculated in terms of WHO age-specific cutoffs and CDC cutoffs.

RESULTS

z-Scores for heights differed little between projects. The between-project difference in weight z-score is twice the between-project z-score difference for height. Differences among males are larger and more often significant. Triceps and subscapular skinfold thickness are significantly greater in Project 2. The rate of overweight and obesity combined, increased 3.3-fold. In multiple regression analyses with sex, height, and age in the model, project is a significant predictor of weight and skinfolds.

CONCLUSIONS

Weight and adiposity have increased substantially from 1979 to 1996-99. Overweight and obesity became significantly more common. Given the increase in adiposity, these youth may be facing significant health risks as adults in terms of cardiovascular disease, cancer, and type II diabetes unless weight and adiposity is reduced.

Prenatal exposure to PCBs in Cyp1a2 knock-out mice interferes with F1 fertility, impairs long-term potentiation, reduces acoustic startle and impairs conditioned freezing contextual memory with minimal transgenerational effects

Polychlorinated biphenyls (PCBs) are toxic environmental pollutants. Humans are exposed to PCB mixtures via contaminated food or water. PCB exposure causes adverse effects in adults and after exposure in utero. PCB toxicity depends on the congener mixture and CYP1A2 gene activity. For coplanar PCBs, toxicity depends on ligand affinity for the aryl hydrocarbon receptor (AHR). Previously, we found that perinatal exposure of mice to a three-coplanar/five-noncoplanar PCB mixture induced deficits in novel object recognition and trial failures in the Morris water maze in Cyp1a2^-/- ::Ahr^b1 C57BL6/J mice compared with wild-type mice (Ahr^b1  = high AHR affinity). Here we exposed gravid Cyp1a2^-/- ::Ahr^b1 mice to a PCB mixture on embryonic day 10.5 by gavage and examined the F₁ and F₃ offspring (not F₂ ). PCB-exposed F₁ mice exhibited increased open-field central time, reduced acoustic startle, greater conditioned contextual freezing and reduced CA1 hippocampal long-term potentiation with no change in spatial learning or memory. F₁ mice also had inhibited growth, decreased heart rate and cardiac output, and impaired fertility. F₃ mice showed few effects. Gene expression changes were primarily in F₁ PCB males compared with wild-type males. There were minimal RNA and DNA methylation changes in the hippocampus from F₁ to F₃ with no clear relevance to the functional effects. F₀ PCB exposure during a period of rapid DNA de-/remethylation in a susceptible genotype produced clear F₁ effects with little evidence of transgenerational effects in the F₃ generation. While PCBs show clear developmental neurotoxicity, their effects do not persist across generations for effects assessed herein.

Polychlorinated biphenyls (PCBs) exposure and cardiovascular, endocrine and metabolic diseases: A population-based cohort study in a North Italian highly polluted area

BACKGROUND AND AIMS

Exposure to polychlorinated biphenyls (PCBs) has been linked to the onset of cardiovascular, endocrine, and metabolic diseases, but no conclusive evidence has been provided so far. A chemical factory produced PCBs from 1938 to 1984 in Brescia (North Italy) resulting in environmental contamination and human exposure. We aimed to evaluate the association between PCB serum levels and subsequent incidence of chronic diseases through a prospective cohort study design.

METHODS

Based on surveys conducted in Brescia province between 2001 and 2013, a cohort of 1331 subjects with at least one measure of PCB serum levels during the period was selected and followed longitudinally. Serum concentration of total PCBs was computed summing up the levels of 24 PCB congeners determined by gas chromatography. The data on incidence of hypertension, cardiovascular diseases, and endocrine and metabolic chronic diseases were retrieved from the Brescia Health Protection Agency database. Poisson regression models adjusted for age, level of education, BMI, cholesterol level, tobacco smoking and alcohol drinking were employed to calculate rate ratios (RRs).

RESULTS

1331 subjects were enrolled (45.7% males, mean age 50.6 years) contributing to 10,006 person-years of follow-up. A dose-response relationship was observed between PCB serum levels and the onset of hypertension (RR for 2nd and 3rd tertiles of serum PCB distribution: 2.07, 95% CI 1.18-3.63, and 2.41, 1.30-4.47, respectively). A possible, though not statistically significant, increase of the risk of cardiovascular disease was also found (RR for 2nd and 3rd tertiles of serum PCB distribution: 1.61, 0.72-3.64, and 1.96, 0.86-4.48, respectively). The results based on lipid-standardized PCBs were slightly attenuated. No association was found between PCB serum levels and occurrence of diabetes and endocrine disorders. Stratified analysis by body mass index showed an increased risk of hypertension in subjects at 2nd and 3rd tertile of serum PCB distribution in overweight/obese subjects only.

CONCLUSIONS

These results suggest that PCBs might play a role in the development of hypertension and possibly cardiovascular disease, though alternative explanations are to be considered too.

