For a healthier future: a virtuous cycle for reducing exposure to persistent organic pollutants

Cancer prevention: past challenges and future directions

Almost 70 years have passed since the molecular mechanism of carcinogenesis was hypothesized to involve multiple gene mutations. More than 1,000 cancer-related genes, including oncogenes and tumor suppressor genes, accelerate carcinogenesis by altering molecular functions and gene expression through mutations and epigenetic changes and have been shown to cause multistep carcinogenesis in several organ cancers. The elucidation of cancer-related gene abnormalities has led to the development of molecular-targeted therapies that focus on driver molecules, known as precision medicine, in addition to conventional treatments such as surgery, radiotherapy, and chemotherapy. Now that the mechanism of cancer development has been largely elucidated, options for cancer treatment and its outcomes have improved, and cancer research is moving to the next stage: cancer prevention. Cancer prevention using chemicals was first proposed approximately 50 years ago. It is the concept of stabilizing, arresting, or reverting precancerous lesions to normal tissues using synthetic vitamin A analogs (retinoids). Cancer chemoprevention is now considered to consist of three elements: "primary prevention," which prevents the development of tumors and prevents benign tumors converting into more malignant ones; "secondary prevention," which aims for early detection through cancer screening and treatment; and "tertiary prevention," which reduces the risk of recurrence and extends the time until death from cancer through treatment. Consequently, there is no clear boundary between the prevention and treatment strategies. Therefore, chemoprevention targets the entire process, from normal cells to precancerous lesions, malignant progression of tumors, and death by cancer. Basic and clinical research has revealed that cancer prevention is influenced by race, regional, and national differences, as well as individual differences such as genetic factors, environmental factors, and lifestyle habits. This review provides an overview of the progress made in cancer prevention and summarizes future directions.

Epigenetics-Based Age Acceleration Associated with 2,3,7,8 TCDD Exposure in Older Americans

2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is highly toxic with potential impacts on aging. While previous studies have linked TCDD exposure to reduced telomere length and altered sperm DNA methylation (DNAm) age, its relationship with epigenetic aging remains unclear. This study investigated the association between serum TCDD levels and epigenetic clocks derived from DNAm in whole blood in older adults. Using data from the 1999-2002 National Health and Nutrition Examination Survey, we analyzed 589 participants aged 50 to 79 years with available blood TCDD and DNA methylation measures. Blood TCDD levels were measured by high-resolution gas chromatography/isotope-dilution high-resolution mass spectrometry. The six DNAm-based epigenetic clocks included Horvath Age, Hannum Age, SkinBlood Age, Pheno Age, Grim Age, and Grim Age2. Multivariable regression analysis showed significant associations between TCDD levels and Horvath Age, Hannum Age, Pheno Age, Grim Age, and Grim Age2. However, when using lipid-adjusted TCDD levels, significant associations remained only for PhenoAge (β = 0.73; SE, 0.31; p = 0.0258) and Grim Age2 (β = 0.44; SE, 0.21; p = 0.0472). The strongest non-linear trends were observed for PhenoAge, Grim Age, and Grim Age2, suggesting a threshold-dependent impact of TCDD on DNAm aging processes. Our findings suggest that TCDD exposure is associated with accelerated epigenetic aging, particularly in mortality-related clocks, with a dose-dependent and non-linear pattern.

Protecting our future: environmental hazards and children's health in the face of environmental threats: a comprehensive overview

