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Tuesday, May 3, 2022

Risky ‘gain-of-function’ studies need stricter guidance

 Researchers and biosecurity specialists are calling on the US government to issue clearer guidance about experiments it might fund that would make pathogens more transmissible or deadly. They made these pleas on 27 April, during the first of a series of public listening sessions organized by the US National Science Advisory Board for Biosecurity (NSABB). The sessions are part of a months-long review, conducted by the NSABB, of US policies governing risky pathogen research.

The board, which advises the US Department of Health and Human Services (HHS), was supposed to begin this review in 2020, but the COVID-19 pandemic delayed it. Given that enhanced pathogens could accidentally cause disease outbreaks, the need for the review is now greater than ever, some researchers say.

“Pandemics are on people’s minds,” says Marc Lipsitch, an epidemiologist at the Harvard T. H. Chan School of Public Health in Boston, Massachusetts, and an outspoken critic of ‘gain-of-function’ research that modifies pathogens to make them more dangerous to humans. “It’s no longer abstract to think about the destruction that the spread of a new virus can cause.”

Although most virologists say that the coronavirus SARS-CoV-2 probably spread to humans directly from wild animals, some politicians and scientists have argued that the COVID-19 pandemic could have been set off when a modified virus escaped from the Wuhan Institute of Virology (WIV) in China.

To address these concerns, in late February, the US National Institutes of Health (NIH) and the White House Office of Science and Technology Policy asked the NSABB to make swift progress on its long-overdue review. The panel plans to draft a report outlining its recommendations by the end of the year.

A long-running debate

Manipulating viruses by, say, making them more transmissible in humans can help scientists to answer important questions about how a pathogen evolved or how to defeat it. But US policymakers have struggled to determine when the risk of creating a pathogen that is more dangerous outweighs the benefits of the research. The worry is that such a pathogen could be accidentally released or even weaponized.

The listening sessions mark the latest chapter in a decade-long effort to better govern such experiments. Debate erupted in 2011 when two research groups separately reported creating a mutant avian-influenza virus that could be readily transmitted between ferrets breathing the same air. Many worried that such a virus could also spread easily among humans. In 2014, the US government announced a funding moratorium on such experiments after a series of accidents involving mishandled pathogens occurred in government laboratories.

The moratorium was lifted in 2017, and the HHS adopted a policy that would add a layer of review to such experiments. The policy created an independent advisory panel to review any research proposals submitted to agencies reporting to the HHS (including the NIH) that describe work on so-called enhanced potential pandemic pathogens (ePPPs). Two years later, Science reported that the advisory panel quietly approved two experiments to manipulate avian-influenza viruses similar to those that set off the original uproar, prompting fresh calls for reform.

Although the scope of the NSABB’s new review of risky pathogen research remains similar to the one it had planned for 2020, the COVID-19 pandemic will undoubtedly have an influence. The NIH, in particular, has been scrutinized during the pandemic for its role in funding potentially risky coronavirus research.

In 2014, the WIV received funding from the NIH, through a subcontract with the New-York-based research organization EcoHealth Alliance, to manipulate bat coronaviruses. Some of the funding came during the federal moratorium on gain-of-function research. But the NIH says it approved the funding because the experiments didn’t meet its definition of ePPP research, a stance that has been contested by some US policymakers.

In response, Republican lawmakers have introduced draft legislation that would again place a moratorium on the funding of gain-of-function research. This move has alarmed some researchers, including those who attended the 27 April listening session. Felicia Goodrum Sterling, president of the American Society of Virology, based in Ann Arbor, Michigan, pointed out that rapid advances in COVID-19 therapeutics and vaccines were made possible, in part, by manipulating viruses. For example, to create the Johnson & Johnson and Oxford–AstraZeneca COVID-19 vaccines, scientists modified adenoviruses to produce the SARS-CoV-2 spike protein.

