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二噁英对新生儿及婴儿甲状腺功能的影响:围产期暴露途径、作用机制及流行病学研究证据

Dioxin effects on neonatal and infant thyroid function: routes of perinatal exposure, mechanisms of action and evidence from epidemiology studies.

作者信息

Giacomini Sara Mariasole, Hou Lifang, Bertazzi Pier Alberto, Baccarelli Andrea

机构信息

EPOCA Epidemiology Research Center, Department of Environmental and Occupational Health Clinica del Lavoro L. Devoto, Maggiore Hospital Foundation IRCCS, University of Milan, via San Barnaba 8, 20122, Milan, Italy.

出版信息

Int Arch Occup Environ Health. 2006 May;79(5):396-404. doi: 10.1007/s00420-005-0049-4. Epub 2005 Oct 11.

Abstract

OBJECTIVES

Animal experiments suggest that thyroid function alterations in newborns and infants may represent one of the most sensitive markers of toxicity from 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Dioxin can be transferred from the mother to the offspring either in utero or through lactation. It has been suggested that thyroid-hormone alterations produced by dioxin in utero or shortly after birth may underlie long-term effects, such as cognitive-ability and neurodevelopment impairment. In the present review article, we appraise available evidence on the effects of perinatal exposure to dioxin on fetal and infant thyroid function.

METHODS

We summarized the routes of perinatal dioxin exposure and research results on possible mechanisms of dioxin toxic effects on thyroid function. We performed a systematic review of epidemiology studies conducted on mother-child pairs exposed to background environmental levels to investigate dioxin effects on neonatal and infant thyroid function.

RESULTS

Toxicological and mechanistic data indicate that dioxin may impair thyroid function in exposed newborns and infants. Investigations on background-exposed children have not consistently demonstrated an association between perinatal TCDD exposure and thyroid function, although some of the studies suggest that sub-clinical hypothyroidism may be induced by perinatal dioxin exposure within 3 months from birth. Between studies inconsistencies may be related to lab method differences, mixed exposures, and small sample size of the populations evaluated.

CONCLUSION

Epidemiology studies have as yet failed to demonstrate an association between perinatal TCDD exposure and thyroid function alterations in human subjects, although suggestive evidence from animal and in-vitro experimental data is available.

摘要

目的

动物实验表明,新生儿和婴儿的甲状腺功能改变可能是2,3,7,8-四氯二苯并对二恶英(TCDD)毒性最敏感的标志物之一。二恶英可在子宫内或通过哺乳从母体转移至后代。有人提出,二恶英在子宫内或出生后不久引起的甲状腺激素改变可能是认知能力和神经发育受损等长期影响的基础。在本综述文章中,我们评估了围产期接触二恶英对胎儿和婴儿甲状腺功能影响的现有证据。

方法

我们总结了围产期二恶英暴露途径以及二恶英对甲状腺功能毒性作用可能机制的研究结果。我们对针对暴露于环境背景水平的母婴对进行的流行病学研究进行了系统综述,以调查二恶英对新生儿和婴儿甲状腺功能的影响。

结果

毒理学和机制数据表明,二恶英可能损害暴露的新生儿和婴儿的甲状腺功能。对背景暴露儿童的调查并未始终证明围产期TCDD暴露与甲状腺功能之间存在关联,尽管一些研究表明,围产期二恶英暴露可能在出生后3个月内诱发亚临床甲状腺功能减退。研究之间的不一致可能与实验室方法差异、混合暴露以及所评估人群的样本量小有关。

结论

尽管有动物和体外实验数据的提示性证据,但流行病学研究尚未证明围产期TCDD暴露与人类受试者甲状腺功能改变之间存在关联。

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