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• W2936281987 abstract "The interesting article by Gaynor and colleagues [1Gaynor J.W. Ittenbach R.F. Calafat A.M. et al.Perioperative exposure to suspect neurotoxicants from medical devices in newborns with congenital heart defects.Ann Thorac Surg. 2019; 107: 567-573Abstract Full Text Full Text PDF Scopus (22) Google Scholar] demonstrates the high serum concentrations after cardiac surgery of di(2-ethylhexyl)phthalate and of bisphenol-A, two potential brain neurotoxicants in infants. This unexpected but important complication represents a clinical model to study the possible selective cerebral toxicity from these substances and the corresponding resistance and susceptibility of the infants’ brain structures. We performed similar histopathologic analysis of brain damage from external environmental toxic substances in cases of sudden infant death syndrome and of sudden intrauterine unexpected death syndrome [2Roncati L. Pusiol T. Piscioli F. Lavezzi A.M. Neurodevelopmental disorder and pesticide exposure: The northeastern Italian experience.Arch Toxicol. 2017; 91: 603-604Google Scholar]. Some methodologic points appear relevant for correlated further research on potential brain toxicants. First, the brain damage has to be clinically evaluated with long-term follow-up, preferably supplied by data obtained from magnetic resonance imaging and laboratory biomarkers (eg, exosomes, neuron-specific enolase, myelin basic proteins). For a precise toxicologic assessment, the possible negative action of the general anesthesia must be considered [3Graham M.R. Clinical updates regarding general anesthesia-associated neurotoxicity in infants and children.Curr Opin Anesthesiol. 2017; 30: 82-87Google Scholar]. Second, histochemical and ultrastructural studies on different brain structures, performed with adequate techniques on autopsy material, can demonstrate specific cellular and subcellular lesions, correlated with functional damages [2Roncati L. Pusiol T. Piscioli F. Lavezzi A.M. Neurodevelopmental disorder and pesticide exposure: The northeastern Italian experience.Arch Toxicol. 2017; 91: 603-604Google Scholar]. Third, experimental in vivo and in vitro research into brain cortex cells or their precursors can provide interesting data in addition to what is already known about toxicity of di(2-ethylhexyl)phthalate on rapidly reproducing cells through their increased apoptosis, and of bisphenol-A related to DNA methylation of imprinted genes [4Fu G. Dai J. Zhang D. Zhu L. et al.Di(2-ethylaxyl) phtalate induces apoptosis through mytochondrial pathway in GC-2spd-cells.Environ Toxicol. 2017; 32: 1055-1064Google Scholar, 5Drobna Z. Henriksen A.D. Wolstenholme J.T. et al.Transgenerational effects of bisphenol A on gene expression and DNA methylation of imprinted genes in brain.Endocrinology. 2018; 159: 132-141Crossref PubMed Scopus (62) Google Scholar]. Our results can offer elements to direct further research [2Roncati L. Pusiol T. Piscioli F. Lavezzi A.M. Neurodevelopmental disorder and pesticide exposure: The northeastern Italian experience.Arch Toxicol. 2017; 91: 603-604Google Scholar]. In particular, we correlated basic pathologic processes as agenesis, dysgenesis, hypoplasia, and structural disarrangement observed in brain structures, with patho-physiologic mechanisms, as endocrine disruption, increased apoptosis, altered mitochondrial respiratory chains, decreased expression of argyrophilic nucleolar organizer or of orexin receptor, and nicotinic receptor abnormalities. All these elements invite deeper investigation of this challenging research topic [1Gaynor J.W. Ittenbach R.F. Calafat A.M. et al.Perioperative exposure to suspect neurotoxicants from medical devices in newborns with congenital heart defects.Ann Thorac Surg. 2019; 107: 567-573Abstract Full Text Full Text PDF Scopus (22) Google Scholar]. Perioperative Exposure to Suspect Neurotoxicants From Medical Devices in Newborns With Congenital Heart DefectsThe Annals of Thoracic SurgeryVol. 107Issue 2PreviewIndustrial chemicals are increasingly recognized as potential developmental neurotoxicants. Di(2-ethylhexyl) phthalate (DEHP), used to impart flexibility and temperature tolerance to polyvinylchloride, and bisphenol A (BPA), used to manufacture polycarbonate, are commonly present in medical devices. The magnitude of exposure in neonates during hospitalization for cardiac operations is unknown. Full-Text PDF" @default.
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• W2936281987 date "2019-11-01" @default.
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• W2936281987 title "Brain Toxicity: A Challenging Research Topic" @default.
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• W2936281987 doi "https://doi.org/10.1016/j.athoracsur.2019.03.024" @default.
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