Policy reform wanted

Many at the listening session pushed for stricter oversight of risky-pathogen research, however. Some suggested that the HHS advisory-panel approach be extended to other US entities. Gregory Koblentz, a biosecurity-policy specialist at George Mason University in Arlington, Virginia, pointed out that pharmaceutical firms, philanthropic institutions and federal agencies, including the Department of Energy, the Department of Agriculture and the Department of Defense, also conduct research on potentially risky pathogens. They should adhere to the same guidelines, he said.

In a nod to concerns about the WIV, others thought that the US government should more carefully consider how it funds gain-of-function research abroad and encourage other countries to adopt a similar ePPP review process.

Some are also calling for changes to the HHS ePPP review panel itself. Lipsitch would like the identities of the advisers on the panel to be revealed and their comments on research grants to be published (typically, this information is kept confidential). Others worry that if this were to happen, advisers might decline to participate over concerns about harassment. Scientists have reported an uptick in harassment during the pandemic, particularly those who discuss the origins of SARS-CoV-2.

Still, the US government could be more transparent when it comes to biosecurity research, experts said. Tom Inglesby, the director of the Johns Hopkins Center for Health Security in Baltimore, Maryland, called for the risks and benefits of funded experiments to be shared openly, the specific criteria used to evaluate projects to be disclosed and for better guidance in communicating results to the public. This would go a long way to improving public trust in science and the NIH, which has declined during the pandemic, he said.

The fact that policies governing ePPPs continue to be tweaked more than a decade after the controversial avian-influenza experiments shows that the issue is extremely nuanced, Koblentz told Nature. He acknowledges the “wonderful benefits” of risky pathogen research, especially with regard to fighting SARS-CoV-2, but he worries that researchers will become complacent about the inherent risk if stricter policies aren’t put in place — especially given that the number of laboratories equipped to handle dangerous pathogens is increasing worldwide.

The NSABB plans to host more listening sessions and a public stakeholder meeting before finalizing its draft report. A date for these sessions has not yet been set, says Ryan Bayha, a spokesperson for the NIH Office of Science Policy.

doi: https://doi.org/10.1038/d41586-022-01209-w

https://www.nature.com/articles/d41586-022-01209-w

COVID fatigue setting in as people battle reinfection for third, fourth time

 India, on Monday, reported 3,157 infections and 26 COVID fatalities in the last 24 hours. According to the Union health ministry, the rise in cases reported on Monday pushed the overall COVID tally of the country to 4,30,82,345 cases and 5,23,869 deaths. However, according to the experts severity of cases is not a concern as it was during the second wave (caused by Delta variant). They have also said that there is uncertainty about the nature of the upcoming variants. For many, dealing with this unknown virus for over 30 months is causing a COVID fatigue. "We are in the third year of the pandemic and are tired of it," a senior journalist based out of Rajasthan shared with News9, "My family has suffered from the virus twice already. We are all vaccinated and most of us (who were eligible) have even taken the booster. But now my young children are getting it and spreading the infection. We are all infected with COVID for the third time. But this time round it is a kind of a fatigue about the virus." He added, "It may not be a severe case but it's extremely exhausting mentally and physically to deal with it now. I am scared that we may never recover from the damage that the virus must have caused our bodies. Then there is mental exhaustion too. This isolation combined with a general feeling of uneasiness is driving the fatigue in us." Rahul Singhla, a professional at an IT firm in Noida reiterated that COVID fatigue is for real. "We have seen COVID around us for over two years now. Although, I haven't yet got the infection (at least not confirmed by a report), I have seen many near and dear family members suffer from the virus multiple times. With reinfection happening all over, it is very disheartening to follow COVID SOPs in a strict manner. I had been the biggest advocate for masks in public places back in 2020 but now I see there is no need for them. There is a general feeling of tiredness with respect to following COVID protocols. There is an overall feeling of 'everything is a lost cause' when it comes to the virus which is plaguing us," Sighla shared his experience. COVID fatigue is setting in again but SOPs need to be followed Dr Viny Kantroo, a pulmonologist at Indraprastha Apollo Hospital in New Delhi agreed that it is has been long since COVID has been around and this may be causing disease-related fatigue in some people. "It is true that people who have been fully vaccinated and have even taken the booster jabs are getting re-infected with the virus. But we cannot just do away with COVID SOPs. The fight against the virus is not over, we have to be at it," she said, adding that the virus is still unknown to us and that we are unaware of the upcoming COVID variants. "It's difficult to keep fighting with this virus but we cannot give up. We have to follow COVID etiquette like wearing masks and social distancing very seriously," Dr Kantroo said. Apart from the rise in COVID positive cases being noticed all over India, Kantroo said we should be wary that SARS CoV2 is still dangerous for senior citizens and for those who suffer from comorbid conditions. "The mild cases reported these days are a good sign that the virus may soon become an endemic. But when is that day going to come, we don't have an answer to that. Till then, following COVID appropriate behaviour is need of hour," she said.