Children face the excitement of a changing world but also encounter environmental threats to their health that were neither known nor suspected several decades ago. Children are at particular risk of exposure to pollutants that are widely dispersed in the air, water, and food. Children and adolescents are exposed to chemical, physical, and biological risks at home, in school, and elsewhere. Actions are needed to reduce these risks for children exposed to a series of environmental hazards. Exposure to a number of persistent environmental pollutants including air pollutants, endocrine disruptors, noise, electromagnetic waves (EMWs), tobacco and other noxious substances, heavy metals, and microplastics, is linked to damage to the nervous and immune systems and affects reproductive function and development. Exposure to environmental hazards is responsible for several acute and chronic diseases that have replaced infectious diseases as the principal cause of illnesses and death during childhood. Children are disproportionately exposed to environmental toxicities. Children drink more water, eat more food, and breathe more frequently than adults. As a result, children have a substantially heavier exposure to toxins present in water, food, or air than adults. In addition, their hand-to-mouth behaviors and the fact that they live and play close to the ground make them more vulnerable than adults. Children undergo rapid growth and development processes that are easily disrupted. These systems are very delicate and cannot adequately repair thetional development in children's environmental health was the Declaration of the Environment Leaders of the Eight on Children's Environmental Health by the Group of Eight. In 2002, the World Health Organization launched an initiative to improve children's environmental protection effort. Here, we review major environmental pollutants and related hazards among children and adolescents.

Effect of oxidative stress induced by 2,3,7,8- tetrachlorodibenzo-p-dioxin on DNA damage

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a highly toxic persistent organic pollutant (POP) that can induce DNA damage within cells. Although oxidative stress is one of the primary mechanisms causing DNA damage, its role in the process of TCDD-induced DNA damage remains unclear. In this study, the TCDD-induced production of reactive oxygen species (ROS) and the occurrence of DNA damage at the AP site were monitored simultaneously. Further investigation revealed that TCDD impaired the activities of superoxide dismutase (SOD) and catalase (CAT), compromising the cellular antioxidant defense system. Consequently, this led to an increase in the production of O2.- and NO, thus inducing DNA damage at the AP site under oxidative stress. Our findings were further substantiated by the upregulation of key genes in the base excision repair (BER) pathway and the absence of DNA AP site damage after inhibiting O2.- and NO. In addition, transcriptome sequencing revealed that TCDD induces DNA damage by upregulating genes associated with oxidative stress in the mitogen-activated protein kinase (MAPK), cyclic adenosine monophosphate (cAMP), and breast cancer pathways. This study provides important insights into the toxicity mechanisms of TCDD.

Comparative study on Perfluoro(2-methyl-3-oxahexanoic) acid removal by quaternary ammonium functionalized silica gel and granular activated carbon from batch and column experiments and molecular simulation-based interpretation

Removing perfluoro(2-methyl-3-oxahexanoic) acid (HFPO-DA) in water treatment is hindered by its hydrophobicity and negative charge. Two adsorbents, quaternary-ammonium-functionalized silica gel (Qgel), specifically designed for anionic hydrophobic compounds, and conventional granular activated carbon (GAC) were investigated for HFPO-DA removal. ANOVA results (p ≪ 0.001) revealed significant effects on initial concentration, contact time, and adsorbent type. Langmuir model-derived capacities were 285.019 and 144.461 mg/g for Qgel and GAC, respectively, with Qgel exhibiting higher capacity irrespective of pH. In column experiments, selective removal of HFPO-DA removal with Qgel was observed; specifically, in the presence of NaCl, the breakthrough time was extended by 10 h from 26 to 36 h. Meanwhile, the addition of NaCl decreased the breakthrough time from 32 to 14 h for GAC. However, in the presence of carbamazepine, neither of the adsorbents significantly changed the breakthrough time for HFPO-DA. Molecular simulations were also used to compare the adsorption energies and determine the preferential interactions of HFPO-DA and salts or other chemicals with Qgel and GAC. Molecular simulations compared adsorption energies, revealing preferential interactions with Qgel and GAC. Notably, HFPO-DA adsorption energy on GAC surpassed other ions during coexistence. Specifically, with Cl- concentrations from 1 to 10 times, Qgel showed lower adsorption energy for HFPO-DA (-62.50 ± 5.44 eV) than Cl- (-52.89 ± 2.59 eV), a significant difference (p = 0.036). Conversely, GAC exhibited comparable or higher adsorption energy for HFPO-DA (-18.33 ± 40.38 eV) than Cl- (-32.36 ± 29.89 eV), with no significant difference (p = 0.175). This suggests heightened selectivity of Qgel for HFPO-DA removal compared to GAC. Consequently, our study positions Qgel as a promising alternative for effective HFPO-DA removal, contributing uniquely to the field. Additionally, our exploration of molecular simulations in predicting micropollutant removal adds novelty to our study.

