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Peralta M, Lizcano F. Endocrine Disruptors and Metabolic Changes: Impact on Puberty Control. Endocr Pract 2024; 30:384-397. [PMID: 38185329 DOI: 10.1016/j.eprac.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
OBJECTIVE This study aims to explore the significant impact of environmental chemicals on disease development, focusing on their role in developing metabolic and endocrine diseases. The objective is to understand how these chemicals contribute to the increasing prevalence of precocious puberty, considering various factors, including epigenetic changes, lifestyle, and emotional disturbances. METHODS The study employs a comprehensive review of descriptive observational studies in both human and animal models to identify a degree of causality between exposure to environmental chemicals and disease development, specifically focusing on endocrine disruption. Due to ethical constraints, direct causation studies in human subjects are not feasible; therefore, the research relies on accumulated observational data. RESULTS Puberty is a crucial life period with marked physiological and psychological changes. The age at which sexual characteristics develop is changing in many regions. The findings indicate a correlation between exposure to endocrine-disrupting chemicals and the early onset of puberty. These chemicals have been shown to interfere with normal hormonal processes, particularly during critical developmental stages such as adolescence. The research also highlights the interaction of these chemical exposures with other factors, including nutritional history, social and lifestyle changes, and emotional stress, which together contribute to the prevalence of precocious puberty. CONCLUSION Environmental chemicals significantly contribute to the development of certain metabolic and endocrine diseases, particularly in the rising incidence of precocious puberty. Although the evidence is mainly observational, it adequately justifies regulatory actions to reduce exposure risks. Furthermore, these findings highlight the urgent need for more research on the epigenetic effects of these chemicals and their wider impact on human health, especially during vital developmental periods.
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Affiliation(s)
- Marcela Peralta
- Center of Biomedical Investigation Universidad de La Sabana, CIBUS, Chía, Colombia
| | - Fernando Lizcano
- Center of Biomedical Investigation Universidad de La Sabana, CIBUS, Chía, Colombia; Department of Endocrinology, Diabetes and Nutrition, Fundación CardioInfantil-Instituto de Cardiología, Bogotá, Colombia.
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Guo N, Zhou F, Jiang X, Yang L, Ma H. The effect of gonadotropin-releasing hormone analog treatment on the endocrine system in central precocious puberty patients: a meta-analysis. J Pediatr Endocrinol Metab 2024; 37:197-208. [PMID: 38235550 DOI: 10.1515/jpem-2023-0480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Gonadotropin-releasing hormone (GnRHa) is the first choice for the treatment of patients with central precocious puberty (CPP). However, the effects of GnRHa on the endocrine system of CPP patients, including insulin sensitivity, lipid level, thyroid function, bone mineral density (BMD), and testosterone (T) level, are currently contradictory. Therefore, the long-term safety of GnRHa therapy remains controversial. CONTENT A systematic literature search was performed using PubMed, Embase, Cochrane Library, and CNKI databases. The changes in HOMA-IR, TG, LDL-C, HDL-C, TSH, FT3, FT4, T, and BMD in CPP patients before and after GnRHa treatment were compared by meta-analysis. As the heterogeneity between studies, we estimated standard deviation mean differences (SMDs) and 95 % confidence intervals (CIs) using a random-effects model. Egger's test was used to assess publication bias. SUMMARY A total of 22 studies were included in our meta-analysis. Compared with before GnRHa treatment, there were no statistically significant differences in endocrine indicators including HOMA-IR, TG, LDL-C, HDL-C, TSH, FT4, FT3, T, and BMD of CPP patients treated with GnRHa. OUTLOOK Treatment with GnRHa for central precocious puberty will not increase the adverse effect on the endocrine system.
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Affiliation(s)
- Na Guo
- Graduate School of Hebei North University, Zhangjiakou, Hebei, P.R. China
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China
| | - Fei Zhou
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, P.R. China
| | - Xiaolan Jiang
- Graduate School of Hebei North University, Zhangjiakou, Hebei, P.R. China
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China
| | - Linlin Yang
- Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, P.R. China
- Data Center, The First Hospital of Hebei Medical University, Hebei, 050031, P.R. China
| | - Huijuan Ma
- Department of Endocrinology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
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Huang XY, Chen JX, Ren Y, Luo HL, Xiang W, He XJ, Li TY. Postnatal feeding with high-fat combined with high-glucose diet induces precocious puberty in Sprague‒Dawley rat pups. Biochem Biophys Res Commun 2024; 693:149199. [PMID: 38118311 DOI: 10.1016/j.bbrc.2023.149199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/23/2023] [Accepted: 10/30/2023] [Indexed: 12/22/2023]
Abstract
With economic development and overnutrition, including high-fat diets (HFD) and high-glucose diets (HGD), the incidence of obesity in children is increasing, and thus, the incidence of precocious puberty is increasing. Therefore, it is of great importance to construct a suitable animal model of overnutrition-induced precocious puberty for further in-depth study. Here, we fed a HFD, HGD, or HFD combined with a HGD to pups after P-21 weaning, while weaned pups fed a normal diet served as the control group. The results showed that HFD combined with a HGD increased the body weight (BW) of weaned rat pups. In addition, a HFD, HGD, and HFD combined with a HGD lowered the age at which vaginal opening occurred and accelerated the vaginal cell cycle. Furthermore, a HFD combined with a HGD increased the weight of the uterus and ovaries of weaned rat pups. Additionally, a HFD combined with a HGD promoted the development of reproductive organs in weaned female rat pups. Ultimately, a HFD combined with a HGD was found to elevate the serum levels of gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), follicle stimulating hormone (FSH), leptin, adiponectin, and oestradiol (E2) and increase hypothalamic GnRH, Kiss-1, and GPR54 expression levels in weaned female rat pups. The current study found that overnutrition, such as that through a HFD combined with HGD, could induce precocious puberty in weaned female rat pups. In addition, a rat model of overnutrition-induced precocious puberty was established.
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Affiliation(s)
- Xiao-Yan Huang
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China; Department of Genetics, Metabolism and Endocrinology, Hainan Women and Children's Medical Center, Haikou, Hainan, China
| | - Ji-Xiong Chen
- Department of Medical Care Center, Hainan Provincial People's Hospital, Haikou, Hainan, China
| | - Yi Ren
- Department of Paediatrics, Haikou Maternal and Child Health Hospital, Haikou, China
| | - Hai-Ling Luo
- Department of Genetics, Metabolism and Endocrinology, Hainan Women and Children's Medical Center, Haikou, Hainan, China
| | - Wei Xiang
- Department of Genetics, Metabolism and Endocrinology, Hainan Women and Children's Medical Center, Haikou, Hainan, China.
| | - Xiao-Jie He
- Department of Paediatrics, The Second Xiangya Hospital, Central South University, Changsha, China.
| | - Ting-Yu Li
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.
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Wu HT, Chiang CC, Wang CT, Chen YH, Hsu SY, Chen YC. Consumption of the nonnutritive sweetener acesulfame potassium increases central precocious puberty risk. Journal of Hazardous Materials 2024; 461:132529. [PMID: 37738850 DOI: 10.1016/j.jhazmat.2023.132529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/25/2023] [Accepted: 09/09/2023] [Indexed: 09/24/2023]
Abstract
The prevalence of precocious puberty and the consumption of nonnutritive sweeteners (NNS) is rapidly growing worldwide. However, the effects of NNSs on precocious puberty remain unclear. We examined the impact of acesulfame potassium (AceK), one of the most widely used NNS, on central precocious puberty (CPP) development using ex vivo and in vitro studies. 884 girls aged 6-12 were enrolled with complete AceK consumption data and CPP outcome assessment in the Taiwan Pubertal Longitudinal Study from 2018 to 2022. After adjustment for confounders, compared with no AceK consumption, AceK consumption at more than the median dose was associated with higher CPP risk in girls (odds ratio = 1.88, 95% confidence interval = 1.16-3.06; p for trend = 0.003). In rats, AceK consumption from in-utero to post-weaning stages accelerated puberty onset, accompanied by increased brain gonadotropin-releasing hormone (GnRH) expression. Intracerebroventricular AceK injection also induced early puberty onset in rats. In N44 hypothalamic neuron cells, AceK treatment increased reactive oxygen species production, which led to protein kinase A (PKA) activation and increased GnRH expression. These findings suggest that prepubertal girls should consume soft drinks or food products containing AceK more cautiously.
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Affiliation(s)
- Hung-Tsung Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Chi-Chen Chiang
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei 110, Taiwan
| | - Chung-Teng Wang
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Yue-Hwa Chen
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110, Taiwan; School of Food Safety, Taipei Medical University, Taipei 110, Taiwan
| | - Shih-Yuan Hsu
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Yang-Ching Chen
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei 110, Taiwan; School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110, Taiwan; Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan; Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
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Gan H, Lan H, Hu Z, Zhu B, Sun L, Jiang Y, Wu L, Liu J, Ding Z, Ye X. Triclosan induces earlier puberty onset in female mice via interfering with L-type calcium channels and activating Pik3cd. Ecotoxicol Environ Saf 2024; 269:115772. [PMID: 38043413 DOI: 10.1016/j.ecoenv.2023.115772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
Triclosan (TCS) is a broad-spectrum antibacterial chemical widely presents in people's daily lives. Epidemiological studies have revealed that TCS exposure may affect female puberty development. However, the developmental toxicity after low-dose TCS continuous exposure remains to be confirmed. In our study, 8-week-old ICR female mice were continuously exposed to TCS (30, 300, 3000 μg/kg/day) or vehicle (corn oil) from 2 weeks before mating to postnatal day 21 (PND 21) of F1 female mice, while F1 female mice were treated with TCS intragastric administration from PND 22 until PND 56. Vaginal opening (VO) observation, hypothalamic-pituitary-ovarian (HPO) axis related hormones and genes detection, and ovarian transcriptome analysis were carried out to investigate the effects of TCS exposure on puberty onset. Meanwhile, human granulosa-like tumor cell lines (KGN cells) were exposed to TCS to further explore the biological mechanism of the ovary in vitro. The results showed that long-term exposure to low-dose TCS led to approximately a 3-day earlier puberty onset in F1 female mice. Moreover, TCS up-regulated the secretion of estradiol (E2) and the expression of ovarian steroidogenesis genes. Notably, ovarian transcriptomes analysis as well as bidirectional validation in KGN cells suggested that L-type calcium channels and Pik3cd were involved in TCS-induced up-regulation of ovarian-related hormones and genes. In conclusion, our study demonstrated that TCS interfered with L-type calcium channels and activated Pik3cd to up-regulate the expression of ovarian steroidogenesis and related genes, thereby inducing the earlier puberty onset in F1 female mice.
