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Farag AGA, Badr EAE, Kholif AOA, Khalifa MN, Ghanem MMM. Serum and Seminal Plasma Levels of Lead and Arsenic in Cigarette Smokers and Their Relation to the Semen Parameters. Biol Trace Elem Res 2024:10.1007/s12011-023-04039-7. [PMID: 38180596 DOI: 10.1007/s12011-023-04039-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
Male infertility along with altered semen parameters have been related to smoking. Smoking-related elevations in serum and seminal lead (Pb) and arsenic (As) may play a role in mediating the toxic effects of smoking on seminogram. This research aims to determine whether smoking has any significant impact on Pb and As levels in the seminal plasma and serum, as well as on the various semen parameters, when compared to nonsmokers. In total, 80 adult males were included: 60 smokers and 20 age-matched nonsmokers. Based on the number of cigarettes smoked/day (CPD), the smokers were categorized into mild (1-10), moderate (11-20), and severe (> 20). The analysis of semen was conducted in accordance with the 2010 WHO laboratory manual. Using an atomic absorption spectrophotometer, Pb and As concentrations in the serum and seminal plasma of all groups were determined. Compared to nonsmokers, smokers had a significantly reduced sperm count, motility, and viability, as well as a larger percentage of aberrant forms (P = 0.001, 0.025, 0.034, 0.002 respectively). Smokers had higher Pb concentrations in their serum and seminal fluid than nonsmokers (P = 0.002, 0.001 respectively). Seminal Pb had a significant negative correlation with sperm count (P = 0.004, r = -0.320). Serum Pb levels were found to positively correlate with seminal Pb levels (P 0.001, r = 0.648), and cigarette smokers had substantially greater seminal As levels than nonsmokers (P = 0.024). Sperm viability was strongly inversely related to seminal As (P = 0.042, r = -0.264). Seminal As levels and aberrant sperm shapes were found to be significantly correlated (P = 0.001, r = 0.414). In smokers, a significant positive relationship between seminal As and seminal Pb was observed. Therefore, semen parameters could be adversely affected by smoking through high levels of Pb and As (P = 0.012, r = 0.298).
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Affiliation(s)
- Azza Gaber Antar Farag
- Dermatology, Andrology and STDs department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Eman Abd-Elfatah Badr
- Medical Biochemistry and Molecular Biology Department Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Alaa Osama Ali Kholif
- Dermatology, Andrology and STDs department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Mostafa Nabil Khalifa
- Dermatology, Andrology and STDs department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - Mai Medhat Mohamed Ghanem
- Dermatology, Andrology and STDs department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt.
- , Birket El Sabe, 32661, Menoufia, Egypt.
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2
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Giulioni C, Maurizi V, De Stefano V, Polisini G, Teoh JYC, Milanese G, Galosi AB, Castellani D. The influence of lead exposure on male semen parameters: a systematic review and meta-analysis. Reprod Toxicol 2023; 118:108387. [PMID: 37119974 DOI: 10.1016/j.reprotox.2023.108387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/01/2023]
Abstract
Lead (Pb) is a metal with a widespread diffusion in the environment. Pb tends to accumulate in the human body and, as a consequence, semen alterations can be present in exposed workers or general population. The aim of the present study is to evaluate the effect on semen parameters among healthy men exposed to environmental or occupational Pb. A systematic literature search was performed on November 12th, 2022, through MEDLINE via PubMed, Scopus, and Embase. Observational studies comparing semen parameters in men exposed to Pb and those not exposed were included. Sperm parameters were pooled using the Cochran-Mantel-Haenszel Method with a random effect model. The weighted mean difference (WMD) was used as a summary measure. Statistical significance was set at p-value <0.05 Ten papers were included. Pb exposure was associated with a significant reduction in semen volume (WMD -0.76ml.95% CI -1.47, -0.05, p=0.04), sperm concentration (WMD -0.63 ×106/ml 95% CI -1.15, -0.12, p=0.02), total sperm count (WMD -1.94 ×106 95% CI -3. 77, -0.11, p=0.04), sperm vitality (WMD -2.18% 95% CI -3.92, -0.45, p=0.01), and total sperm motility (WMD -1.31% 95% CI -2.33, -0.30, p=0.01). No difference was found in sperm normal morphology, progressive motility, and seminal viscosity. This review demonstrated the negative effect of Pb exposure on most of semen parameters. Given the diffuse exposure to this metal of the general population, public health concerns should be considered and exposed workers should be assessed to evaluate their semen. DATA AVAILABILITY STATEMENT: Data will be provided by the corresponding author upon a reasonable request.