https://www.news9live.com/health/covid-19/covovax-now-available-for-children-aged-12-17-in-india-adar-poonawalla-168121

When It's Not Long, but Medium COVID

 Symptom timelines surrounding COVID infection tend to center on either the immediate 5-day quarantine protocols for acute infection or the long-COVID symptoms that can last a month or potentially far longer.

But some patients report a "middle-range" COVID that will resolve before it becomes long COVID, yet still lasts longer than is typical for viral infections. People may return to work or daily routines, but something is off: What had been simple exercise regimens become onerous. Everyday tasks take more effort.

Does this ill-defined subset point to a "medium COVID?"

Dr Farha Ikramuddin

Farha Ikramuddin, MD, MHA, a physiatrist and rehabilitation specialist at the University of Minnesota Medical School in Minneapolis and M Health Fairview points out there is no definition or diagnostic code or shared official understanding of a middle category for COVID.

"But am I seeing that? Absolutely," she told Medscape Medical News.

"I have seen patients who are younger, healthier, [and] with not so many comorbidities have either persistence of symptoms or reappearance after the initial infection is done," she said.

Some patients report they had very low infection or were nonsymptomatic and returned to their normal health fairly quickly after infection. Then a week later they began experiencing fatigue, lost appetite, loss of smell, and feeling full after a few bites, Ikramuddin said.

Part of the trouble in categorizing the space between returning to normal after a week and having symptoms for months is that organizations can't agree on a timeline for when symptoms warrant a "long COVID" label.

For instance, the Centers for Disease Control and Prevention (CDC) defines it as 4 or more weeks after infection. The World Health Organization defines it as starting 3 months after COVID-19 symptom onset.

"I'm seeing 'medium COVID' — as one would call it — in younger and healthier patients. I'm also noticing that these symptoms are not severe enough to warrant stopping their job or changing their job schedules," Ikramuddin said.

They go back to work, she said, but start noticing something is off.

"I am seeing that."

"I discharge at least two patients a week from my clinic because they have moved on and no longer have symptoms," Ikramuddin said.

In a story from Kaiser Health News published last month on Medscape, WHYY health reporter Nina Feldman writes: "[W]hat I've come to think of as my 'medium covid' affected my life. I couldn't socialize much, drink, or stay up past 9:30 p.m. It took me 10 weeks to go for my first run — I'd been too afraid to try."

She described a dinner with a friend after ending initial isolation protocols: "One glass of wine left me feeling like I'd had a whole bottle. I was bone-achingly exhausted but couldn't sleep."

Medical Mystery

Ikramuddin notes the mechanism behind prolonged COVID-19 symptoms is still a medical mystery.

"In one scenario," she said, "the question is being asked about whether the virus is staying dormant, similar to herpes zoster or HIV."

"Right now, instead of getting more answers, we're getting more questions," Ikramuddin  said.

Mouhib Naddour, MD, a pulmonary specialist with Sharp HealthCare in San Diego, California, said he's seeing that it's taking some patients who have had COVID longer to recover than it would for other viral infections.

Some patients fall between those recovering within 2-3 weeks and patients having long COVID. Those patients in the gap could be lumped into a middle-range COVID, he told Medscape Medical News.

"We try to put things into tables and boxes but it is hard with this disease, " Naddour said.

