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Kaye E, Marques E, Agudelo Areiza J, Modaresi SMS, Slitt A. Exposure to a PFOA, PFOS and PFHxS Mixture during Gestation and Lactation Alters the Liver Proteome in Offspring of CD-1 Mice. TOXICS 2024; 12:348. [PMID: 38787127 PMCID: PMC11126053 DOI: 10.3390/toxics12050348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/27/2024] [Accepted: 04/28/2024] [Indexed: 05/25/2024]
Abstract
Perfluroalkyl substances (PFASs) are persistent man-made chemicals considered to be emerging pollutants, with Perfluorooctanoic acid (PFOA), Perfluorooctanesulfonic acid (PFOS), and Perfluorohexanesulphonic acid (PFHxS) being linked to hepatotoxicity and steatosis. PFOA, PFOS, and PFHxS can undergo placental and lactational transfer, which results in PFOA, PFOS, and PFHxS distribution to the neonatal liver. Moreover, in pregnant dams, exposure to a PFAS mixture, in combination with a high fat diet, increased hepatic steatosis in offspring at postnatal day 21, but the mechanisms have not been elucidated. It was hypothesized that gestational/lactational PFAS exposure would alter the pup liver proteome and biochemical/signaling pathways. Timed-pregnant CD-1 dams were fed a standard chow or 60% kcal high-fat diet. From GD1 until PND20, dams were dosed via oral gavage with vehicle (0.5% Tween 20), individual doses of PFOA, PFOS, PFHxS at 1 mg/kg, or a mixture (1 mg/kg each, totaling 3 mg/kg). Livers were collected from PND21 offspring and SWATH-MS proteomics was performed. IPA analysis revealed PFAS exposure modified disease and biological function pathways involved in liver damage, xenobiotics, and lipid regulation in the PND21 liver. These pathways included lipid and fatty acid transport, storage, oxidation, and synthesis, as well as xenobiotic metabolism and transport, and liver damage and inflammation. This indicates the pup liver proteome is altered via maternal exposure and predisposes the pup to metabolic dysfunctions.
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Affiliation(s)
- Emily Kaye
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, RI 02881, USA; (E.K.); (E.M.); (J.A.A.); (S.M.S.M.)
| | - Emily Marques
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, RI 02881, USA; (E.K.); (E.M.); (J.A.A.); (S.M.S.M.)
- Office of Pollution Prevention and Toxics, US EPA, 1200 Pennsylvania Ave. NW, Washington, DC 20460, USA
| | - Juliana Agudelo Areiza
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, RI 02881, USA; (E.K.); (E.M.); (J.A.A.); (S.M.S.M.)
| | - Seyed Mohamad Sadegh Modaresi
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, RI 02881, USA; (E.K.); (E.M.); (J.A.A.); (S.M.S.M.)
| | - Angela Slitt
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, RI 02881, USA; (E.K.); (E.M.); (J.A.A.); (S.M.S.M.)
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Rosato I, Bonato T, Fletcher T, Batzella E, Canova C. Estimation of per- and polyfluoroalkyl substances (PFAS) half-lives in human studies: a systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2024; 242:117743. [PMID: 38008199 DOI: 10.1016/j.envres.2023.117743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) constitute a heterogeneous group of synthetic compounds widely used in industrial applications. The estimation of PFAS half-life (t1/2) is essential to quantify their persistence, their toxicity and mechanism of action in humans. OBJECTIVES The purpose of this review is to summarize the evidence on PFAS half-lives in humans from the available literature, and to investigate the limitations and uncertainties characterizing half-life estimation. METHODS The search was conducted on PubMed, Scopus, and Embase databases up to July 03, 2023 and was aimed at identifying all papers that estimated PFAS half-life in human populations. We excluded studies on temporal trends or providing estimates of half-life based solely on renal clearance. As persistent and ongoing exposures can influence half-life estimation, we decided to include only studies that were conducted after the main source of exposure to PFAS had ceased. A random-effects meta-analysis was conducted on studies that reported perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS) or perfluorohexanesulfonic acid (PFHxS) half-life estimation. Risk of bias was evaluated using the OHAT tool. RESULTS A total of 13 articles were included in the review, with 5 studies conducted in exposed general populations and 8 studies conducted in exposed workers; the estimated mean half-life ranged from 1.48 to 5.1 years for PFOA, from 3.4 to 5.7 years for total PFOS, and from 2.84 to 8.5 years for PFHxS. High heterogeneity among studies was observed; potential reasons include the variability among the investigated populations, discrepancies in considering ongoing exposures, variability in PFAS isomeric compositions, accounting for background exposure, time since exposure stopped and methods used for half-life estimation. DISCUSSION Despite the efforts made to better understand PFAS toxicokinetics, further studies are needed to identify important characteristics of these persistent chemicals. Biomonitoring studies should focus on persistent and unaccounted sources of exposure to PFAS and on individual characteristics potentially determining half-life, to ensure accurate estimates.