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Affiliation(s)
- Hongya Gan
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
| | - Huili Lan
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
| | - Zhiqin Hu
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
| | - Bingqi Zhu
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
| | - Ling Sun
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
| | - Yan Jiang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
| | - Lixiang Wu
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
| | - Jing Liu
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China
| | - Zhishan Ding
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China.
| | - Xiaoqing Ye
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China.
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Luo X, Zhang C, Yang Y, Xu X, Cheng X, Wei H, Wang L, Huang F, Shi X, Cabri P. Efficacy and Safety of Triptorelin 3-Month Formulation in Chinese Children with Central Precocious Puberty: A Phase 3, Open-Label, Single-Arm Study. Adv Ther 2023; 40:4574-4588. [PMID: 37584898 PMCID: PMC10499740 DOI: 10.1007/s12325-023-02617-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/14/2023] [Indexed: 08/17/2023]
Abstract
INTRODUCTION Triptorelin is available as 1- and 3-month prolonged-release (PR) formulations; at the time of the study, only the former was approved for central precocious puberty (CPP) in China. This study assessed the efficacy and safety of the triptorelin 3-month PR formulation in Chinese children with CPP. METHODS In this 12-month, prospective, open-label, multicentre, single-arm study (NCT04736602), Chinese children (mean age [standard deviation (SD)], 7.6 ± 0.8 years) with CPP received triptorelin pamoate 15 mg on day 1 and at months 3, 6 and 9. The primary endpoint was the proportion with luteinizing hormone (LH) suppression (stimulated peak LH ≤ 3 IU/L after gonadotropin-releasing hormone [GnRH] stimulation) at month 3. Secondary endpoints included changes from baseline in hormone levels and clinical parameters, as well as safety assessments. RESULTS Overall, 32 children were enrolled, including three boys. LH suppression to prepubertal levels (≤ 3 IU/L) after GnRH stimulation was observed in 100%, 93.5% and 93.5% of participants at months 3, 6 and 12, respectively. Basal and peak LH and follicle-stimulating hormone levels were substantially suppressed at months 3, 6 and 12, and most participants showed sex hormone suppression. At months 6 and 12 respectively 92.9% and 89.3% of girls had stable breast development, and all boys had stable genital development. There was a decrease in mean growth velocity from baseline (8.96 cm/year) to months 3, 6 and 12 (8.07, 5.24 and 6.94 cm/year, respectively). The mean difference between bone and chronological age decreased from baseline (2.85 years) to month 12 (2.39 years). In girls, uterine length was stable or reduced at month 12; in boys, testicular volume was reduced. Triptorelin was well tolerated. CONCLUSION The triptorelin 3-month PR formulation demonstrated similar efficacy to that previously reported in non-Chinese patients with CPP and had an acceptable safety profile. This supports triptorelin 3-month PR as a viable option for Chinese children with CPP.
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Affiliation(s)
- Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Cai Zhang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Yang
- Department of Endocrinology, Metabolism, and Genetics, Children's Hospital of Nanchang University and Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Xu Xu
- Department of Pediatric Endocrinology, Wuxi Children's Hospital, Wuxi, China
| | - Xinran Cheng
- Department of Endocrinology and Metabolism, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Haiyan Wei
- Department of Endocrinology, Metabolism and Genetics, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Lanying Wang
- Department of Child Health Care, Tangshan Maternal and Child Health Hospital, Tangshan, China
| | - Frank Huang
- Ipsen (Shanghai) Innovation Pharmaceutical Co., Ltd., Shanghai, China
| | - Xiaofeng Shi
- Ipsen (Shanghai) Innovation Pharmaceutical Co., Ltd., Shanghai, China
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Eviz E, Yeşiltepe Mutlu G, Yılmaz Ağladıoğlu S, Hatun Ş. Letter to the Editor Regarding “Effect of Propolis on Precocious Puberty in Female Rats” - Does Propolis Induce Thelarche and Gynecomastia in Prepubertal Children? J Clin Res Pediatr Endocrinol 2023; 15:334-335. [PMID: 37338296 PMCID: PMC10448554 DOI: 10.4274/jcrpe.galenos.2023.2023-5-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/26/2023] [Indexed: 06/21/2023] Open
Affiliation(s)
- Elif Eviz
- Koç University Faculty of Medicine; Koç University Hospital, Division of Pediatric Endocrinology and Diabetes, İstanbul, Turkey
| | - Gül Yeşiltepe Mutlu
- Koç University Faculty of Medicine; Koç University Hospital, Division of Pediatric Endocrinology and Diabetes, İstanbul, Turkey
| | | | - Şükrü Hatun
- Koç University Faculty of Medicine; Koç University Hospital, Division of Pediatric Endocrinology and Diabetes, İstanbul, Turkey
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Galip N, Ankay N, Bundak R. Vasculitis-like Palpable Purpuric Rash Induced by Decapeptyl in a Pediatric Patient Diagnosed Central Precocious Puberty. J Clin Res Pediatr Endocrinol 2023; 15:307-311. [PMID: 34763385 PMCID: PMC10448555 DOI: 10.4274/jcrpe.galenos.2021.2021.0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/04/2021] [Indexed: 12/01/2022] Open
Abstract
Central precocious puberty (CPP) is defined as the appearance of secondary sexual signs in girls younger than eight years of age or the onset of menarche before the age of 10 years. Gonadotropin-releasing hormone analogs (GnRHa) are the most effective therapy in CPP. Drug-induced hypersensitivity vasculitis is an inflammation of blood vessels, which may be due to the use of a number of pharmacologic agents. This case report describes drug-induced vasculitis in a girl being treated with Decapeptyl. A 7.25 year-old girl was admitted to Pediatric Endocrinology outpatients with premature breast development. She was diagnosed with CPP on the basis of physical examination and laboratory findings and tripoteline acetate (Decapeptyl®) treatment was initiated. She experienced multiple widespread skin rashes and mild abdominal pain with high temperature eight hours after the second dose of Decapeptyl. She was admitted to hospital with the diagnosis of drug-induced vasculitis and a single dose of intravenous methyl-prednisolone (1 mg/kg) and oral cetirizine was given. Her blood and urine analysis revealed no other organ involvement, other than skin. On the third day, the purpuric lesions began to resolve and had completely disappeared by the sixth day. Her treatment for CPP was switched to Depot Leuprolide acetate and she continued her treatment for two years uneventfully. To the best of our knowledge, this is the first report of a child with CPP experiencing drug-induced vasculitis due to tripotelin injection. Effective treatment may be continued by switching to an alternative gonadotropin releasing hormone analog.
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Affiliation(s)
- Nilüfer Galip
- University of Kyrenia, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Allergy and Clinical Immunology, Kyrenia, North Cyprus
| | - Nermin Ankay
- Dr. Burhan Nalbantoğlu State Hospital, Clinic of Pediatrics, Nicosia, North Cyprus
| | - Rüveyde Bundak
- University of Kyrenia, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kyrenia, North Cyprus
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Gea M, Toso A, Bentivegna GN, Buganza R, Abrigo E, De Sanctis L, Schilirò T. Oestrogenic Activity in Girls with Signs of Precocious Puberty as Exposure Biomarker to Endocrine Disrupting Chemicals: A Pilot Study. Int J Environ Res Public Health 2022; 20:14. [PMID: 36612336 PMCID: PMC9819927 DOI: 10.3390/ijerph20010014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The relationship between endocrine disrupting chemical (EDC) exposure and Precocious Puberty (PP) was investigated in this pilot study, involving girls with signs of PP (P) and pre-pubertal girls (C). Risk factors for PP were assessed through questionnaires, while 17β-oestradiol (E2) levels and oestrogenic activity were quantified on sera. The oestrogenic activity, expressed as E2 equivalent concentration (EEQ), was applied as EDC exposure biomarker. Questionnaires showed a low EDC knowledge, a high EDC exposure, and a potential relationship between some habits at risk for EDC exposure and PP. EEQs were similar between C and P; however, they were significantly higher in girls living in an urban environment than in girls living in a rural environment, suggesting a potential higher EDC exposure in cities. The results of this pilot study highlighted the need to raise awareness on EDCs and can be considered a starting point to clarify the relationship between EDC exposure and PP.
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Affiliation(s)
- Marta Gea
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Anna Toso
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Institut régional du Cancer de Montpellier (ICM), Université Montpellier, 34090 Montpellier, France
| | | | - Raffaele Buganza
- Unit of Pediatric Endocrinology, Department of Public Health and Pediatrics, Regina Margherita Children Hospital, University of Turin, 10126 Turin, Italy
| | - Enrica Abrigo
- Unit of Pediatric Endocrinology, Department of Public Health and Pediatrics, Regina Margherita Children Hospital, University of Turin, 10126 Turin, Italy
| | - Luisa De Sanctis
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Unit of Pediatric Endocrinology, Department of Public Health and Pediatrics, Regina Margherita Children Hospital, University of Turin, 10126 Turin, Italy
| | - Tiziana Schilirò
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
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Polat R, Çokluk E, Budak Ö, Tuncer FB. Effect of Propolis on Precocious Puberty in Female Rats. J Clin Res Pediatr Endocrinol 2022; 14:415-421. [PMID: 35770944 PMCID: PMC9724062 DOI: 10.4274/jcrpe.galenos.2022.2022-1-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/15/2022] [Indexed: 12/14/2022] Open
Abstract
Objective Nutrition and exposure to various chemicals, including environmental pollution, insecticides, and plant phytoestrogens (having oestrogen-like effects), are environmental factors that affect puberty onset. The aim of this study was to identify the effects of propolis, which has been reported to have oestrogenic effects, on precocious puberty and the reproductive system in prepubertal female rats (ovary, endometrium, breast). Methods Thirty-four 25-day-old, prepubertal, female Sprague-Dawley rats were included. Rats were randomly divided into the propolis (n=17) and control groups (n=17). The primary endpoint was the number of rats that developed vaginal opening, a sign of puberty, at 12-day follow-up. In addition, the effect of propolis on ovary, uterus and breast tissue was evaluated histologically. Results Vaginal patency occurred earlier (about 7.5 days sooner) in the propolis group and all animals in the propolis group had vaginal patency by day 12. The number of ovarian follicles (in all follicles), endometrial thickness, and mammary gland secretory gland area were significantly higher in the propolis group than in the control group (all p<0.001). In addition, Ki-67 activity in the endometrium, breast tissue and ovary was more intense in the propolis group compared to the control group (all p<0.001). Conclusion Propolis triggers precocious puberty in female rats, possibly by interacting with the oestrogen receptor. The mechanism of action of propolis should be considered before prescribing it. In addition, further studies are needed to explore the mechanism of action of propolis and to determine the component of propolis that triggers puberty.