Dr Mouhib Naddour

He agrees there's no medical definition for "medium" COVID, but he said the idea should bring hope for patients to know that if their symptoms are persisting they don't necessarily have long COVID — and their symptoms may still disappear.

"This is an illness that may take longer to completely recover from," he said. "The majority of patients we're seeing in this group could be healthy young patients who get COVID, then 2-3 weeks after they test negative, still have lingering symptoms."

Common Symptoms

Some commonly reported symptoms of those with enduring illness, which often overlap with other stages of COVID, are difficulty breathing, chest tightness, dry cough, chest pain, muscle and joint pain, fatigue, difficulty sleeping, and mood swings, Naddour said. 

"We need to do an extensive assessment to make sure there's no other problem causing these symptoms," he said.

Still, there is no set timeline for the medium COVID range, he noted, so checking in with a primary care physician is important for people experiencing symptoms. 

It's a Continuum, Not a Category

Fernando Carnavali, MD, coordinator for Mount Sinai's Center for Post-COVID Care in New York City, said he is not ready to recognize a separate category for a "medium" COVID.

Dr Fernando Carnavali

He noted that science can't even agree on a name for lasting post-COVID symptoms, whether it's "long COVID" or "long-haul COVID," "post-COVID syndrome" or "post-acute sequelae of COVID-19 (PASC )." There's no agreed-upon pathophysiology or biomarker.

"That creates these gaps of understanding on where we are," Carnavali told Medscape Medical News.

He said he understands people's need to categorize symptoms, but rather than a middle ground he sees a continuum.

It doesn't mean what others may call COVID's middle ground doesn't exist, Carnavali said: "We are in the infancy of defining this. Trying to classify them may create more anxiety."

The clinicians interviewed for this story report no relevant financial relationships.

https://www.medscape.com/viewarticle/973328

Reducing sedentary time mitigates risk of type 2 diabetes, cardiovascular diseases

 A new study suggests that reducing daily sedentary time can have a positive effect on the risk factors of lifestyle diseases already in three months. Spending just one hour less sitting daily and increasing light physical activity can help in the prevention of these diseases.

Type 2 diabetes and cardiovascular diseases are the most common chronic diseases globally. The risk of developing these diseases is increased particularly by overweight caused by physical inactivity and unhealthy diet, and metabolic disorders often associated with it.

Regular exercise is well known to be beneficial in weight management and disease prevention. However, many adults do not meet the weekly recommendation of 2.5 hours of moderate-intensity exercise, and the majority of the day is typically spent sitting.

In an intervention study of the Turku PET Centre and the UKK Institute in Finland, the researchers investigated whether health benefits can be achieved by reducing daily sedentary time during a three-month intervention period. The research participants were sedentary and physically inactive working-age adults with an increased risk of type 2 diabetes and cardiovascular diseases.

The researchers compared two groups: the intervention group was guided to reduce their sitting time by one-hour per day through increasing standing and light-intensity physical activity, and the control group was instructed to maintain their usual habits and sedentary lifestyle.

"What makes our research design unique is that sedentary time and physical activity of both groups were measured with accelerometers throughout the entire three-month period, whereas in earlier studies activity has typically been measured only for a few days at the beginning and end of the study period. This makes it possible to receive more information on the actual behaviour changes over a longer time period," says Doctoral Candidate Taru Garthwaite from the University of Turku in Finland.

The intervention group managed to reduce sedentary time by 50 minutes per day on average, mainly by increasing the amount of light- and moderate-intensity physical activity. In the three-month period, the researchers observed benefits in health outcomes related to blood sugar regulation, insulin sensitivity and liver health in the intervention group.

"It is an encouraging thought that health benefits can be achieved by reducing the time spent sitting and increasing the amount of even light-intensity physical activity. For many, this may be an easier starting point than increasing actual exercise," says Garthwaite.

Particularly beneficial for physically inactive individuals

It is likely that people who do not meet the weekly physical activity recommendations will benefit the most from replacing sedentary time with light physical activity. However, reducing sedentary time is probably not enough in itself to prevent diseases if the person has several risk factors of diabetes and cardiovascular diseases.

