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Nakajima T, Wang H, Yuan Y, Ito Y, Naito H, Kawamoto Y, Takeda K, Sakai K, Zhao N, Li H, Qiu X, Xia L, Chen J, Wu Q, Li L, Huang H, Yanagiba Y, Yatsuya H, Kamijima M. Increased serum anti-CYP2E1 IgG autoantibody levels may be involved in the pathogenesis of occupational trichloroethylene hypersensitivity syndrome: a case-control study. Arch Toxicol 2022; 96:2785-2797. [PMID: 35763063 PMCID: PMC9352743 DOI: 10.1007/s00204-022-03326-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/01/2022] [Indexed: 01/23/2023]
Abstract
Occupational exposure to trichloroethylene (TCE) causes a systemic skin disorder with hepatitis known as TCE hypersensitivity syndrome (TCE-HS). Human Leukocyte Antigen (HLA)-B*13:01 is its susceptibility factor; however, the immunological pathogenesis of TCE-HS remains unknown. We herein examined the hypothesis that autoantibodies to CYP2E1 are primarily involved in TCE-HS. A case–control study of 80 TCE-HS patients, 186 TCE-tolerant controls (TCE-TC), and 71 TCE-nonexposed controls (TCE-nonEC) was conducted to measure their serum anti-CYP2E1 antibody (IgG) levels. The effects of TCE exposure indices, such as 8-h time-weighted-average (TWA) airborne concentrations, urinary metabolite concentrations, and TCE usage duration; sex; smoking and drinking habits; and alanine aminotransferase (ALT) levels on the antibody levels were also analyzed in the two control groups. There were significant differences in anti-CYP2E1 antibody levels among the three groups: TCE-TC > TCE-HS patients > TCE-nonEC. Antibody levels were not different between HLA-B*13:01 carriers and noncarriers in TCE-HS patients and TCE-TC. The serum CYP2E1 measurement suggested increased immunocomplex levels only in patients with TCE-HS. Multiple regression analysis for the two control groups showed that the antibody levels were significantly higher by the TCE exposure. Women had higher antibody levels than men; however, smoking, drinking, and ALT levels did not affect the anti-CYP2E1 antibody levels. Anti-CYP2E1 antibodies were elevated at concentrations lower than the TWA concentration of 2.5 ppm for TCE exposure. Since HLA-B*13:01 polymorphism was not involved in the autoantibody levels, the possible mechanism underlying the pathogenesis of TCE-HS is that TCE exposure induces anti-CYP2E1 autoantibody production, and HLA-B*13:01 is involved in the development of TCE-HS.
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Affiliation(s)
- Tamie Nakajima
- Research Institute of Life and Health Sciences, Chubu University, Kasugai, Aichi, 487-8501, Japan.
| | - Hailan Wang
- Laboratory of Key Technology Research, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, People's Republic of China
| | - Yuan Yuan
- Research Institute of Life and Health Sciences, Chubu University, Kasugai, Aichi, 487-8501, Japan
| | - Yuki Ito
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Hisao Naito
- College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Aichi, Japan
| | - Yoshiyuki Kawamoto
- College of Life and Health Sciences, Chubu University, Kasugai, Aichi, Japan
| | - Kozue Takeda
- College of Life and Health Sciences, Chubu University, Kasugai, Aichi, Japan
| | - Kiyoshi Sakai
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Na Zhao
- Laboratory of Key Technology Research, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, People's Republic of China
| | - Hongling Li
- Laboratory of Key Technology Research, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, People's Republic of China
| | - Xinxiang Qiu
- Poison Control Center Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, People's Republic of China
| | - Lihua Xia
- Poison Control Center Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, People's Republic of China
| | - Jiabin Chen
- Poison Control Center Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, People's Republic of China
| | - Qifeng Wu
- Poison Control Center Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, People's Republic of China
| | - Laiyu Li
- Laboratory of Key Technology Research, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, People's Republic of China
| | - Hanlin Huang
- Guangdong Province Hospital for Women and Children Healthcare, Guangdong, People's Republic of China
| | - Yukie Yanagiba
- Division of Industrial Toxicology and Biological Monitoring, National Institute of Occupational Safety and Health, Kawasaki, Kanagawa, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Serum levels of miR-21-5p and miR-339-5p associate with occupational trichloroethylene hypersensitivity syndrome. J Occup Med Toxicol 2021; 16:19. [PMID: 34001196 PMCID: PMC8127200 DOI: 10.1186/s12995-021-00308-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 05/03/2021] [Indexed: 12/29/2022] Open
Abstract
Background Trichloroethylene (TCE) hypersensitivity syndrome (THS) is a dose-independent and potentially life-threatening disease. In this study, we sought to identify THS-related miRNAs and evaluate its potential clinical value. Methods Serum samples of five patients and five matched TCE contacts were used for screening differential miRNAs. Another 34 patients and 34 matched TCE contacts were used for verifying significantly differential miRNAs with SYBR™ Green PCR and MGB PCR. The diagnostic model based on these miRNAs was established via the support vector machine (SVM) algorithm. Correlation between differential miRNAs and liver function was analyzed via the Spearman correlation test. Results A total of 69 miRNAs was found to be differentially expressed. MiR-21-5p and miR-339-5p were verified to have significant higher expressions in patients. The sensitivity, specificity and accuracy of disease model were 100, 75 and 86%, respectively. The two miRNAs showed significant correlations with liver function. Conclusion These findings suggested that miRNAs profiles in serum of THS patients had changed significantly, and miR-21-5p and miR-339-5p were associated with THS. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-021-00308-0.
