Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of the National Toxicology Program (DNTP), NTP Laboratory, National Institute of Environmental Health Sciences (NIEHS), National Institute of Health (NIH), Research Triangle Park, NC, USA.
Division of the National Toxicology Program (DNTP), NTP Laboratory, National Institute of Environmental Health Sciences (NIEHS), National Institute of Health (NIH), Research Triangle Park, NC, USA.
Toxicology. 2020 Oct;443:152565. doi: 10.1016/j.tox.2020.152565. Epub 2020 Aug 27.
Per- and polyfluoroalkyl substances (PFAS) are ubiquitous drinking water contaminants of concern due to mounting evidence implicating adverse health outcomes associated with exposure, including reduced kidney function, metabolic syndrome, thyroid disruption, and adverse pregnancy outcomes. PFAS have been produced in the U.S. since the 1940s and now encompass a growing chemical family comprised of diverse chemical moieties, yet the toxicological effects have been studied for relatively few compounds. Critically, exposures to some PFAS in utero are associated with adverse outcomes for both mother and offspring, such as hypertensive disorders of pregnancy (HDP), including preeclampsia, and low birth weight. Given the relationship between HDP, placental dysfunction, adverse health outcomes, and increased risk for chronic diseases in adulthood, the role of both developmental and lifelong exposure to PFAS likely contributes to disease risk in complex ways. Here, evidence for the role of some PFAS in disrupted thyroid function, kidney disease, and metabolic syndrome is synthesized with an emphasis on the placenta as a critical yet understudied target of PFAS and programming agent of adult disease. Future research efforts must continue to fill the knowledge gap between placental susceptibility to environmental exposures like PFAS, subsequent perinatal health risks for both mother and child, and latent health effects in adult offspring.
全氟和多氟烷基物质（PFAS）是无处不在的饮用水污染物，因为越来越多的证据表明接触这些物质与不良健康后果有关，包括肾功能下降、代谢综合征、甲状腺功能紊乱和不良妊娠结局。PFAS 自 20 世纪 40 年代以来就在美国生产，现在已经形成了一个不断增长的化学家族，包含了各种不同的化学基团，但对其毒性作用的研究相对较少。至关重要的是，一些 PFAS 在子宫内的暴露与母婴的不良后果有关，如妊娠高血压疾病（HDP），包括子痫前期和低出生体重。鉴于 HDP、胎盘功能障碍、不良健康后果以及成年后患慢性疾病的风险增加之间的关系，PFAS 的发育和终生暴露可能以复杂的方式导致疾病风险。在这里，一些 PFAS 对甲状腺功能紊乱、肾脏疾病和代谢综合征的作用的证据被综合在一起，重点是胎盘作为 PFAS 和成年疾病编程剂的一个关键但研究不足的靶标。未来的研究工作必须继续填补 PFAS 等环境暴露对胎盘易感性、母婴围产期健康风险以及成年后代潜在健康影响之间的知识空白。
