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Life (Basel, Switzerland) Jan 2023Exposure to endocrine disrupting chemicals (EDCs) can result in alterations of the female reproductive system, including polycystic ovary syndrome (PCOS). The aim of... (Review)
Review
Exposure to endocrine disrupting chemicals (EDCs) can result in alterations of the female reproductive system, including polycystic ovary syndrome (PCOS). The aim of this review was to summarize the knowledge about the association of EDCs (bisphenols, parabens, and triclosan) with PCOS. We conducted an electronic literature search using PubMed for studies published between January 2007 and October 2022 on EDCs related to PCOS, and evaluated the association of PCOS with bisphenols, parabens and triclosan in 15 articles. Most studies revealed significantly higher plasma, urinary or follicular fluid levels of bisphenol A (BPA) in women with PCOS, and some showed a positive correlation of BPA with insulin resistance, polycystic morphology on ultrasound, hepatic steatosis, bilirubin levels, as well as free androgen index, androstenedione and testosterone serum levels, and markers of low-grade chronic inflammation. There was a negative correlation of BPA with markers of ovarian reserve, sex hormone binding globulin and vitamin D-binding protein. Parabens and triclosan have been studied in only one study each, with no significant associations with PCOS observed. Our review revealed an association of BPA with PCOS and negative effects of BPA on human ovaries; more research is needed to assess the potential associations of parabens and triclosan with PCOS.
PubMed: 36676087
DOI: 10.3390/life13010138 -
Lancet (London, England) Nov 2021Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This study aimed to test both interventions in low-income and middle-income countries.
METHODS
FALCON was a 2 × 2 factorial, randomised controlled trial stratified by whether surgery was clean-contaminated, or contaminated or dirty, including patients undergoing abdominal surgery with a skin incision of 5 cm or greater. This trial was undertaken in 54 hospitals in seven countries (Benin, Ghana, India, Mexico, Nigeria, Rwanda, and South Africa). Patients were computer randomised 1:1:1:1 to: (1) 2% alcoholic chlorhexidine and non-coated suture, (2) 2% alcoholic chlorhexidine and triclosan-coated suture, (3) 10% aqueous povidone-iodine and non-coated suture, or (4) 10% aqueous povidone-iodine and triclosan-coated suture. Patients and outcome assessors were masked to intervention allocation. The primary outcome was SSI, reported by trained outcome assessors, and presented using adjusted relative risks and 95% CIs. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT03700749.
FINDINGS
Between Dec 10, 2018, and Sept 7, 2020, 5788 patients (3091 in clean-contaminated stratum, 2697 in contaminated or dirty stratum) were randomised (1446 to alcoholic chlorhexidine and non-coated suture, 1446 to alcoholic chlorhexidine and triclosan-coated suture, 1447 to aqueous povidone-iodine and non-coated suture, and 1449 to aqueous povidone-iodine and triclosan-coated suture). 14·0% (810/5788) of patients were children and 66·9% (3873/5788) had emergency surgery. The overall SSI rate was 22·0% (1163/5284; clean-contaminated stratum 15·5% [454/2923], contaminated or dirty stratum 30·0% [709/2361]). For both strata, there was no evidence of a difference in the risk of SSI with alcoholic chlorhexidine versus povidone-iodine (clean-contaminated stratum 15·3% [223/1455] vs 15·7% [231/1468], relative risk 0·97 [95% CI 0·82-1·14]; contaminated or dirty stratum 28·3% [338/1194] vs 31·8% [371/1167], relative risk 0·91 [95% CI 0·81-1·02]), or with triclosan-coated sutures versus non-coated sutures (clean-contaminated stratum 14·7% [215/1459] vs 16·3% [239/1464], relative risk 0·90 [95% CI 0·77-1·06]; contaminated or dirty stratum 29·4% [347/1181] vs 30·7% [362/1180], relative risk 0·98 [95% CI 0·87-1·10]). With both strata combined, there were no differences using alcoholic chlorhexidine or triclosan-coated sutures.