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Affiliation(s)
- Recep Polat
- Sakarya University, Sakarya Training and Research Hospital, Clinic of Pediatric Endocrinology, Sakarya, Turkey
| | - Erdem Çokluk
- Sakarya University Faculty of Medicine, Department of Medical Biochemistry, Sakarya, Turkey
| | - Özcan Budak
- Sakarya University Faculty of Medicine, Department of Histology-Embryology, Sakarya, Turkey
| | - Fatıma Betül Tuncer
- Sakarya University, Sakarya Training and Research Hospital, Clinic of Medical Biochemistry, Sakarya, Turkey
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Cheng TS, Ong KK, Biro FM. Trends Toward Earlier Puberty Timing in Girls and Its Likely Mechanisms. J Pediatr Adolesc Gynecol 2022; 35:527-531. [PMID: 35537618 DOI: 10.1016/j.jpag.2022.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/19/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023]
Abstract
This is the first of two installments examining early puberty in girls. The first paper will discuss secular trends in onset of puberty and the possible mechanisms to explain these developments. The potential etiologies examined will include the role of endocrine-disrupting chemicals and obesogens, the impact of body mass index and obesity, genetic and biologic pathways, and the influence of lifestyle behaviors. The second paper of the two-part series will examine the potential health impacts of early puberty on young and adult women and offer suggestions for clinical management and public health prevention.
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Affiliation(s)
- Tuck Seng Cheng
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Department of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Box 116, Cambridge CB20QQ UK
| | - Ken K Ong
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Department of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Frank M Biro
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America.
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Hu Y, Li J, Yuan T, Yu T, Chen Y, Kong H, Lin C, Shen Z, Tian Y, Tong S, Yu X, Liu S. Exposure to antibiotics and precocious puberty in children: A school-based cross-sectional study in China. Environ Res 2022; 212:113365. [PMID: 35490828 DOI: 10.1016/j.envres.2022.113365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/11/2022] [Accepted: 04/21/2022] [Indexed: 05/26/2023]
Abstract
Foods and water can be contaminated with antibiotics in China, which may affect children's health, but evidence on antibiotic exposure with precocious puberty (PP) is limited. This study explored the association of antibiotic exposure with PP in a school-based setting. A cross-sectional study with multistage stratified cluster random sampling was conducted in Zhongshan City, Guangdong Province and Qufu City, Shandong Province in China from October 11 to December 5, 2019. A first-morning urine sample was collected to detect antibiotic exposure. We detected 33 of 45 types of antibiotics from eight categories in 928 primary school children aged 6-12 years using HPLS-MS/MS. Detection rate of antibiotics was stratified by sex, study site, and BMI. The Tanner stages were assessed by professional pediatricians from local hospitals. PP is defined as the onset of secondary characters before 8-year-old or menarche before 10-year-old for girls and before 9-year-old for boys. Multivariable logistic regression was performed to examine the association between antibiotic exposure and PP after adjusting potential confounders. The overall detection rate of antibiotics was 93.0% in 928 children. We found the detection rate of tetracyclines and fluoroquinolones in children with PP was significantly higher than that of children with normal puberty (41.4% vs 29.9%, 56.8% vs 50.6%, respectively, all p < 0.05). Both fluoroquinolones (odds ratio (OR): 1.835, 95% confidence interval (CI): 1.066-3.158) and tetracyclines (OR: 2.120, 95% CI: 1.175-3.825) were associated with increased OR of PP after adjusting sex, age, BMI, study site, and family income. Specifically, compared to the values less than the limits of detection, low concentration of ofloxacin from fluoroquinolones (OR: 2.056, 95% CI: 1.091-3.875) and high concentration of chlortetracycline (OR: 3.027, 95% CI: 1.126-8.140) and tetracycline from tetracyclines (OR: 2.756, 95% CI: 1.167-6.506) were associated with increased OR of PP. Exposure to antibiotics, especially fluoroquinolones and tetracyclines was positively associated with precocious puberty.
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Affiliation(s)
- Yabin Hu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Juan Li
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Yuan
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Tingting Yu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yao Chen
- Department of Endocrinology, Genetics and Metabolism, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Huijun Kong
- Department of Pediatrics, People's Hospital of Qu Fu, Shandong, China
| | - Cuilan Lin
- Department of Developmental and Behavioral Pediatrics, Bo Ai Hospital of Zhongshan City, The Second School of Clinical Medicine, Southern Medical University, Guangdong, China
| | - Zhemin Shen
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Tian
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Xiaodan Yu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
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dos Santos NR, Rodrigues JLG, Bandeira MDJ, Anjos ALDS, Araújo CFDS, Adan LFF, Menezes-Filho JA. Manganese and Lead Exposure and Early Puberty Onset in Children Living near a Ferromanganese Alloy Plant. Int J Environ Res Public Health 2022; 19:7158. [PMID: 35742410 PMCID: PMC9222911 DOI: 10.3390/ijerph19127158] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Manganese (Mn) and lead (Pb) have been associated with the deregulation of the neuroendocrine system, which could potentially favor the appearance of precocious puberty (PP) in environmentally exposed children. This study aims to evaluate the exposure to Mn and Pb and their potential effects in anticipating puberty in school-aged children living near a ferromanganese alloy plant in Bahia, Brazil. Toenail, occipital hair and blood samples were collected from 225 school-aged children. Tanner’s scale was used for pubertal staging. Mn in blood (MnB), toenail (MnTn) and hair (MnH) and blood lead (PbB) levels were measured by graphite furnace atomic absorption spectrometry. Puberty-related hormone concentrations were determined by chemiluminescence. The age at which girls’ breasts began to develop was inversely correlated with weight-for-age, height-for-age and BMI-for-age Z-scores (p < 0.05); pubarche also had similar results. Mn biomarker levels did not present differences among pubertal classification nor among children with potential PP or not. Furthermore, Mn exposure was not associated with the age of onset of sexual characteristics for either girls or boys. However, PbB levels were positively correlated with boys’ pubic hair stages (rho = 0.258; p = 0.009) and associated with the age of onset of girls’ pubarche (β = 0.299, 95%CI = 0.055−0.542; p = 0.017). Testosterone and LH concentrations were statistically higher in boys with an increased PbB (p = 0.09 and p = 0.02, respectively). Prospective studies are needed to better assess the association between exposure to Mn and Pb and the early onset of puberty.
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Affiliation(s)
- Nathália Ribeiro dos Santos
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador 40170-110, Brazil; (N.R.d.S.); (A.L.d.S.A.)
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador 40170-110, Brazil; (J.L.G.R.); (M.d.J.B.)
| | - Juliana Lima Gomes Rodrigues
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador 40170-110, Brazil; (J.L.G.R.); (M.d.J.B.)
| | - Matheus de Jesus Bandeira
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador 40170-110, Brazil; (J.L.G.R.); (M.d.J.B.)
| | - Ana Laura dos Santos Anjos
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador 40170-110, Brazil; (N.R.d.S.); (A.L.d.S.A.)
| | - Cecília Freitas da Silva Araújo
- Environmental and Public Health Program, National School of Public Health, Oswald Cruz Foundation, Rio de Janeiro 21041-210, Brazil;
| | - Luis Fernando Fernandes Adan
- Graduate Program in Medicine and Health, College of Medicine, Federal University of Bahia, Salvador 40170-110, Brazil;
| | - José Antonio Menezes-Filho
- Laboratory of Toxicology, College of Pharmacy, Federal University of Bahia, Salvador 40170-110, Brazil; (N.R.d.S.); (A.L.d.S.A.)
- Graduate Program in Pharmacy, College of Pharmacy, Federal University of Bahia, Salvador 40170-110, Brazil; (J.L.G.R.); (M.d.J.B.)
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Yang X, Qi Z, Yang H, Li J, Liu Y, Sang Y, Li M, Du X, Wang H, Liu B, Xu B, Liu W, Xu Z, Deng Y. The m 6A mRNA demethylase FTO regulates GnRH secretion in Mn-induced precocious puberty. Mol Cell Endocrinol 2022; 542:111523. [PMID: 34843901 DOI: 10.1016/j.mce.2021.111523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022]
Abstract
The GABAA receptor (GABAAR) plays important roles in the regulation of Mn-induced GnRH secretion in immature female rats. However, the underlying molecular mechanisms remain unknown. Here, we assessed whether FTO and its substrate m6A are correlated with GABAAR expression in GnRH neurons after treatment with Mn in vitro and in vivo. Our study indicated that Mn treatment increased the expression of GnRH mRNA and decreased the levels of GABAAR protein but had no effect on GABAAR mRNA. Moreover, Mn upregulated the levels of FTO and inhibited global cellular m6A levels and GABAAα2 mRNA m6A levels. Knockdown of FTO increased the expression of GABAAR protein and GABAAα2 mRNA m6A levels. Data from rat models further demonstrate that inhibition of FTO suppressed GABAAR protein expression in the hypothalamus, causing delayed puberty onset. Collectively, our findings suggest that FTO-dependent m6A demethylation plays a critical role in regulating GABAAR mRNA processing in GnRH neurons.
