Plasticizer Exposure and Its Consequences on Health (PEACH)

Medical University of Vienna

Status: Not yet enrolling

Conditions: Glioma; Healthy Controls; Intracranial Hemorrhages; Beta-thalassemia; Toxicity; Transfusion-dependent Beta-Thalassemia

Study type: Observational

Funder types: Other

Identifiers

NCT06512298

1716/2023

10.55776/KLP1811624 (Other Grant/Funding Number)

Details and patient eligibility

About

Plasticizers are chemicals commonly found in many everyday items, from food packaging to medical equipment. Although they are pervasive in our daily lives, researchers still don't have a clear picture of their long-term effects on human health. Evidence suggests that these substances might disrupt various biological functions such as the immune system, the balance of gut bacteria, hormone regulation, and brain processes. While some studies have linked plasticizer exposure to health issues, definitive data from human studies are still lacking.

The PEACH study aims to bridge these knowledge gaps by investigating how plasticizers affect human health. The study focuses on understanding how these chemicals are absorbed, distributed, and accumulated in the body across different groups of patients. The investigators are particularly interested in how plasticizers influence gut microbiota and the functionality of immune cells, as well as their effects on neurotransmitters involved in brain function.

A combination of patient data, systems biology, and laboratory models will be used to thoroughly assess the biological impacts of plasticizers. Advanced techniques such as mass spectrometry will aid in studying toxicokinetic properties, sequencing technologies will be used to examine immune effects, and radiouptake assays will be employed to explore interactions with neurotransmitter transport. This comprehensive methodology will provide new insights into the effects of both short-term and long-term exposure to plasticizers.

The PEACH study introduces innovative methods to the field, aiming to create a robust model for understanding how plasticizer compounds behave in the human body. It employs state-of-the-art techniques to assess the dynamics of these chemicals, marking a significant advancement in environmental health research.

Full description

Wider research context: Industrial plasticizers are ubiquitous in modern society, utilized in products ranging from food packaging to medical supplies. Despite their widespread use, the health implications of chronic plasticizer exposure in humans remain inadequately understood. These substances potentially interfere and disrupt various biological processes, including immune activity, gut microbiota balance, endocrinological function, and neurophysiological health. Current epidemiological or exposure studies were able to pinpoint clinical associations with plasticizer exposures, but conclusive mechanistic human in vivo data are missing.

Research questions: The PEACH study is designed to fill critical gaps in the understanding of the biological implications of plasticizer exposure. The investigators aim to analyse the pharmacokinetics of plasticizers in different patient cohorts and elucidate their bioaccumulation, distribution, and metabolism. Thereby, the interplay between plasticizer exposure and metabolism, gut microbiota composition and immune cell functionality will be explored. Furthermore, the impact of plasticizer exposure on neurotransmitter physiology will be elucidated.

Approach: The study employs a comprehensive methodology that integrates the findings from clinical cohorts, systems biology approaches, and in vitro models. Three distinct work packages will examine pharmacokinetic properties via mass spectrometry, study immunological effects through advanced sequencing technologies & phenotypization, and investigate pharmacodynamic interactions with neurotransmitter transporters using human in-vitro assays. Longitudinal sampling from acute and chronic exposure cohorts will offer an evolving perspective on effects of plasticizer exposure.

Level of originality: The PEACH study introduces groundbreaking methodologies and scope to the investigation of plasticizer exposure. It aims to support the scientific community with first human in-vivo pharmacokinetic models for these compounds while utilizing high-throughput techniques for pharmacodynamic assessment, marking a notable advancement in the field.

Enrollment: 120 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

TDTM:

• Inclusion: Adult, homozygous ß-Thalassemia Major, transfusion dependency.
• Exclusion: Plastic implants, chronic infectious disease, pregnancy.

Thalassemia Intermedia/Minor:

• Inclusion: Adult, homozygous/heterozygous ß-Thalassemia Intermedia/Minor
• Exclusion: Plastic implants, chronic infectious disease, pregnancy, transfusion dependency

Healthy adults:

• Inclusion: Adult
• Exclusion: Chronic disease, plastic implants, infectious disease, pregnancy, anemia, medication-, drug-, or alcohol-abuse

Glioma patients:

• Inclusion: Adult, high/low-grade glioma, tumor larger then 3cm, resection with access to the ventricular system
• Exclusion: Large intraventricular hemorrhage, plastic implants, infectious disease

ICU patients:

• Inclusion: Adult, brain hemorrhage, external CSF drain from ventricle
• Exclusion: intraventricular hemorrhage, plastic implants, ECMO, hemodialysis, infectious disease

Patients undergoing diagnostic lumbar-puncture:

• Inclusion: Adult, diagnostic CSF sampling, outpatient setting
• Exclusion: Ventricular hemorrhage, plastic implants, infectious disease

Trial design

120 participants in 6 patient groups

Transfusion-dependent thalassemia major (TDTM)

Description:

Patients suffering from homozygous transfusion-dependent Thalassemia Major.

Thalassemia Minor

Description:

Patients suffering from heterozygous transfusion-independent Thalassemia Minor.

Healthy controls

Description:

Healthy adult controls without any prevalent substance use (nicotine, alcohol etc.).

Glioma patients

Description:

Adults with high/low-grade glioma, a tumor size \> 3cm that require resection with access to the ventricular system without ventricular hemorrhage.

ICU patients

Description:

Adults with brain hemorrhage (intracranial, subdural, subarachnoidal), treated with a ventricular shunt.

Patients undergoing diagnostic lumbar-puncture (plastic-naive)

Description:

Adults that receive a diagnostic lumbar puncture in an outpatient setting.