INTERPRETATION
This trial did not show benefit from 2% alcoholic chlorhexidine skin preparation compared with povidone-iodine, or with triclosan-coated sutures compared with non-coated sutures, in preventing SSI in clean-contaminated or contaminated or dirty surgical wounds. Both interventions are more expensive than alternatives, and these findings do not support recommendations for routine use.
FUNDING
National Institute for Health Research (NIHR) Global Health Research Unit Grant, BD.
Topics: Abdomen; Adult; Anti-Infective Agents, Local; Child; Chlorhexidine; Developing Countries; Female; Humans; Male; Povidone-Iodine; Preoperative Care; Surgical Wound Infection; Sutures; Treatment Outcome; Triclosan
PubMed: 34710362
DOI: 10.1016/S0140-6736(21)01548-8 -
Military Medical Research Feb 2023Triclosan [5-chloro-2-(2,4-dichlorophenoxy) phenol, TCS], a common antimicrobial additive in many personal care and health care products, is frequently detected in human...
BACKGROUND
Triclosan [5-chloro-2-(2,4-dichlorophenoxy) phenol, TCS], a common antimicrobial additive in many personal care and health care products, is frequently detected in human blood and urine. Therefore, it has been considered an emerging and potentially toxic pollutant in recent years. Long-term exposure to TCS has been suggested to exert endocrine disruption effects, and promote liver fibrogenesis and tumorigenesis. This study was aimed at clarifying the underlying cellular and molecular mechanisms of hepatotoxicity effect of TCS at the initiation stage.
METHODS
C57BL/6 mice were exposed to different dosages of TCS for 2 weeks and the organ toxicity was evaluated by various measurements including complete blood count, histological analysis and TCS quantification. Single cell RNA sequencing (scRNA-seq) was then carried out on TCS- or mock-treated mouse livers to delineate the TCS-induced hepatotoxicity. The acquired single-cell transcriptomic data were analyzed from different aspects including differential gene expression, transcription factor (TF) regulatory network, pseudotime trajectory, and cellular communication, to systematically dissect the molecular and cellular events after TCS exposure. To verify the TCS-induced liver fibrosis, the expression levels of key fibrogenic proteins were examined by Western blotting, immunofluorescence, Masson's trichrome and Sirius red staining. In addition, normal hepatocyte cell MIHA and hepatic stellate cell LX-2 were used as in vitro cell models to experimentally validate the effects of TCS by immunological, proteomic and metabolomic technologies.
RESULTS
We established a relatively short term TCS exposure murine model and found the TCS mainly accumulated in the liver. The scRNA-seq performed on the livers of the TCS-treated and control group profiled the gene expressions of > 76,000 cells belonging to 13 major cell types. Among these types, hepatocytes and hepatic stellate cells (HSCs) were significantly increased in TCS-treated group. We found that TCS promoted fibrosis-associated proliferation of hepatocytes, in which Gata2 and Mef2c are the key driving TFs. Our data also suggested that TCS induced the proliferation and activation of HSCs, which was experimentally verified in both liver tissue and cell model. In addition, other changes including the dysfunction and capillarization of endothelial cells, an increase of fibrotic characteristics in B plasma cells, and M2 phenotype-skewing of macrophage cells, were also deduced from the scRNA-seq analysis, and these changes are likely to contribute to the progression of liver fibrosis. Lastly, the key differential ligand-receptor pairs involved in cellular communications were identified and we confirmed the role of GAS6_AXL interaction-mediated cellular communication in promoting liver fibrosis.
CONCLUSIONS
TCS modulates the cellular activities and fates of several specific cell types (including hepatocytes, HSCs, endothelial cells, B cells, Kupffer cells and liver capsular macrophages) in the liver, and regulates the ligand-receptor interactions between these cells, thereby promoting the proliferation and activation of HSCs, leading to liver fibrosis. Overall, we provide the first comprehensive single-cell atlas of mouse livers in response to TCS and delineate the key cellular and molecular processes involved in TCS-induced hepatotoxicity and fibrosis.
