1. Introduction
Per- and polyfluoroalkyl substances (PFAS) are a heterogeneous class of fluorinated synthetic compounds encompassing a great number of molecules with different structures [
1]. They have gained global notoriety due to their persistence and adverse effects on living organisms and environmental health [
2]. While a compendious definition of these chemicals is challenging to provide, the Organization of Economic Co-operation and Development (OECD) recently defined PFAS as molecules containing at least a perfluorinated methyl (‒CF
3) or a perfluorinated methylene group (‒CF
2‒) without any H/Cl/Br/I attached to it [
3]. However, there are several PFAS classifications that are based on diverse definitions and include a variable number of molecules. For instance, PubChem’s classification, based on OECD’s general description, includes more than 6.3 million PFAS molecules [
4], while the United States Environmental Protection Agency’s (EPA) classification, founded on molecular substructures and threshold of fluorine percentage [
5], contains 14,735 compounds [
6]. Despite the challenges and discrepancies in defining these substances, the OECD currently recognizes 4730 molecules as
bona fide PFAS, which are further classified based on their carbon chain length and molecular structure, which determines their unique physicochemical properties and environmental behavior. Short chain and long chain PFAS are distinguished based on their carbon chain length, and polymeric and non-polymeric PFAS are differentiated based on the presence or absence of repeating monomer units in their molecular structure. Moreover, PFAS are commonly classified based on their legal status as either legacy or emerging PFAS. Emerging PFAS are compounds such as HFPO-DA or GenX, ADONA, C6O4, which were introduced after the ban on perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) production, import, and use. These emerging PFAS are characterized by a shorter C-F backbone and are considered less hazardous than legacy PFAS due to their lower bioaccumulation potential and toxicity [
7].
PFAS have unique chemical properties that fostered their widespread production and use in a multitude of industrial products since the 1950s [
8]. The C‒F bond in PFAS molecules confers high molecular stability, but also results in high resistance to degradation [
8]. Additionally, the chemical attributes of amphiphilic and hydrophobic PFAS make them ideal surfactants and surface protectors, while also making them resistant to high temperatures. The versatility of PFAS has led to their use in a wide range of products, including non-stick pans, firefighting foams (aqueous film-forming foams, AFFF), waterproof textiles, pesticides, building and construction materials, cleaning products, medical and personal care products, among many others [
2,
8].
Despite their widespread use, the potential risks of PFAS exposure to human health and the environment have become increasingly apparent. PFAS have been found to be ubiquitously present in the environment, where, thanks to their intrinsic chemical stability, they can persist for several years owing to their resistance to degradation [
2]. Water basins have been identified as major repositories of PFAS and are capable of transferring these substances over long distances, making the water ecosystem a crucial gateway for PFAS entry into the food chain up to humans [
9,
10]. Numerous studies have focused on specific PFAS molecules, such as PFOS and PFOA, and have shown that their accumulation can have detrimental effects on aquatic and terrestrial ecosystems, as well as on animal species and plants. As a result, limitations on the use of PFOA and PFOS were introduced in some regions [
2,
11,
12,
13,
14]. Moreover, the presence of PFAS in human biological matrices has been highlighted in numerous studies, with a global distribution. PFAS have been detected in serum [
15,
16], breast milk [
17,
18], placenta [
19,
20], hair [
21] and semen [
22], indicating widespread exposure in human populations.
The vast majority physiological and molecular research on PFAS has been directed towards human health, revealing their toxicological effects on biological processes and metabolism. These negative impacts include reduced fertility, altered gene transcription [
12,
23,
24,
25,
26,
27,
28,
29] and the promotion of certain types of cancer, such as kidney and liver cancer [
30,
31]. However, there are conflicting data on the involvement of PFAS in cancer pathogenesis [
30]. Furthermore, PFAS have been shown to negatively affect the activity of the immune system, particularly in children, by impairing immune reactions and vaccinations responses [
23,
24,
25]. Lipid metabolism is also heavily impacted by PFAS exposure, leading to dyslipidemia and increased plasma levels of cholesterol [
32,
33,
34,
35,
36,
37].
Numerous studies have demonstrated that PFAS affect multiple species through detectable molecular mechanisms [
38,
39,
40,
41]. These compounds can directly interact with molecules such as the peroxisome proliferator-activated receptor α (PPARα), which mediates PFAS toxicity [
42]. Most importantly, PFAS are capable of modifying the transcriptional expression of many genes in humans and other species [
12], which has significant repercussions on the mentioned pathways and diseases.
