Rates of liver disease in children are rising rapidly – scientists may have discovered why
Prenatal exposure to chemicals in consumer and industrial items is linked to increases in liver disease in children.
Researchers at Mount Sinai University have found a link between prenatal exposure to various endocrine disrupting chemicals and the increasing prevalence of potentially carcinogenic liver disease in children.
This is the first comprehensive study of the relationship between prenatal exposure to certain chemicals and chemical mixtures and non-alcoholic fatty liver disease. The researchers used cytokeratin-18 as a new marker for the disease in children. The results, recently published in Open JAMA Networkhighlight the importance of understanding prenatal exposure to environmental chemicals as a risk factor for non-alcoholic fatty liver disease, a problem that is rapidly becoming more common in children and can lead to serious chronic liver disease and liver cancer in the ‘adulthood.
“These findings may inform more effective prevention and intervention strategies in early life to address the current epidemic of nonalcoholic fatty liver disease,” said Vishal Midya, Ph.D., first author and postdoctoral researcher in the Department environmental medicine and public health. and Fellow of the Mount Sinai Institute for Exposomic Research at the Icahn School of Medicine at Mount Sinai.
Damaskini Valvi, MD, Ph.D., MPH, lead author, assistant professor of environmental medicine and public health, and member of the Mount Sinai Institute for Exposomic Research at Icahn Mount Sinai, added, “We are all exposed to these daily chemicals in the food we eat, the water we drink and the use of consumer products. This is a serious public health problem. These results show that early exposure to many endocrine-disrupting chemicals is a risk factor for pediatric non-alcoholic fatty liver disease, and call attention to further research needed to elucidate how environmental chemical exposures may interact with genetic factors. and lifestyle-related in the pathogenesis of liver disease.”
Non-alcoholic fatty liver disease, one of the most common liver conditions worldwide, is increasingly being diagnosed in children, affecting 6-10% of the pediatric population and approximately 34% of obese children. Many pesticides, plastics, flame retardants, hazardous metals, and other environmental pollutants fall into the category of endocrine disruptors.
Examples include perfluoroalkyl substances (PFAS), also known as “eternal chemicals” used in nonstick cookware and food packaging, and polybrominated diphenyl ethers (PBDEs) used as flame retardants in furniture and products. for babies. Endocrine disruptors interfere with hormonal and metabolic systems in humans. Several experimental studies have shown that exposure to these chemicals can lead to liver damage and non-alcoholic fatty liver disease. however, to date, the potential effects of prenatal exposures to these chemicals have not been studied in humans.
In this study, researchers measured 45 chemicals in the blood or urine of 1,108 pregnant women from 2003 to 2010. The chemicals included endocrine disruptors such as PFAS, organochlorine and organophosphate pesticides, plasticizers (phenols , phthalates), PBDEs and parabens. . When children reached the age of 6 to 11, scientists measured levels of enzymes and cytokeratin-18 that indicate risk of liver disease in children’s blood, finding high levels of these biomarkers in children who had been more heavily exposed to environmental chemicals during pregnancy.
“By understanding the environmental factors that accelerate fatty liver disease, we can reduce people’s risk by giving them actionable information to make informed choices that reduce the risk or impact of the disease,” said Robert Wright, MD, MPH, Ethel H. Wise Chair of the Department of Environmental Medicine and Public Health and Co-Director of the Exposomic Research Institute at Icahn Mount Sinai.
“Exposomics is the wave of the future because once you’ve sequenced the human genome, which has been done, you can’t do much more in genomics alone. The missing piece of the puzzle for us to understand different diseases is to measure their environmental causes, and exposomics is a way to accelerate our knowledge of how the environment affects our health.
Reference: “Association of Prenatal Exposure to Endocrine-Disrupting Chemicals With Liver Injury in Children” by Vishal Midya, Ph.D., MStat, Elena Colicino, Ph.D., David V. Conti, Ph.D., Kiros Berhane, Ph.D., Erika Garcia, Ph.D., Nikos Stratakis, Ph.D., Sandra Andrusaityte, Ph.D., Xavier Basagaña, Ph.D., Maribel Casas, Ph.D., Serena Fossati, MD, Ph.D., Regina Gražulevičienė, MD, Line Småstuen Haug, Ph.D., Barbara Heude, Ph.D., Léa Maitre, Ph.D., Rosemary McEachan, Ph.D., Eleni Papadopoulou, Ph.D. , Theano Roumeliotaki, MPH, Claire Philippat, Ph.D., Cathrine Thomsen, Ph.D., Jose Urquiza, Ph.D., Marina Vafeiadi, Ph.D., Nerea Varo, Ph.D., Miriam B. Vos , MD, John Wright, MD, Rob McConnell, MD, Ph.D., Martine Vrijheid, Ph.D., Lida Chatzi, MD, PhD and Damaskini Valvi, MD, MPH, Ph.D., July 6, 2022, Open JAMA Network.
Study participants were enrolled in the Human Early-Life Exposome project, a collaborative network of six prospective population-based birth cohort studies underway in six European countries: France, Greece, Lithuania, Norway , Spain and Great Britain. Limitations of this study include the inability to perform a liver biopsy, considered the gold standard for establishing a causal link with non-alcoholic fatty liver disease, due to the risk and ethical limitations due to the age of the children. .
This research was funded by the National Institute of Environmental Health Sciences (NIEHS) and the European Community’s Seventh Framework Program.