Topics: Humans; Mice; Animals; Triclosan; Transcriptome; Endothelial Cells; Ligands; Proteomics; Mice, Inbred C57BL; Liver Cirrhosis; Fibrosis; Chemical and Drug Induced Liver Injury
PubMed: 36814339
DOI: 10.1186/s40779-023-00441-3 -
International Journal of Molecular... Sep 2022Hygiene is essential to avoid diseases, and this is thanks to daily cleaning and disinfection habits. Currently, there are numerous commercial products containing... (Review)
Review
Hygiene is essential to avoid diseases, and this is thanks to daily cleaning and disinfection habits. Currently, there are numerous commercial products containing antimicrobial agents, and although they are efficient in disinfecting, it is still not known the effect of the constant use of these products on human health. In fact, a massive use of disinfectants has been observed due to COVID-19, but the possible adverse effects are not yet known. Triclosan is one of the antimicrobial agents used in cosmetic products, toothpaste, and disinfectants. This compound is an endocrine disruptor, which means it can interfere with hormonal function, with its estrogenic and androgenic activity having already been stated. Even if the use of triclosan is well-regulated, with the maximum allowed concentration in the European Union of 0.3% (/), its effects on human health are still uncertain. Studies in animals and humans suggest the possibility of harmful health outcomes, particularly for the reproductive system, and in a less extent for the cardiovascular and thyroid functions. Thus, the purpose of this review was to analyse the possible implications of the massive use of triclosan, mainly on the reproductive and cardiovascular systems and on the thyroid function, both in animals and humans.
Topics: Animals; Anti-Infective Agents, Local; COVID-19; Cardiovascular System; Disinfectants; Endocrine Disruptors; Humans; Thyroid Gland; Toothpastes; Triclosan
PubMed: 36232730
DOI: 10.3390/ijms231911427 -
Environment International Dec 2021Exposure to triclosan, an antimicrobial chemical used in some personal care and cleaning products, has been associated with reduced birth weight in some, but not all... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Exposure to triclosan, an antimicrobial chemical used in some personal care and cleaning products, has been associated with reduced birth weight in some, but not all epidemiological studies.
OBJECTIVES
We conducted a systematic review and meta-analysis to characterize the relation of gestational triclosan exposure with infant birth weight and identify sources of heterogeneity between studies.
METHODS
We identified original studies measuring urinary triclosan concentrations during pregnancy and reporting their association with infant birth weight, gestational age (GA) adjusted birth weight (g), or GA-standardized birth weight z-scores. Using a random effects model, we estimated differences in these outcomes per 10-fold increase in triclosan concentrations and considered triclosan levels and infant sex as sources of heterogeneity. Using Navigation Guide Methods, we evaluated risk of bias within individual studies and across the body of evidence.
RESULTS
Among thirteen studies, median triclosan concentrations varied by almost 2-orders of magnitude (0.6-29 ng/mL), with higher concentrations in North American and some European studies compared to Asian ones. Associations between triclosan and birth weight (β:-20 g; 95% CI:-65, 26; n = 6) were stronger than those for GA-adjusted birth weight (β:-12 g; 95% CI:-29, 5; n = 9). Triclosan was not associated with GA-standardized birth weight z-scores (β:-0.04; 95% CI:-0.16, 0.07; n = 5). The association between triclosan and GA-adjusted birth weight was stronger in studies with median triclosan values ≥10 ng/mL compared to studies with median values < 10 ng/mL (β:-27 g; 95% CI:-61, 7; n = 4 vs. β:6g; 95% CI:-20, 31; n = 5). With a limited number of studies, we observed suggestive evidence that inverse associations were more apparent in studies with ≥ 2 prospective triclosan measures compared to those with one measure.
DISCUSSION
Available evidence, with "low" risk of bias, provides limited evidence that triclosan exposure and reduces infant birth weight. We observed stronger inverse associations between triclosan concentrations and birth weight in populations with higher triclosan exposure.