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Affiliation(s)
- Isabella Rosato
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padova, Italy
| | - Tiziano Bonato
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padova, Italy
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Erich Batzella
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padova, Italy
| | - Cristina Canova
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, Padova, Italy.
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Wang L, Sun W, Ma X, Griffin N, Liu H. Perfluorooctanoic acid (PFOA) exposure induces renal filtration and reabsorption disorders via down-regulation of aquaporins. Toxicol Lett 2024; 392:22-35. [PMID: 38123106 DOI: 10.1016/j.toxlet.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/18/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
Perfluorooctanoic acid (PFOA) exposure is associated with kidney dysfunction, however the exact mechanisms by which PFOA induces nephrotoxicity and the specific involvement of aquaporins (AQPs) in kidney tissue remains unclear. In this study, adult male Sprague-Dawley (SD) rats were exposed to PFOA by oral gavage for 28 days and compared with controls. Body weight, water intake and urine volume were recorded daily. At the end of the experiment, blood and kidney samples were collected, and serum urea, creatine and uric acid levels were assessed. The renal expression levels of water channel proteins AQP1, AQP3, AQP2 and p-AQP2 (Ser256) were observed by immunohistochemical staining, and the corresponding transcription levels were detected by Western blot and qRT-PCR. The results showed that PFOA exposure inhibited weight gain and increased water intake, urine volume, kidney weight and renal visceral index. PASM staining and transmission electron microscopy revealed pathological thickening of the glomerular capsule and basement membrane. Serum urea levels were increased, while serum creatine levels were decreased compared to controls. Additionally, the expression levels of AQP1, AQP3, AQP2 and p-AQP2 in kidney tissues were decreased, and the phosphorylation of AQP2 at Ser256 was inhibited. In conclusion, we demonstrate that PFOA exposure can damage the renal filtration barrier and reduce the expression level of AQPs in renal tissues, leading to renal filtration and reabsorption disorders.
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Affiliation(s)
- Li Wang
- School of Public Health, Bengbu Medical College, Bengbu 233030, PR China
| | - Weiqiang Sun
- Bengbu Medical College, Bengbu 233030, PR China; Bengbu Medical College Key Laboratory of Cancer Research and Clinical Laboratory Diagnosis, Bengbu 233030, PR China; Anhui Province Key Laboratory of Immunology in Chronic Diseases, Bengbu 233030, PR China; Department of Biochemistry and Molecular Biology, School of Laboratory Medicine, Bengbu 233030, PR China
| | - Xinzhuang Ma
- School of Public Health, Bengbu Medical College, Bengbu 233030, PR China
| | - Nathan Griffin
- Department of Cell and Tissue Biology, University of California, San Francisco, CA, USA
| | - Hui Liu
- Bengbu Medical College, Bengbu 233030, PR China; Bengbu Medical College Key Laboratory of Cancer Research and Clinical Laboratory Diagnosis, Bengbu 233030, PR China; Anhui Province Key Laboratory of Immunology in Chronic Diseases, Bengbu 233030, PR China; Department of Biochemistry and Molecular Biology, School of Laboratory Medicine, Bengbu 233030, PR China.