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Affiliation(s)
- Carlo Giulioni
- Polytechnic University of Marche, Azienda Ospedaliera Universitaria della Marche, Department of Urology, Ancona, Italy.
| | - Valentina Maurizi
- Polytechnic University of Marche, Azienda Ospedaliera Universitaria della Marche, Department of Clinical and Molecular Sciences, Ancona, Italy
| | - Virgilio De Stefano
- Polytechnic University of Marche, Azienda Ospedaliera Universitaria della Marche, Department of Urology, Ancona, Italy
| | - Giordano Polisini
- Polytechnic University of Marche, Azienda Ospedaliera Universitaria della Marche, Department of Urology, Ancona, Italy
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Giulio Milanese
- Polytechnic University of Marche, Azienda Ospedaliera Universitaria della Marche, Department of Urology, Ancona, Italy
| | - Andrea Benedetto Galosi
- Polytechnic University of Marche, Azienda Ospedaliera Universitaria della Marche, Department of Urology, Ancona, Italy
| | - Daniele Castellani
- Polytechnic University of Marche, Azienda Ospedaliera Universitaria della Marche, Department of Urology, Ancona, Italy
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Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Jolles M, Pinotti R, Swan SH. Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries. Hum Reprod Update 2023; 29:157-176. [PMID: 36377604 DOI: 10.1093/humupd/dmac035] [Citation(s) in RCA: 118] [Impact Index Per Article: 118.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Numerous studies have reported declines in semen quality and other markers of male reproductive health. Our previous meta-analysis reported a significant decrease in sperm concentration (SC) and total sperm count (TSC) among men from North America-Europe-Australia (NEA) based on studies published during 1981-2013. At that time, there were too few studies with data from South/Central America-Asia-Africa (SAA) to reliably estimate trends among men from these continents. OBJECTIVE AND RATIONALE The aim of this study was to examine trends in sperm count among men from all continents. The broader implications of a global decline in sperm count, the knowledge gaps left unfilled by our prior analysis and the controversies surrounding this issue warranted an up-to-date meta-analysis. SEARCH METHODS We searched PubMed/MEDLINE and EMBASE to identify studies of human SC and TSC published during 2014-2019. After review of 2936 abstracts and 868 full articles, 44 estimates of SC and TSC from 38 studies met the protocol criteria. Data were extracted on semen parameters (SC, TSC, semen volume), collection year and covariates. Combining these new data with data from our previous meta-analysis, the current meta-analysis includes results from 223 studies, yielding 288 estimates based on semen samples collected 1973-2018. Slopes of SC and TSC were estimated as functions of sample collection year using simple linear regression as well as weighted meta-regression. The latter models were adjusted for predetermined covariates and examined for modification by fertility status (unselected by fertility versus fertile), and by two groups of continents: NEA and SAA. These analyses were repeated for data collected post-2000. Multiple sensitivity analyses were conducted to examine assumptions, including linearity. OUTCOMES Overall, SC declined appreciably between 1973 and 2018 (slope in the simple linear model: -0.87 million/ml/year, 95% CI: -0.89 to -0.86; P < 0.001). In an adjusted meta-regression model, which included two interaction terms [time × fertility group (P = 0.012) and time × continents (P = 0.058)], declines were seen among unselected men from NEA (-1.27; -1.78 to -0.77; P < 0.001) and unselected men from SAA (-0.65; -1.29 to -0.01; P = 0.045) and fertile men from NEA (-0.50; -1.00 to -0.01; P = 0.046). Among unselected men from all continents, the mean SC declined by 51.6% between 1973 and 2018 (-1.17: -1.66 to -0.68; P < 0.001). The slope for SC among unselected men was steeper in a model restricted to post-2000 data (-1.73: -3.23 to -0.24; P = 0.024) and the percent decline per year doubled, increasing from 1.16% post-1972 to 2.64% post-2000. Results were similar for TSC, with a 62.3% overall decline among unselected men (-4.70 million/year; -6.56 to -2.83; P < 0.001) in the adjusted meta-regression model. All results changed only minimally in multiple sensitivity analyses. WIDER IMPLICATIONS This analysis is the first to report a decline in sperm count among unselected men from South/Central America-Asia-Africa, in contrast to our previous meta-analysis that was underpowered to examine those continents. Furthermore, data suggest that this world-wide decline is continuing in the 21st century at an accelerated pace. Research on the causes of this continuing decline and actions to prevent further disruption of male reproductive health are urgently needed.
