Per- and Polyfluoroalkyl Substances (PFAS) in Serum of 2 to 5 year-Old Children: Temporal Trends, Determinants, and Correlations with Maternal PFAS Concentrations.

Young children may experience higher per- and polyfluoroalkyl substances (PFAS) exposure than adults due to breastfeeding, higher dust ingestion rates, and frequent hand-to-mouth activities. We explored temporal trends and determinants of child serum PFAS concentrations and their correlations with paired maternal PFAS concentrations. From 2009 to 2017, we collected one blood sample from each of 541 children aged 2-5 years participating in the Childhood Autism Risks from Genetics and Environment (CHARGE) study and quantified 14 PFAS in serum. For nine frequently detected PFAS (>65% of samples), we performed multiple regression adjusting for potential determinants to estimate mean percent concentration changes. For a subset of 327 children, we also quantified nine PFAS in their mother's serum collected at the same visit and computed Spearman correlation coefficients (rsp) between maternal and child PFAS concentrations. During 2009-2017, child serum concentrations of all nine PFAS decreased by 6-25% annually. Several PFAS concentrations were higher among non-Hispanic white children and those with highly educated parents. Most maternal and child PFAS concentrations were moderately correlated (rsp = 0.13-0.39), with a strong correlation for N-methyl perfluorooctane sulfonamido acetic acid (rsp = 0.68). Breastfeeding duration appeared to contribute to higher child and lower maternal PFAS concentrations, resulting in relatively weak correlations between maternal and child PFAS concentrations for samples collected in early childhood. Considering that more than half of our study children had neurodevelopmental concerns, the generalizability of our findings might be limited.

Gemcitabine treatment of rat soft tissue sarcoma with phosphatidyldiglycerol-based thermosensitive liposomes.

PURPOSE: The pyrimidine analogue gemcitabine (dFdC) is frequently used in the treatment of patients with solid tumors. However, after i.v. application dFdC is rapidly inactivated by metabolization. Here, the potential of thermosensitive liposomes based on 1,2-dipalmitoyl-sn-glycero-3-phosphodiglycerol (DPPG2-TSL) were investigated as carrier and targeting system for delivery of dFdC in combination with local hyperthermia (HT). METHODS: DPPG2-TSL were prepared by the lipid film hydration and extrusion method and characterized by dynamic light scattering, thin layer chromatography, phosphate assay and HPLC. In vivo experiments were performed in Brown Norway rats with a syngeneic soft tissue sarcoma. Local HT treatment was performed by light exposure. RESULTS: DPPG2-TSL were stable at 37°C in serum and showed a temperature dependent dFdC release >40°C. Plasma half-life of dFdC was strongly increased from 0.07 h (non-liposomal) to 0.53 h (liposomal, vesicle size 105 nm) or 2.59 h (liposomal, 129 nm). Therapy of BN175 tumors with dFdC encapsulated in DPPG2-TSL + HT showed significant improvement in tumor growth delay compared to non-liposomal dFdC without HT (p < 0.05), non-liposomal dFdC with HT (p < 0.01), and liposomal dFdC without HT (p < 0.05), respectively. CONCLUSIONS: Gemcitabine encapsulated in DPPG2-TSL in combination with local HT is a promising tool for the treatment of solid tumors. Therefore, these encouraging results ask for further investigation and evaluation.

Tooth biomarkers to characterize the temporal dynamics of the fetal and early-life exposome.