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Ma X, Ren X, Zhang X, Wang G, Liu H, Wang L. Rutin ameliorate PFOA induced renal damage by reducing oxidative stress and improving lipid metabolism. J Nutr Biochem 2024; 123:109501. [PMID: 37890710 DOI: 10.1016/j.jnutbio.2023.109501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/09/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023]
Abstract
Perfluorooctanoic acid (PFOA) is a persistent environmental pollutant that can accumulate in the kidneys and eventually cause kidney damage. Rutin (RUTIN) is a natural flavonoid with multiple biological activities, and its use in against kidney damage has been widely studied in recent years. It is not yet known whether rutin protects against kidney damage caused by PFOA. In this study, 30 ICR mice were randomly divided into three groups: CTRL group, PFOA group and PFOA+RUTIN group. The mice were fed continuously by gavage for 28 days. Renal pathological changes were assessed by HE and PASM staining, and serum renal function and lipid indicators were measured. RNA-seq and enrichment analysis using GO, KEGG and PPI to detect differential expression of genes in treatment groups. Kidney tissue protein expression was determined by Western blot. Research has shown that rutin can improve glomerular and tubular structural damage, and increase serum CREA, HDL-C levels and decrease LDH, LDL-C levels. The expression of AQP1 and ACOT1 was up-regulated after rutin treatment. Transcriptomic analysis indicated that PFOA and rutin affect the transcriptional expression of genes related to lipid metabolism and oxidative stress, and may affected by PI3K-Akt, PPAR, NRF2/KEAP1 signaling pathways. In conclusion, rutin ameliorated renal damage caused by PFOA exposure, and this protective effect may be exerted by ameliorating oxidative stress and regulating lipid metabolism.
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Affiliation(s)
- Xinzhuang Ma
- School of Public Health, Bengbu Medical College, Bengbu, PR China
| | - Xijuan Ren
- School of Public Health, Bengbu Medical College, Bengbu, PR China
| | - Xuemin Zhang
- Department of Biochemistry and Molecular Biology, School of Laboratory Medicine; Anhui Province Key Laboratory of Immunology in Chronic Diseases, Bengbu Medical College, Bengbu, PR China
| | - Guangyin Wang
- School of Public Health, Bengbu Medical College, Bengbu, PR China
| | - Hui Liu
- Department of Biochemistry and Molecular Biology, School of Laboratory Medicine; Anhui Province Key Laboratory of Immunology in Chronic Diseases, Bengbu Medical College, Bengbu, PR China.
| | - Li Wang
- School of Public Health, Bengbu Medical College, Bengbu, PR China.
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Hensen T, Fässler D, O’Mahony L, Albrich WC, Barda B, Garzoni C, Kleger GR, Pietsch U, Suh N, Hertel J, Thiele I. The Effects of Hospitalisation on the Serum Metabolome in COVID-19 Patients. Metabolites 2023; 13:951. [PMID: 37623894 PMCID: PMC10456321 DOI: 10.3390/metabo13080951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
COVID-19, a systemic multi-organ disease resulting from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is known to result in a wide array of disease outcomes, ranging from asymptomatic to fatal. Despite persistent progress, there is a continued need for more accurate determinants of disease outcomes, including post-acute symptoms after COVID-19. In this study, we characterised the serum metabolomic changes due to hospitalisation and COVID-19 disease progression by mapping the serum metabolomic trajectories of 71 newly hospitalised moderate and severe patients in their first week after hospitalisation. These 71 patients were spread out over three hospitals in Switzerland, enabling us to meta-analyse the metabolomic trajectories and filter consistently changing metabolites. Additionally, we investigated differential metabolite-metabolite trajectories between fatal, severe, and moderate disease outcomes to find prognostic markers of disease severity. We found drastic changes in serum metabolite concentrations for 448 out of the 901 metabolites. These results included markers of hospitalisation, such as environmental exposures, dietary changes, and altered drug administration, but also possible markers of physiological functioning, including carboxyethyl-GABA and fibrinopeptides, which might be prognostic for worsening lung injury. Possible markers of disease progression included altered urea cycle metabolites and metabolites of the tricarboxylic acid (TCA) cycle, indicating a SARS-CoV-2-induced reprogramming of the host metabolism. Glycerophosphorylcholine was identified as a potential marker of disease severity. Taken together, this study describes the metabolome-wide changes due to hospitalisation and COVID-19 disease progression. Moreover, we propose a wide range of novel potential biomarkers for monitoring COVID-19 disease course, both dependent and independent of the severity.