"Reducing the time spent sitting might still slow down the development of these diseases, but greater benefits can of course be gained by increasing the amount or intensity of physical activity in addition to sitting less," encourages Garthwaite.

The next step for the researchers is to study how changes in daily activity and sedentary time affect energy metabolism and body composition in addition to the risk factors of diabetes and cardiovascular diseases during a six-month study period.


Story Source:

Materials provided by University of TurkuNote: Content may be edited for style and length.


Journal Reference:

  1. Taru Garthwaite, Tanja Sjöros, Saara Laine, Henri Vähä-Ypyä, Eliisa Löyttyniemi, Harri Sievänen, Noora Houttu, Kirsi Laitinen, Kari Kalliokoski, Tommi Vasankari, Juhani Knuuti, Ilkka Heinonen. Effects of reduced sedentary time on cardiometabolic health in adults with metabolic syndrome: A three-month randomized controlled trialJournal of Science and Medicine in Sport, 2022; DOI: 10.1016/j.jsams.2022.04.002

Children with vegetarian diet have similar growth, nutrition v. those who eat meat

 A study of nearly 9,000 children found those who eat a vegetarian diet had similar measures of growth and nutrition compared to children who eat meat. The study, published in Pediatrics and led by researchers at St. Michael’s Hospital of Unity Health Toronto, also found that children with a vegetarian diet had higher odds of underweight weight status, emphasizing the need for special care when planning the diets of vegetarian kids.

The findings come as a shift to consuming a plant-based diet grows in Canada. In 2019, updates to Canada’s Food Guide urged Canadians to embrace plant-based proteins, such as beans and tofu, instead of meat.

“Over the last 20 years we have seen growing popularity of plant-based diets and a changing food environment with more access to plant-based alternatives, however we have not seen research into the nutritional outcomes of children following vegetarian diets in Canada,” said Dr. Jonathon Maguire, lead author of the study and a pediatrician at St. Michael’s Hospital of Unity Health Toronto.

“This study demonstrates that Canadian children following vegetarian diets had similar growth and biochemical measures of nutrition compared to children consuming non-vegetarian diets. Vegetarian diet was associated with higher odds of underweight weight status, underscoring the need for careful dietary planning for children with underweight when considering vegetarian diets.”

Researchers evaluated 8,907 children age six months to eight years. The children were all participants of the TARGet Kids! cohort study and data was collected between 2008 and 2019. Participants were categorized by vegetarian status – defined as a dietary pattern that excludes meat – or non-vegetarian status.

Researchers found children who had a vegetarian diet had similar mean body mass index (BMI), height, iron, vitamin D, and cholesterol levels compared to those who consumed meat. The findings showed evidence that children with a vegetarian diet had almost two-fold higher odds of having underweight, which is defined as below the third percentile for BMI. There was no evidence of an association with overweight or obesity.

Underweight is an indicator of undernutrition, and may be a sign that the quality of the child’s diet is not meeting the child’s nutritional needs to support normal growth. For children who eat a vegetarian diet, the researchers emphasized access to healthcare providers who can provide growth monitoring, education and guidance to support their growth and nutrition.

International guidelines about vegetarian diet in infancy and childhood have differing recommendations, and past studies that have evaluated the relationship between vegetarian diet and childhood growth and nutritional status have had conflicting findings.

“Plant-based dietary patterns are recognized as a healthy eating pattern due to increased intake of fruits, vegetables, fiber, whole grains, and reduced saturated fat; however, few studies have evaluated the impact of vegetarian diets on childhood growth and nutritional status. Vegetarian diets appear to be appropriate for most children,” said Dr. Maguire, who is also a scientist at MAP Centre for Urban Health Solutions at St. Michael’s Hospital.

A limitation of the study is that researchers did not assess the quality of the vegetarian diets. The researchers note that vegetarian diets come in many forms and the quality of the individual diet may be quite important to growth and nutritional outcomes. The authors say further research is needed to examine the quality of vegetarian diets in childhood, as well as growth and nutrition outcomes among children following a vegan diet, which excludes meat and animal derived products such as dairy, egg, and honey.

