Repositório Científico do Instituto Nacional de Saúde
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Association between exposure to airborne endocrine disrupting chemicals and asthma in children or adolescents: A systematic review and meta-analysis
Publication . Hatem, Georges; Faria, Ana Margarida; Pinto, Mariana Bessa; Teixeira, João Paulo; Salamova, Amina; Costa, Carla; Madureira, Joana
Various studies have explored the association between Endocrine Disrupting Chemicals (EDCs) exposure and children's and adolescents' respiratory health, showing potential long-term effects and links to asthma. This systematic review explores the association between exposure to seven EDC groups during school age and adolescence and asthma onset or exacerbation while highlighting the predominant compounds underlying these potential associations. PubMed, Web of Science, Scopus, and Cochrane Library databases were searched with no time restriction. The risk of bias and heterogeneity across the included studies were assessed using the Newcastle Ottawa scale and I2 test, respectively. Pooled Odds Ratios (OR) and their 95% Confidence Intervals (CI) were calculated using the random effect model, and the quality of evidence for each outcome was measured using the GRADE approach. The review included 64851 children and adolescents from 61 observational studies, most with a low risk of bias in the studied domains. The pooled OR for asthma onset was significant for phthalates in dust samples (OR:1.21, CI:1.02; 1.44). Due to limited studies, the overall pooled effects for the other groups were not computed. Individual compounds demonstrating significant associations with asthma onset included airborne nickel (OR:1.10, CI:1.03; 1.18) and zinc (OR:1.13, CI:1.11; 1.15), urinary Bisphenol S (OR:1.40, CI:1.13; 1.73), Bisphenol A (OR:1.57, CI:1.02; 2.40) and arsenic (OR:2.08, CI:1.33; 3.26), and DiBP (OR:1.41, CI:1.08; 1.82), DEHP (OR:1.89, CI:1.00; 3.57), and TBOEP (OR:2.61, CI:1.08; 6.30) in the dust. Individual compounds with significant associations with greater asthma exacerbation odds comprised airborne nickel (OR:1.08, CI:1.01; 1.16) and zinc (OR:1.09, CI:1.01; 1.17), and urinary MEHHP (OR:1.24, CI:1.02; 1.51), MECPP (OR:1.30, CI:1.07; 1.57), MEOHP (OR:1.30, CI:1.09; 1.55), and MCOP (OR:1.32, CI:1.11; 1.57). Exposure to EDCs was significantly associated with asthma onset and exacerbation in children and adolescents, namely for phthalates, bisphenols A and S, arsenic, nickel, and zinc. Further research is recommended to focus on the impact of synergistic and co-exposure to other indoor air pollutants.
Exposure to per-and poly-fluoroalkyl substances and respiratory and skin effects in children and adolescents: A systematic review and meta-analysis
Publication . Hatem, Georges; Faria, Ana Margarida; Pinto, Mariana Bessa; Salamova, Amina; Teixeira, João Paulo; Costa, Carla; Madureira, Joana
Despite being previously banned due to long-term health effects, Per- and polyfluoroalkyl substances (PFAS) remain widespread in the environment, accumulating in animals and humans. This systematic review and meta-analysis explores associations between exposure to PFAS and asthma onset, wheezing, atopic dermatitis, and eczema in children and adolescents while addressing exposure timing and sex-specific differences. After comprehensive search conducted in several databases, including risk of bias, study heterogeneity, and quality of evidence evaluation, the review included 28 observational studies, most with low risk of bias in all domains. PFAS exposure was not significantly associated with asthma onset (OR:1.03, CI:0.99;1.07), but revealed significantly lower association in the prenatal period (OR:0.97, CI:0.94;0.99), higher in the postnatal period (OR:1.20, CI:1.07;1.35), and no differences among sexes. PFAS exposure (mainly prenatal) was associated with 4 % significantly lower odds of wheezing (OR:0.96, CI:0.94;0.98), higher in girls (OR:0.94, CI:0.91;0.98) than in boys (OR:0.97, CI:0.94;1.00). No significant impact was noted on atopic dermatitis (OR:1.04, CI:0.94;1.16), while PFAS exposure was associated with 8 % significantly lower eczema odds (OR:0.92, CI:0.89;0.96). Evidence was insufficient to perform sensitivity analyses on atopic dermatitis and eczema. Additional research is needed on the impact of synergistic and co-exposure to other pollutants on children and adolescents' health.
