Zusammenfassung
Zahlreiche Substanzen aus der technischen und natürlichen
Umwelt können Schädigungen des Endokriniums bewirken.
Tierversuche belegen, dass sogenannte Endocrine Disruptors (ED),
z. B. Pestizide, Fungizide, Weichmacher (Phthalate), Bisphenol
A (BPA), zinnorganische Verbindungen, zu erheblichen Störungen
führen können. Aus in vitro Untersuchungen an
humanen Zellen und Geweben sowie aufgrund vieler klinischer Hinweise
darf man schließen, dass auch der Mensch betroffen sein
kann. Auch zeigen bestimmte medizinische Therapieverfahren, wie sehr
empfindlich das endokrine System des Menschen ist. Angriffspunkte
der ED sind vor allem die Schlüsselenzyme des Sexualhormon-Metabolismus
und die hormonelle Signalübertragung in die und innerhalb
der jeweiligen Zielzelle. Im Vordergrund stehen Störungen
der Reproduktion wie Beeinträchtigung der Spermatogenese,
verminderte Testosteronsynthese und Missbildungen der externen Genitalien
sowie Tumoren wie z. B. das Mammakarzinom. Beim Menschen
ist es jedoch schwierig, Störungen des Hormonsystems bzw.
der Reproduktionsfunktion auf bestimmte ED zurückzuführen.
Die Fülle der Befunde veranlassten die amerikanische FDA u. a.
präventiv zu empfehlen, die Produktion BPA-haltiger Plastikflaschen
und Babyfläschchen zu stoppen. Die EU fördert
Verbundprojekte wie COMPRENDO, mit Studien über das Gefährdungspotential
und die Risikoabschätzung bestimmter Chemikalien für
die Gesundheit. Bemerkenswert ist, dass bei manchen EDs die Dosis-Wirkungsbeziehung
nicht monoton sondern u-förmig verläuft und dass
zahlreiche Chemikalien bei extrem niedrigen Konzentrationen stark schädigend
wirken können (Low Dose Impact). Weitere Forschungen sind
erforderlich, um zu klären, ob die beobachteten Befunde
nur Assoziationen oder kausale Ergebnisse darstellen.
Abstract
Many substances from the technical and natural environment can
cause damage to the endocrine system. Animal tests show that so-called
endocrine disruptors (ED), such as pesticides, fungicides, plasticizers
(phthalates), bisphenol A (BPA), and organotin compounds can interfere
with the endocrine system. In humans, it is difficult to attribute
such changes to specific ED. Nevertheless, in vitro studies with
human cells and tissues clearly show that ED are able to interfere
with endogenous hormones, i. e. affecting the steroid hormone
metabolism and intracellular signaling. Several clinical studies
show that humans are also affected, including reproductive disorders
like reduction of spermatogenesis, decreased testosterone production
or malformation of the genitals or induction of tumors like mammary
carcinoma. Facing the body of reports documenting the effects of
ED, the European Union supported – inter alia – COMPRENDO,
a project addressing risk assessment of particular ED in human and
wildlife species, while the FDA supports the industry’s
actions to stop producing BPA-containing baby bottles and infant feeding
cups. Some ED show an u-shaped dose response curve and specific
ED have effects at levels dramatically lower than thought relevant
to traditional toxicology, a phenomenon termed „Low Dose
Impact”. Further research is needed to clarify whether
the observed findings represent associations or causal results.
Schlüsselwörter
endokrine Disruptoren - Umweltchemikalien - Phthalate - Bisphenol A - Testicular Dysgenesis
Syndrome
Keywords
endocrine disruptors - environmental chemicals - phthalates - bisphenol A - testicular
dysgenesis syndrome
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Prof. Dr. Dietrich Klingmüller
Arzt für Innere Medizin – Endokrinologie
Institut
für Klinische Chemie und Pharmakologie
Universitätsklinikum
Bonn
Sigmund-Freud-Str. 25
53105 Bonn
Telefon: 0228/2871-6513
Fax: 0228/2871-5028
eMail: d.klingmueller@uni-bonn.de