利用实验模型解读对乙酰氨基酚和非甾体抗炎药对生殖发育及健康的影响。

Using Experimental Models to Decipher the Effects of Acetaminophen and NSAIDs on Reproductive Development and Health.

作者信息

Boizet-Bonhoure Brigitte, Déjardin Stéphanie, Rossitto Moïra, Poulat Francis, Philibert Pascal

机构信息

Institute of Human Genetics, CNRS, University of Montpellier, Montpellier, France.

INRAE, University of Bordeaux, Bordeaux, France.

出版信息

Front Toxicol. 2022 Mar 8;4:835360. doi: 10.3389/ftox.2022.835360. eCollection 2022.

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (acetylsalicylic acid), diclofenac and ibuprofen (IBU), and analgesic drugs, such as acetaminophen (APAP, or paracetamol), are widely used to treat inflammation and pain. APAP and IBU are over-the-counter drugs and are among the most commonly taken drugs in the first trimester of pregnancy, even in combination. Furthermore, these drugs and their metabolites are released in the environment, and can be frequently detected in wastewater, surface water, and importantly in drinking water. Although their environmental concentrations are much lower than the therapeutics doses, this suggests an uncontrolled low-dose exposure of the general population, including pregnant women and young children, two particularly at risk populations. Epidemiological studies show that exposure to these molecules in the first and second trimester of gestation can favor genital malformations in new-born boys. To investigate the cellular, molecular and mechanistic effects of exposure to these molecules, studies with human or rodent gonadal explants and experiments in rodents have been performed in the past years. This review recapitulates recent data obtained in rodent models after or postnatal exposure to these drugs. The first part of this review discusses the mechanisms by which NSAIDs and analgesics may impair gonadal development and maturation, puberty development, sex hormone production, maturation and function of adult organs, and ultimately fertility in the exposed animals and their offspring. Like other endocrine disruptors, NSAIDs and APAP interfere with endocrine gland function and may have inter/transgenerational adverse effects. Particularly, they may target germ cells, resulting in reduced quality of male and female gametes, and decreased fertility of exposed individuals and their descendants. Then, this review discusses the effects of exposure to a single drug (APAP, aspirin, or IBU) or to combinations of drugs during early embryogenesis, and the consequences on postnatal gonadal development and adult reproductive health. Altogether, these data may increase medical and public awareness about these reproductive health concerns, particularly in women of childbearing age, pregnant women, and parents of young children.

摘要

非甾体抗炎药(NSAIDs),如阿司匹林(乙酰水杨酸)、双氯芬酸和布洛芬(IBU),以及镇痛药,如对乙酰氨基酚(APAP,或扑热息痛),被广泛用于治疗炎症和疼痛。APAP和IBU是非处方药,是妊娠头三个月最常用的药物之一,甚至会联合使用。此外,这些药物及其代谢产物会释放到环境中,并且经常在废水、地表水,重要的是在饮用水中被检测到。尽管它们在环境中的浓度远低于治疗剂量,但这表明包括孕妇和幼儿这两个特别高危人群在内的普通人群存在不受控制的低剂量暴露。流行病学研究表明,在妊娠头三个月和第二个月接触这些分子会增加新生男婴生殖器畸形的风险。为了研究接触这些分子的细胞、分子和机制效应,过去几年进行了人体或啮齿动物性腺外植体研究以及啮齿动物实验。本综述总结了近年来在啮齿动物模型中,产前或产后接触这些药物后获得的数据。本综述的第一部分讨论了NSAIDs和镇痛药可能损害性腺发育和成熟、青春期发育、性激素产生、成年器官成熟和功能,以及最终影响暴露动物及其后代生育能力的机制。与其他内分泌干扰物一样,NSAIDs和APAP会干扰内分泌腺功能,并可能产生代内/跨代不良影响。特别是,它们可能靶向生殖细胞,导致雄性和雌性配子质量下降,以及暴露个体及其后代的生育能力降低。然后,本综述讨论了在早期胚胎发育过程中接触单一药物(APAP、阿司匹林或IBU)或药物组合的影响,以及对产后性腺发育和成年生殖健康的后果。总之,这些数据可能会提高医学界和公众对这些生殖健康问题的认识,特别是育龄妇女、孕妇和幼儿的父母。

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