The association between phthalate exposure
and asthma
Ming-Ju Tsai a,b, Po-Lin Kuo c,d, Ying-Chin Ko c,d,*
a Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical
University, Kaohsiung, Taiwan b Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital,
Kaohsiung Medical University, Kaohsiung, Taiwan c Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan d Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
Abstract: Asthma is a chronic inflammatory disorder of the airway,
characterized by airway hyperresponsiveness. It is a disabling
disease with an increasing prevalence, resulting in heavy social and economic burdens worldwide. Humans are extensively exposed to phthalates, and many epidemiological studies have shown a
relationship between phthalate exposure and asthma in recent decades. Earlier experimental studies focused on inflammatory cells, demonstrating the adjuvant effects, immunomodulatory effects, or immunosuppressive effects related to phthalate
exposure. Recent studies have shown that phthalates may have a direct effect on airway epithelial cells and contribute to airway
remodeling, which is the cardinal pathologic characteristic of chronic asthma, with a high correlation with disease severity. Through these efforts, phthalates have been recognized as important
environmental factors in the pathogenesis of asthma, but further studies are still required to elucidate the detailed mechanism. This review discusses the current status of human exposure to
phthalates in Taiwan and summarizes the epidemiological and experimental evidence related to the roles of phthalate exposure in the development of asthma and associated diseases.