Ginsenoside Rg1 protects mice against 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced liver injury by inhibiting CYP1A1 through the aryl hydrocarbon receptor

ETHNOPHARMACOLOGICAL RELEVANCE

Panax ginseng C. A. Meyer (ginseng) is a widely used traditional Chinese medicine that has played a beneficial role in the treatment of various diseases, including liver diseases. Ginsenoside Rg1 is a saponin isolated and purified from ginseng that exerts protective effects on the liver in some liver injury models. 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is a ubiquitous dioxin found mostly in food products that causes liver injury and other human diseases. Although significant efforts have been made to reduce the burden of liver disease, there is still a lack of effective treatment methods.

AIM OF THE STUDY

Although ginsenoside Rg1 was reported to inhibit TCDD-mediated cytochrome P450 1A1 (CYP1A1) induction in HepG2 cells, we sought to verify its hepatoprotective effects and elucidate its mechanism in a TCDD-induced liver injury model in mice.

MATERIAL AND METHODS

The mouse liver injury model was established by intraperitoneal TCDD injection, followed by treatment with various doses of ginsenoside Rg1 (50, 100, and 200 mg/kg). Clinical indicators of liver injury, such as an increase in serum aspartate aminotransferase and alanine aminotransferase levels, as well as histopathological changes were evaluated.

RESULTS

The common clinical indicators of liver injury were detected following TCDD injection, including an increase in serum alanine aminotransferase and aspartate aminotransferase levels, increased relative liver weight, and histopathological changes. Following treatment with ginsenoside Rg1, the levels of aspartate aminotransferase and alanine aminotransferase decreased significantly, and the liver histology was improved. In addition, ginsenoside Rg1 competitively inhibited TCDD-induced Cyp1a1 mRNA transcription through the modulation of aryl hydrocarbon receptor (AhR) nuclear translocation.

CONCLUSION

Ginsenoside Rg1 is a potent partial AhR agonist that has potential as an effective medication for protecting against TCDD-associated liver injury.

Health Economics Research in Primary Prevention of Cancer: Assessment, Current Challenges, and Future Directions

In the past 2 decades, the demand for information on health economics research to guide health care decision making has substantially increased. Studies have provided evidence that eliminating or reducing tobacco use; eating a healthy diet, including fruit and vegetables; being physically active; reducing alcohol consumption; avoiding ultraviolet radiation; and minimizing exposure to environmental and occupational carcinogenic agents should substantially reduce cancer incidence in the population. The benefits of these primary prevention measures in reducing cancer incidence are not instantaneous. Therefore, health economics research has an important role to play in providing credible information to decision makers on the health and economic benefits of primary prevention. This article provides an overview of health economics research related to primary prevention of cancer. We addressed the following questions: 1) What are the gaps and unmet needs for performing health economics research focused on primary prevention of cancer? 2) What are the challenges and opportunities to conducting health economics research to evaluate primary prevention of cancer? and 3) What are the future directions for enhancing health economics research on primary prevention of cancer? Modeling primary prevention of cancer is often difficult given data limitations, long delays before the policy or intervention is effective, possible unintended effects of the policy or intervention, and the necessity of outside expertise to understand key inputs or outputs to the modeling. Despite these challenges, health economics research has an important role to play in providing credible information to decision makers on the health and economic benefits of primary prevention of cancer.