Biocompatibility testing and antioxidant properties of cerium dioxide nanoparticles in human nervous system cells
Publication . Fernández-Bertólez, Natalia; Touzani, Assia; Ramos-Pan, Lucía; Reis, Ana Teresa; Teixeira, João Paulo; Laffon, Blanca; Valdiglesias, Vanessa
Cerium dioxide nanoparticles (CeO NP), or nanoceria, are versatile materials with interesting properties for industry and medicine fields, particularly redox properties and catalytic activity. Because of their distinctive features, they have gained high attention in biomedical and pharmacological research to be employed in drug delivery, tissue regeneration, radioprotection, or diagnostic imaging. However, previous works reported that nanoceria may also induce reactive oxygen species (ROS) under certain conditions, leading to cellular stress, cellular damage, or cell death. In this study, the effects of CeO NP on cell viability and morphology as well as their influence on oxidative stress (both oxidant and ROS scavenging capacities) were investigated in nervous system cells (SH-SY5Y neuronal and A172 glial cells) treated with a wide range of CeO NP concentrations (1-100 µg/mL) for several treatment times. Results obtained showed that, despite being stable in time and effectively internalized by both cell types, CeO NP did not produce significant decrease in viability, evaluated by MTT assay, morphological alterations, or intrinsic cell-free ROS, but they generated cellular ROS limited to longer exposure periods. Furthermore, CeO NP demonstrated a certain intrinsic ability to scavenge ROS generated by HO in both tested cell types, more pronounced in neuronal cells. These results confirm the good biocompatibility of nanoceria on human nervous system cells and support further exploring their potential use in biomedicine field, particularly for those therapeutic and diagnostic applications related to the nervous system.
Lifestyle, environment and other major determinants of frailty in older adults: a population-based study from the UK Biobank
Publication . Hemadeh, Ali; Lema-Arranz, Carlota; Bonassi, Stefano; Buscarini, Leonardo; Infarinato, Francesco; Romano, Paola; Finti, Alessia; Marinozzi, Franco; Bini, Fabiano; Fernández-Bertólez, Natalia; Teixeira, João Paulo; Lorenzo-López, Laura; Valdiglesias, Vanessa; Laffon, Blanca
Frailty is a geriatric multidimensional syndrome characterized by a loss of physiologic reserves and disproportionate vulnerability to external stressors and associated with increased risk of multiple negative health outcomes. Since frailty can be prevented, controlled, and even reverted in its early stages, identifying the main factors involved in its development is crucial to implement preventive and/or restorative interventions. The aim of this study was to assess the impact of a broad range of parameters, including host factors, lifestyle, diet, and environmental and occupational conditions, on the development of frailty in later life. A cross-sectional study was conducted on 221,896 individuals aged 60 and over classified as non-frail (119,332, 53.8%), pre-frail (93,180, 42.0%), and frail (9384, 4.2%) according to the frailty phenotype. Using principal component analysis and machine learning to streamline the data, significant associations were found between frailty risk and air quality, diet, smoking, working conditions, and heavy alcohol consumption. Early-life factors, including breastfed as a baby and maternal smoking around birth, also emerged as predictors of frailty, which was further characterized by clinical indicators like polypharmacy, levels of C-reactive protein and other biomarkers of inflammageing. This study provided robust and original evidence on the association between a large battery of potential risk factors, from early to later stages of life, and the occurrence of frailty in older age. These results will contribute to the development of effective prevention strategies and facilitate the early detection of individuals at high risk of developing frailty.
Impact of occupational exposure to wildfire events on systemic inflammatory biomarkers in Portuguese wildland firefighters
Publication . Esteves, Filipa; Madureira, Joana; Barros, Bela; Alves, Sara; Pires, Joana; Martins, Sandra; Oliveira, Marta; Vaz, Josiana; Slezakova, Klara; Pereira, Maria do Carmo; Fernandes, Adília; Morais, Simone; Guimarães, João Tiago; Bonassi, Stefano; Teixeira, João Paulo; Costa, Solange
While occupational exposure as a firefighter is considered a dangerous occupation, research on the underlying mechanisms remains limited, particularly in wildland firefighters. Inflammation, a key effect of wildfire exposure, plays a significant role in the development of various diseases. The current study aims to investigate the impact of wildland firefighting exposure on the levels of pro-inflammatory systemic biomarkers. A pre-post study design investigated 59 wildland firefighters comparing data collected after participation in a wildfire event (Phase II) with data obtained before wildfire season (Phase I). Data on demographics, lifestyle, health and occupational-related factors were assessed. Exposure factors, such as fire combat (e.g., exposure duration), were also registered. Inflammatory biomarkers (i.e. interleukin-6 [IL-6], interleukin-8 [IL-8], tumor necrosis factor α [TNF-α] and high-sensitivity C-reactive protein [hs-CRP]) and hydroxylated polycyclic aromatic hydrocarbons metabolites (1-OHNaph+1-OHAce, 2-OHFlu, 1-OHPhen, 1-OHPyr) were analysed in blood and urine samples, respectively. Serum IL-8 and IL-6 levels were significantly increased after wildland fire combat. IL-8 levels were 2.62 times higher (95 % CI: 1.96-3.50; p < 0.01), whereas IL-6 levels were 1.25 times higher (95 % CI: 1.00-1.57; p = 0.04). Furthermore, IL-8 levels were significantly correlated with urinary 2-hydroxyfluorene levels and fire combat duration (>12 h). In addition, the mean hs-CRP level, in both phases, was above 3.0 mg/L, indicating a potential risk for cardiovascular events. Given the long-term health implications of firefighting occupational exposure, biomonitoring and early detection of occupational risks are essential for protecting firefighters' health. Protective measures must be urgently implemented to enhance occupational health and strengthen preventive strategies in this sector.