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Wang H, Nakajima T, Ito Y, Naito H, Zhao N, Li H, Qiu X, Xia L, Chen J, Wu Q, Li L, Huang H, Yanagiba Y, Qu H, Yatsuya H, Kamijima M. Increased risk of occupational trichloroethylene hypersensitivity syndrome at exposure levels higher than 15 mg/L of urinary trichloroacetic acid, regardless of whether the patients had the HLA-B*13:01 allele. ENVIRONMENTAL RESEARCH 2020; 191:109972. [PMID: 32758551 DOI: 10.1016/j.envres.2020.109972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/18/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
Occupational trichloroethylene (TCE) exposure can cause hypersensitivity syndrome (TCE-HS). The human leukocyte antigen (HLA)-B*13:01 is reportedly an important allele involved in TCE-HS onset. However, the threshold exposure level causing TCE-HS in relation to HLA-B*13:01 remains unknown. We conducted a case-control study comprising 37 TCE-HS patients and 97 age- and sex-matched TCE-tolerant controls from the Han Chinese population. Urine and blood of patients were collected on the first day of hospitalization, and those of controls were collected at the end of their shifts. Urinary trichloroacetic acid (TCA) was measured as an exposure marker, and end-of-shift levels in the patients were estimated using the biological half-life of 83.7 h. HLA-B genotype was identified using DNA from blood. Crude odds ratios (ORs) for TCE-HS in the groups with urinary TCA concentration >15 mg/L to ≤50 mg/L and of >50 mg/L were 21.9 [95% confidence interval (CI) 4.2-114.1] and 27.6 (6.1-125.8), respectively, when the group with urinary TCA ≤15 mg/L was used as a reference. The frequency of HLA-B*13:01, the most common allele in the patients, was 62.2% (23/37), which was significantly higher than 17.5% (17/97) in the TCE-tolerant controls, with a crude OR of 8.4 (3.1-22.6). The mutually-adjusted ORs for urinary TCA >15 to ≤50 mg/L, >50 mg/L, and for HLA-B*13:01 were 33.4 (4.1-270.8), 34.0 (5.3-217.1), and 11.0 (2.4-50.7), respectively. In conclusion, reduction of TCE exposure to ≤15 mg/L is required for TCE-HS prevention because urinary TCA concentration >15 mg/L showed increased risk of TCE-HS, regardless of whether the patients had the HLA-B*13:01 allele.
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Affiliation(s)
- Hailan Wang
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Tamie Nakajima
- Department of Life and Health Sciences, Chubu University, 487-8501, Kasugai, Japan.
| | - Yuki Ito
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, 467-8601, Nagoya, Japan.
| | - Hisao Naito
- Department of Public Health, Fujita Health University School of Medicine, 470-1192, Toyoake, Japan.
| | - Na Zhao
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Hongling Li
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Xinxiang Qiu
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Lihua Xia
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Jiabin Chen
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Qifeng Wu
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Laiyu Li
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Hanlin Huang
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Yukie Yanagiba
- National Institute of Occupational Safety and Health, 214-8585, Kawasaki, Japan.
| | - Hongyung Qu
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, 510300, Guangzhou, PR China.
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, 470-1192, Toyoake, Japan.
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, 467-8601, Nagoya, Japan.