Detoxification Enhanced Lifestyle Intervention Targeting Endotoxemia (DELITE) in the Setting of Obesity and Pain: Results of a Pilot Group Intervention

BACKGROUND

Obesity is a complex multifactorial disorder affecting a growing proportion of the population. While therapeutic lifestyle change (TLC) is foundational, results of interventional programs are often inconsistent. Factors related to systemic inflammation, toxin load and endotoxemia have been postulated to play a contributory role. This pilot study sought to evaluate the role of TLC with enhanced laboratory evaluation and interventions to address these emerging therapeutic targets.

METHODS

Twelve participants with a body mass index (BMI) greater than 30 (or 27 with metabolic co-morbidities) were recruited from an outpatient clinic for participation with a primary outcome of pre/post changes in body composition. Participants completed a 12-week program involving weekly group and individualized dietary, exercise, and behavioral support, supplemented with a commercial, 30-day dietary detoxification intervention and ongoing nutritional counseling. All participants completed baseline and post-intervention evaluation including metabolic, toxin load, endotoxin, body composition and functional fitness profiles.

RESULTS

After 12-weeks, participants as a group significantly improved body composition parameters including BMI, body fat, fat mass, and waist and hip circumference (P < .01). Significant improvement in several secondary outcomes including levels of lipopolysaccharide, zonulin and leptin were noted. Additionally, results demonstrate substantial improvements in pain, pain interference and functional fitness. Upon completion, all participants rated the program favorably with a high likelihood of continuing or recommending participation to others.

CONCLUSIONS

Obesity remains a challenging and often refractory clinical scenario with emerging evidence indicating the potential role of systemic inflammation, toxin load and endotoxemia. A group therapeutic lifestyle change program enhanced with a detoxification component is feasible and may provide a promising intervention for achieving weight loss while also addressing functional and pain related co-morbidities. Future randomized trials evaluating the components of such a program are needed to better delineate the role of specific interventions in the complex setting of obesity.

Body Representations of Internal Pollution: The Risk Perception of the Circulation of Environmental Contaminants in Pregnant and Breastfeeding Women in Spain

In this article, we analyze how pregnant and breastfeeding women perceive the inside of their bodies as well as their thoughts regarding the accumulation and elimination of chemical compounds present in food, and how these are then transmitted to the fetus. We explore different social perceptions of risk regarding the circulation of chemical compounds inside the body using qualitative research based on the technique of body mapping, comprised of women’s figures of their bodies in combination with comments on the figures, food diaries and narratives from in-depth interviews. We examine how these 41 women (21 pregnant and 20 breastfeeding) perceive the body’s internal mechanisms during the stages of pregnancy and breastfeeding, as well as the circulation of chemical contaminants within it. The body mapping technique allowed us to analyze participants’ knowledge of internal pollution, a little-understood process in society. Thanks to these pregnant and breastfeeding women, who made an effort to represent and reflect on these new risks, this study shows that scientists and obstetricians need to collaborate with women in order to better understand and publicize the risks of internal pollution.

TCDD promotes liver fibrosis through disordering systemic and hepatic iron homeostasis

2, 3, 7, 8-Tetrachlorodibenzo-p-dioxin (TCDD) is a toxic environmental pollutant which can cause severe health problems, such as fibrosis. However, the toxic effects and related mechanism of TCDD on the liver remain largely unknown. In this study, we established a liver fibrosis mouse model upon exposure of TCDD, as evidenced by increased collagen I, tumor growth factor β1 (TGFβ1), α-smooth muscle actin (α-SMA), and Masson staining. Meanwhile, there was also a significant increase of inflammatory factors and TUNEL-positive hepatocytes in liver, indicating that liver inflammation and hepatic cell apoptosis occurred. In addition, increased serum and liver iron were concomitant with liver injury induced by TCDD. We further investigated the mechanism underlying TCDD-induced hepatocyte apoptosis through apoptosis polymerase chain reaction array, and found that a crucial apoptosis-related gene, cell death-inducing DFF45-like effector b (Cideb), was significantly increased in primary hepatocytes from TCDD-exposed mice, and accompanied by liver iron deposition in hepcidin knockout mice. Therefore, Cideb depletion could effectively attenuated TCDD or iron induced cell death related genes expression. In conclusion, our results showed that iron-induced Cideb expression played a critical role in promoting TCDD-induced hepatocyte apoptosis and liver fibrosis, which provide a novel mechanism for understanding TCDD-induced liver injury.