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Affiliation(s)
- Hagai Levine
- Braun School of Public Health and Community Medicine, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Niels Jørgensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Jaime Mendiola
- Division of Preventive Medicine and Public Health, University of Murcia School of Medicine and Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), Murcia, Spain
| | - Dan Weksler-Derri
- Clalit Health Services, Kiryat Ono, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Maya Jolles
- Braun School of Public Health and Community Medicine, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rachel Pinotti
- Gustave L. and Janet W. Levy Library, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Krzastek SC, Farhi J, Gray M, Smith RP. Impact of environmental toxin exposure on male fertility potential. Transl Androl Urol 2021; 9:2797-2813. [PMID: 33457251 PMCID: PMC7807371 DOI: 10.21037/tau-20-685] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Idiopathic infertility is the most common individual diagnosis in male infertility, representing nearly 44% of cases. Research studies dating over the last half-century consistently demonstrate a decline in male fertility that is incompletely explained by obesity, known genetic causes, or diet and lifestyle changes alone. Human exposures have changed dramatically over the same time course as this fertility decline. Synthetic chemicals surround us. Some are benevolent; however, many are known to cause disruption of the hypothalamic-pituitary-gonadal axis and impair spermatogenesis. More than 80,000 chemicals are registered with the United States National Toxicology Program and nearly 2,000 new chemicals are introduced each year. Many of these are known toxins, such as phthalates, polycyclic aromatic hydrocarbons, aromatic amines, and organophosphate esters, and have been banned or significantly restricted by other countries as they carry known carcinogenic effects and are reproductively toxic. In the United States, many of these chemicals are still permissible in exposure levels known to cause reproductive harm. This contrasts to other chemical regulatory legislature, such as the European Union’s REACH (Registration, Evaluation, Authorization and Restriction of Chemicals) regulations which are more comprehensive and restrictive. Quantification of these diverse exposures on an individual level has proven challenging, although forthcoming technologies may soon make this data available to consumers. Establishing causality and the proportion of idiopathic infertility attributable to environmental toxin exposures remains elusive, however, continued investigation, avoidance of exposure, and mitigation of risk is essential to our reproductive health. The aim of this review is to examine the literature linking changes in male fertility to some of the most common environmental exposures. Specifically, pesticides and herbicides such as dichlorodiphenyltrichloroethane (DDT), dibromochloropropane (DBCP), organophosphates and atrazine, endocrine disrupting compounds including plastic compounds phthalates and bisphenol A (BPA), heavy metals, natural gas/oil, non-ionizing radiation, air and noise pollution, lifestyle factors including diet, obesity, caffeine use, smoking, alcohol and drug use, as well as commonly prescribed medications will be discussed.