Topics: Birth Weight; Female; Gestational Age; Humans; Infant; Maternal Exposure; Pregnancy; Prospective Studies; Triclosan
PubMed: 34560323
DOI: 10.1016/j.envint.2021.106854 -
Molecules (Basel, Switzerland) May 2021In the late 1930s and early 1940s, it was discovered that the substitution on aromatic rings of hydrogen atoms with chlorine yielded a novel chemistry of antimicrobials.... (Review)
Review
In the late 1930s and early 1940s, it was discovered that the substitution on aromatic rings of hydrogen atoms with chlorine yielded a novel chemistry of antimicrobials. However, within a few years, many of these compounds and formulations showed adverse effects, including human toxicity, ecotoxicity, and unwanted environmental persistence and bioaccumulation, quickly leading to regulatory bans and phase-outs. Among these, the triclocarban, a polychlorinated aromatic antimicrobial agent, was employed as a major ingredient of toys, clothing, food packaging materials, food industry floors, medical supplies, and especially of personal care products, such as soaps, toothpaste, and shampoo. Triclocarban has been widely used for over 50 years, but only recently some concerns were raised about its endocrine disruptive properties. In September 2016, the U.S. Food and Drug Administration banned its use in over-the-counter hand and body washes because of its toxicity. The withdrawal of triclocarban has prompted the efforts to search for new antimicrobial compounds and several analogues of triclocarban have also been studied. In this review, an examination of different facets of triclocarban and its analogues will be analyzed.
Topics: Animals; Anti-Bacterial Agents; Biotransformation; Carbanilides; Ecotoxicology; Humans; Triclosan
PubMed: 34068616
DOI: 10.3390/molecules26092811 -
Ecotoxicology and Environmental Safety Jul 2021Microplastic contamination has been considered as a global environmental problem in marine ecosystem. Due to small size (< 5 mm) in overlapping with that of microalgae,... (Review)
Review
Microplastic contamination has been considered as a global environmental problem in marine ecosystem. Due to small size (< 5 mm) in overlapping with that of microalgae, microplastics can easily be ingested by a wide range of marine copepods both in the laboratory and in situ. Although many studies have reported adverse effects of microplastics on marine copepods, it still lacks a systematic overview about the bioavailability of microplastics and their potential ecological consequences. As copepods dominate zooplankton biomass and provide an essential trophic link in marine ecosystem, this review indicates the bioavailability and toxicity of microplastics in such taxon depend on the shape, size, abundance, and properties of plastics. Also, ours is purposed to tease out the possible molecular mechanisms behind. Microplastic ingestion is prevalent; they impede food intake, block the digestive tract, and cause physiological stress in copepods (e.g., immune responses, metabolism disorders, energy depletion, behavioral alterations, growth retardation, and reproduction disturbance). Notably, in response to microplastic exposure, the copepods show both species- and stage-specificity. Furthermore, microplastics can serve as vectors of organic contaminants (e.g., triclosan, chlorpyrifos, and dibutyl phthalate) and thus increase their toxicity in marine copepods, consequently aggravating the adverse impacts of microplastics in marine ecosystem. Given that most previous studies have partially used pristine microplastics and their short-term exposure might have undervalued their negative effects, more multigenerational mechanistic researches (for example, via an integration of omics-based technology and phenotypic trait analysis) are urgently required for numerous marine copepods exposed to environmental-characteristics plastics as demonstrated by aged microplastics at environmentally realistic concentrations and added with other environmental pollutants; thus it will not only provide mechanistic insights into the biological impacts of microplastics, but also help make the seawater-benchmark setting and ecological assessment for microplastic pollution in marine environment.
Topics: Animals; Biological Availability; Biomass; Copepoda; Ecosystem; Environmental Monitoring; Microalgae; Microplastics; Plastics; Reproduction; Seawater; Water Pollutants, Chemical; Zooplankton
PubMed: 33915449
DOI: 10.1016/j.ecoenv.2021.112243 -
Dental and Medical Problems 2022Dentistry as a profession should take into account the goals of sustainable development in daily practice and encourage the transition to a green economy. Consumers are... (Review)
Review
Dentistry as a profession should take into account the goals of sustainable development in daily practice and encourage the transition to a green economy. Consumers are becoming more conscious about the impact of self-care products, including toothpastes, on the environment. Organic toothpastes are considered very safe. A broad literature review was conducted to: (i) identify the ingredients in available organic toothpastes; (ii) classify them into active and inactive; and (iii) evaluate each ingredient's purpose and the adverse events that may be associated with its use. A comprehensive list of available organic toothpastes and their ingredients was compiled based on the products from the largest Italian organic supermarket chain (NaturaSì®) that is representative of the European market. Then, PubMed, Scopus and Google Scholar databases were searched to identify, classify and evaluate each ingredient. The final sample consisted of 46 organic toothpastes that included 156 ingredients; 139 (89.1%) and 17 (10.9%) were classified as active and inactive, respectively. Overall, 32 (20.5%) ingredients were associated with known adverse events. The results of this study indicate that organic toothpastes are highly biocompatible with oral cavity tissues. Careful product selection may help consumers avoid potential adverse effects that can be caused by ingredients such as polymers (e.g., polyethylene glycol) and carbomers, detergent agents (e.g., sodium lauryl sulfate), and triclosan. The lack of clinical studies should encourage the development of sufficient evidence to provide consumers with recommendations for daily use, based on both efficacy and biocompatibility.
