Prenatal exposure to chemicals in consumer and industrial products is associated with increasing liver disease in children

The increasing incidence of a potentially cancer-causing liver disease in children has been linked to prenatal exposure to several endocrine-disrupting chemicals, Mount Sinai researchers report.

It is the first comprehensive study on the association between prenatal exposure and mixtures of these chemicals and non-alcoholic fatty acids liver disease† The researchers used cytokeratin-18 as a new marker for the disease in children. The findings, reported in JAMA network opened in July, underline the importance of understanding prenatal exposure until environmental chemicals as a risk factor for non-alcoholic fatty liver disease, a rapidly growing problem in children that can lead to severe chronic liver disease and liver cancer in adulthood.

“These findings may lead to more efficient early-life prevention and intervention strategies to address the current epidemic of nonalcoholic fatty liver disease,” said Vishal Midya, Ph.D., first author and postdoctoral researcher in the Department of Environmental Medicine and Public Health. and a member of the Mount Sinai Institute for Exposomic Research at the Icahn School of Medicine at Mount Sinai.

Damaskini Valvi, MD, Ph.D., MPH, senior 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 chemicals on a daily basis through the food we eat, the water we drink and the use of consumer products Public health issue. These findings demonstrate that early age exposure to many endocrine-disrupting chemicals is a risk factor for pediatric nonalcoholic fatty liver disease, and draw attention to additional research needed to elucidate how the environment is affected. chemical exposures may interact with genetic and lifestyle factors in the pathogenesis of liver disease.”

Non-alcoholic fatty liver disease is one of the most common liver diseases worldwide and is increasingly diagnosed in childhood. It affects 6 to 10 percent of the general pediatric population and about 34 percent of obese children. Hormone-disrupting chemicals are a broad class of environmental pollutants, including various pesticides, plastics, flame retardants, and toxic metals. Examples include perfluoroalkyls (PFAS), also known as “forever chemicals” used in non-stick cookware and food packaging, and polybrominated diphenyl ethers (PBDEs) used as flame retardants in furniture and baby products. Hormone-disrupting chemicals interfere with hormone 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; to date, however, the possible effects of prenatal exposure of mixtures 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-disrupting chemicals such as PFAS, organochlorine and organophosphate pesticides, plasticizers (phenols, phthalates), PBDEs, and parabens. When the children reached the ages of 6 to 11, scientists measured the levels of enzymes and cytokeratin-18 that indicate the risk of liver disease in the children’s blood, and found elevated levels of those biomarkers in children who were more highly exposed to environmental chemicals during pregnancy.

“By understanding the environmental factors that accelerate fatty livercan we reduce people’s risk by giving them actionable information to make informed choices that reduce the risk or impact of disease,” said Robert Wright, MD, MPH, Ethel H. Wise Chair of the Division of Environmental Medicine and Public Health and Co-Director of the Institute for Exposomic Research at Icahn Mount Sinai “Exposomics is the wave of the future because once you sequence the human genome, what’s 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 understanding of how the environment affects our health.”

The study participants participated in the Human Early-Life Exposome project, a collaborative network of six ongoing population-based prospective birth cohort studies from six European countries: France, Greece, Lithuania, Norway, Spain and Great Britain. Limitations of this study include the inability to liver biopsy, considered the gold standard to establish a causal relationship with non-alcoholic fatty liver diseasebecause of the risk and ethical constraints due to the age of the children.