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Affiliation(s)
- Sarah C Krzastek
- Department of Urology, University of Virginia, Charlottesville, VA, USA.,Division of Urology, Virginia Commonwealth University, Richmond, VA, USA.,Division of Urology, Hunter Holmes McGuire VAMC, Richmond, VA, USA
| | - Jack Farhi
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | - Marisa Gray
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | - Ryan P Smith
- Department of Urology, University of Virginia, Charlottesville, VA, USA
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5
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Balachandar R, Bagepally BS, Kalahasthi R, Haridoss M. Blood lead levels and male reproductive hormones: A systematic review and meta-analysis. Toxicology 2020; 443:152574. [PMID: 32860866 DOI: 10.1016/j.tox.2020.152574] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/18/2020] [Accepted: 08/24/2020] [Indexed: 12/14/2022]
Abstract
Present study aimed to systematically review and synthesise quantitative evidence on association between occupational Lead (Pb) exposure and male reproductive hormones (MRH) and sperm quality from the existing literature. Observational studies investigating the effects of Pb exposure on MRH, sperm-count and sperm motility are systematically searched in PubMed, Scopus and EMBASE databases since inception to May 2019. The PRISMA guidelines are adhered during the entire study procedure and details such as participant characteristics, occupational Pb exposure, MRH, sperm-count and sperm motility from individual articles are extracted to the perform meta-analysis. Sub-group analysis and sensitivity analysis are additionally explored. Further, meta-regression is executed to investigate the influence of participant's age, duration of workplace Pb exposure on the individual outcome parameters. We observed that otherwise normal (fertile) male participants from all studies were within the age range of 25-45 years. Male employees occupationally exposed to Pb exhibited significantly higher blood Pb, lower sperm-count, poor sperm motility and higher serum prolactin levels as compared to the Pb unexposed males. The testosterone, follicle stimulating hormone and luteinising hormone levels of the occupationally Pb exposed participants are comparable to that of unexposed comparators. Studies included for synthesising quantitative evidence had unacceptable levels of heterogeneity. Explorative subgroup or meta-regression analysis had no additional results to the study. Lastly, included studies were driven by publication bias (positive results) and low powered (small sample size) studies. Thus, Pb exposure at workplaces is detrimental to male reproductive function, with lower sperm-count and higher prolactin levels. However, to enumerate the precise quantity of Pb exposure detrimental on male reproductive functions, high quality longitudinal studies with large cohorts are needed.
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6
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Ramos-Treviño J, Bassol-Mayagoitia S, Hernández-Ibarra JA, Ruiz-Flores P, Nava-Hernández MP. Toxic Effect of Cadmium, Lead, and Arsenic on the Sertoli Cell: Mechanisms of Damage Involved. DNA Cell Biol 2018; 37:600-608. [PMID: 29746152 DOI: 10.1089/dna.2017.4081] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Over the past decades, an increase has been described in exposure to environmental toxins; consequently, a series of studies has been carried out with the aim of identifying problems associated with health. One of the main risk factors is exposure to heavy metals. The adverse effects that these compounds exert on health are quite complex and difficult to elucidate, in that they act at different levels and there are various signaling pathways that are implicated in the mechanisms of damage. The Sertoli cells plays a role of vital importance during the process of spermatogenesis, and it has been identified as one of the principal targets of heavy metals. In the present review, cadmium, lead, and arsenic are broached as altering the physiology of the Sertoli cells, citing mechanisms that have been cited in the literature.
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Affiliation(s)
- Juan Ramos-Treviño
- 1 Department of Reproductive Biology, Biomedical Research Center, Faculty of Medicine, Autonomous University of Coahuila (UAdeC) , Torreón, Coahuila, Mexico
| | - Susana Bassol-Mayagoitia
- 1 Department of Reproductive Biology, Biomedical Research Center, Faculty of Medicine, Autonomous University of Coahuila (UAdeC) , Torreón, Coahuila, Mexico
| | - José Anselmo Hernández-Ibarra
- 1 Department of Reproductive Biology, Biomedical Research Center, Faculty of Medicine, Autonomous University of Coahuila (UAdeC) , Torreón, Coahuila, Mexico
| | - Pablo Ruiz-Flores
- 2 Department of Genetics and Molecular Medicine, Biomedical Research Center, Faculty of Medicine, Autonomous University of Coahuila (UAdeC) , Torreón, Coahuila, Mexico
| | - Martha P Nava-Hernández
- 1 Department of Reproductive Biology, Biomedical Research Center, Faculty of Medicine, Autonomous University of Coahuila (UAdeC) , Torreón, Coahuila, Mexico
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7