The study was funded by the Canadian Institutes of Health Research (CIHR), St. Michael’s Hospital Foundation and SickKids Foundation.


Story Source:

Materials provided by St. Michael's Hospital. Original written by Jennifer Stranges. Note: Content may be edited for style and length.


'Resetting' the injured brain offers clues for concussion treatment

 New research in mice raises the prospects for development of post-concussion therapies that could ward off cognitive decline and depression, two common conditions among people who have experienced a moderate traumatic brain injury.

The study in mice clarified the role of specific immune cells in the brain that contribute to chronic inflammation. Using a technique called forced cell turnover, researchers eliminated these cells in the injured brains of mice for a week and then let them repopulate for two weeks.

"It's almost like hitting the reset button," said senior study author Jonathan Godbout, professor of neuroscience in The Ohio State University College of Medicine.

Compared to brain-injured mice recovering naturally, mice that were given the intervention showed less inflammation in the brain and fewer signs of thinking problems 30 days after the injury.

Though temporarily clearing away these cells, called microglia, in humans isn't feasible, the findings shed light on pathways to target that could lower the brain's overall inflammatory profile after a concussion, potentially reducing the risk for behavioral and cognitive problems long after the injury.

"In a moderate brain injury, if the CT scan doesn't show damage, patients go home with a concussion protocol. Sometimes people come back weeks, months later with neuropsychiatric issues. It's a huge problem affecting millions of people," said Godbout, faculty director of Ohio State's Chronic Brain Injury Program and assistant director of basic science in the Institute for Behavioral Medicine Research.

"How do you treat that? At least in mice, by turning over the microglia in the brain we had a very positive effect on their behavior, cognitive status and level of inflammation in the brain. Now we can focus on cellular pathways that generate chronic inflammation as a target."

The research is published online in the Journal of Neuroscience.

About 85% of traumatic brain injuries are similar to the type of concussion examined in this study, involving dispersed impact to the head that causes brain tissue to bump against the skull. Previous research suggests that at least 75% of people who experience a moderate brain injury have long-term mental health and cognitive complications.

Godbout's lab previously linked depressive symptoms in mice to microglia's sustained "high alert" status after a head injury, which causes the cells to overreact to later challenges to the immune system and become excessively inflammatory. In a more recent study in mice, his team showed that forced turnover of microglia before a head injury could reduce later neuropsychiatric complications.

"That was a proof of principle to show that a lot of the inflammation, especially in the long term, is mediated by microglia," he said. "But there is an acute phase of inflammation -- you want to initiate that repair process. There's a positive to that early inflammatory response in the brain or spinal cord. If it lasts a long time and doesn't fully resolve, that's when it's dangerous."

In this new study, researchers waited for seven days after the brain injury to force the turnover of microglia, giving the cells time to carry out their work promoting initial healing. An experimental drug that inhibits a protein that microglia in mice need for survival was added to their food for a week, resulting in depletion of over 95% of microglia in their brains.

After allowing 16 days for the microglia to repopulate, researchers compared the intervention mice to injured mice that recovered without the cell turnover treatment. The intervention mice performed better than control mice on tasks testing their memory and depressive symptoms.

Further analyses of injured brain tissue suggested the cell turnover reversed some injury-related damage to neurons, lowered overall inflammation and improved the brain's ability to adapt to change. Researchers also injected mice with a molecule that triggers an immune response to mimic an infection, and found that sickness behavior was lower in the intervention mice.

Godbout said these combined findings suggest that the repopulating microglia returned in a less "primed" state of readiness, lowering chances for a lifetime of exaggerated inflammatory responses in the brain to any challenge to the immune system -- that brain inflammation being the likely culprit behind the neuropsychiatric complications that follow a head injury.

"If microglia in the human brain don't return to normal and chronic inflammation persists after a head injury, it's not just a secondary brain injury that causes problems. Even getting a viral infection after concussion recovery can progress into a cognitive or behavioral issue or amplify some other part of behavior, like depression," Godbout said. "There is a real connection between a head injury and mental health, and the risk doesn't go away.