BACKGROUND: Teeth have unique histology that make this biomatrix a time-capsule for retrospective exposure analysis of fetal and early life. However, most analytic methods require pulverizing the whole tooth, which eliminates exposure timing information. Further, the range of chemicals and endogenous exposures that can be measured in teeth has yet to be fully characterized. METHODS: We performed untargeted metabolomics on micro-dissected layers from naturally shed deciduous teeth. Using four liquid-chromatography high-resolution mass spectrometry analytical modes, we profiled small molecules (<1000 Da) from prenatal and postnatal tooth fractions. In addition, we employed linear regression on the tooth fraction pairs from 31 children to identify metabolites that discriminate between prenatal and postnatal exposures. RESULTS: Of over 10,000 features measured in teeth dentin, 390 unique compounds were annotated from 62 chemical classes. The class with the largest number of compounds was carboxylic acids and their derivatives (36%). Of the annotated exogenous metabolites (phthalates, parabens, perfluoroalkyl compounds, and cotinine) and endogenous metabolites (fatty acids, steroids, carnitines, amino acids, and others), 91 are linked to 256 health conditions through published literature. Differential analysis revealed 267 metabolites significantly different between the prenatal and the postnatal tooth fractions (adj. p-value < 0.05, Bonferroni correction), and 21 metabolites exclusive to the prenatal fraction. CONCLUSIONS: The prenatal and early postnatal exposome revealed from dental biomarkers represents a broad range of endogenous and exogenous metabolites for a comprehensive characterization in environmental health research. Most importantly, this technology provides a direct window into fetal exposures that is not possible by maternal biomarkers. Indeed, we identified several metabolites exclusively in the prenatal fraction, suggesting unique fetal exposures that are markedly different to postnatal exposures. Expansion of databases that include tooth matrix metabolites will strengthen biological interpretation and shed light on exposures during gestation and early life that may be causally linked with later health conditions.

Perceptions of professionalism vary most with educational rank and age.

The purpose of this study was to assess whether the perception of what constitutes professionalism varies with age, discipline, gender, or educational level among students and faculty at the major academic health sciences center in West Virginia. This exploratory descriptive survey study asked participants to classify behaviors described in a survey as professional, unprofessional, or unrelated to professionalism. Results were analyzed using contingency tables. For 2 x 2 contingency tables, test of independence of homogeneity was carried out by using Fisher's exact test. For tables of higher dimensions, chi square test was used. The survey yielded a 45 percent return rate and demonstrated that the perception of professionalism varied most with the level of education and age and, to a lesser extent, with gender and health care discipline. Undergraduates, females, the youngest age group (< or = 26), nursing students, and faculty other than dental or medical were more likely to label behavior depicted in the survey statements as unprofessional. The findings of this study underscore the complexities of the genesis of professionalism. Further study in regard to the teaching of professionalism is warranted.

Environmental chemical exposures and autism spectrum disorders: a review of the epidemiological evidence.

In the past decade, the number of epidemiological publications addressing environmental chemical exposures and autism has grown tremendously. These studies are important because it is now understood that environmental factors play a larger role in causing autism than previously thought and because they address modifiable risk factors that may open up avenues for the primary prevention of the disability associated with autism. In this review, we covered studies of autism and estimates of exposure to tobacco, air pollutants, volatile organic compounds and solvents, metals (from air, occupation, diet, dental amalgams, and thimerosal-containing vaccines), pesticides, and organic endocrine-disrupting compounds such as flame retardants, non-stick chemicals, phthalates, and bisphenol A. We included studies that had individual-level data on autism, exposure measures pertaining to pregnancy or the 1st year of life, valid comparison groups, control for confounders, and adequate sample sizes. Despite the inherent error in the measurement of many of these environmental exposures, which is likely to attenuate observed associations, some environmental exposures showed associations with autism, especially traffic-related air pollutants, some metals, and several pesticides, with suggestive trends for some volatile organic compounds (e.g., methylene chloride, trichloroethylene, and styrene) and phthalates. Whether any of these play a causal role requires further study. Given the limited scope of these publications, other environmental chemicals cannot be ruled out, but have not yet been adequately studied. Future research that addresses these and additional environmental chemicals, including their most common routes of exposures, with accurate exposure measurement pertaining to several developmental windows, is essential to guide efforts for the prevention of the neurodevelopmental damage that manifests in autism symptoms.

Proteins and cholesterol lipid vesicles are mediators of drug release from thermosensitive liposomes.

