The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index.
Exposure to per-fluoroalkyl and polyfluoroalkyl substances leads to immunotoxicity: epidemiological and toxicological evidence
Open accessAbstract
In this perspective, we evaluate key and emerging epidemiological and toxicological data concerning immunotoxicity of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) and seek to reconcile conflicting conclusions from two reviews published in 2016. We summarize ways that immunosuppression and immunoenhancement are defined and explain how specific outcomes are used to evaluate immunotoxicity in humans and experimental animals. We observe that different approaches to defining immunotoxicological outcomes, particularly those that do not produce clinical disease, may lead to different conclusions from epidemiological and toxicological studies. The fundamental point that we make is that aspects of epidemiological studies considered as limitations can be minimized when data from toxicological studies support epidemiological findings. Taken together, we find that results of epidemiological studies, supported by findings from toxicological studies, provide strong evidence that humans exposed to PFOA and PFOS are at risk for immunosuppression.
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“Emerging evidence confirms that PFASs are immunotoxic, particularly in children.”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [84]
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“Exposure has been linked to diminished antibody responses to routine vaccinations and an increased susceptibility to respiratory infections, driven by the dysregulation of cytokine profiles and systemic effects on both innate and adaptive immunity [6,84].”
From Exposure to Per- and Polyfluoroalkyl Substances (PFASs) in Healthcare: Environmental and Clinical Insights (2025) · cites this paper as [84]
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Citations
Cites
A Never-Ending Story of Per- and Polyfluoroalkyl Substances (PFASs)?
Wang, Z., DeWitt, J. C., Higgins, C. P., & Cousins, I. T. (2017) · Environmental Science & Technology · doi:10.1021/acs.est.6b04806 · Cited by 1,921
Self-citationDeininger, P. L. (1991) · Analytical Biochemistry · doi:10.1016/0003-2697(91)90283-y · Cited by 894
Serum Vaccine Antibody Concentrations in Children Exposed to Perfluorinated Compounds
Grandjean, P., Andersen, E. W., Budtz-Jørgensen, E., Nielsen, F., Mølbak, K., Weihe, P., & Heilmann, C. (2012) · JAMA · doi:10.1001/jama.2011.2034 · Cited by 809
Risk assessment in immunotoxicology I. Sensitivity and predictability of immune tests
Luster, M. I. (1992) · Fundamental and Applied Toxicology · doi:10.1016/0272-0590(92)90047-l · Cited by 566
Granum, B., Haug, L. S., Namork, E., Stølevik, S. B., Thomsen, C., Aaberge, I. S., van Loveren, H., Løvik, M., & Nygaard, U. C. (2013) · Journal of Immunotoxicology · doi:10.3109/1547691x.2012.755580 · Cited by 339
Suppression of Humoral Immunity in Mice following Exposure to Perfluorooctane Sulfonate
Peden‐Adams, M. M., Keller, J. M., EUDALY, J. G., Berger, J., Gilkeson, G. S., & Keil, D. E. (2008) · Toxicological Sciences · doi:10.1093/toxsci/kfn059 · Cited by 278
Steenland, K., Zhao, L., Winquist, A. G., & Parks, C. G. (2013) · Environmental Health Perspectives · doi:10.1289/ehp.1206449 · Cited by 242
Grandjean, P., Heilmann, C. J., Weihe, P., Nielsen, F., Mogensen, U. B., Timmermann, C. A. G., & Budtz–Jørgensen, E. (2017) · Journal of Immunotoxicology · doi:10.1080/1547691x.2017.1360968 · Cited by 242
Perfluorooctanoic Acid–Induced Immunomodulation in Adult C57BL/6J or C57BL/6N Female Mice
DeWitt, J. C., Copeland, C. B., Strynar, M. J., & Luebke, R. W. (2008) · Environmental Health Perspectives · doi:10.1289/ehp.10896 · Cited by 222
Self-citationDong, G., Tung, K., Tsai, C., Liu, M.-M., Wang, D., Liu, W., Jin, Y., Hsieh, W., Lee, Y. L., & Chen, P. (2013) · Environmental Health Perspectives · doi:10.1289/ehp.1205351 · Cited by 199
Research works printed but not linked: 2
- Science Advisory Board (SAB). SAB review of EPA’s draft risk assessment of potential human health effects associated with PFOA and its salts. 2006.
- Kaplan BLF, Sulentic CEW, Holsapple MP, Kaminski NE. Chapter 12: toxic responses of the immune system. In: Curtis D. Klaassen and John B. Watkins III (eds.). Casarett and Doull’s essentials of toxicology. (McGraw-Hill Education, U.S.) 2015. p. 177–94.
Cited by
Sorted by citations
Fenton, S. E., Ducatman, A., Boobis, A., DeWitt, J. C., Lau, C., Ng, C., Smith, J. S., & Roberts, S. M. (2020) · Environmental Toxicology and Chemistry · doi:10.1002/etc.4890 · Cited by 2,445
Self-citationAnkley, G. T., Cureton, P., Hoke, R. A., Houde, M., Kumar, A., Kurias, J., Lanno, R., McCarthy, C., Newsted, J., Salice, C. J., et al. (2020) · Environmental Toxicology and Chemistry · doi:10.1002/etc.4869 · Cited by 454
Cordner, A., De La Rosa, V. Y., Schaider, L. A., Rudel, R. A., Richter, L., & Brown, P. (2019) · Journal of Exposure Science & Environmental Epidemiology · doi:10.1038/s41370-018-0099-9 · Cited by 363
Self-citationSzilagyi, J. T., Avula, V., & Fry, R. C. (2020) · Current Environmental Health Reports · doi:10.1007/s40572-020-00279-0 · Cited by 328
Thermal Stability and Decomposition of Perfluoroalkyl Substances on Spent Granular Activated Carbon
Xiao, F., Sasi, P. C., Yao, B., Kubátová, A., Golovko, S. A., Golovko, M. Y., & Soli, D. (2020) · Environmental Science & Technology Letters · doi:10.1021/acs.estlett.0c00114 · Cited by 316
Metadata
- Authors
- DeWitt, J. C., Blossom, S. J., & Schaider, L. A.
- Affiliations
- East Carolina University (US)
- Arkansas Children's Research Institute (US)
- Silent Spring Institute (US)
- Corresponding author
- DeWitt, Jamie C.
- Venue
- Journal of Exposure Science & Environmental Epidemiology
- Published
- 2018-11-27
- Volume
- 29
- Issue
- 2
- Pages
- 148-156
- ISSN
- 1559-0631 (ISSN-L)
- 1559-064X
- PMC
- PMC6380927
- OpenAlex
- W2903188676
- Cited by
- 241
- References
- 54
- Citations by year
- 2026: 31 · 2025: 34 · 2024: 35 · 2023: 42 · 2022: 27 · 2021: 33 · 2020: 25 · 2019: 13
- FWCI
- 1.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Exposure Science & Environmental Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Environmental Health Sciences (P42ES027706)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Life Sciences › Immunology and Microbiology › Immunology › Immunotoxicology and immune responses
- Physical Sciences › Materials Science › Polymers and Plastics › Synthesis and properties of polymers
- Keywords
- perfluorooctanoic acid, PFOS, per- and polyfluoroalkyl substances, immunotoxicity, immunosuppression, immune enhancement, human exposure, toxicological evidence, epidemiological evidence
- MeSH terms
- Animals, Immunotoxins, Caprylates, Environmental Exposure, Fluorocarbons, Humans, Alkanesulfonic Acids, Risk Assessment
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