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接触草甘膦类除草剂与非霍奇金淋巴瘤风险:荟萃分析及支持证据。

Exposure to glyphosate-based herbicides and risk for non-Hodgkin lymphoma: A meta-analysis and supporting evidence.

机构信息

Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, USA.

Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, USA.

出版信息

Mutat Res Rev Mutat Res. 2019 Jul-Sep;781:186-206. doi: 10.1016/j.mrrev.2019.02.001. Epub 2019 Feb 10.

Abstract

Glyphosate is the most widely used broad-spectrum systemic herbicide in the world. Recent evaluations of the carcinogenic potential of glyphosate-based herbicides (GBHs) by various regional, national, and international agencies have engendered controversy. We investigated whether there was an association between high cumulative exposures to GBHs and increased risk of non-Hodgkin lymphoma (NHL) in humans. We conducted a new meta-analysis that includes the most recent update of the Agricultural Health Study (AHS) cohort published in 2018 along with five case-control studies. Using the highest exposure groups when available in each study, we report the overall meta-relative risk (meta-RR) of NHL in GBH-exposed individuals was increased by 41% (meta-RR = 1.41, 95% confidence interval, CI: 1.13-1.75). For comparison, we also performed a secondary meta-analysis using high-exposure groups with the earlier AHS (2005), and we calculated a meta-RR for NHL of 1.45 (95% CI: 1.11-1.91), which was higher than the meta-RRs reported previously. Multiple sensitivity tests conducted to assess the validity of our findings did not reveal meaningful differences from our primary estimated meta-RR. To contextualize our findings of an increased NHL risk in individuals with high GBH exposure, we reviewed publicly available animal and mechanistic studies related to lymphoma. We documented further support from studies of malignant lymphoma incidence in mice treated with pure glyphosate, as well as potential links between glyphosate / GBH exposure and immunosuppression, endocrine disruption, and genetic alterations that are commonly associated with NHL or lymphomagenesis. Overall, in accordance with findings from experimental animal and mechanistic studies, our current meta-analysis of human epidemiological studies suggests a compelling link between exposures to GBHs and increased risk for NHL.

摘要

草甘膦是世界上使用最广泛的广谱系统性除草剂。最近,各地区、国家和国际机构对草甘膦类除草剂(GBHs)的致癌潜力进行了评估,引起了争议。我们研究了人类是否存在高累积暴露于 GBHs 与非霍奇金淋巴瘤(NHL)风险增加之间的关联。我们进行了一项新的荟萃分析,其中包括 2018 年发表的农业健康研究(AHS)队列的最新更新以及五项病例对照研究。我们使用每个研究中可用的最高暴露组,报告了暴露于 GBHs 的个体 NHL 的总体荟萃相对风险(meta-RR)增加了 41%(meta-RR=1.41,95%置信区间,CI:1.13-1.75)。相比之下,我们还使用较早的 AHS(2005 年)的高暴露组进行了二次荟萃分析,我们计算出 NHL 的 meta-RR 为 1.45(95%CI:1.11-1.91),高于以前报告的 meta-RR。为了评估我们的发现的有效性而进行的多项敏感性测试并未显示与我们的主要估计 meta-RR 有明显差异。为了使我们在高 GBH 暴露个体中发现 NHL 风险增加的结果得到背景化,我们审查了与淋巴瘤相关的公开可用的动物和机制研究。我们记录了在接受纯草甘膦治疗的小鼠恶性淋巴瘤发病率研究中进一步提供的支持,以及草甘膦/GBH 暴露与免疫抑制、内分泌失调和遗传改变之间的潜在联系,这些改变通常与 NHL 或淋巴瘤发生有关。总的来说,根据实验动物和机制研究的结果,我们目前对人类流行病学研究的荟萃分析表明,暴露于 GBHs 与 NHL 风险增加之间存在引人注目的联系。

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