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Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Mindlis I, Pinotti R, Swan SH. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum Reprod Update 2018; 23:646-659. [PMID: 28981654 DOI: 10.1093/humupd/dmx022] [Citation(s) in RCA: 705] [Impact Index Per Article: 117.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/28/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Reported declines in sperm counts remain controversial today and recent trends are unknown. A definitive meta-analysis is critical given the predictive value of sperm count for fertility, morbidity and mortality. OBJECTIVE AND RATIONALE To provide a systematic review and meta-regression analysis of recent trends in sperm counts as measured by sperm concentration (SC) and total sperm count (TSC), and their modification by fertility and geographic group. SEARCH METHODS PubMed/MEDLINE and EMBASE were searched for English language studies of human SC published in 1981-2013. Following a predefined protocol 7518 abstracts were screened and 2510 full articles reporting primary data on SC were reviewed. A total of 244 estimates of SC and TSC from 185 studies of 42 935 men who provided semen samples in 1973-2011 were extracted for meta-regression analysis, as well as information on years of sample collection and covariates [fertility group ('Unselected by fertility' versus 'Fertile'), geographic group ('Western', including North America, Europe Australia and New Zealand versus 'Other', including South America, Asia and Africa), age, ejaculation abstinence time, semen collection method, method of measuring SC and semen volume, exclusion criteria and indicators of completeness of covariate data]. The slopes of SC and TSC were estimated as functions of sample collection year using both simple linear regression and weighted meta-regression models and the latter were adjusted for pre-determined covariates and modification by fertility and geographic group. Assumptions were examined using multiple sensitivity analyses and nonlinear models. OUTCOMES SC declined significantly between 1973 and 2011 (slope in unadjusted simple regression models -0.70 million/ml/year; 95% CI: -0.72 to -0.69; P < 0.001; slope in adjusted meta-regression models = -0.64; -1.06 to -0.22; P = 0.003). The slopes in the meta-regression model were modified by fertility (P for interaction = 0.064) and geographic group (P for interaction = 0.027). There was a significant decline in SC between 1973 and 2011 among Unselected Western (-1.38; -2.02 to -0.74; P < 0.001) and among Fertile Western (-0.68; -1.31 to -0.05; P = 0.033), while no significant trends were seen among Unselected Other and Fertile Other. Among Unselected Western studies, the mean SC declined, on average, 1.4% per year with an overall decline of 52.4% between 1973 and 2011. Trends for TSC and SC were similar, with a steep decline among Unselected Western (-5.33 million/year, -7.56 to -3.11; P < 0.001), corresponding to an average decline in mean TSC of 1.6% per year and overall decline of 59.3%. Results changed minimally in multiple sensitivity analyses, and there was no statistical support for the use of a nonlinear model. In a model restricted to data post-1995, the slope both for SC and TSC among Unselected Western was similar to that for the entire period (-2.06 million/ml, -3.38 to -0.74; P = 0.004 and -8.12 million, -13.73 to -2.51, P = 0.006, respectively). WIDER IMPLICATIONS This comprehensive meta-regression analysis reports a significant decline in sperm counts (as measured by SC and TSC) between 1973 and 2011, driven by a 50-60% decline among men unselected by fertility from North America, Europe, Australia and New Zealand. Because of the significant public health implications of these results, research on the causes of this continuing decline is urgently needed.
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Affiliation(s)
- Hagai Levine
- Braun School of Public Health and Community Medicine, Hadassah-Hebrew University, the Hebrew University Center of Excellence in Agriculture and Environmental Health, Ein Kerem Campus, PO BOX 12272, Jerusalem 9110202, Israel.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Niels Jørgensen
- University Department of Growth and Reproduction, University of Copenhagen, Rigshospitalet, CopenhagenDK-2100, Denmark
| | - Anderson Martino-Andrade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Department of Physiology, Federal University of Parana, Curitiba 81531-980, Brazil
| | - Jaime Mendiola
- Division of Preventive Medicine and Public Health, University of Murcia School of Medicine and Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), Murcia30100, Spain
| | - Dan Weksler-Derri
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva6676814, Israel
| | - Irina Mindlis
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY10029, USA
| | - Rachel Pinotti
- Gustave L. and Janet W. Levy Library, Icahn School of Medicine at Mount Sinai, New York, NY10029, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY10029, USA
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Impaired hypothalamic-pituitary-testicular axis activity, spermatogenesis, and sperm function promote infertility in males with lead poisoning. ZYGOTE 2017; 25:103-110. [PMID: 28185602 DOI: 10.1017/s0967199417000028] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Lead poisoning is a stealthy threat to human physiological systems as chronic exposure can remain asymptomatic for long periods of time before symptoms manifest. We presently review the biophysical mechanisms of lead poisoning that contribute to male infertility. Environmental and occupational exposure of lead may adversely affect the hypothalamic-pituitary-testicular axis, impairing the induction of spermatogenesis. Dysfunction at the reproductive axis, namely testosterone suppression, is most susceptible and irreversible during pubertal development. Lead poisoning also appears to directly impair the process of spermatogenesis itself as well as sperm function. Spermatogenesis issues may manifest as low sperm count and stem from reproductive axis dysfunction or testicular degeneration. Generation of excessive reactive oxygen species due to lead-associated oxidative stress can potentially affect sperm viability, motility, DNA fragmentation, membrane lipid peroxidation, capacitation, hyperactivation, acrosome reaction, and chemotaxis for sperm-oocyte fusion, all of which can contribute to deter fertilization. Reproductive toxicity has been tested through cross-sectional analysis studies in humans as well as in vivo and in vitro studies in animals.