Persistent organic pollutants as predictors of increased FSH:LH ratio in naturally cycling, reproductive age women

Although several recent studies suggest endocrine disrupting compounds, such as polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene (p,p', DDE), and hexachlorobenzene (HCB), target different organs and systems in the body, their impact on female reproductive function in humans is not well characterized. We seek to determine the relationship between several known endocrine disrupting compounds and a marker of ovarian responsivity, the FSH:LH ratio (higher ratio indicates less ovarian responsivity). For this analysis, 169 naturally cycling women between 21 and 38 years of age completed interviews and had their blood drawn on day 3 of their menstrual cycle for analyses of toxicants, gonadal sex hormones (E₂ and P₄), and gonadotropins (FSH and LH). PCB congeners were classified into five groups based on their environmental persistence, distribution in human tissue, and toxicological action, reflecting the structure, mechanism, and known biological activity of individual PCB congeners. For every unit (ppb) increase in the level of the estrogenic PCB group, there was a 5-fold greater risk of a FSH:LH ratio ≥ 2, controlling for individual differences in age, percent body fat, cycle day 3 estradiol levels, parity, alcohol use and cigarette smoking in the past year (exp[ß] = 5; p = ≤0.01). PCB congeners identified as estrogenic were analyzed individually, and, of the 19 potentially estrogenic congeners, five were significantly, and positively related to an increased FSH:LH ratio. Four of these congeners are non-persistent, easily volatilize in the environment, and are easily metabolized, and hence, are indicative of very recent or current exposure. p,p'-DDE and HCB were not associated with FSH:LH ratio. We find a clinical indicator of ovarian responsivity, FSH:LH ratio, is associated with a specific group of estrogenic PCBs. These congeners may become airborne when they volatilize from dredged PCB-contaminated soil or from indoor PCB-containing window caulk and sealants in older buildings leading to inhalation exposure. PCB exposure, particularly to non-persistent, estrogenic congeners, may pose an unrecognized threat to female fecundity within the general population.

Water contamination by endocrine disruptors: Impacts, microbiological aspects and trends for environmental protection

Hormone active agents constitute a dangerous class of pollutants. Among them, those agents that mimic the action of estrogens on target cells and are part of the group of endocrine-disruptor compounds (EDCs) are termed estrogenic EDCs, the main focus of this review. Exposure to these compounds causes a number of negative effects, including breast cancer, infertility and animal hermaphroditism. However, especially in underdeveloped countries, limited efforts have been made to warn people about this serious issue, explain the methods of minimizing exposure, and develop feasible and efficient mitigation strategies at different levels and in various environments. For instance, the use of bioremediation processes capable of transforming EDCs into environmentally friendly compounds has been little explored. A wide diversity of estrogen-degrading microorganisms could be used to develop such technologies, which include bioremediation processes for EDCs that could be implemented in biological filters for the post-treatment of wastewater effluent. This review describes problems associated with EDCs, primarily estrogenic EDCs, including exposure as well as the present status of understanding and the effects of natural and synthetic hormones and estrogenic EDCs on living organisms. We also describe potential biotechnological strategies for EDC biodegradation, and suggest novel treatment approaches for minimizing the persistence of EDCs in the environment.

Testing ovarian reserve in pre-menopausal women: why, whom and how?

Numerous social and environmental factors (environmental hazards, social factors such as education and career, higher economic status desired before the decision is made to have children) influence a women's decision to postpone pregnancy until late reproductive age. In turn, age is related to a fall in ovarian reserve. The main goal of testing ovarian reserve is the identification of women with so-called diminished ovarian reserve (DOR). Additionally, it provides assistance in the counselling of women who are planning to use assisted reproductive techniques (ART). This review examines current methods of testing ovarian reserve and their application. The most useful methods of assessing ovarian reserve are ultrasonographic count of ovarian antral follicles (AFC) and serum tests of both the anti-Müllerian hormone (AMH) level and the third-day level of follicle stimulating hormone (FSH). However, there are limitations to the currently used methods of testing ovarian reserve, especially in relation to their specificity and sensitivity. It is also difficult to predict egg quality based on these tests. The value of screening programmes of ovarian reserve is yet to be determined.

Exposure to endocrine disruptors during adulthood: consequences for female fertility

Endocrine disrupting chemicals are ubiquitous chemicals that exhibit endocrine disrupting properties in both humans and animals. Female reproduction is an important process, which is regulated by hormones and is susceptible to the effects of exposure to endocrine disrupting chemicals. Disruptions in female reproductive functions by endocrine disrupting chemicals may result in subfertility, infertility, improper hormone production, estrous and menstrual cycle abnormalities, anovulation, and early reproductive senescence. This review summarizes the effects of a variety of synthetic endocrine disrupting chemicals on fertility during adult life. The chemicals covered in this review are pesticides (organochlorines, organophosphates, carbamates, pyrethroids, and triazines), heavy metals (arsenic, lead, and mercury), diethylstilbesterol, plasticizer alternatives (di-(2-ethylhexyl) phthalate and bisphenol A alternatives), 2,3,7,8-tetrachlorodibenzo-p-dioxin, nonylphenol, polychlorinated biphenyls, triclosan, and parabens. This review focuses on the hypothalamus, pituitary, ovary, and uterus because together they regulate normal female fertility and the onset of reproductive senescence. The literature shows that several endocrine disrupting chemicals have endocrine disrupting abilities in females during adult life, causing fertility abnormalities in both humans and animals.