Thermosensitive liposomes (TSL) are a promising tool for triggered drug delivery in combination with local hyperthermia. Objective of this study was to investigate the influence of serum on TSL in more detail and to identify serum components which are responsible for increasing drug release. Four different formulations were investigated: DPPC/DSPC/1,2-dipalmitoyl-sn-glycero-3-phosphodiglycerol (DPPG(2)) 50/20/30 (mol/mol) (DPPG(2)-TSL); DPPC/DSPC/DPPG(2)/DSPE-PEG2000 50/15/30/5 (mol/mol) (DPPG(2)/PEG-TSL), DPPC/P-Lyso-PC/DSPE-PEG2000 90/10/4 (mol/mol) (PEG/Lyso-TSL), and DPPC/DSPC/DSPE-PEG2000 80/15/5 (mol/mol) (PEG-TSL). DPPG(2)-TSL was the only formulation which was unaffected by osmotic stress. All formulations tested were influenced by serum components but the susceptibility was depended on the lipid composition of the vesicle. Presence of albumin (HSA) or cholesterol-containing lipid vesicles (DPPC/Chol-LLV) increased the membrane permeability for all tested formulations at temperatures around and above T(m) in a concentration based manner. PEGylation was not able to prevent the observed effect. PEG-TSL and PEG/Lyso-TSL were more susceptible to DPPC/Chol-LLV than DPPG(2)-containing TSL. In contrast, immunoglobulin type G (IgG) affected only anionic formulations. The membrane of DPPG(2)-TSL and DPPG(2)/PEG-TSL was more susceptible toward IgG as compared to HSA. DPPG(2)-TSL and PEG/Lyso-TSL were differentially influenced by fetal calf serum (FCS). As DPPG(2)-TSL was stabilized by pre-incubation with FCS at 37°C, this was the opposite for PEG/Lyso-TSL which were destabilized under these conditions. Individual serum components were unable to mimic the complex situation in full serum. Hence, the use of plasma or serum is still inevitable to investigate stability and release properties of novel TSL formulations until all serum components have been identified that alter TSL integrity.

Size of thermosensitive liposomes influences content release.

Thermosensitive liposomes (TSL) in combination with regional hyperthermia represent a powerful tool for tumor specific drug delivery. The objective of this study was to investigate the influence of vesicle size on the biophysical properties of TSL. TSL were composed of DPPC/DSPC/1,2-dipalmitoyl-sn-glycero-3-phosphoglyceroglycerol (DPPG(2)) 50:20:30 (mol/mol) (DPPG(2)-TSL) and DPPC/P-Lyso-PC/DSPE-PEG2000 90:10:4 (mol/mol) (PEG/Lyso-TSL) with encapsulated fluorescent dye carboxyfluorescein, anticancer drug doxorubicin or magnetic resonance contrast agent gadodiamide. Extrusion was performed with polycarbonate filters of distinct pore size to obtain TSL with different diameters (50 to 200nm). Phase transition temperature (T(m)) of the bilayer forming phospholipids was not influenced by vesicle size in the tested range. However, vesicle size had a major impact on in vitro content release properties of TSL in the investigated temperature range between 30 and 45°C. Generally, vesicle size was inversely related to content release properties with increased content release rates for decreased vesicle sizes. Size dependency of content release properties varied between all tested formulations and DPPG(2)-TSL were generally less affected by size changes in the range of 100 to 150nm as compared to PEG/Lyso-TSL. Independent from gadodiamide release, vesicle size influenced the signal intensity of DPPG(2)-TSL also at temperatures below T(m) due to improved water exchange for smaller vesicles. Liposomes around 100nm in size are routinely used in vivo, hence a quality control for TSL preparations is required prior to use. Even small changes in size or a wider size distribution might affect stability and release properties and thus yield in decreased efficacy or unwanted side effects of drug loaded TSL during in vivo applications.

Methoxy polyethylene glycol-epoetin beta: worth waiting for or a novelty worn off?

BACKGROUND: Since their inception nearly two decades ago, erythropoietin-stimulating agents (ESAs) have revolutionized the care of patients with renal anemia. Until recently, treatment options included the epoetins and darbepoetin alfa. As the use of these agents for chronic kidney disease (CKD) became widespread, the introduction of ESAs--touted for their longer-acting properties--was excitedly anticipated. OBJECTIVES: To review the option of methoxy polyethylene glycol-epoetin beta for ESA therapy in patients with renal anemia. METHODS: Peer-reviewed scientific literature, published abstracts and renal business journals were reviewed in the writing of this opinion. RESULTS/CONCLUSION: Methoxy polyethylene glycol-epoetin beta (CERA) is an effective long-acting ESA approved for treatment of renal anemia and available for use outside of the United States. CERA corrects and maintains hemoglobin (Hb) levels in patients with CKD and its efficacy mirrors that of the epoetins and darbepoetin alfa. CERA holds promise for its safety record, administration requirements, and the potential impact on social and pharmacoeconomic barriers to treatment for patients with renal anemia.