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Affiliation(s)
- Xinxin Yang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China; School of Public Health, Xuzhou Medical University, Xuzhou, 221004, China.
| | - Zhipeng Qi
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Haibo Yang
- Department of Occupational Diseases, Linyi People's Hospital, Shandong, 276000, China.
| | - Jiashuo Li
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Yanan Liu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Yanqi Sang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Minghui Li
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Xianchao Du
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Haiying Wang
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Bingchen Liu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Bin Xu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Wei Liu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Zhaofa Xu
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
| | - Yu Deng
- Department of Environmental Health, School of Public Health, China Medical University, Shenyang, 110122, China.
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Abstract
BACKGROUND Central precocious puberty (CPP) is caused by early activation of the hypothalamic-pituitary-gonadal axis but its major cause remains unclear. Studies have indicated an association between chronic environmental exposure to endocrine-disrupting chemicals and pubertal onset. Essential oil is widely used in homes worldwide for relief of respiratory symptoms, stress, and/or sleep disturbance. METHODS To evaluate this association, we compared the hormone levels and timing of vaginal opening (VO) in female rats exposed to lavender oil (LO) through different routes (study groups: control, LO nasal spray [LS], and indoor exposure to LO [LE]) during the prepubertal period. The body weights of the animals were also compared every 3 days until the day of VO, at which time gonadotropin levels and internal organ weights were assessed. RESULTS The LS group showed early VO at 33.8 ± 1.8 days compared with the control (38.4 ± 2.9 days) and LE (36.6 ± 1.5 days) groups. Additionally, luteinizing hormone levels were significantly higher in the LE and LS groups than those in the control group. Body weights did not differ significantly among the groups. CONCLUSION Inhalation exposure to an exogenic simulant during the prepubertal period might trigger early pubertal onset in female rats. Further evaluation of exposure to other endocrine-disrupting chemicals capable of inducing CPP through the skin, orally, and/or nasally is warranted.
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Affiliation(s)
- Yoo-Mi Kim
- Department of Pediatrics, College of Medicine, Chungnam National University, Daejeon, Korea
- Department of Pediatrics, Chungnam National University Sejong Hospital, Sejong, Korea.
| | - Han Hyuk Lim
- Department of Pediatrics, College of Medicine, Chungnam National University, Daejeon, Korea
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
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Franssen D, Svingen T, Lopez Rodriguez D, Van Duursen M, Boberg J, Parent AS. A Putative Adverse Outcome Pathway Network for Disrupted Female Pubertal Onset to Improve Testing and Regulation of Endocrine Disrupting Chemicals. Neuroendocrinology 2022; 112:101-114. [PMID: 33640887 DOI: 10.1159/000515478] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/25/2021] [Indexed: 11/19/2022]
Abstract
The average age for pubertal onset in girls has declined over recent decades. Epidemiological studies in humans and experimental studies in animals suggest a causal role for endocrine disrupting chemicals (EDCs) that are present in our environment. Of concern, current testing and screening regimens are inadequate in identifying EDCs that may affect pubertal maturation, not least because they do not consider early-life exposure. Also, the causal relationship between EDC exposure and pubertal timing is still a matter of debate. To address this issue, we have used current knowledge to elaborate a network of putative adverse outcome pathways (pAOPs) to identify how chemicals can affect pubertal onset. By using the AOP framework, we highlight current gaps in mechanistic understanding that need to be addressed and simultaneously point towards events causative of pubertal disturbance that could be exploited for alternative test methods. We propose 6 pAOPs that could explain the disruption of pubertal timing by interfering with the central hypothalamic trigger of puberty, GnRH neurons, and by so doing highlight specific modes of action that could be targeted for alternative test method development.
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Affiliation(s)
- Delphine Franssen
- Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium
| | - Terje Svingen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Majorie Van Duursen
- Department of Environment and Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Julie Boberg
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Anne-Simone Parent
- Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium
- Department of Pediatrics, CHU de Liège, Liège, Belgium
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Shi Y, Ma Z, Yang X, Ying Y, Luo X, Hou L. Gonadotropin-releasing hormone analogue and recombinant human growth hormone treatment for idiopathic central precocious puberty in girls. Front Endocrinol (Lausanne) 2022; 13:1085385. [PMID: 36589818 PMCID: PMC9794601 DOI: 10.3389/fendo.2022.1085385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To investigate the effectiveness and safety of gonadotropin-releasing hormone analogue (GnRHa) in combination with recombinant human growth hormone (rhGH) in girls with central precocious puberty (CPP). METHODS Clinical data of 80 girls diagnosed with idiopathic central precocious puberty (ICPP) between January 2017 and June 2021 were retrospectively analyzed. Treatment strategy involved GnRHa alone (group A: n=34) and GnRHa+rhGH (group B: n=46). Children's heights (Ht), weights (Wt) and sex hormone levels were measured every 3 months after treatment and bone age (BA) every six months. Heights, growth velocity (GV), predicted adult height (PAH), weights, body mass index (BMI), sex hormone levels and bone age were compared between the two groups. RESULTS Children in group B showed greater height gain at the 12th, 24th and 30th months after treatment (p<0.05) than those in group A, had faster growth rates in the first and second year following treatment (p<0.05) and better PAH (p<0.05). No statistical differences in weight or BMI were found between the two groups before treatment or at any time after treatment (p>0.05). Levels of LH and FSH were lower in both groups after treatment with no statistical differences between groups (p>0.05). The gap between bone age and chronological age gradually decreased in both groups and no abnormal progression of bone age or other adverse side effects occurred. CONCLUSIONS The combination of GnRHa with rhGH produced better height gains than GnRHa alone for patients with CPP. The gonadal axis was suppressed and progression of bone age delayed with good safety and efficacy.
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Affiliation(s)
| | | | | | | | | | - Ling Hou
- *Correspondence: Ling Hou, ; Xiaoping Luo,
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Lee MS, Lee GM, Ko CW, Moon JE. Precocious puberty in Korean girls with and without exposure to endocrine-disrupting chemicals in toy slime: a comparative analysis. BMC Endocr Disord 2021; 21:190. [PMID: 34535098 PMCID: PMC8449472 DOI: 10.1186/s12902-021-00855-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Toy slime is popular in Korea, and in parallel, pre-pubertal girls visit hospitals for early pubertal signs. Thus far, numerous studies have investigated the association of endocrine-disrupting chemicals (EDCs) with precocious puberty (PP). However, there is a lack of studies on the clinical manifestations and sex hormones. We aimed to investigate early pubertal development in Korean girls with or without a history of toy slime exposure and determine changes in bone age, Tanner stage, and sex hormones. METHODS In this study, 140 girls underwent stimulation tests at Kyungpook National University Children's Hospital Endocrinology Department, during January 2018 and December 2020. Patients were divided into two groups for gonadotropin-releasing hormone (GnRH) stimulation test and frequency of exposure to toy slime (EDCs). GnRH stimulation test was conducted after an intravenous injection of 100 µg of luteinizing hormone-releasing hormone. Slime exposure was defined as Slime ≥ 3 times/week for ≥ 3 months. RESULTS History of slime exposure was found in 14 of 58 and 65 of 82 patients in the central PP (CPP) and non-CPP groups, respectively. Slime-exposed patients had advanced bone age, although their Tanner stage was low. Patients with a history of toy slime exposure were 5.5 times more likely to be diagnosed with non-CPP than patients without slime exposure (p < 0.05). CONCLUSIONS Exposure to toy slime in prepubertal girls may be associated with rapid clinical advancement of pubertal development and bone age, and the patients appear more likely to be diagnosed with non-CPP.
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Affiliation(s)
- Mi Seon Lee
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Gi Min Lee
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Cheol Woo Ko
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jung Eun Moon
- Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
- Department of Pediatric Endocrinology, Kyungpook National University Children's Hospital, 807, Hoguk-ro, Buk-gu, 41404, Daegu, Republic of Korea.
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Abstract
Sexual maturation in humans is characterized by a unique individual variability. Pubertal onset is a highly heritable polygenic trait but it is also affected by environmental factors such as obesity or endocrine disrupting chemicals. The last 30 years have been marked by a constant secular trend toward earlier age at onset of puberty in girls and boys around the world. More recent data, although more disputed, suggest an increased incidence in idiopathic central precocious puberty. Such trends point to a role for environmental factors in pubertal changes. Animal data suggest that the GnRH-neuronal network is highly sensitive to endocrine disruption during development. This review focuses on the most recent data regarding secular trend in pubertal timing as well as potential new epigenetic mechanisms explaining the developmental and transgenerational effects of endocrine disrupting chemicals on pubertal timing.
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Affiliation(s)
| | - Delphine Franssen
- GIGA Neurosciences, Neuroendocrinology Unit, University of Liège, Belgium
| | - Sabine Heger
- Children's Hospital Bult, Janusz-Korczak-Allee 12, 30173, Hannover, Germany
| | - Anne-Simone Parent
- GIGA Neurosciences, Neuroendocrinology Unit, University of Liège, Belgium; Department of Pediatrics, University Hospital Liège, Belgium.
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Felício JS, de Alcântara AL, Janaú LC, de Moraes LV, de Oliveira MCNI, de Lemos MN, de Souza Neto NJK, Neto JFA, da Silva WM, de Souza ÍJA, Said NM, de Lemos GN, Vieira GM, Khayat AS, dos Santos ÂKCR, de Queiroz NNM, de Sousa ACCB, dos Santos MC, de Melo FTC, Piani PPF, Felício KM. Association of Soy and Exclusive Breastfeeding With Central Precocious Puberty: A Case-Control Study. Front Endocrinol (Lausanne) 2021; 12:667029. [PMID: 34290667 PMCID: PMC8287825 DOI: 10.3389/fendo.2021.667029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction While soy is suggested as a possible risk factor, exclusive breastfeeding (EBF) has a likely protective effect in precocious puberty. Our aim was to evaluate the association between both of these variables with central precocious puberty (CPP). Methods We performed a retrospective, case-control study. A total of 161 girls were divided into two groups: 84 patients diagnosed with CPP composed the case group and 77 patients without the diagnosis of CPP (had gone through normal onset of puberty) were the control group. Results Our control group had a higher presence of EBF >6 months, which was an important protective factor for CPP (OR: 0.5; IC 95%: 0.3-0.9, p = 0.05) and also correlated negatively with the presence of it (r = -0.2; p < 0.05). Oppositely, the use of soy was significantly higher in the CPP group, (OR: 3.8; IC 95%: 1.5-6, p < 0.05) and positively correlating (r = 0.2; p < 0.01) with the presence of CPP. Duration of soy intake (years) correlated with bone age (r = 0.415; p < 0.05). A logistic regression was performed to evaluate the effects of EBF duration and soy on CPP. The model was significant (x² (2) = 20,715, p = <0.001) and explained 12.2% (Nagelkerke R2) of the variance, correctly classifying 62.5% of cases. EBF was associated with a reduction of likelihood of having CPP [OR = 0,187 (CI = 0.055-0,635); Wald = 7,222, p = 0.007], while soy intake increased the risk [OR = 3.505 (CI) = 1,688-7,279, Wald = 11,319, p = 0.001]. Conclusion Our data found the use of soy was associated with CPP. Additionally, EBF was pointed as a protective factor. However, future prospective studies are needed to clarify this issue.
