Lavanya Sirigala, Hema Shree Kasirajan, Ramani Prathiba
Department of Oral Pathology, Government Dental college and hospital, Vijayawada, Andhra Pradesh, India.
Department of Oral Pathology, Saveetha Dental college and hospital, Saveetha University of Medical Sciences, Chennai, Tamilnadu, India.
J Oral Biol Craniofac Res. 2024 Nov-Dec;14(6):735-745. doi: 10.1016/j.jobcr.2024.10.002. Epub 2024 Oct 15.
This systematic review evaluates the toxicological effects of exposure to fluoride on renal and hepatic functioning. It compiles both in vitro & in vivo studies across the last decade. By highlighting the potential health risks, the review aims to raise awareness and encourage a more attentive approach to fluoride use and exposure, instilling a sense of concern and vigilance in the audience.
A thorough literature search covered relevant studies from 2013 to 2023, both experimental (in vitro) and animal (in vivo) research. The data extraction process focused on critical aspects such as sample size, methodologies used, key findings, and conclusions regarding fluoride's impact on kidney and liver functions. The review also includes a detailed analysis of gene expression, KEGG pathways, and STRING analysis, further enhancing the reliability of the results.
Significant renal and liver damage were demonstrated in animal models exposed to high fluoride doses for long duration. Ferulic acid was found to mitigate fluoride-induced oxidative damage. The combined mean difference across studies was 6.52 [-5.22, 18.26], indicating high heterogeneity, which reflects diverse methodologies and findings. Notably, epigenetic and immune system impacts were underscored, with gene analysis identifying several genes involved in oxidative stress response, apoptosis, and inflammation pathways.
The findings emphasize the substantial evidence of its harmful effects on renal and liver functions at high exposure levels. Some studies indicate minimal impact, others demonstrate significant organ damage. The results underline the necessity for continued research to establish safe fluoride exposure limits and comprehend the mechanisms underlying its toxicity.
本系统评价评估了接触氟化物对肾脏和肝脏功能的毒理学影响。它汇编了过去十年的体外和体内研究。通过强调潜在的健康风险，该评价旨在提高认识，并鼓励对氟化物的使用和接触采取更谨慎的方法，在受众中灌输关注和警惕意识。
全面的文献检索涵盖了2013年至2023年的相关研究，包括实验性（体外）和动物（体内）研究。数据提取过程侧重于关键方面，如样本量、所用方法、主要发现以及关于氟化物对肾脏和肝脏功能影响的结论。该评价还包括对基因表达、KEGG通路和STRING分析的详细分析，进一步提高了结果的可靠性。
在长期暴露于高氟剂量的动物模型中证实了明显的肾脏和肝脏损伤。发现阿魏酸可减轻氟化物诱导的氧化损伤。各研究的合并平均差异为6.52[-5.22,18.26]，表明异质性较高，这反映了方法和结果的多样性。值得注意的是，强调了表观遗传学和免疫系统的影响，基因分析确定了几个参与氧化应激反应、细胞凋亡和炎症通路的基因。
研究结果强调了高暴露水平下氟化物对肾脏和肝脏功能有害影响的大量证据。一些研究表明影响最小，另一些研究则表明有明显的器官损伤。结果强调了继续开展研究以确定安全的氟化物暴露限值并了解其毒性潜在机制的必要性。