Despite the vast evidence of transcriptional changes induced by PFAS in multiple species and despite the presence of numerous quantitative transcriptome-wide studies measuring gene expression responses to PFAS exposure [
38,
39,
43], a comprehensive and comparative analysis of the data generated by these studies has yet to be performed. To address this gap, we propose a rational integration and comparison of transcriptome-wide studies performed in animal species and cell models, in the form of RNA-Seq or microarray datasets. Using the opportunities offered by transcriptomics, we aim to elucidate the molecular effects induced by PFAS not only at the single gene level, but also across different pathways and cell types. Our research provides a comprehensive understanding of the molecular mechanisms underlying PFAS toxicity that translate across species, while accelerating evidence-based policies and treatments to safeguard public and environmental health.
4. Discussion
Our comprehensive analysis gathered and compared all currently available quantitative transcriptomics datasets on PFAS response in animals. The resulting data collection is heterogeneous in terms of species, compounds, concentration, time of exposure, organ, sequencing technology. However, despite this biological diversity, we detected significant recurring responses both at the gene and pathway levels, indicating a cross-compound, cross-tissue and cross-species conservation of transcriptional effects induced by PFAS.
Our investigation then deepened towards specific genes and pathways underlying this cross-species conservation. For example, our analysis detected a strongly conserved PFAS-induced upregulation of lipid metabolism and transport, as well as gonadotropin and FSH pathways (
Figure 6). All these processes are clearly related to ovarian development, estrogens production, ovulation and the physiological functioning of the female reproductive system [
86] and this deregulation may provide molecular mechanisms to explain PFAS-related detrimental effects on fertility [
26,
27,
28,
29,
83] and fetal development [
87,
88,
89,
90,
91].
Another interesting finding is the conserved down-regulation of another component of ovarian development, the
ESR1 gene (
Figure 4).
ESR1 encodes for the estrogen receptor alpha (ER-α), a nuclear receptor that influences the expression of numerous genes and physiological processes [
92]. By interacting with estrogens, mainly with estradiol (E2), it affects female fertility being essential for ovulation, cellular proliferation, and tissue differentiation [
92]. Ovary E2/ER-α axis promotes ovulation, and lower or absent expression of ER-α is associated with infertility [
92,
93]. ER-α is expressed even in kisspeptin neurons, in which the E2-ER-α interaction inhibits the activity of these neurons and the subsequent synthesis of gonadotropins in hypothalamic-pituitary axis [
94,
95]. Lack of ER-α is also associated with increased synthesis of gonadotropins [
96], which in turn determines the production of estradiol in the ovary [
83].
ESR1 down-regulation is associated with the up-regulation of response to gonadotropins also in Polycystic Ovary Syndrome, leading to infertility [
96]. The setup of low
ESR1/high gonadotropins is enacted, at least from a gene expression point of view, also by PFAS exposure.
However, there appears to be effects of PFAS that go beyond the disruption of reproductive functionality. For example, our data shows the upregulation of the
ID1 gene across species (
Figure 4 and
Figure 5).
ID1 encodes for an inhibitor of DNA-binding proteins, which regulates the cell cycle and differentiation. Overexpression of
ID1 has been linked to various types of cancer, including leukemia, breast, and pancreatic cancers [
97,
98]. Epidemiologic data suggest that also PFAS are associated with certain types of cancers, with some elements suggesting a pro-oncogenic effect [
30]. Notably, elevated exposure to PFOA and PFOS appears to significantly increase the mortality of individuals affected by liver cancer and malignant neoplasms of lymphatic and hematopoietic tissues [
31]. The finding of a conserved upregulation of
ID1 may provide a molecular support to the involvement of PFAS molecules in cancer pathogenesis.