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Affiliation(s)
- João Soares Felício
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
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Azova S, Wolfsdorf J. Precocious sexual development in a male toddler caused by unrecognized transdermal exposure to testosterone: case report and review of the literature. J Pediatr Endocrinol Metab 2021; 34:675-678. [PMID: 33660485 PMCID: PMC10653730 DOI: 10.1515/jpem-2020-0616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 11/22/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Exogenous exposure to transdermal testosterone is often overlooked as a cause of precocious sexual development in children. CASE PRESENTATION A 16-month-old male presented for a second opinion consultation before commencing treatment with bicalutamide and anastrozole for a presumptive diagnosis of familial gonadotropin-independent male-limited sexual precocity. Enlargement of the penis was first observed at four months of age. The initial evaluation showed isolated elevation of his plasma testosterone level; however, by 16 months, his testosterone level was prepubertal and no pathogenic variants in the LHC GR gene were identified. The history revealed that his grandfather, who had cared for him regularly in the first year of life, had used testosterone gel for treatment of hypogonadism. CONCLUSIONS Despite the 2009 "black box" warning issued by the United States Food and Drug Administration (FDA) regarding potential consequences of transdermal testosterone exposure to women and children, this continues to be an important cause of sexual precocity in children. Children are often subjected to unnecessary and costly evaluation before this exposure is recognized, underscoring the importance of obtaining a thorough medical, family, and social history tailored to the differential diagnosis.
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Affiliation(s)
- Svetlana Azova
- Division of Endocrinology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Joseph Wolfsdorf
- Division of Endocrinology, Boston Children’s Hospital, Boston, MA, USA; and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Bigambo FM, Sun H, Yan W, Wu D, Xia Y, Wang X, Wang X. Association between phenols exposure and earlier puberty in children: A systematic review and meta-analysis. Environ Res 2020; 190:110056. [PMID: 32805251 DOI: 10.1016/j.envres.2020.110056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/21/2020] [Accepted: 08/01/2020] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To identify the association between phenolic chemicals and the risk of earlier puberty based on the available evidence by systematic review and meta-analysis. METHODS Databases PubMed, Web of Science, and Cochrane Library were searched and retrieved appropriate journal articles on the association between phenols exposure and earlier puberty in children published before February 14, 2020. Stata software version 12.0 and Excel were used for statistical analysis. RESULTS Nine studies were included in the meta-analysis with total subjects of 4737. All the subjects included in our studies were girls. The pooled estimate has shown the association between 2, 5- dichrolophenol exposure, and earlier puberty in children with effect size (ES) 1.13 (95% CI: 1.06, 1.20). Exposed to other types of phenolic chemicals such as bisphenol A, Triclosan, Benzophenone-3 were not statistically significant associated with the risk of earlier puberty in children with the overall pooled estimates of ES of 1.09 (95%CI: 0.88, 1.35), ES 1.05(95% CI: 0.96, 1.15), and ES 0.98 (95% CI: 0.88, 1.10) respectively. CONCLUSION Our results portray that phenols particularly 2, 5- dichlorophenol exposure might be associated with the risk of earlier puberty in children. Also, caution should be taken to other type of phenolic chemicals since in subgroup analysis some individual studies have shown a positive relationship between bisphenol A, Triclosan and Benzophenone-3 exposures, and the risk of earlier puberty in children. Future cohort studies should be conducted with more sample sizes to determine the relationship between 2, 5- dichlorophenol, and the risk of earlier puberty in children of all gender.
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Affiliation(s)
- Francis Manyori Bigambo
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Hanqing Sun
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Wu Yan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Di Wu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Xu Wang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Nanjing Children's Hospital Affiliated to Nanjing Medical University, 210008, Nanjing, China.
| | - Xinru Wang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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Ramsey JT, Diaz A, Naidu A, Korach KS. Response to Letter to the Editor: "Lavender Products Associated With Prematuire Thelarche and Prepubertal Gynecomastia: Case Reports and Endocrine Disrupting Chemicals Activities". J Clin Endocrinol Metab 2020; 105:5861657. [PMID: 32575119 PMCID: PMC7753053 DOI: 10.1210/clinem/dgaa395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022]
Affiliation(s)
- J Tyler Ramsey
- Campbell University School of Osteopathic Medicine, Lillington, North Carolina
- Correspondence and Reprint Requests: J. Tyler Ramsey, DO candidate, Campbell University School of Osteopathic Medicine, 4350 US Highway 421 South, Lillington, NC 27546. E-mail: ; or Kenneth S. Korach, PhD, Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, 111 Alexander Dr., P.O. Box 12233, Research Triangle Park, NC 27709. E-mail:
| | - Alejandro Diaz
- Division of Pediatric Endocrinology, Nicklaus Children’s Hospital, Miami, Florida
| | - Ajanta Naidu
- University of California, Irvine Health, Pediatric Endocrinology, Irvine, California
| | - Kenneth S Korach
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, North Carolina
- Correspondence and Reprint Requests: J. Tyler Ramsey, DO candidate, Campbell University School of Osteopathic Medicine, 4350 US Highway 421 South, Lillington, NC 27546. E-mail: ; or Kenneth S. Korach, PhD, Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, 111 Alexander Dr., P.O. Box 12233, Research Triangle Park, NC 27709. E-mail:
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Larkman T. Letter to the Editor: "Lavender Products Associated With Premature Thelarche and 1 Prepubertal Gynecomastia: Case Reports and Endocrine-Disrupting Chemical Activities". J Clin Endocrinol Metab 2020; 105:5862126. [PMID: 32579676 DOI: 10.1210/clinem/dgaa392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/22/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Tony Larkman
- Australian Tea Tree Industry Association Ltd. (ATTIA Ltd), Casino, Australia
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Giroux JM, Orjubin M. Letter to the Editor: "Lavender Products Associated With Premature Thelarche and Prepubertal Gynecomastia: Case Reports and Endocrine-Disrupting Chemical Activities". J Clin Endocrinol Metab 2020; 105:5831862. [PMID: 32379885 PMCID: PMC7263747 DOI: 10.1210/clinem/dgaa226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 05/04/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Jean-Marc Giroux
- Consortium HE coordinator, Consortium Huiles Essentielles (Consortium HE), Aix-en-Provence, France
| | - Marie Orjubin
- Consortium HE Project Manager, Consortium Huiles Essentielles (Consortium HE), Aix-en-Provence, France
- Correspondenceand Reprint Requests: Marie Orjubin, Cosmed—les Ocres de l’Arbois—495 rue René Descartes—13100 Aix-en-Provence (France).
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Tyler Ramsey J, Diaz A, Korach KS. Response to Letter to the Editor: "Lavender products associated with premature thelarche and prepubertal gynecomastia: Case reports and EDC activities". J Clin Endocrinol Metab 2020; 105:5831865. [PMID: 32379886 PMCID: PMC7448301 DOI: 10.1210/clinem/dgaa227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/05/2020] [Indexed: 11/19/2022]
Affiliation(s)
- J Tyler Ramsey
- Campbell University School of Osteopathic Medicine, Lillington, NC
- Correspondence: J. Tyler Ramsey, Campbell University School of Osteopathic Medicine, 4350 US Highway 421 South, Lillington, NC 27546; . Kenneth S. Korach, Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, 111 Alexander Dr., P.O. Box 12233, Research Triangle Park, NC 27709, USA;
| | - Alejandro Diaz
- Division of Pediatric Endocrinology, Nicklaus Children’s Hospital, Miami, FL
| | - Kenneth S Korach
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
- Correspondence: J. Tyler Ramsey, Campbell University School of Osteopathic Medicine, 4350 US Highway 421 South, Lillington, NC 27546; . Kenneth S. Korach, Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, 111 Alexander Dr., P.O. Box 12233, Research Triangle Park, NC 27709, USA;
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Ramsey JT, Li Y, Arao Y, Naidu A, Coons LA, Diaz A, Korach KS. Lavender Products Associated With Premature Thelarche and Prepubertal Gynecomastia: Case Reports and Endocrine-Disrupting Chemical Activities. J Clin Endocrinol Metab 2019; 104:5393-5405. [PMID: 31393563 PMCID: PMC6773459 DOI: 10.1210/jc.2018-01880] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 08/02/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT Previous case reports associated prepubertal gynecomastia with lavender-containing fragrances, but there appear to be no reports of premature thelarche. OBJECTIVE To add to a case series about lavender-fragranced product use and breast growth in children and to measure endocrine-disrupting chemical activity of essential oil components. DESIGN, SETTING, AND PATIENTS Patients experiencing premature thelarche or prepubertal gynecomastia with continuous exposure to lavender-fragranced products were evaluated in the pediatric endocrinology departments of two institutions. Mechanistic in vitro experiments using eight components of lavender and other essential oils were performed at National Institute of Environmental Health Sciences. MAIN OUTCOME MEASURES Case reports and in vitro estrogen and androgen receptor gene expression activities in human cell lines with essential oils. RESULTS Three prepubertal girls and one boy with clinical evidence of estrogenic action and a history of continuous exposure to lavender-containing fragrances were studied. Breast growth dissipated in all patients with discontinuation of the fragranced products. Some of the components tested elicited estrogenic and antiandrogenic properties of varying degrees. CONCLUSION We report cases of premature thelarche that resolved upon cessation of lavender-containing fragrance exposure commonly used in Hispanic communities. The precise developmental basis for such conditions could be multifactorial. In vitro demonstration of estrogenic and antiandrogenic properties of essential oil components suggests essential oils in these cases could be considered a possible source and supports a possible link with idiopathic prepubertal breast development. Whether the level of lavender oil estrogenic potency is sufficient to cause these effects is unknown.