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Affiliation(s)
- Tim Hensen
- School of Medicine, University of Galway, H91 TK33 Galway, Ireland;
- School of Microbiology, University of Galway, H91 TK33 Galway, Ireland
- Ryan Institute, University of Galway, H91 TK33 Galway, Ireland
- APC Microbiome Ireland, T12 K8AF Cork, Ireland; (L.O.); (W.C.A.)
| | - Daniel Fässler
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Liam O’Mahony
- APC Microbiome Ireland, T12 K8AF Cork, Ireland; (L.O.); (W.C.A.)
- Department of Medicine and School of Microbiology, University College Cork, T12 K8AF Cork, Ireland
| | - Werner C. Albrich
- APC Microbiome Ireland, T12 K8AF Cork, Ireland; (L.O.); (W.C.A.)
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, 9007 St. Gallen, Switzerland
| | - Beatrice Barda
- Fondazione Epatocentro Ticino, Via Soldino 5, 6900 Lugano, Switzerland; (B.B.); (C.G.)
| | - Christian Garzoni
- Fondazione Epatocentro Ticino, Via Soldino 5, 6900 Lugano, Switzerland; (B.B.); (C.G.)
- Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese Moncucco, 6900 Lugano, Switzerland
| | - Gian-Reto Kleger
- Division of Intensive Care, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland;
| | - Urs Pietsch
- Department of Anesthesia, Intensive Care, Emergency and Pain Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland;
| | - Noémie Suh
- Division of Intensive Care, Geneva University Hospitals, The Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland;
| | - Johannes Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany;
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Ines Thiele
- School of Medicine, University of Galway, H91 TK33 Galway, Ireland;
- School of Microbiology, University of Galway, H91 TK33 Galway, Ireland
- Ryan Institute, University of Galway, H91 TK33 Galway, Ireland
- APC Microbiome Ireland, T12 K8AF Cork, Ireland; (L.O.); (W.C.A.)
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Gao B, Chen L, Xu W, Shan J, Shen W, Gao N. Effects of Perfluorooctanoic Acid on Gut Microbiota and Microbial Metabolites in C57BL/6J Mice. Metabolites 2023; 13:707. [PMID: 37367865 DOI: 10.3390/metabo13060707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 06/28/2023] Open
Abstract
Perfluorooctanoic acid (PFOA) represents an increasing public health concern due to its persistence in the environment and its toxic effects. The gut microbiota is known to produce various metabolites that assist the host to maintain metabolic homeostasis. However, few studies have explored the effects of PFOA on gut-microbiota-related metabolites. In the present study, male C57BL/6J mice were exposed to 1 ppm of PFOA in drinking water for four weeks and integrative analysis of the gut microbiome and metabolome was performed to reveal the health effects of PFOA. Our results showed that PFOA disturbed both the gut microbiota composition and the metabolic profiles of the feces, serum, and liver in mice. A correlation was found between Lachnospiraceae UCG004, Turicibacter, Ruminococcaceae, and different fecal metabolites. Significant alterations of gut-microbiota-related metabolites were induced by PFOA exposure, including bile acids and tryptophan metabolites such as 3-indoleacrylic acid and 3-indoleacetic acid. The findings of this study are helpful to improve the understanding of the health effects of PFOA, which might be mediated through the gut microbiota and its related metabolites.