How polluted is your fat? What the study of adipose tissue can contribute to environmental epidemiology

The study of the potential contribution of low-dose exposure to environmental chemicals on the development of chronic conditions in human populations is often hampered by methodological issues, including exposure misclassification and the inability to assess biological effects in target organs. White adipose tissue (WAT) presents the unique feature of being both an advantageous matrix for assessing long-term exposure to mixtures of persistent organic pollutants and an interesting tissue to investigate early preclinical effects. Moreover, other lipophilic non-persistent chemicals and heavy metals have been recently quantified in fat, suggesting that human WAT contains chemical mixtures more complex than initially thought. However, WAT has been scarcely used in environmental epidemiology due to collection difficulties. In this essay we discuss the potential of using human WAT as a source of both exposure and effect biomarkers, with the aim of advancing the epidemiological research of obesity-related diseases, including metabolic syndrome and cancer. Overall, we discuss the implications of investigating WAT in a multidisciplinary framework combining toxicological and epidemiological knowledge in order to improve the inference of causal relationships in observational settings. We finalise by suggesting feasible designs and scenarios in which WAT samples may be reasonably collected.

Timescales of developmental toxicity impacting on research and needs for intervention

Much progress has happened in understanding developmental vulnerability to preventable environmental hazards. Along with the improved insight, the perspective has widened, and developmental toxicity now involves latent effects that can result in delayed adverse effects in adults or at old age and additional effects that can be transgenerationally transferred to future generations. Although epidemiology and toxicology to an increasing degree are exploring the adverse effects from developmental exposures in human beings, the improved documentation has resulted in little progress in protection, and few environmental chemicals are currently regulated to protect against developmental toxicity, whether it be neurotoxicity, endocrine disruption or other adverse outcome. The desire to obtain a high degree of certainty and verification of the evidence used for decision-making must be weighed against the costs and necessary duration of research, as well as the long-term costs to human health because of delayed protection of vulnerable early-life stages of human development and, possibly, future generations. Although two-generation toxicology tests may be useful for initial test purposes, other rapidly emerging tools need to be seriously considered from computational chemistry and metabolomics to CLARITY-BPA-type designs, big data and population record linkage approaches that will allow efficient generation of new insight; epigenetic mechanisms may necessitate a set of additional regulatory tests to reveal such effects. As reflected by the Prenatal Programming and Toxicity (PPTOX) VI conference, the current scientific understanding and the timescales involved require an intensified approach to protect against preventable adverse health effects that can harm the next generation and generations to come. While further research is needed, the main emphasis should be on research translation and timely public health intervention to avoid serious, irreversible and perhaps transgenerational harm.

Dietary Habits and Cooking Methods Could Reduce Avoidable Exposure to PCBs in Maternal and Cord Sera

Polychlorinated biphenyls (PCBs), like other persistent organic pollutants, are accumulating throughout the food chain and pose health threats to humans, especially children and foetuses. There is no protocol for reducing the contamination levels of the PCBs in humans. This study identified food items and cooking methods that reduce serum PCB levels by analysing data collected from the Chiba Study of Mother and Child Health. The sample size was 194 subjects. Serum PCB levels were measured using gas chromatography-electron capture negative ionization quadrupole mass spectrometry. Information on dietary habits was obtained from a brief diet history questionnaire that included questions about food items and cooking methods. Food items were categorized into food groups, and nutrient levels were calculated based on food item consumption. Principal component analysis and lasso regression were used as statistical methods. The analyses of food items and nutrients suggested that food items rich in dietary fibre reduce avoidable exposure to PCBs, as could grilling and deep frying of food, which could reduce avoidable exposure to serum PCBs in mothers and foetuses. (174 words).