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Dai Y, Zhou W, Jia Q, Dong H, Niu Y, He J, Bin P, Yi J, Xiang Y, Duan H, Huang H, Sha Y, Shen M, Ye M, Huang X, Zheng Y. Utility evaluation of HLA-B*13:01 screening in preventing trichloroethylene-induced hypersensitivity syndrome in a prospective cohort study. Occup Environ Med 2020; 77:201-206. [PMID: 32024660 DOI: 10.1136/oemed-2019-106171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/02/2020] [Accepted: 01/11/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Trichloroethylene (TCE) -induced hypersensitivity syndrome (TIHS) is a potentially life-threatening disease. Several genetic susceptibility biomarkers have been found to be associated with TIHS, and this systematic prospective study has been conducted to evaluate the utility of these genetic susceptibility biomarkers in preventing the disease. METHODS The newly hired TCE-exposed workers were recruited from March 2009 to October 2010. HLA-B*13:01 genotyping and 3-month follow-up procedure were conducted. All workers were monitored for adverse reaction by telephone interview every week. The workers with early symptoms of TIHS were asked to go to the hospital immediately for further examination, diagnosis and treatment. The medical expense record data of patients with TIHS were collected for cost-effectiveness analysis in 2018. RESULTS Among 1651 workers, 158 (9.57%) were found to carry the HLA-B*13:01 allele and 16 (0.97%) were diagnosed with TIHS. HLA-B*13:01 allele was significantly associated with an increased TIHS risk (relative risk=28.4, 95% CI 9.2 to 86.8). As a risk predictor of TIHS, HLA-B*13:01 testing had a sensitivity of 75%, a specificity of 91.1% and an area under curve of 0.83 (95% CI 0.705 to 0.955), the positive and negative predictive values were 7.6% and 99.7%, respectively. The incidence of TIHS was significantly decreased in HLA-B*13:01 non-carriers (0.27%) compared with all workers (0.97%, p=0.014). Cost-effectiveness analysis showed that HLA-B*13:01 screening could produce an economic saving of $4604 per TIHS avoided. CONCLUSIONS Prospective HLA-B*13:01 screening may significantly reduce the incidence of TIHS and could be a cost effective option for preventing the disease in TCE-exposed workers.
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Affiliation(s)
- Yufei Dai
- Key Laboratory, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Zhou
- Department of Occupational Hazards assessment, Hospital for Occupational Diseases Control of Shenzhen, Shenzhen, Guangdong, China
| | - Qiang Jia
- Department of Toxicology, Shandong Academy of Occupational Health and Occupational Medicine, Jinan, Shandong, China
| | - Haiyan Dong
- Key Laboratory, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.,Department of Nutrition and Food Hygiene, Center for Disease Control and Prevention of Yunnan Province, Kunming, Yunnan, China
| | - Yong Niu
- Key Laboratory, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaxi He
- Department of Occupational Hazards assessment, Hospital for Occupational Diseases Control of Shenzhen, Shenzhen, Guangdong, China
| | - Ping Bin
- Key Laboratory, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Yi
- Department of Occupational Hazards assessment, Hospital for Occupational Diseases Control of Shenzhen, Shenzhen, Guangdong, China
| | - Yingping Xiang
- Department of Occupational Hazards assessment, Hospital for Occupational Diseases Control of Shenzhen, Shenzhen, Guangdong, China
| | - Huawei Duan
- Key Laboratory, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huiping Huang
- Department of Occupational Hazards assessment, Hospital for Occupational Diseases Control of Shenzhen, Shenzhen, Guangdong, China
| | - Yan Sha
- Department of Occupational Hazards assessment, Hospital for Occupational Diseases Control of Shenzhen, Shenzhen, Guangdong, China
| | - Meili Shen
- Key Laboratory, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meng Ye
- Key Laboratory, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xianqing Huang
- Department of Occupational Hazards assessment, Hospital for Occupational Diseases Control of Shenzhen, Shenzhen, Guangdong, China
| | - Yuxin Zheng
- School of Public Health, Qingdao University, Qingdao, Shandong, China
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Wang F, Huang LP, Yang P, Ye LP, Wu C, Zhu QX. Inflammatory kidney injury in trichloroethylene hypersensitivity syndrome mice: Possible role of C3a receptor in the accumulation of Th17 phenotype. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 186:109772. [PMID: 31614297 DOI: 10.1016/j.ecoenv.2019.109772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/04/2019] [Accepted: 10/05/2019] [Indexed: 06/10/2023]
Abstract