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Affiliation(s)
- J Tyler Ramsey
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Campbell University School of Osteopathic Medicine, Lillington, North Carolina
| | - Yin Li
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Yukitomo Arao
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Ajanta Naidu
- University of California, Irvine Health, Pediatric Endocrinology, Irvine, California
| | - Laurel A Coons
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Alejandro Diaz
- Division of Pediatric Endocrinology, Nicklaus Children’s Hospital, Miami, Florida
| | - Kenneth S Korach
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- Correspondence and Reprint Requests: Kenneth S. Korach, PhD, Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, 111 Alexander Drive, PO Box 12233, Research Triangle Park, North Carolina 27709. E-mail:
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Shao P, Wang Y, Zhang M, Wen X, Zhang J, Xu Z, Hu M, Jiang J, Liu T. The interference of DEHP in precocious puberty of females mediated by the hypothalamic IGF-1/PI3K/Akt/mTOR signaling pathway. Ecotoxicol Environ Saf 2019; 181:362-369. [PMID: 31212184 DOI: 10.1016/j.ecoenv.2019.06.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/29/2019] [Accepted: 06/05/2019] [Indexed: 06/09/2023]
Abstract
DEHP is reported to cause precocious puberty of females in both humans and rodents, but the underlying mechanisms were largely unknown. This study was designed to clarify the effects and the mechanisms of DEHP on the pathogenesis of sexual precocity. Prepubertal female rats were treated with DEHP for 4 weeks. Key organs were analyzed in control conditions and after exposure to 0.2, 1, and 5 mg/kg/day DEHP in pubertal female rats. To determine the role of the IGF-1/PI3K/Akt/mTOR signaling pathway in DEHP-induced female precocious puberty, 36 rats were treated with 5 mg/kg/day DEHP to establish a model of female precocious puberty. And we investigated the expression of genes and proteins related to IGF-1 pathway in rat hypothalamus after treatment with inhibitors. In the present study, we observed that DEHP treatment resulted in earlier vaginal opening time, higher number of Nissl bodies in the hypothalamus neurons, lower apoptosis of hypothalamic cells, higher IGF-1 and GnRH levels in the serum and hypothalamus. DEHP could also upregulated the expression of IGF-1/PI3K/Akt/mTOR pathway and GnRH in the hypothalamus of adolescent female rats, and inhibition of IGF-1R and mTOR in hypothalamus could block the activation of Kiss-1, GPR54, and GnRH by DEHP. In summary, our study suggested that DEHP might activate the hypothalamic GnRH neurons prematurely through the IGF-1 signaling pathway and promote GnRH release, leading to the initiation of female sexual development. Our results provide a new molecular mechanism underlying reproductive and developmental toxicity in pubertal female rats induced by DEHP.
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Affiliation(s)
- Pu Shao
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yuzhuo Wang
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China; Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Meng Zhang
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xinggui Wen
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jun Zhang
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Zhonghang Xu
- Gastrointestinal and Colorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Min Hu
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Jinlan Jiang
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China.
| | - Te Liu
- Scientific Research Center, China-Japan Union Hospital of Jilin University, Changchun, China.
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30
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Ye X, Li F, Zhang J, Ma H, Ji D, Huang X, Curry TE, Liu W, Liu J. Pyrethroid Insecticide Cypermethrin Accelerates Pubertal Onset in Male Mice via Disrupting Hypothalamic-Pituitary-Gonadal Axis. Environ Sci Technol 2017; 51:10212-10221. [PMID: 28731686 DOI: 10.1021/acs.est.7b02739] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pyrethroids, a class of insecticides that are widely used worldwide, have been identified as endocrine-disrupting chemicals (EDCs). Our recent epidemiological study reported on an association of increased pyrethroids exposure with elevated gonadotropins levels and earlier pubertal development in Chinese boys. In this study, we further investigated the effects of cypermethrin (CP), one of the most ubiquitous pyrethroid insecticides, on hypothalamic-pituitary-gonadal (HPG) axis and pubertal onset in male animal models. Early postnatal exposure to CP at environmentally relevant doses (0.5, 5, and 50 μg/kg CP) significantly accelerated the age of puberty onset in male mice. Administration of CP induced a dose-dependent increase in serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone in male mice. CP did not affect gonadotropin-releasing hormone (GnRH) gene expression in the hypothalamus, but CP at higher concentrations stimulated GnRH pulse frequency. CP could induce the secretion of LH and FSH, as well as the expression of gonadotropin subunit genes [chorionic gonadotropin α (CGα), LHβ, and FSHβ] in pituitary gonadotropes. CP stimulated testosterone production and the expression of steroidogenesis-related genes [steroidogenic acute regulatory (StAR) and Cytochrome p 450, family 11, subfamily A, polypeptide 1 (CYP11A1)] in testicular Leydig cells. The interference with hypothalamic sodium channels as well as calcium channels in pituitary gonadotropes and testicular Leydig cells was responsible for CP-induced HPG axis maturation. Our findings established in animal models provide further evidence for the biological plausibility of pyrethroid exposure as a potentially environmental contributor to earlier puberty in males.
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Affiliation(s)
- Xiaoqing Ye
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
| | - Feixue Li
- Zhejiang Key Laboratory of Organ Development and Regeneration, College of Life and Environmental Sciences, Hangzhou Normal University , Hangzhou 310036, China
| | - Jianyun Zhang
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
| | - Huihui Ma
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
| | - Dapeng Ji
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
- Research Center for Air Pollution and Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
| | - Xin Huang
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
| | - Thomas E Curry
- Department of Obstetrics and Gynecology, Chandler Medical Center, University of Kentucky , Lexington, Kentucky 40536, United States
| | - Weiping Liu
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
- Research Center for Air Pollution and Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
| | - Jing Liu
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
- Research Center for Air Pollution and Health, College of Environmental and Resource Sciences, Zhejiang University , Hangzhou 310058, China
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Leonardi A, Cofini M, Rigante D, Lucchetti L, Cipolla C, Penta L, Esposito S. The Effect of Bisphenol A on Puberty: A Critical Review of the Medical Literature. Int J Environ Res Public Health 2017; 14:ijerph14091044. [PMID: 28891963 PMCID: PMC5615581 DOI: 10.3390/ijerph14091044] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 02/08/2023]
Abstract
Many scientific studies have revealed a trend towards an earlier onset of puberty and have disclosed an increasing number of children that display precocious puberty. As an explanation, some authors have considered the global socio-economic improvement across different populations, and other authors have considered the action of endocrine disrupting chemicals (EDCs). Among these, bisphenol A (BPA), an aromatic compound largely used worldwide as a precursor of some plastics and chemical additives, is well known for its molecular oestrogen-like and obesogenic actions. We reviewed the medical literature of the previous 20 years that examined associations between BPA exposure and the age of puberty in humans, considering only those referring to clinical or epidemiological data. Of 19 studies, only 7 showed a correlation between BPA and puberty. In particular, the possible disruptive role of BPA on puberty may be seen in those with central precocious puberty or isolated premature breast development aged 2 months to 4 years old, even if the mechanism is undefined. Some studies also found a close relationship between urinary BPA, body weight, and early puberty, which can be explained by the obesogenic effect of BPA itself. The currently available data do not allow establishment of a clear role for BPA in pubertal development because of the conflicting results among all clinical and epidemiological studies examined. Further research is needed to fully understand the potential role of exposure to EDCs and their adverse endocrine health outcomes.
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Affiliation(s)
- Alberto Leonardi
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06129 Perugia, Italy.
| | - Marta Cofini
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06129 Perugia, Italy.
| | - Donato Rigante
- Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy.
| | - Laura Lucchetti
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06129 Perugia, Italy.
| | - Clelia Cipolla
- Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy.
| | - Laura Penta
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06129 Perugia, Italy.
| | - Susanna Esposito
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06129 Perugia, Italy.
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Humbert E. [Not Available]. Krankenpfl Soins Infirm 2017; 110:68-69. [PMID: 30549666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Yang R, Wang YM, Zhang L, Zhao ZM, Zhao J, Peng SQ. Prepubertal exposure to an oestrogenic mycotoxin zearalenone induces central precocious puberty in immature female rats through the mechanism of premature activation of hypothalamic kisspeptin-GPR54 signaling. Mol Cell Endocrinol 2016; 437:62-74. [PMID: 27519634 DOI: 10.1016/j.mce.2016.08.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 07/19/2016] [Accepted: 08/08/2016] [Indexed: 01/12/2023]
Abstract
Sporadic epidemics and several researches in rodents indicated that zearalenone (ZEA) and its metabolites, the prevailing oestrogenic mycotoxins in foodstuffs, were a triggering factor for true precocious puberty development in girls. Nevertheless, the neuroendocrine mechanism through which ZEA mycoestrogens advance puberty onset is not fully understood. To elucidate this issue, hypothalamic kisspeptin-G-protein coupled receptor-54 (GPR54) signaling pathway that regulates the onset of puberty was focused on in the present study. Immature female SD rats were given a daily intragastric administration of corn oil (vehicle control), 50 μg/kg body weight (bw) of 17β-estradiol (E2, positive control), and 3 doses (0.2, 1 and 5 mg/kg bw) of ZEA for consecutive 5 days starting from postnatal day 15, respectively. Puberty onset was evaluated by detecting the physiological and hormonal responses, and hypothalamic kisspeptin-GPR54 pathway was determined to reveal the neuroendocrine mechanism. As the markers of puberty onset, vaginal opening was significantly accelerated and uterine weight was increased in both E2 and 5 mg/kg ZEA groups. Serum levels of follicle stimulating hormone, luteinizing hormone and estradiol were also markedly elevated by E2 and 5 mg/kg ZEA, which is compatible with the changes in peripheral reproductive organs. The mRNA and protein expressions of hypothalamic gonadotropin-releasing hormone (GnRH) were both obviously elevated by E2 and 5 mg/kg ZEA. GnRH expression changes occurred in parallel with increased expressions of hypothalamic Kiss1 and its receptor GPR54 at both mRNA and protein levels. Most of these changes were also noted in 1 mg/kg ZEA group, but none in 0.2 mg/kg group. Therefore, within the context of this study, the No Observed Adverse Effect Level (NOAEL) for ZEA in terms of oestrogenic activity and puberty-promoting effect in immature female rats was considered to be 0.2 mg/kg bw per day, and the Lowest Observed Adverse Effect Level (LOAEL) was 1 mg/kg bw per day. In conclusion, prepubertal exposure to dietary relevant levels of ZEA induced central precocious puberty in female rats by premature activation of hypothalamic kisspeptin-GPR54-GnRH signaling pathway, followed by the stimulation of gonadotropins release at an earlier age, resulting in the advancement of vaginal opening and enlargement of uterus at periphery.
