Qu Haoyang, Han Yating, Wang Chenglu, Zheng Dongwang, Ni Ya, Xiao Xiang
Center for Reproductive Health, School of Pharmaceutical Sciences, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, China.
School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China.
Adv Exp Med Biol. 2025;1469:127-162. doi: 10.1007/978-3-031-82990-1_7.
Per- and polyfluoroalkyl substances (PFAS) represent an emerging concern for male reproductive health. Epidemiological studies have reported associations between increased PFAS exposure and reduced semen quality parameters, lower sperm counts, and potential alterations in reproductive hormone levels. Toxicology research has revealed possible mechanisms including blood-testis barrier disruption, oxidative stress, interference with testicular cell function, and epigenetic changes. However, significant uncertainties remain regarding definitive exposure-response relationships, developmental windows of heightened vulnerability, combined mixture effects, and causality interpretation, given limitations inherent to observational studies. Ongoing investigation of short-chain and replacement PFAS compounds is also critically needed. Additionally, directly connecting the mechanistic insights from animal models to human fertility impacts remains challenging. While controlled toxicology studies have described pathways by which PFAS could impair cellular functioning in the testes, uncertainty persists in extrapolating these experimental effects to real-world human exposures and sperm parameter declines reported epidemiologically. Overall, current findings suggest PFAS may contribute to declining male reproductive function, but additional clarification through well-designed longitudinal cohort studies integrated with mechanistic animal work is still warranted to confirm exposure-fertility links across a range of PFAS types and inform evidence-based public health mitigation strategies.
全氟和多氟烷基物质(PFAS)已成为男性生殖健康领域一个新的关注问题。流行病学研究报告称,PFAS暴露增加与精液质量参数降低、精子数量减少以及生殖激素水平的潜在变化之间存在关联。毒理学研究揭示了可能的机制,包括血睾屏障破坏、氧化应激、对睾丸细胞功能的干扰以及表观遗传变化。然而,鉴于观察性研究固有的局限性,在确定暴露-反应关系、高易感性发育窗口、混合效应以及因果关系解释方面仍存在重大不确定性。对短链和替代PFAS化合物的持续研究也至关重要。此外,将动物模型中的机制见解直接与对人类生育能力的影响联系起来仍然具有挑战性。虽然对照毒理学研究已经描述了PFAS可能损害睾丸细胞功能的途径,但将这些实验效应外推到实际的人类暴露以及流行病学报告的精子参数下降情况时,不确定性依然存在。总体而言,目前的研究结果表明PFAS可能导致男性生殖功能下降,但仍需要通过精心设计的纵向队列研究结合机制性动物研究来进一步阐明,以确认一系列PFAS类型的暴露与生育能力之间的联系,并为基于证据的公共卫生缓解策略提供依据。