Topics: Dentistry; Detergents; Humans; Polyethylene Glycols; Polymers; Sodium Dodecyl Sulfate; Toothpastes; Triclosan
PubMed: 36206496
DOI: 10.17219/dmp/146133 -
Environmental Science and Pollution... Feb 2023Humans are exposed to the variety of emerging environmental pollutant in everyday life. The special concern is paid to endocrine disrupting chemicals especially to... (Review)
Review
Humans are exposed to the variety of emerging environmental pollutant in everyday life. The special concern is paid to endocrine disrupting chemicals especially to triclosan which could interfere with normal hormonal functions. Triclosan could be found in numerous commercial products such as mouthwashes, toothpastes and disinfectants due to its antibacterial and antifungal effects. Considering the excessive use and disposal, wastewaters are recognized as the main source of triclosan in the aquatic environment. As a result of the incomplete removal, triclosan residues reach surface water and even groundwater. Triclosan has potential to accumulate in sediment and aquatic organisms. Therefore, the detectable concentrations of triclosan in various environmental and biological matrices emerged concerns about the potential toxicity. Triclosan impairs thyroid homeostasis and could be associated with neurodevelopment impairment, metabolic disorders, cardiotoxicity and the increased cancer risk. The growing resistance of the vast groups of bacteria, the evidenced toxicity on different aquatic organisms, its adverse health effects observed in vitro, in vivo as well as the available epidemiological studies suggest that further efforts to monitor triclosan toxicity at environmental levels are necessary. The safety precaution measures and full commitment to proper legislation in compliance with the environmental protection are needed in order to obtain triclosan good ecological status. This paper is an overview of the possible negative triclosan effects on human health. Sources of exposure to triclosan, methods and levels of detection in aquatic environment are also discussed.
Topics: Humans; Triclosan; Risk; Disinfectants; Antifungal Agents; Aquatic Organisms; Outcome Assessment, Health Care; Water Pollutants, Chemical
PubMed: 34741734
DOI: 10.1007/s11356-021-17273-0 -
European Review For Medical and... Feb 2022Sutures are used to facilitate wound healing and play an important role in ensuring the success of surgical interventions in healthcare facilities. Suture-associated... (Review)
Review
Sutures are used to facilitate wound healing and play an important role in ensuring the success of surgical interventions in healthcare facilities. Suture-associated surgical site infection (SSI) may develop when bacterial contaminants colonize the suture surface and establish biofilms that are highly resistant to antibiotic treatment. The outcome of SSI affects postoperative care, leading to high rates of morbidity and mortality, prolonged hospitalization, and increased financial burden. Antimicrobial sutures coated with antiseptics such as triclosan and chlorhexidine have been used to minimize the occurrence of SSI. However, as the efficacy of antiseptic-based sutures may be affected due to the emergence of resistant strains, new approaches for the development of alternative antimicrobial sutures are necessary. This review provides an update and outlook of various approaches in the design and development of antimicrobial sutures. Attaining a zero SSI rate will be possible with the advancement in suturing technology and implementation of good infection control practice in clinical settings.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Local; Humans; Surgical Wound Infection; Sutures; Triclosan
PubMed: 35179749
DOI: 10.26355/eurrev_202202_27991