"Now we're looking more closely at the pathways that cause changes in microglia, and targeting something specific in that pathway. That is a way forward."

This work was supported by the National Institute of Neurological Disorders and Stroke, the National Institute on Aging, the National Institute of Dental and Craniofacial Research, an Ohio State University Presidential Fellowship and the Thailand Research Fund-Royal Golden Jubilee Program.

Co-authors include Chelsea Bray, Kristina Witcher, Dunni Adekunle-Adegbite, Michelle Ouvina, Mollie Witzel, Emma Hans, Zoe Tapp, Jonathan Packer, Ethan Goodman, Fangli Zhao, Shane O'Neil, John Sheridan, Olga Kokiko-Cochran and Candice Askwith, all of Ohio State, and Titikorn Chunchai and Siriporn Chattipakorn of Chiang Mai University in Thailand.


Story Source:

Materials provided by Ohio State University. Original written by Emily Caldwell. Note: Content may be edited for style and length.


Journal Reference:

  1. Chelsea E. Bray, Kristina G. Witcher, Dunni Adekunle-Adegbite, Michelle Ouvina, Mollie Witzel, Emma Hans, Zoe M. Tapp, Jonathan Packer, Ethan Goodman, Fangli Zhao, Titikorn Chunchai, Shane O’Neil, Siriporn C Chattipakorn, John Sheridan, Olga N. Kokiko-Cochran, Candice Askwith, Jonathan P. Godbout. Chronic Cortical Inflammation, Cognitive Impairment and Immune Reactivity Associated with Diffuse Brain Injury are Ameliorated by Forced Turnover of MicrogliaThe Journal of Neuroscience, 2022; JN-RM-1910-21 DOI: 10.1523/JNEUROSCI.1910-21.2022

Endocrine-disrupting chemicals may impair bone health in male teens

 Per- and polyfluoroalkyl substances (PFAS) and phthalates (two types of endocrine-disrupting chemicals) may be associated with lower bone mineral density in male teens, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism.

Endocrine-disrupting chemicals are chemicals or mixtures of chemicals that interfere with the way the body's hormones work. Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals used in nonstick cookware, clothing and food packaging, and are increasingly being found in U.S. water supplies. Phthalates are used in personal care products, food processing and children's toys.

"Adolescence is an important time when our bodies build up bone. Almost all U.S. children and adolescents are exposed to PFAS and phthalates, but few studies have looked at how these chemicals could be impacting our bone health," said Abby F. Fleisch, M.D., M.P.H., of the Maine Medical Center Research Institute and Maine Medical Center in Portland, Maine. "Our research found an association between certain PFAS and phthalates and reduced bone mineral density in adolescent males. Because bone accrual primarily occurs during adolescence, if replicated, this finding may have implications for lifelong bone health."

The researchers leveraged urine and blood samples from 453 boys and 395 girls from the National Health and Nutrition Examination Survey (NHANES) and found higher levels of PFAS and phthalates may be associated with lower bone mineral density in adolescent males. The researchers did not find the same effect in girls.

Other authors of this study include: Jenny L. Carwile, Shravanthi M. Seshasayee and Clifford J. Rosen of the Maine Medical Center Research Institute; Katherine A. Ahrens of the University of Southern Maine in Portland, Maine; Russ Hauser of the Harvard T. H. Chan School of Public Health in Boston, Mass.; Jeffrey B. Driban of the Tufts Medical Center in Boston, Mass.; and Catherine M. Gordon of the Texas Children's Hospital and Baylor College of Medicine in Houston, Texas.

The study received funding from the National Institute of Environmental Health Sciences.


Story Source:

Materials provided by The Endocrine SocietyNote: Content may be edited for style and length.


Journal Reference:

  1. Jenny L Carwile et al. Serum PFAS and Urinary Phthalate Biomarker Concentrations and Bone Mineral Density in 12-19 Year Olds: 2011-2016 NHANESJCEM, 2022 DOI: 10.1210/clinem/dgac228