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MESH Headings
- Animals
- Estrogens/toxicity
- Estrous Cycle/drug effects
- Female
- Genitalia, Female/drug effects
- Genitalia, Female/growth & development
- Genitalia, Female/pathology
- Gonadotropin-Releasing Hormone/genetics
- Gonadotropin-Releasing Hormone/metabolism
- Hormones/blood
- Hypothalamus/drug effects
- Hypothalamus/metabolism
- Kisspeptins/metabolism
- Male
- Mycotoxins/toxicity
- Pituitary Gland/drug effects
- Pituitary Gland/metabolism
- Puberty, Precocious/blood
- Puberty, Precocious/chemically induced
- Puberty, Precocious/metabolism
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Rats, Sprague-Dawley
- Receptors, G-Protein-Coupled/metabolism
- Receptors, Kisspeptin-1
- Receptors, LHRH/genetics
- Receptors, LHRH/metabolism
- Sexual Maturation/drug effects
- Signal Transduction/drug effects
- Zearalenone/toxicity
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Affiliation(s)
- Rong Yang
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dongdajie Street, Fengtai District, Beijing 100071, PR China
| | - Yi-Mei Wang
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dongdajie Street, Fengtai District, Beijing 100071, PR China.
| | - Li Zhang
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dongdajie Street, Fengtai District, Beijing 100071, PR China
| | - Zeng-Ming Zhao
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dongdajie Street, Fengtai District, Beijing 100071, PR China
| | - Jun Zhao
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dongdajie Street, Fengtai District, Beijing 100071, PR China
| | - Shuang-Qing Peng
- Evaluation and Research Center for Toxicology, Institute of Disease Control and Prevention, Academy of Military Medical Sciences, 20 Dongdajie Street, Fengtai District, Beijing 100071, PR China.
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Supornsilchai V, Jantarat C, Nosoognoen W, Pornkunwilai S, Wacharasindhu S, Soder O. Increased levels of bisphenol A (BPA) in Thai girls with precocious puberty. J Pediatr Endocrinol Metab 2016; 29:1233-1239. [PMID: 26812862 DOI: 10.1515/jpem-2015-0326] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/19/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Reports on the secular trend of pubertal onset indicate a recent earlier start especially in girls. Bisphenol A (BPA), which posses estrogenic activity, might be a cause of advanced puberty. The objective of the study was to determine the association between BPA and advanced puberty. METHODS A cross-sectional study was conducted in patients with advanced puberty (n=41) compared to age-matched controls (n=47). Anthropometric measurements, estradiol, basal and gonadotropin releasing hormone (GnRH)-stimulated follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, uterine sizes, ovarian diameters and bone ages were obtained. Urinary BPA concentrations were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC/MSMS) with the lower limit of quantification (LLOQ) of 0.05 ng/mL. RESULTS The median adjust-BPA concentration in advanced puberty group was higher than in control groups [1.44 vs. 0.59 μg/g creatinine (Cr): p<0.05]. We also found that the median adjust-BPA concentration in girls with advanced puberty who were overweight/obese, was greater than in the normal pubertal overweight/obese girls (1.74 vs. 0.59 μg/g Cr: p<0.05), and was in the same trend among normal weight girls with advanced and normal puberty (0.83 vs. 0.49 μg/g Cr: p=0.09), but not statistically significant. CONCLUSIONS The present findings suggest that BPA exposure appears to be related to an earlier age at onset of puberty especially in obese girls.
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Srivastava VK, Hiney JK, Dees WL. Manganese-Stimulated Kisspeptin Is Mediated by the IGF-1/Akt/Mammalian Target of Rapamycin Pathway in the Prepubertal Female Rat. Endocrinology 2016; 157:3233-41. [PMID: 27309941 PMCID: PMC4967113 DOI: 10.1210/en.2016-1090] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Low-dose administration of manganese chloride (MnCl2) causes release of hypothalamic LH-releasing hormone (LHRH) and advances puberty in rat. Recently, this element was shown to up-regulate mammalian target of rapamycin (mTOR), kisspeptin gene (KiSS-1), and LHRH gene expressions in the brain preoptic area (POA)/anteroventral periventricular (AVPV) nucleus. Because these genes are critical for puberty, this study was conducted to identify the upstream mechanism by which Mn activates the mTOR/KiSS-1 pathway. On day 12, immature female rats began receiving a daily supplemental dose of 10 mg/kg of MnCl2 or saline by gavage, and POA/AVPV tissues were collected on day 29 for specific protein assessments. Another experiment assessed in vitro IGF-1 release in response to Mn and assessed signal transduction pathways in the POA/AVPV region after Mn delivery into the third ventricle. Chronic Mn exposure increased (P < .05) basal expressions of mTOR and kisspeptin proteins. Mn increased protein kinase B (Akt) and Ras homolog enriched in brain, both capable of activating mTOR. Central Mn delivery increased expressions of phosphorylated IGF-1 receptor (IGF-1R) (P < .05) and Akt (P < .01) in the POA/AVPV region. The previous central delivery of JB1, an IGF-1R antagonist, blocked Mn-induced expressions of both phosphorylated IGF-1R and Akt. Downstream to Akt, centrally administered Mn increased tuberous sclerosis complex 2 (P < .05), Ras homolog enriched in brain (P < .01), mTOR (P < .05), and kisspeptin (P < .05). Finally, we observed that the early puberty induced by Mn was blocked by the administration of an mTOR inhibitor. These results suggest that Mn acts, at least in part, through the IGF-1/Akt/mTOR pathway to influence prepubertal kisspeptin and LHRH.
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Affiliation(s)
- Vinod K Srivastava
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas 77843-4458
| | - Jill K Hiney
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas 77843-4458
| | - William L Dees
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas 77843-4458
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De Pinho JC, Aghajanova L, Herndon CN. Prepubertal Gynecomastia Due to Indirect Exposure to Nonformulary Bioidentical Hormonal Replacement Therapy: A Case Report. J Reprod Med 2016; 61:73-77. [PMID: 26995893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Gynecomastia is a disorder of the endocrine system characterized by an abnormal presence of a palpable unilateral or bilateral enlargement and proliferation of glandular ductal benign breast tissue in male individuals. This case discusses the medical implications of an unregulated, indirect exposure to nonformulary, bioidentical hormone replacement therapy in male children. CASE An 8-year-old boy presented with prepubertal gynecomastia secondary to estrogen exposure from maternal use of bioidentical hormonal replacement therapy (the Wiley protocol). We review the literature on prepubertal gynecomastia secondary to exogenous estrogen exposure, evaluation, clinical surveillance of the pubertal development, and relevant short- and long-term implications. CONCLUSION Indirect exposure to nonformulary hormonal replacement in our case report was an etiologic factor in the development of prepubertal gynecomastia. This novel estrogen exposure source has important implications in the differential diagnosis of prepubertal gynecomastia and potential adverse effects secondary to precocious hormonal exposure.
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Latrech H, Gaouzi A. Le pronostic statural après une pseudo-puberté précoce par déficit en 11ß hydroxylase chez une fille de 7 ans: à propos d’un cas avec revue de la littérature. Pan Afr Med J 2015; 20:162. [PMID: 26113905 PMCID: PMC4469453 DOI: 10.11604/pamj.2015.20.162.5905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 12/29/2014] [Indexed: 11/11/2022] Open
Abstract
L'hyperplasie congénitale des surrénales par déficit en 11ß hydroxylase se voit dans 5 à 10% des cas et est diagnostiquée, habituellement, devant des signes de virilisation d'un nouveau né ou d'un fœtus 46 XX et plus tard devant une HTA avec une hypokaliémie. Le pronostic de taille chez ces patients est très souvent compromis. Nous rapportons le cas d'un déficit en 11ß hydroxylase chez une enfant âgée de 7 ans révélé par une pseudo- puberté précoce traitée par hydrocortisone. La survenue d'une puberté précoce centrale complique encore plus la situation par la mise en jeu du pronostic de taille finale et nécessitant une prise en charge thérapeutique particulière.
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Affiliation(s)
- Hanane Latrech
- Department of Endocrinology, Mohammed VI hospital, Medical school, University Mohamed First, Oujda, Morocco
| | - Ahmed Gaouzi
- Department of Endocrinology Paediatrics, Medical school, Mohammed V Souissi University, Ibn Sina Hospital, Rabat, Morocco
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Zaiem A, Aouinti I, Lakhoua G, Kastalli S, Daghfous R, Lakhal M, El Aïdli S. Precocious puberty in an epileptic child treated with valproate. Therapie 2012; 67:537-8. [PMID: 23249581 DOI: 10.2515/therapie/2012071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 07/09/2012] [Indexed: 11/20/2022]
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Zhu L, Cai DP. [The establishment of environmental endocrine disruptors induced precocious puberty Macaca fascicularis model and the intervention of yin nourishing fire purging Chinese materia medica]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2012; 32:1679-1683. [PMID: 23469612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To establish the environmental endocrine disruptors (EEDs) induced precocious puberty macaca fascicularis model, thus verifying the antagonism of yin nourishing fire purging Chinese materia medica (YNFPCMM) against the estrogenic effects. METHODS (1) The female prepubescent monkeys at different months old were fed with high dose and low dose EEDs. By observing EEDs' estrogenic effects, the optimal age, the optimal exposure dose, and the optimal exposure time were determined. (2) Fifteen female prepubescent monkeys were randomly divided into the exposure group, the treatment group, and the control group, 5 in each group. Those in the exposure group were fed with EEDs such as nonylphenol (4-NP) and bisphenol A (BPA). Those in the treatment group were fed with EEDs and YNFPCMM. Those in the control group were fed with dissolvent such as corn oil. The therapeutic course was 4 weeks. By the end of the treatment, the serum estrogen level was measured and the maturation index of the vaginal keratinocytes was calculated. The uterus was extracted to measure the wet weight, the endometrial thickness, the ring-shaped myometrium thickness, the endometrial epithelial cells, and the glandular epithelium height. RESULTS (1) Twenty month was the optimal exposure age. The low dose EEDs was the best exposure dose, and 4 weeks was the optimal exposure time. (2) Compared with the control group, the serum estrogen level obviously increased, the maturation index of the vaginal keratinocytes significantly increased, the wet uterus weight, the endometrial thickness, the ring-shaped myometrium thickness, the endometrial epithelial cells, and the glandular epithelium height significantly increased in the exposure group (P<0.05). Compared with the exposure group, the aforesaid indices significantly decreased in the treatment group (P<0.05). CONCLUSIONS The EEDs induced precocious puberty macaca fascicularis model was successfully established in this study. The EEDs were proved to have estrogenic-like activities. YNFPC-MM was proved to have significant antagonism like estrogenic activities.