Our integrated pipeline also detected a strong conserved downregulation of the tertiary granule pathway (
Figure 6), a component of the immune defense against microorganisms enacted by neutrophil cells [
85]. Recent independent findings also suggest that PFAS affect the function of neutrophils, likely inhibiting the granules formation or the degranulation process [
99]. More scientific literature supports the fact PFAS exposure impairs immune reactions, antibody production and vaccination responses, particularly in children exposed to PFAS during prenatal and postnatal periods [
23,
24,
25]. This immunotoxicity has been observed not only in humans but also in other animals [
23,
24,
25] and can increase the incidence and severity of many pathologies, including COVID-19 [
100,
101,
102]. In addition, PFAS exposure increases the serum concentration of inflammatory and oxidative stress markers, potentially promoting the development of systemic diseases as liver injury and cardiovascular diseases, including atherosclerosis and thromboembolic events [
103,
104,
105]. The size and width of our collected PFAS transcriptomics dataset provides the neutrophil tertiary granule mechanism as a strong molecular candidate behind the observed toxic effect of PFAS on the immune system.
Our analysis shows that the transcription of genes involved in lipid metabolism is significantly affected by PFAS exposure, not only in humans but also in other species (
Figure 4,
Figure 5 and
Figure 6). This is confirmed by previous studies, where PFAS exposure is associated with chronic dyslipidemia and increasing of lipid serum levels [
32,
33,
34,
35,
36,
37]. PFAS also increase the plasma levels of total cholesterol and triglycerides, in a dosage-dependent manner [
32,
33,
34,
35,
36]. It is worth noting that dyslipidemic changes are more pronounced in females than males [
35,
36] and are also observed in mice [
37], as confirmed by our data. The relationship between dyslipidemia and PFAS has also been found in human children and adolescents [
80], where the exposure to these chemicals increases the risk of developing NASH and NAFLD [
81] as well as impairing glucose metabolism [
106]. Notably, we found that
CYP4A11, previously associated with NAFLD [
72,
73], is highly up-regulated in both humans and mice, possibly indicating a causative role in NASH development due to PFAS exposure. The impact of PFAS on children is a crucial issue, and it seems that these chemicals can even be transferred through breastfeeding [
17,
18], which is of great concern.
While encouraging, it must be noted that the conservation of pathways and genes detected by our analysis is based on an animal-only dataset and, while we took measures to limit the preponderance of data from certain species (human and mouse), the available data is currently dominated by mammalians and vertebrates. If the future will provide more data for more species from different phylogenetic clades, it will certainly provide a more evolutionarily balanced overview of conservation of transcriptional response to PFAS.
Using recent developments of gene expression data mining for metabolite level predictions [
67], we could further analyze PFAS exposure through the prediction of their effects on the metabolome (
Figure 7). In particular, the finding that PFAS molecules increase the levels of different kind of lipids, mainly triacylglycerols as C52:3 TAG (
Figure 7), is supported by studies in humans showing that PFAS exposure enhances the concentration of triglycerides and cholesterol in the blood [
32,
33,
34,
35,
36]. Similarly, mice exposed to PFAS exhibit an increase in cholesterol and triglycerides in the liver [
107]. Another PFAS-induced metabolite is oxidized glutathione, a thiol compound resulting from the reduction of reactive oxygen species, xenobiotics, and drugs; it plays an important role in protection from oxidative stress and redox homeostasis maintenance and its high levels are potentially toxic [
108]. This induction is consistent with the previously shown PFAS-induced increase of glutathione S-transferase in the liver of Atlantic cod [
109], whose increased activity is a marker of oxidative stress, and with reduced levels of reduced glutathione in human liver cells [
110]. Our analysis predicted three aminoacids amongst the top 10 metabolites downregulated by PFAS: Serine, Lysine and Glutamate (
Figure 7). The downregulation of Serine agrees with current literature displaying that Serine deficiency is associated with increase in lipid accumulation in liver [
111], a mechanism that mimics the impact of exposure to PFAS [
12,
47,
79,
107]. Lysine is an essential metabolite for a healthy pregnancy [
112] and its deficiency is known to be detrimental to embryonal development [
113], while Glutamate is essential for embryonal neurogenesis [
114]. Another metabolite predicted to be strongly downregulated by PFAS is Pantothenate (NES=-12.25,
p-adjusted=8.63x10
-34), a vitamin required for the synthesis of coenzyme-A (CoA), which is in turn essential for fatty acid and energetic metabolisms [
115]. Pantothenate deficiency is associated with enhanced production of reactive oxygen species and oxidative stress [
115], emulating the oxidative stress stimulated by PFAS exposure [
116]. In the water flea
Daphnia magna, Pantothenate was experimentally shown to be downregulated by PFAS exposure [
117].