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9
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Schrader SM, Marlow KL. Assessing the reproductive health of men with occupational exposures. Asian J Androl 2014; 16:23-30. [PMID: 24369130 PMCID: PMC3901877 DOI: 10.4103/1008-682x.122352] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 08/24/2013] [Accepted: 08/28/2013] [Indexed: 12/16/2022] Open
Abstract
The earliest report linking environmental (occupational) exposure to adverse human male reproductive effects dates back to1775 when an English physician, Percival Pott, reported a high incidence of scrotal cancer in chimney sweeps. This observation led to safety regulations in the form of bathing requirements for these workers. The fact that male-mediated reproductive harm in humans may be a result of toxicant exposures did not become firmly established until relatively recently, when Lancranjan studied lead-exposed workers in Romania in 1975, and later in 1977, when Whorton examined the effects of dibromochloropropane (DBCP) on male workers in California. Since these discoveries, several additional human reproductive toxicants have been identified through the convergence of laboratory and observational findings. Many research gaps remain, as the pool of potential human exposures with undetermined effects on male reproduction is vast. This review provides an overview of methods used to study the effects of exposures on male reproduction and their reproductive health, with a primary emphasis on the implementation and interpretation of human studies. Emphasis will be on occupational exposures, although much of the information is also useful in assessing environmental studies, occupational exposures are usually much higher and better defined.
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Affiliation(s)
- Steven M Schrader
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Applied Research and Technology, Cincinnati, OH, USA
| | - Katherine L Marlow
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Applied Research and Technology, Cincinnati, OH, USA
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10
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Mendiola J, Moreno JM, Roca M, Vergara-Juárez N, Martínez-García MJ, García-Sánchez A, Elvira-Rendueles B, Moreno-Grau S, López-Espín JJ, Ten J, Bernabeu R, Torres-Cantero AM. Relationships between heavy metal concentrations in three different body fluids and male reproductive parameters: a pilot study. Environ Health 2011; 10:6. [PMID: 21247448 PMCID: PMC3036599 DOI: 10.1186/1476-069x-10-6] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 01/19/2011] [Indexed: 05/20/2023]
Abstract
BACKGROUND Animal studies have shown the reproductive toxicity of a number of heavy metals. Very few human observational studies have analyzed the relationship between male reproductive function and heavy metal concentrations in diverse biological fluids. METHODS The current study assessed the associations between seminal and hormonal parameters and the concentration of the 3 most frequent heavy metal toxicants (lead, cadmium and mercury) in three different body fluids. Sixty one men attending infertility clinics that participated in a case-control study to explore the role of environmental toxins and lifestyles on male infertility were analyzed. Concentration of lead, cadmium and mercury were measured in blood and seminal plasma and whole blood using anodic stripping voltammetry and atomic absorption spectrophotometry. Serum samples were analyzed for follicle-stimulating hormone, luteinizing hormone and testosterone. Semen analyses were performed according to World Health Organization criteria. Mann-Whitney test and Spearman's rank correlations were used for unadjusted analyses. Multiple linear regression models were performed controlling for age, body mass index and number of cigarettes per day. RESULTS There were no significant differences between cases and controls in the concentrations of heavy metals in any of the three body fluids. In multivariate analyses using all subjects no significant associations were found between serum hormone levels and metal concentrations. However there was a significant positive association between the percentage of immotile sperms and seminal plasma levels of lead and cadmium. CONCLUSIONS Our results suggest that the presence of lead and cadmium in the reproductive tract of men may be related to a moderate alteration of their seminal parameters.
