Several laboratories have assessed clinical and immunological effects attributed to perfluorinated compounds in mice (
Nelson et al., 1992;
Yang et al., 2000,
2001,
2002a and
b;
Peden-Adams et al., 2007,
2008,
2009;
DeWitt et al., 2008,
2009a;
Fang et al., 2008,
2009;
Keil et al., 2008;
Lefebvre et al., 2008;
Loveless et al., 2008;
Zheng et al., 2008;
Dong et al., 2009;
Guruge et al., 2009;
Qazi et al., 2009a and
b;
Son et al., 2009), but few rodent studies have examined these effects across exposure concentrations that include environmentally relevant concentrations (
Lefebvre et al., 2008;
Peden-Adams et al., 2008;
Dong et al., 2009;
Guruge et al., 2009). PFOS causes suppression of SRBC-specific IgM production at 0.05 and 0.5 mg/kg TAD over 28 d in male and female B
6C
3F
1 mice, respectively (
Peden-Adams et al., 2008). This deficit in immune function has been reported at serum PFOS concentrations comparable to documented blood levels from both humans and wildlife (
Olsen et al., 2003a and
b,
2005;
Houde et al., 2005;
Keller et al., 2005;
Peden-Adams et al., 2008). Decreases in the plaque-forming cell (PFC) response in the B
6C
3F
1 model are considered predictive of immunotoxicity and decreased host resistance (
Luster et al., 1992,
1993;
Selgrade, 1999) and alterations in murine immune function have been linked to human health risks (
Selgrade, 2007). In fact, decreases in the PFC response are suggested to be predicative of susceptibility to influenza virus (
Burleson and Burleson, 2008) and it was recently shown that 0.525 mg PFOS/kg TAD in female B
6C
3F
1 mice causes increased susceptibility to the influenza A virus (
Guruge et al., 2009). Moreover, MOE values for PFOS, based on serum PFOS concentrations at the NOAEL for immune parameters reported by
Peden-Adams et al., (2008), suggest possible human health risk (). At this time the mode/mechanism of PFOS-induced SRBC-specific IgM suppression is not known and could affect human health risk assessment depending on the sensitivity of humans as compared with mice (
Andersen et al., 2008;
DeWitt et al., 2009b). Information on the mode/mechanism of action would permit adjustment of the uncertainty factors and allow better estimations of risk (
Faustman and Omenn, 2001;
Andersen et al., 2008). Thus, a series of studies were begun to assess various possible modes of action of PFOS on IgM production.
It has often been reported that exposure to PFOS causes a wasting syndrome and a significant drop in body weight (
OECD, 2002;
Qazi et al., 2009b). To demonstrate that overt, nutritional, or general systemic toxicity was not a confounding factor in the immunological evaluations for these animals at these environmentally relevant PFOS concentrations, body and organ weights, clinical serum chemistries, hematology, and histophathology were assessed. These negative results establish that the animals do not exhibit signs of overt toxicity. Therefore, the immune alterations reported here and in previous studies at these PFOS exposure concentrations (
Peden-Adams et al., 2008) are not likely attributed to systemic toxicity as no indication of this was observed in the clinical, histopathology, organ mass, or body mass data. There was a general lack of histological alterations, with the exception of brain lesions in one animal in each of the highest two doses that may or may not reflect experimental treatment. Brain asymmetry and neurologic endpoints were not assessed in the current study, but PFOS has been shown to alter neurologic endpoints in adult rodents (
Austin et al., 2003;
Fuentes et al., 2007) and to increase the frequency of brain asymmetry in
in ovo-exposed chicks (
Peden-Adams et al., 2009b).
Due to known interactions of the hypothalamus-pituitary-thyroid axis with humoral immunological function (
Gupta et al., 1983;
Nandakumar et al., 2008), total serum T4 and T3 levels were evaluated in this study. Recent studies report that PFOS exposure (≥ 5 mg/kg/day) can induce a state of hypothyroidism (
Lau et al., 2003;
Thibodeaux et al., 2003). The current results are consistent with the previous studies as no alterations in serum total T3 or T4 levels were observed at the current PFOS concentrations that were less than 5 mg/kg/d. A recent study by
Chang et al. (2008) identified that PFOS may specifically interfere with proteins that bind thyroid hormones such as albumin and thyroxine binding globulin, thereby, leading to a false hypothyroidic profile. Based on technical challenges associated with identifying free vs. bound hormone combined with minimal amounts of mouse serum, thyroid-binding proteins were not measured in this study. Considering that no changes in total thyroid hormone levels were apparent, it is unlikely that thyroid hormones contribute to PFOS-induced humoral immunosuppression.
