Dong Yiwen, Wang Xingang, Hu Weijiang, Wang Xin, Bian Hongying, Zhang Wencui, Kang Ning, Zhang Lin, Ye Meng
Department of Occupational Epidemiology and Risk Assessment Research National Institute for Occupational Health and Poison Control Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Department of Occupational Health and Radiological Health Center for Disease Control and Prevention in Bin Hai New Area of Tian Jin City, Tian Jin 300480, China.
J Toxicol. 2024 Jul 30;2024:1951046. doi: 10.1155/2024/1951046. eCollection 2024.
Liver impairment caused by VCM has been linked to irreversible damage such as fibrosis, necrosis, hepatocellular carcinoma, and liver angiosarcoma. However, the ability to detect abnormalities during initial phase have not been achieved so far. Thus, this study aimed to investigate the effect of interleukin 8 (IL-8) and C-X-C chemokines 2 (CXCR2) on screening for a VCM-exposed group ( = 227) from a PVC manufacturing factory compared to a control group ( = 110) in Tianjin City in 2020 with influence factors evaluation. Ambient concentrations of VCM and health archives from 2012 to 2018 were collected for establishing the dose-effect trend. A cross-sectional survey in 2020 was performed to measure TDGA, IL-8, CXCR2, 8-OHdG, SOD, GPX, CAT, MDA, and ROS levels. Results indicated a continuous increased incidence on liver abnormalities despite a fluctuated downward trend in cumulative time-weighted average (C) VCM concentrations over the years. ALT, AST, and AST/ALT ratio all contributed to liver abnormalities that contained fatty liver, liver calcification, and liver cysts, IL-8 and CXCR2 correlated with each other strongly and showed significant associations with oxidative stress markers, even AST/ALT ratio. IL-8 (>1547 g/m) or CXCR2 (<139 g/m) influenced the AST/ALT ratio through reciprocal interactions under oxidative stress injury, CXCR2 (>222 g/m), working years of 21 to 30 (a) and 11 to 20 (a), TDGA (>1.52 mg/L), alcohol consumption, smoking habit, and a less sleeping duration of <4 h per day would also be potential factors affecting the AST/ALT ratio. In conclusion (1) even with decreased VCM concentrations in PVC manufacturing factories liver abnormalities that contained fatty liver, liver calcification, and liver cysts could still occur due to oxidative stress injury with involvement of IL-8 and CXCR2. The status of protective measure and appropriate mask types also play a role; (2) the AST/ALT ratio could be a specific indicator for detecting abnormalities when combined with liver ultrasonography results before impairment altered from bad to worse; and (3) factors such as definite medication history, fully broken protective facilities, alcohol consumption, less sleeping duration, inappropriate mask types, and longer working years could also influence AST/ALT ratio alterations through complex interactions.
氯乙烯（VCM）所致肝损伤与纤维化、坏死、肝细胞癌和肝血管肉瘤等不可逆损伤有关。然而，目前尚未实现对初始阶段异常情况的检测能力。因此，本研究旨在调查白细胞介素8（IL-8）和C-X-C趋化因子受体2（CXCR2）在筛选2020年天津市一家聚氯乙烯（PVC）制造厂的VCM暴露组（n = 227）与对照组（n = 110）中的作用，并进行影响因素评估。收集2012年至2018年的VCM环境浓度和健康档案，以建立剂量-效应趋势。2020年进行横断面调查，测量总二硫代氨基甲酸酯（TDGA）、IL-8、CXCR2、8-羟基脱氧鸟苷（8-OHdG）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GPX）、过氧化氢酶（CAT）、丙二醛（MDA）和活性氧（ROS）水平。结果表明，尽管多年来累积时间加权平均（C）VCM浓度呈波动下降趋势，但肝脏异常的发生率仍持续上升。谷丙转氨酶（ALT）、谷草转氨酶（AST）和AST/ALT比值均与包含脂肪肝、肝钙化和肝囊肿的肝脏异常有关，IL-8和CXCR2相互之间强烈相关，并与氧化应激标志物甚至AST/ALT比值显示出显著关联。在氧化应激损伤下，IL-8（>1547 pg/mL）或CXCR2（<139 pg/mL）通过相互作用影响AST/ALT比值，CXCR2（>222 pg/mL）、工作年限21至30年（a）和11至20年（a）、TDGA（>1.52 mg/L）、饮酒、吸烟习惯以及每天睡眠时间少于4小时也可能是影响AST/ALT比值的潜在因素。总之，（1）即使PVC制造厂的VCM浓度降低，由于IL-8和CXCR2参与的氧化应激损伤，仍可能发生包含脂肪肝、肝钙化和肝囊肿的肝脏异常。防护措施的状况和合适的口罩类型也起作用；（2）AST/ALT比值在肝脏损伤从不良转变为更严重之前，与肝脏超声检查结果相结合时，可能是检测异常的一个特异性指标；（3）明确的用药史、防护设施完全破损、饮酒、睡眠时间少、口罩类型不合适以及工作年限长等因素也可能通过复杂的相互作用影响AST/ALT比值的改变。