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Affiliation(s)
- Bei Gao
- School of Marine Sciences, Nanjing University of Information Science and Technology, Nanjing 210044, China
- Key Laboratory of Hydrometeorological Disaster Mechanism and Warning of Ministry of Water Resources, Nanjing University of Information Science and Technology, Nanjing 210044, China
| | - Lixia Chen
- School of Marine Sciences, Nanjing University of Information Science and Technology, Nanjing 210044, China
| | - Weichen Xu
- Medical Metabolomics Center, Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Jinjun Shan
- Medical Metabolomics Center, Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Weishou Shen
- School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing 210044, China
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative In-novation Center of Atmospheric Environment and Equipment Technology, Nanjing 210044, China
- Institute of Soil Health and Climate-Smart Agriculture, Nanjing University of Information Science and Technology, Nanjing 210044, China
| | - Nan Gao
- School of Biological and Pharmaceutical Engineering, Nanjing Tech University, Nanjing 211816, China
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Seltenrich N. From Drinking Water to Individual Body Burden: Modeling Toxicokinetics of Four PFAS. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:14001. [PMID: 36696105 PMCID: PMC9875838 DOI: 10.1289/ehp12514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
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Hong A, Zhuang L, Cui W, Lu Q, Yang P, Su S, Wang B, Zhang G, Chen D. Per- and polyfluoroalkyl substances (PFAS) exposure in women seeking in vitro fertilization-embryo transfer treatment (IVF-ET) in China: Blood-follicular transfer and associations with IVF-ET outcomes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156323. [PMID: 35636536 DOI: 10.1016/j.scitotenv.2022.156323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
As follicular fluid constitutes a critical microenvironment for the development of oocytes, investigation of environmental contaminants in follicular fluid may facilitate a better understanding of the influence of environmental exposure on reproductive health. In the present study, we aimed to investigate per- and polyfluoroalkyl substances (PFAS) exposure in women receiving in vitro fertilization-embryo transfer (IVF-ET) treatment, determine the blood-follicle transfer efficiencies (BFTE) of PFAS, and explore potential associations between PFAS exposure and selected IVF-ET outcomes. Our results revealed that n-PFOA was the most abundant PFAS in both serum and follicular fluid (FF) (median = 5.85 and 5.56 ng/mL, respectively), followed by n-PFOS (4.95 and 4.28 ng/mL), 6:2 Cl-PFESA (2.18 and 2.10 ng/mL), PFNA (1.37 and 1.37 ng/mL), PFUdA (0.33 and 0.97 ng/mL), PFDA (0.37 and 0.66 ng/mL), PFHxS (0.42 and 0.39 ng/mL), and PFHpS (0.11 and 0.10 ng/mL). The median BFTE ranged from 0.65 to 0.92 for individual PFAS, indicating a relatively high tendency of PFAS to cross the blood-follicle barrier (BFB). An inverted V-shaped trend was observed between the median BFTE and the number of fluorinated carbon atoms or the log Kow (octanol-water partition coefficient) for individual PFAS, suggesting the influence by physicochemical properties and molecular structures. Although our data did not find any clear pattern in the link between blood or follicular fluid concentrations of PFAS and selected IVF-ET outcomes, our study raises the need for better characterization of exposure to environmental chemicals in follicular fluid together with its potential influence on reproductive health.
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Affiliation(s)
- Aobo Hong
- School of Environment and Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, China
| | - Lili Zhuang
- Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, Yantai, Shandong 264000, China
| | - Wenxuan Cui
- School of Environment and Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, China.
| | - Qun Lu
- Reproductive Medical Center, Peking University People's Hospital, Beijing 100044, China
| | - Pan Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, Guangdong 510632, China
| | - Shu Su
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health, Peking University, Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China
| | - Bin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health, Peking University, Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China
| | - Guohuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, School of Public Health, Peking University, Beijing 100191, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing 100191, China
| | - Da Chen
- School of Environment and Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, China.
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