To verify that alterations in antibody responses previously reported at these PFOS concentrations were not merely attributed to decreases in cell subpopulations, quantitation of splenic T-helper cells, B-cells, and MHC-II
+ cells were performed. Numbers of B-cells as determined by CD19
+/CD21
− (immature), CD19
+/CD21
+ (mature), B220
+/CD40
−, and B220
+/CD40
+ cells were not decreased, suggesting suppression of antibody production is not simply due to decreases in B-cell numbers or types (
Tedder et al., 1997). This is also consistent with studies evaluating sulfluramid (a perfluorinated pesticide that is metabolized to PFOS), where the numbers of B220
+ lymphocytes were not altered with corresponding suppression of the PFC response (
Peden-Adams et al., 2007). Number of cells expressing MHC-II and CD40 surface markers, which are found on antigen-presenting cells, were not altered by PFOS treatment. This is supported by data from
Mollenhauer (2008) that indicates no alteration in the percent of splenic F4/80
+ cells (macrophages) at these PFOS concentrations. Moreover, data from this study confirms that numbers of CD4
+ cells were within normal ranges. This contrasts a previous report from this laboratory where absolute numbers of CD4
+ cells were decreased in female B
6C
3F
1 mice at 0.1 mg/kg/TAD but not at 1.0 mg/kg TAD using a similar 28-day exposure regime (
Peden-Adams et al., 2008). This previous observation was from a single experiment, whereas in this study, the experiment was repeated twice for absolute numbers and three times for percent changes with all experiments yielding the same results. The effect previously reported was not dose-responsive and is likely to be a transient effect. Overall, these data indicate that T-helper cells, B-cells, and MHC-II
+ cells were not selectively eliminated.
Cell signaling through ligation of CD40 on the B-cell with CD154 on the T-helper cell is an important step in antibody responses (
Grewal and Flavell, 1998;
Schonbeck and Libby, 2001;
Xu and Song, 2004). Binding of CD40 to CD154 aids in moving the resting B-cell into the cell cycle and is essential for B-cell responses to T-dependent antigens, such as SRBC (
Lee et al., 2003). Numbers of CD4 cells expressing CD154 (CD4
+/CD154
+) were not altered by PFOS exposures above and below the LOAEL in this rodent model, nor were absolute numbers of B-cells (B220
+) expressing CD40 (B220
+/CD40
+). Therefore, PFOS exposure did not alter expression of CD40 or CD154 in resting B- or T-helper cells indicating no effect on background expression levels.
Interleukin-6 is produced for varied purposes by many cell types including muscle, macrophages, B-cells, and T-cells. It is a marker of inflammation, a necessary component for antibody production, and has roles in the hypothalamic-pituitary-adrenal axis (
Boss and Neeck, 2000). Moreover, studies have shown its role in autocrine stimulation of B-cells resulting in antibody production (
Melgosa et al., 1999;
Contin et al., 2003). CD40 ligation on the surface of B-cells with CD154 on helper T-cells is critical for humoral responses to T-dependent antigens and results in B-cell proliferation, differentiation, and IL-6 stimulation of immunoglobulin production (
Melgosa et al., 1999;
Contin et al., 2003). CD40 mediated control of the IL-6 gene requires NF-κβ and activation of c-Jun (AP-1) transcriptional activity (
Baccam et al., 2003;
Bishop and Hostager 2003). A PPARα-agonist such as WY14,643 represses c-Jun transcription of the IL-6 promoter through negative regulation of NF-κβ and activator protein-1 (AP-1) signaling pathways (
Delerive et al., 1999;
Cunard et al., 2002a and
b). Taken together, PFOS, a PPARα agonist (
Shipley et al., 2004), could cause suppression of B-cell IL-6 production, which might explain, in part, the previously reported PFOS-induced SRBC-specific IgM suppression.