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Affiliation(s)
- Jaime Mendiola
- Public Health and Epidemiology Research Group, Division of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Espinardo (Murcia), Spain
| | - José M Moreno
- Department of Environmental and Chemical Engineering, Technical University of Cartagena, Cartagena, Spain
| | - Manuela Roca
- Public Health and Epidemiology Research Group, Division of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Espinardo (Murcia), Spain
| | - Nuria Vergara-Juárez
- Department of Environmental and Chemical Engineering, Technical University of Cartagena, Cartagena, Spain
| | - María J Martínez-García
- Department of Environmental and Chemical Engineering, Technical University of Cartagena, Cartagena, Spain
| | - Antonio García-Sánchez
- Department of Environmental and Chemical Engineering, Technical University of Cartagena, Cartagena, Spain
| | - Belén Elvira-Rendueles
- Department of Environmental and Chemical Engineering, Technical University of Cartagena, Cartagena, Spain
| | - Stella Moreno-Grau
- Department of Environmental and Chemical Engineering, Technical University of Cartagena, Cartagena, Spain
| | - José J López-Espín
- Department of Statistics, Mathematics and Informatics, Miguel Hernández University, Elche, Spain
| | - Jorge Ten
- Department of Reproductive Biology and Medicine, Instituto Bernabeu, Alicante, Spain
| | - Rafael Bernabeu
- Department of Reproductive Biology and Medicine, Instituto Bernabeu, Alicante, Spain
- Reproductive Medicine Chair, Miguel Hernández University-Instituto Bernabeu, Alicante, Spain
| | - Alberto M Torres-Cantero
- Public Health and Epidemiology Research Group, Division of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Espinardo (Murcia), Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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11
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Meeker JD, Rossano MG, Protas B, Padmanahban V, Diamond MP, Puscheck E, Daly D, Paneth N, Wirth JJ. Environmental exposure to metals and male reproductive hormones: circulating testosterone is inversely associated with blood molybdenum. Fertil Steril 2010; 93:130-40. [PMID: 18990371 PMCID: PMC2823119 DOI: 10.1016/j.fertnstert.2008.09.044] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 09/04/2008] [Accepted: 09/09/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To explore associations between exposure to metals and male reproductive hormone levels. DESIGN Cross-sectional epidemiology study with adjustment for potential confounders. SETTING University Medical Center. PATIENT(S) Men recruited through two infertility clinics in Michigan. INTERVENTION(S) Metal concentrations and reproductive hormone levels were measured in blood samples collected from 219 men. MAIN OUTCOME MEASURE(S) Serum FSH, LH, inhibin B, T, and sex hormone-binding globulin levels. RESULT(S) Cadmium, copper, and lead were all significantly or suggestively positively associated with T when modeled individually, findings that are consistent with limited previous human and animal studies. Conversely, molybdenum was associated with reduced T. A significant inverse trend between molybdenum and T remained when additionally considering other metals in the model, and a positive association between T and zinc was also found. Finally, in exploratory analysis there was evidence for an interaction between molybdenum and zinc, whereby high molybdenum was associated with a 37% reduction in T (relative to the population median level) among men with low zinc. CONCLUSION(S) Although reductions in T and reproductive toxicity after molybdenum exposure have been previously demonstrated in animal studies, more research is needed to determine whether molybdenum poses a risk to human reproductive health.
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Affiliation(s)
- John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, USA.
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12
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Hsieh SJ, Chiu YW, Li WF, Wu CH, Chen HI, Chuang HY. Increased concentrations of serum inhibin B among male workers with long-term moderate lead exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2009; 407:2603-2607. [PMID: 19193394 DOI: 10.1016/j.scitotenv.2008.12.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2008] [Revised: 12/22/2008] [Accepted: 12/22/2008] [Indexed: 05/27/2023]
Abstract
Lead is known to have an adverse effect to human reproductive system. This study investigates the association between different lead indices (both current and cumulative) and serum inhibin B as well as hormone concentrations in a group of 181 male lead workers. We used data collected during annual health examinations, including measurements of blood lead levels, inhibin B, follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (TTE) as well as age, gender, height, weight, smoking and drinking habits. The cumulative lead index included index of cumulative blood lead (ICL) and time weighted index of cumulative blood lead (TWICL) which were calculated from the series blood lead concentrations by annual health examinations since 1991 to the time of the study. Data was analyzed by Pearson correlation and multiple regressions. We found the Pearson correlation coefficients of ICL and TWICL vs. inhibin B to be 0.220 (p=0.003) and 0.231 (p=0.008), respectively. After adjusting for age, smoking, drinking, LH, FSH, and TTE, our multiple regression models revealed that with each unit increase in ICL and TWICL, there was a 0.047 pg/mL (p=0.017) and 1.333 pg/mL (p=0.007) increase in inhibin B. We found an association between cumulative lead index and concentration of serum inhibin B in male workers exposed to lead over long period, possibly indirectly affecting spermatogenesis.
