Nikos Stratakis1, Lucy Golden-Mason2, Katerina Margetaki1, Yinqi Zhao1, Damaskini Valvi3, Erika Garcia1, Léa Maitre4,5,6, Sandra Andrusaityte7, Xavier Basagana4,5,6, Eva Borràs5,8, Mariona Bustamante4,5,6, Maribel Casas4,5,6, Serena Fossati4,5,6, Regina Grazuleviciene7, Line Småstuen Haug9, Barbara Heude10, Rosemary R C McEachan11, Helle Margrete Meltzer9, Eleni Papadopoulou9, Theano Roumeliotaki12, Oliver Robinson13, Eduard Sabidó5,8, Jose Urquiza4,5,6, Marina Vafeiadi12, Nerea Varo14, John Wright11, Miriam B Vos15,16, Howard Hu1, Martine Vrijheid4,5,6, Kiros T Berhane17, David V Conti1, Rob McConnell1, Hugo R Rosen2, Lida Chatzi1. 1. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA. 2. Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA. 3. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY. 4. ISGlobal, Barcelona, Spain. 5. Universitat Pompeu Fabra, Barcelona, Spain. 6. Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain. 7. Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania. 8. Proteomics Unit, Centre de Regulació Genòmica, Barcelona Institute of Science and Technology, Barcelona, Spain. 9. Norwegian Institute of Public Health, Oslo, Norway. 10. Centre for Research in Epidemiology and Statistics, Université de Paris, INSERM, INRAE, Paris, France. 11. Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. 12. Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece. 13. MRC Centre for Environment and Health, Imperial College London, London, UK. 14. Laboratorio de Bioquímica, Clínica Universidad de Navarra, Pamplona, Spain. 15. Department of Pediatrics, School of Medicine and Nutrition Health Sciences, Emory University, Atlanta, GA. 16. Children's Healthcare of Atlanta, Atlanta, GA. 17. Mailman School of Public Health, Columbia University, New York, NY.
Abstract
BACKGROUND AND AIMS: Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of liver disease in children. Mercury (Hg), a ubiquitous toxic metal, has been proposed as an environmental factor contributing to toxicant-associated fatty liver disease. APPROACH AND RESULTS: We investigated the effect of prenatal exposure to Hg on childhood liver injury by combining epidemiological results from a multicenter mother-child cohort with complementary in vitro experiments on monocyte cells that are known to play a key role in liver immune homeostasis and NAFLD. We used data from 872 mothers and their children (median age, 8.1 years; interquartile range [IQR], 6.5-8.7) from the European Human Early-Life Exposome cohort. We measured Hg concentration in maternal blood during pregnancy (median, 2.0 μg/L; IQR, 1.1-3.6). We also assessed serum levels of alanine aminotransferase (ALT), a common screening tool for pediatric NAFLD, and plasma concentrations of inflammation-related cytokines in children. We found that prenatal Hg exposure was associated with a phenotype in children that was characterized by elevated ALT (≥22.1 U/L for females and ≥25.8 U/L for males) and increased concentrations of circulating IL-1β, IL-6, IL-8, and TNF-α. Consistently, inflammatory monocytes exposed in vitro to a physiologically relevant dose of Hg demonstrated significant up-regulation of genes encoding these four cytokines and increased concentrations of IL-8 and TNF-α in the supernatants. CONCLUSIONS: These findings suggest that developmental exposure to Hg can contribute to inflammation and increased NAFLD risk in early life.
BACKGROUND AND AIMS: Nonalcoholic fatty liver disease (NAFLD) is the most prevalent cause of liver disease in children. Mercury (Hg), a ubiquitous toxic metal, has been proposed as an environmental factor contributing to toxicant-associated fatty liver disease. APPROACH AND RESULTS: We investigated the effect of prenatal exposure to Hg on childhood liver injury by combining epidemiological results from a multicenter mother-child cohort with complementary in vitro experiments on monocyte cells that are known to play a key role in liver immune homeostasis and NAFLD. We used data from 872 mothers and their children (median age, 8.1 years; interquartile range [IQR], 6.5-8.7) from the European Human Early-Life Exposome cohort. We measured Hg concentration in maternal blood during pregnancy (median, 2.0 μg/L; IQR, 1.1-3.6). We also assessed serum levels of alanine aminotransferase (ALT), a common screening tool for pediatric NAFLD, and plasma concentrations of inflammation-related cytokines in children. We found that prenatal Hg exposure was associated with a phenotype in children that was characterized by elevated ALT (≥22.1 U/L for females and ≥25.8 U/L for males) and increased concentrations of circulating IL-1β, IL-6, IL-8, and TNF-α. Consistently, inflammatory monocytes exposed in vitro to a physiologically relevant dose of Hg demonstrated significant up-regulation of genes encoding these four cytokines and increased concentrations of IL-8 and TNF-α in the supernatants. CONCLUSIONS: These findings suggest that developmental exposure to Hg can contribute to inflammation and increased NAFLD risk in early life.
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