Interestingly, these data in
in vitro-activated cells (i.e., those not exposed to antigen
in vivo) suggest a somewhat different picture from the theory above.
Ex vivo B-cell IL-6 production stimulated
in vitro through CD40 engagement using anti-CD40 (thereby mimicking ligation with CD154 following antigen challenge and causing activation
ex vivo) was increased at both dose levels assessed.
Qazi et al. (2009a) report increased serum IL-6 concentrations following a 10-day PFOS exposure (0.02% in diet) in male C57Bl/6 mice, but observed no effect on IL-6 production from mixed splenocyte cultures. Noted differences in
ex vivo splenocyte IL-6 production between the current study and that of
Qazi et al. (2009a) may be related to strain, gender, dose regime, or methodological (i.e., isolated cell types compared to mixed cell cultures) differences. Further studies are needed to directly assess the effects of PFOS on c-Jun (AP-1), as well as other components suggested to be important to this pathway such as TNF receptor-associated factors (TRAFs) (
Bishop and Hostager 2003). Additionally, the role of PPARα in these responses should be determined, as PPARα agonists are generally considered anti-inflammatory and would be expected to cause a decrease in IL-6 production.
One possible indirect mechanism that should be mentioned is alteration of steroid hormone homeostasis. Although no histopathological alterations were detected, in this study PFOS decreased uterine wet weight in a linear manner (Kendall Tau b = −0.4, p<0.05). This is similar to results with sulfluramid (
Peden-Adams et al., 2007) and with previous reports of decreased uterine mass, although not statistically significant with ANOVA, following PFOS exposure at these same concentrations (
Peden-Adams et al., 2008). Furthermore, uterine weight was decreased in rats following PFOS exposure (10 mg/kg/d) (
Wetzel, 1983). The rodent uterotropic response that utilizes uterus wet weight or blotted weight is considered the ‘gold standard’ for assessing the estrogenicity of a compound (
Evans et al., 1941;
Dickerson et al., 1995;
Okazaki et al., 2002). Although the classic experiments for this type of study commonly employ either ovariectomized adults or sexually immature female rats (
Kanno et al., 2001;
Owens and Ashby, 2002) assessment of this parameter in intact adult rodents can be indicative of modulation in reproductive or endocrine function suggesting the need for further studies (
Okazaki et al., 2002). Thus, it may be plausible that PFOS possesses anti-estrogenic effects since decreased uterine mass is a standard marker for anti-estrogenicity (
Evans et al., 1941;
Dickerson et al., 1995;
Okazaki et al., 2002). Whether these observations are due to antagonism of the estrogen receptor or a decrease in circulating estradiol is unclear. PFOS has been shown to decrease aromatase activity in fathead minnows and
Xenopus, causing increased plasma 11-ketotestosterone and testosterone, respectively (Ankley et al., 2005;
Fort et al., 2007). In
Cynomolgus monkeys, however, females did not exhibit a decrease in circulating plasma estradiol levels, yet males did without a corresponding increase in testosterone levels (
Seacat et al., 2002). Since estradiol can increase IgM production (Kanda and Tamaki, 1999) while testosterone can inhibit IgM production (Kanda et al., 1996), modulation of aromatase activity and the culminating changes in circulating testosterone and estradiol levels could affect IgM production and should be assessed.
These results corroborate earlier studies demonstrating that immunological function is sensitive to PFOS exposure (
Keil et al., 2008;
Peden-Adams et al., 2008). This study establishes that low-level exposure at environmentally relevant concentrations can modulate lymphocyte cytokine production. Although the current data from resting,
in vitro-activated cells indicates that suppression of B-cell IL-6 production may not play a role in the previously reported PFOS-induced IgM suppression, this should be verified in mice challenged with antigen. Assessing these key pathways in isolated resting cells activated
in vitro rather than
in vivo was, however, a necessary first step in determination of the effects of PFOS on immune function parameters associated with IgM production. Increases in IL-6 secretion could indicate a proclivity toward inflammatory processes, as increased IL-6 is a marker for inflammation in mammals (
Bauer, 1991; Jaatela, 1991). Studies determining the immune effects of PFOS should, therefore, include assessment of inflammatory markers to better understand the overall effects PFOS may have on immunity and health, as well as continue to assess events related to the mode of action of PFOS-induced antibody suppression.