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Affiliation(s)
- Shu-Jung Hsieh
- Department of Public Health, College of Health Sciences, and Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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13
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Doumouchtsis KK, Doumouchtsis SK, Doumouchtsis EK, Perrea DN. The effect of lead intoxication on endocrine functions. J Endocrinol Invest 2009; 32:175-83. [PMID: 19411819 DOI: 10.1007/bf03345710] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Studies on the effects of lead on the endocrine system are mainly based on occupationally lead-exposed workers and experimental animal models. Although evidence is conflicting, it has been reported that accumulation of lead affects the majority of the endocrine glands. In particular, it appears to have an effect on the hypothalamic-pituitary axis causing blunted TSH, GH, and FSH/LH responses to TRH, GHRH, and GnRH stimulation, respectively. Suppressed GH release has been reported, probably caused by reduced synthesis of GHRH, inhibition of GHRH release or reduced somatotrope responsiveness. Higher levels of PRL in lead intoxication have been reported. In short-term lead-exposed individuals, high LH and FSH levels are usually associated to normal testosterone concentrations, whereas in long-term exposed individuals' low testosterone levels do not induce high LH and FSH concentrations. These findings suggest that lead initially causes some subclinical testicular damage, followed by hypothalamic or pituitary disturbance when longer periods of exposure take place. Similarly, lead accumulates in granulosa cells of the ovary, causing delays in growth and pubertal development and reduced fertility in females. In the parenchyma of adrenals histological and cytological changes are demonstrated, causing changes in plasma basal and stress-mediated corticosterone concentrations and reduced cytosolic and nuclear glucocorticoid receptor binding. Thyroid hormone kinetics are also affected. Central defect of the thyroid axis or an alteration in T4 metabolism or binding to proteins may be involved in derangements in thyroid hormone action. Lead toxicity involves alterations on calcitropic hormones' homeostasis, which increase the risk of skeletal disorders.
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Affiliation(s)
- K K Doumouchtsis
- Department of General Medicine and Endocrinology, St George's Hospital, University of London, London, UK.
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14
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Ellingsen DG, Chashchin V, Haug E, Chashchin M, Tkachenko V, Lubnina N, Bast-Pettersen R, Thomassen Y. An epidemiological study of reproductive function biomarkers in male welders. Biomarkers 2007; 12:497-509. [PMID: 17701748 DOI: 10.1080/13547500701366496] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In a cross-sectional study, the serum concentrations of inhibin B and prolactin of 96 male current welders were compared with the concentrations measured in 96 age-matched referents. Also, 23 patients who were all former welders diagnosed as having welding-related manganism were studied. The current welders' geometric mean (GM) airborne exposure to manganese (Mn) was 121 microg m(-3) (range 7-2320). The serum concentrations of prolactin adjusted for age and smoking habits (GM 193 mIU l(-1) vs. 166 mIU l(-1); p=0.047) and inhibin B adjusted for alcohol consumption (arithmetic mean (AM) 151 ng l(-1) vs. 123 ng l(-1); p=0.001) were higher in the welders compared with the referents. The whole blood Mn concentration was associated with the serum prolactin concentrations. Tobacco smoking resulted in lower serum prolactin concentrations. The GM serum prolactin concentrations of the patients did not significantly differ from that of the referents, but their AM serum inhibin B concentration was statistically significantly lower. The results may suggest an effect of Mn on the pituitary that is reversible upon cessation of exposure. Lower inhibin B concentrations in the patients could point to a functional impairment of the testicular Sertoli cells, that may be caused by a welding fume component or other factors in their work environment.
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