Trichloroethylene (TCE) is a common organic solvent which can cause TCE hypersensitivity syndrome (THS) in exposure workers. THS is an adverse skin disorder with severe inflammatory kidney damage. Complement C3a receptor (C3aR) acts as a specific receptor for the key complement cleavage product C3a and involves multiple inflammatory responses, but the role of C3aR in TCE induced kidney inflammatory injury remains unknown. In this study, BALB/c mouse model of skin sensitization induced by TCE was set up in the presence or absence of C3aR antagonist (C3aRA). Kidney pathology and renal function, expression of inflammatory mediators and C3aR, changes in Th17 cell numbers, and activation of signal transducer and activator of transcription 3 (STAT3) in the kidney were examined. TCE sensitization produced histopathological and functional damage to the kidney, accompanied by increased levels of interleukin (IL-) 1β, IL-6, and IL-23. Local accumulation of Th17 cells and enhanced phosphorylation of STAT3 were also seen in the impaired kidney in TCE sensitization-positive mice. C3aR was mainly located in the impaired glomerulus and upregulated in TCE sensitization-positive mice. C3aRA pretreatment alleviated the structural and functional kidney damage and the inflammatory cytokine and Th17 responses by TCE sensitization, and specifically reduced the phosphorylation of STAT3. Together, our results demonstrate that C3aR signaling promotes the inflammatory responses and regulates the accumulation of Th17 phenotype via phosphorylation of STAT3 in TCE sensitization induced inflammatory kidney damage. C3aR may serve as a potential therapeutic target in TCE sensitization mediated kidney injury.
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Affiliation(s)
- Feng Wang
- Department of Dermatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Dermatology, Ministry of Education, Hefei, Anhui, China
| | - Li-Ping Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Peng Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Liang-Ping Ye
- Department of Dermatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Changhao Wu
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Qi-Xing Zhu
- Department of Dermatology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Dermatology, Ministry of Education, Hefei, Anhui, China.
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Pan Y, Hou X, Meng Q, Yang X, Shang L, Wei X, Hao W. The critical role for TAK1 in trichloroethylene-induced contact hypersensitivity in vivo and in CD4 + T cell function alteration by trichloroethylene and its metabolites in vitro. Toxicol Appl Pharmacol 2019; 380:114705. [PMID: 31400415 DOI: 10.1016/j.taap.2019.114705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/22/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
Occupational exposure to trichloroethylene (TCE) has been associated with severe, generalized contact hypersensitivity (CHS) skin disorder, which is considered a delayed-type hypersensitivity reaction mediated by antigen-specific T cells. Transforming growth factor-β activated kinase-1 (TAK1) is essential for regulating the development and effector function of T cells. We hypothesized that disrupting TAK1 activity might inhibit TCE-induced CHS response. In this study, a local lymph node assay was employed to build a CHS model induced by TCE combined with the inducible-TAK1 deletion system to study the effect of TAK1 on it. It was observed that TAK1 deficiency ameliorated the TCE-induced CHS response and was associated with defective T cell expansion and activation and IFN-γ production in vivo. Furthermore, we investigated the effects of TCE and its metabolites trichloroacetic acid (TCA) and dichloroacetic acid (DCA) on CD4+ T cell function and the effect of TAK1 on it in vitro. The results showed that TCE, TCA and DCA augmented the proliferation, activation and differentiation of CD4+ T cells through Jnk MAPK and NF-κB pathways. TAK1 deletion significantly attenuated these effects induced by TCE, TCA or DCA on CD4+ T cells. In conclusion, it is suggested that TAK1 plays a critical role both in TCE-induced CHS response in vivo and in TCE and its metabolite-induced CD4+ T cell activation in vitro. Local inhibition of TAK1 might offer a promising alternative feasible strategy for TCE-induced CHS.
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Affiliation(s)
- Yao Pan
- Department of Toxicology, School of Public Health, Peking University, Beijing 100191, China; Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China; Department of Cosmetics, School of Science, Beijing Technology and Business University, Beijing 100048, China
| | - Xiaohong Hou
- Department of Toxicology, School of Public Health, Peking University, Beijing 100191, China; Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China
| | - Qinghe Meng
- Department of Toxicology, School of Public Health, Peking University, Beijing 100191, China; Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China
| | - Xiaohua Yang
- Department of Toxicology, School of Public Health, Peking University, Beijing 100191, China; Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China
| | - Lanqin Shang
- Department of Toxicology, School of Public Health, Peking University, Beijing 100191, China; Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China
| | - Xuetao Wei
- Department of Toxicology, School of Public Health, Peking University, Beijing 100191, China; Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China
| | - Weidong Hao
- Department of Toxicology, School of Public Health, Peking University, Beijing 100191, China; Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China.
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