Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Basic Clin Pharmacol Toxicol. 2019 Aug;125 Suppl 3(Suppl 3):70-80. doi: 10.1111/bcpt.13162. Epub 2018 Dec 10.
Much progress has happened in understanding developmental vulnerability to preventable environmental hazards. Along with the improved insight, the perspective has widened, and developmental toxicity now involves latent effects that can result in delayed adverse effects in adults or at old age and additional effects that can be transgenerationally transferred to future generations. Although epidemiology and toxicology to an increasing degree are exploring the adverse effects from developmental exposures in human beings, the improved documentation has resulted in little progress in protection, and few environmental chemicals are currently regulated to protect against developmental toxicity, whether it be neurotoxicity, endocrine disruption or other adverse outcome. The desire to obtain a high degree of certainty and verification of the evidence used for decision-making must be weighed against the costs and necessary duration of research, as well as the long-term costs to human health because of delayed protection of vulnerable early-life stages of human development and, possibly, future generations. Although two-generation toxicology tests may be useful for initial test purposes, other rapidly emerging tools need to be seriously considered from computational chemistry and metabolomics to CLARITY-BPA-type designs, big data and population record linkage approaches that will allow efficient generation of new insight; epigenetic mechanisms may necessitate a set of additional regulatory tests to reveal such effects. As reflected by the Prenatal Programming and Toxicity (PPTOX) VI conference, the current scientific understanding and the timescales involved require an intensified approach to protect against preventable adverse health effects that can harm the next generation and generations to come. While further research is needed, the main emphasis should be on research translation and timely public health intervention to avoid serious, irreversible and perhaps transgenerational harm.
在理解易受可预防环境危害影响的发育脆弱性方面已经取得了很大进展。随着认识的提高,视角也扩大了,发育毒性现在涉及潜在效应,这些效应可能导致成年人或老年时出现延迟的不良后果,以及可能传递给后代的额外效应。尽管流行病学和毒理学越来越多地探索人类发育暴露的不良影响,但改进的文献记录并没有在保护方面取得多少进展,目前几乎没有环境化学物质受到监管以防止发育毒性,无论是神经毒性、内分泌干扰还是其他不良后果。在权衡决策证据的确定性和验证程度与研究的成本和必要持续时间,以及由于延迟保护人类发育的早期脆弱阶段和可能的后代而对人类健康造成的长期成本时,必须权衡利弊。虽然两代毒理学测试可能对初始测试目的有用,但其他新兴工具,如计算化学和代谢组学,CLARITY-BPA 型设计、大数据和人群记录链接方法等,也需要认真考虑,这些方法将允许高效地产生新的见解;表观遗传机制可能需要一套额外的监管测试来揭示这些效应。正如产前编程和毒性 (PPTOX) VI 会议所反映的那样,当前的科学认识和所涉及的时间尺度需要采取强化措施来预防可预防的不良健康影响,这些影响可能会对下一代和后代造成伤害。虽然需要进一步研究,但主要重点应该是研究转化和及时的公共卫生干预,以避免严重、不可逆转的,甚至可能是跨代的伤害。