Evidence Heightens Concerns about Exposure to Plasticizer in Premature Infants, Reports Pediatric Research Study

Philadelphia, Pa. (July 20, 2010) – In newborns, immune cells called neutrophils are more sensitive to potentially harmful effects of phthalate plasticizers, according to a new study in Pediatric Research. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

High exposure to phthalates might contribute to the development of serious inflammatory diseases in premature infants, suggests the new study, led by Dr. Anna M. Vetrano of the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick. The researchers believe their results may encourage further efforts to limit newborns' exposure to phthalate-containing medical devices. Smallest Newborns May Be Most Vulnerable to Harmful Effects of PhthalatesDr. Vetrano and colleagues compared the effects of phthalate exposure on neutrophils from newborn infants and adults. Neutrophils are immune system cells that normally work to fight infections by promoting inflammation. Phthalates are widely used to increase the flexibility and durability of plastic products. There is a long history of concern about exposure to phthalates in medical settings, related to the use of the plasticizer DEHP in plastic tubing and other devices. In the new experiments, Dr. Vetrano and colleagues found that the neutrophils of newborns were more affected by phthalates than the neutrophils of adults. When exposed to the DEHP metabolite MEHP, newborn neutrophils showed significantly reduced natural clearance (apoptosis), compared to adult neutrophils. Exposure to MEHP also resulted in increased attraction of certain inflammation-promoting substances, called cytokines, by newborn neutrophils. A specific cellular pathway that acts to reduce the effects of these pro-inflammatory cytokines—thus allowing inflammation to resolve—was specifically affected by phthalate exposure.

Because phthalates are so widely used as plasticizers, practically everyone has some level of exposure. Premature infants have particularly high phthalate exposure because of the many tubes and catheters used in their treatment. Previous studies have suggested a possible link between phthalates and some of the inflammatory diseases—including necrotizing enterocolitis and chronic lung disease—to which premature infants are vulnerable.

The new research adds to this evidence by showing that phthalates have a greater effect on neutrophils—and thus on the inflammatory process—in newborns. In response to past concerns about adverse health effects of phthalate exposure, many U.S. hospitals are voluntarily phasing out the use of tubes and other plastic products containing phthalates. "Understanding the inflammatory effects of phthalates in neonates may support efforts to limit the use of phthalate-containing medical devices in neonates," Dr. Vetrano and co-authors conclude.

About Pediatric ResearchPediatric Research ( http://www.pedresearch.org) presents the work of leading authorities in pediatric pulmonology, neonatology, cardiology, hematology, neurology, developmental biology, fetal physiology, endocrinology and metabolism, gastroenterology, and nutrition. Directed to research-oriented pediatricians and faculty, the journal publishes the results of significant clinical and laboratory studies. The Journal includes original peer-reviewed articles, abstracts of society meetings, state-of-the-art reviews, as well as supplements on pediatric health issues. It is the official publication of the American Pediatric Society, the European Society for Paediatric Research, and the Society for Pediatric Research.

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