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Exposure to per-fluoroalkyl and polyfluoroalkyl substances leads to immunotoxicity: epidemiological and toxicological evidence

Journal of Exposure Science & Environmental Epidemiology volume 29, pages 148–156 (2019)Cite this article

Abstract

In this perspective, we evaluate key and emerging epidemiological and toxicological data concerning immunotoxicity of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) and seek to reconcile conflicting conclusions from two reviews published in 2016. We summarize ways that immunosuppression and immunoenhancement are defined and explain how specific outcomes are used to evaluate immunotoxicity in humans and experimental animals. We observe that different approaches to defining immunotoxicological outcomes, particularly those that do not produce clinical disease, may lead to different conclusions from epidemiological and toxicological studies. The fundamental point that we make is that aspects of epidemiological studies considered as limitations can be minimized when data from toxicological studies support epidemiological findings. Taken together, we find that results of epidemiological studies, supported by findings from toxicological studies, provide strong evidence that humans exposed to PFOA and PFOS are at risk for immunosuppression.

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Acknowledgements

We gratefully acknowledge comments and suggestions on this manuscript provided by Dr. Philippe Grandjean of the University of Southern Denmark and Department of Environmental Health, Harvard T.H. Chan School of Public Health. Research reported in this publication was supported by the National Institute of Environmental Health Sciences of the National Institutes of Health under Award Number P42ES027706 to LAS. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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All authors contributed to the drafting and editing of the manuscript and all read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Pharmacology & Toxicology, Brody School of Medicine, East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA

    Jamie C. DeWitt

  2. Department of Pediatrics, College of Medicine, Arkansas Children’s Research Institute, University of Arkansas for Medical Sciences, 13 Children’s Way, Little Rock, AR, 72202, USA

    Sarah J. Blossom

  3. Silent Spring Institute, 320 Nevada Street, Suite 302, Newton, MA, 02460, USA

    Laurel A. Schaider

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  1. Jamie C. DeWitt
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Correspondence to Jamie C. DeWitt.

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Dr. DeWitt reports that she was a protocol reviewer and a draft report reviewer for the NTP Monograph on Immunotoxicity associated with exposure to perfluorooctanoic acid or perfluorooctane sulfonate. The remaining authors declare that they have no conflict of interest.

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DeWitt, J.C., Blossom, S.J. & Schaider, L.A. Exposure to per-fluoroalkyl and polyfluoroalkyl substances leads to immunotoxicity: epidemiological and toxicological evidence. J Expo Sci Environ Epidemiol 29, 148–156 (2019). https://doi.org/10.1038/s41370-018-0097-y

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