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Affiliation(s)
- Lin Zhu
- Department of Integrated Traditional and Western Medicine, Children's Hospital of Fudan University, Shanghai 201102
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Ozen S, Darcan S, Bayindir P, Karasulu E, Simsek DG, Gurler T. Effects of pesticides used in agriculture on the development of precocious puberty. Environ Monit Assess 2012; 184:4223-4232. [PMID: 21805074 DOI: 10.1007/s10661-011-2257-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2010] [Accepted: 07/15/2011] [Indexed: 05/31/2023]
Abstract
The present study aims to evaluate the effects of pesticides on premature breast development. Forty-five girls (group 1) with premature breast development living in the Menderes region, where greenhouse cultivation is the main income, 16 girls (group 2) living in Izmir city with early puberty, and 33 girls (group 3) who had no signs of puberty were included in the study. Endosulphan 1, endosulphan 2, endosulphan sulphate, methoxychlor, vinclozolin, 4,4-dichlorodiphenyldichlorethylene (DDE), 4,-dichlorodiphenyltrichloroethane (DDT), and 2,4-DDT were evaluated in the serum and adipose tissues of the groups by using a gas chromatography-mass spectrometry method. With the exception of 4,4'-DDE, the pesticides studied were undetectable in the serum and adipose tissue samples. The levels of basal luteinizing hormone (LH), stimulated LH, follicle-stimulating hormone, and the long axis of the uterus and both ovaries were significantly different in the girls who had premature thelarche and detectable 4,4'-DDE levels compared to the girls who had premature thelarche and undetectable 4,4'-DDE levels in serum and adipose tissues. The presence and levels of pesticides in serum and adipose tissues were not related to precocious puberty (PP). The mechanisms that lead to PP may also result in obesity, and obesity may be the underlying cause for PP in this group.
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Affiliation(s)
- Samim Ozen
- Department of Pediatric Endocrinology and Metabolism, Ege University School of Medicine, 35100, Bornova, Izmir, Turkey.
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Deng F, Tao FB, Liu DY, Xu YY, Hao JH, Sun Y, Su PY. Effects of growth environments and two environmental endocrine disruptors on children with idiopathic precocious puberty. Eur J Endocrinol 2012; 166:803-9. [PMID: 22318748 DOI: 10.1530/eje-11-0876] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The incidence of idiopathic precocious puberty (IPP) might have an increasing trend. But the causes and risk factors of IPP are unknown. The objective of our study is to evaluate the effects of growth environments and two environmental endocrine disruptors (EDCs), zearalenone (ZEA), and 1,1-dichloro-2,2,bisethylene (p,p'-DDE), on patients with IPP. DESIGN Case-control study. METHODS The study consisted of 78 IPP patients at diagnosis and 100 control children matched for age and sex. A questionnaire was designed to collect data on growth environments, and serum ZEA and p,p'-DDE were tested in all subjects. We analyzed data on growth environments, two EDCs, and biological interaction between growth environments and EDCs. RESULTS In growth environments, small for gestational age, maternal physical disease during pregnancy, early maternal menarche, early puberty of same-degree relatives, and father's absence in 4- to 6-year olds were risk factors for children with IPP (P<0.05). Serum ZEA concentration, ZEA, and p,p'-DDE-positive rates in the IPP group were significantly higher than those in the control group (P<0.05). There was a biological interaction between growth environments and ZEA (relative excess risk due to interaction =34.562, attributable proportion due to interaction =0.745, synergy index =4.193). CONCLUSIONS Results suggest possible effects of growth environments and two EDCs on the development of IPP. In addition, growth environments and ZEA have biological interaction that might increase the risk of developing IPP.
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Affiliation(s)
- Fang Deng
- Department of Pediatrics, First Affiliated Hospital, Anhui Medical University, Hefei, China
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Abstract
Zearalenone (ZEN) is a non-steroidal mycoestrogen that widely contaminates agricultural products. ZEN and its derivatives share similar molecular mechanisms and activity with estrogens and interact with ERα and ERβ leading to changes in the reproductive system in both animals and humans. The reduced form of ZEN, α-ZEA ralenol, has been used as an anabolic agent for animals and also proposed as hormonal replacement therapy in postmenopausal women. Furthermore, both zearelanol ZEN and derivatives have been patented as oral contraceptives. ZEN has been widely used in the United States since 1969 to improve fattening rates in cattle by increasing growth rate and feed conversion efficiency. Evidence of human harm from this practice is provided by observations of central precocious puberty. As a result, this practice has been banned by the European Union. As ZEN has been associated with breast enlargement in humans, it has been included in many bust-enhancing dietary supplements but epidemiological evidence is lacking with regard to breast cancer risk. Extensive work with human breast cancer cell lines has shown estrogenic stimulation in those possessing ER but a reduction in DMBA-induced breast cancers in rodents given ZEN. Protein disulfide isomerase provides a molecular biomarker of dietary exposure to ZEN and its derivatives allowing the detection and control of harmful food intake. The interaction of ZEN with anti-estrogens, anticancer agents and antioxidants requires further investigation.
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Affiliation(s)
- A Pazaiti
- 1st Department of Surgery, University of Athens, Laiko Hospital, Athens, Greece
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Abstract
A 4-month-old girl presented with sexual development, including breast enlargement, menstruation, uterine length of 69 mm at ultrasonography, and dramatically high estrogen bioactivity, but no growth acceleration, pubic hair, pelvis masses or adrenal tumors. Gas chromatography with an electron capture detector and mass spectrometry detected pesticides (p,p'-DDD, p,p'-DDT, lindane and endosulfan sulfate) in plasma from the infant, the mother, and the 38-year-old father, who reported a dramatic decrease in libido, and in soil samples from their farm. The precocious sexual development was probably caused by the estrogen activity of the environmental contamination by tons of pesticides stored in the family farm.
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Affiliation(s)
- Laura Gaspari
- Unité d'Endocrinologie-Gynécologie Pédiatrique, Service de Pédiatrie 1, Hôpital Arnaud-de-Villeneuve, CHU Montpellier, Université Montpellier I, Montpellier, France
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Cleemann L, Holm K. [Precocious pseudopuberty in a seven year-old girl due to estrogen treatment of labial adhesion]. Ugeskr Laeger 2011; 173:1435-1436. [PMID: 21586251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Labial adhesions are well-known in prepubertal girls. We present a seven year-old girl treated with estrogen gel due to labial adhesion resulting in precocious pseudopuberty. Endocrine tests and bone age were normal. Symptoms regressed upon cessation of treatment. Labial adhesions often resolve spontaneously in early puberty. Precocious pseudopuberty is a well-known side effect to estrogen gel used in excess which should only be initiated in prepubertal girls with great caution and after careful consideration.
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Affiliation(s)
- Line Cleemann
- Børneafdelingen, Hillerød Hospital, 3400 Hillerød, Denmark.
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Anupama H, Pooli R, Sahay R, Gundam CSR. Hormone dust exposure a reversible cause of precocious pseudopuberty in siblings. Indian Pediatr 2011; 48:323-325. [PMID: 21532103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A seven year old female child presented with two episodes of vaginal bleeding and bilateral breast development. Examination showed normal anthropometric measurements and external genitalia of prepubertal type. Her 5-year old younger brother and her father had gynaecomastia. Search for a structural cause for precocious puberty was negative. Occupational exposure of her father to hormonal dust was identified as the cause. All pubertal changes reverted to normal after observing suitable precautions.
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Affiliation(s)
- Hari Anupama
- Department of Obstetrics and Gynaecology, Gandhi Medical College, Secunderabad, Hyderabad, India.
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Franklin SL. Effects of unintentional exposure of children to compounded transdermal sex hormone therapy. Pediatr Endocrinol Rev 2011; 8:208-212. [PMID: 21525797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Gynecomastia and rapid growth progressed in twin brothers and pubic hair in one, over a period of 2 years. A combination of contra- and isosexual development was induced by transdermal exposure to compounded estradiol, estrone, and testosterone creams applied to their mother's body as part of a hormone replacement regimen.
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Affiliation(s)
- Sherry L Franklin
- Pediatric Endocrinology of San Diego, University of California San Diego, San Diego, CA 92123, USA
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Abstract
Endocrine disrupting compounds (EDCs) alter the function of the endocrine system and consequently cause adverse health effects. Phytoestrogens, natural plant compounds abundantly found in soy and soy products, behave as weak estrogen mimics or as antiestrogens. They are considered to be EDCs, and have some beneficial effects on health, including reducing the risk of breast cancer and improving metabolic parameters. However, the supporting evidence that consumption of phytoestrogens is beneficial is indirect and inconsistent. Lifetime exposure to estrogenic substances, especially during critical periods of development, has been associated with formation of malignancies and several anomalies of the reproductive systems. Phytoestrogen consumption in infants, through soy-based formulas, is of particular concern. Prospective epidemiological studies for the evaluation of the effect of phytoestrogens alone, and in combination with other estrogenic chemicals, are lacking, yet possible adverse effects should not be taken lightly.
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Affiliation(s)
- Dadon S Bar-El
- School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel
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Affiliation(s)
- A Mason
- Royal Hospital for Sick Children, Glasgow G3 8SJ
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