The authors have designated this AOP as all rights reserved. Re-use in any form requires advanced permission from the authors.

AOP: 510


A descriptive phrase which references both the Molecular Initiating Event and Adverse Outcome.It should take the form “MIE leading to AO”. For example, “Aromatase inhibition leading to reproductive dysfunction” where Aromatase inhibition is the MIE and reproductive dysfunction the AO. In cases where the MIE is unknown or undefined, the earliest known KE in the chain (i.e., furthest upstream) should be used in lieu of the MIE and it should be made clear that the stated event is a KE and not the MIE.  More help

Demethylation of PPAR promotor leading to vascular disrupting effects

Short name
A name that succinctly summarises the information from the title. This name should not exceed 90 characters. More help
Demethylation of PPAR promotor leading to vascular disrupting effects
The current version of the Developer's Handbook will be automatically populated into the Handbook Version field when a new AOP page is created.Authors have the option to switch to a newer (but not older) Handbook version any time thereafter. More help
Handbook Version v2.6

Graphical Representation

A graphical representation of the AOP.This graphic should list all KEs in sequence, including the MIE (if known) and AO, and the pair-wise relationships (links or KERs) between those KEs. More help
Click to download graphical representation template Explore AOP in a Third Party Tool


The names and affiliations of the individual(s)/organisation(s) that created/developed the AOP. More help

Yanhong Wei

Department of Toxicology, School of Public Health

Sun Yat-sen University, Guangdong, China

Point of Contact

The user responsible for managing the AOP entry in the AOP-KB and controlling write access to the page by defining the contributors as described in the next section.   More help
Yanhong Wei   (email point of contact)


Users with write access to the AOP page.  Entries in this field are controlled by the Point of Contact. More help
  • Yanhong Wei


This field is used to identify coaches who supported the development of the AOP.Each coach selected must be a registered author. More help

OECD Information Table

Provides users with information concerning how actively the AOP page is being developed and whether it is part of the OECD Workplan and has been reviewed and/or endorsed. OECD Project: Assigned upon acceptance onto OECD workplan. This project ID is managed and updated (if needed) by the OECD. OECD Status: For AOPs included on the OECD workplan, ‘OECD status’ tracks the level of review/endorsement of the AOP . This designation is managed and updated by the OECD. Journal-format Article: The OECD is developing co-operation with Scientific Journals for the review and publication of AOPs, via the signature of a Memorandum of Understanding. When the scientific review of an AOP is conducted by these Journals, the journal review panel will review the content of the Wiki. In addition, the Journal may ask the AOP authors to develop a separate manuscript (i.e. Journal Format Article) using a format determined by the Journal for Journal publication. In that case, the journal review panel will be required to review both the Wiki content and the Journal Format Article. The Journal will publish the AOP reviewed through the Journal Format Article. OECD iLibrary published version: OECD iLibrary is the online library of the OECD. The version of the AOP that is published there has been endorsed by the OECD. The purpose of publication on iLibrary is to provide a stable version over time, i.e. the version which has been reviewed and revised based on the outcome of the review. AOPs are viewed as living documents and may continue to evolve on the AOP-Wiki after their OECD endorsement and publication.   More help
OECD Project # OECD Status Reviewer's Reports Journal-format Article OECD iLibrary Published Version
This AOP was last modified on August 28, 2023 07:21

Revision dates for related pages

Page Revision Date/Time
peroxisome proliferator activated receptor promoter demethylation September 16, 2017 10:14
Activation of PPAR August 20, 2023 22:14
Increase, Oxidative Stress March 03, 2022 10:40
Abnormal expression of NO August 20, 2023 22:18
Activation of MMP-2 MMP-9 August 20, 2023 22:20
Activation of angiopoietin like protein 4 August 20, 2023 22:23
Activation of Angiogenic cytokines August 20, 2023 22:24
increased,Vascular endothelial dysfunction September 01, 2021 20:37
Increase, Vascular disrupting effects August 19, 2023 20:12
Angiogenesis dysfunction August 28, 2023 05:00
demethylation, PPARg promoter leads to Activation of PPAR August 20, 2023 23:11
Activation of PPAR leads to Increase, Oxidative Stress August 20, 2023 23:11
Activation of PPAR leads to Activation of MMP-2 MMP-9 August 20, 2023 23:12
Activation of PPAR leads to Activation of angiopoietin like protein 4 August 20, 2023 23:12
Activation of PPAR leads to Activation of Angiogenic cytokines August 20, 2023 23:13
Increase, Oxidative Stress leads to Abnormal expression of NO August 20, 2023 23:13
Activation of MMP-2 MMP-9 leads to increased,Vascular endothelial dysfunction August 20, 2023 23:14
Activation of angiopoietin like protein 4 leads to increased,Vascular endothelial dysfunction August 20, 2023 23:14
Activation of Angiogenic cytokines leads to increased,Vascular endothelial dysfunction August 20, 2023 23:15
Abnormal expression of NO leads to increased,Vascular endothelial dysfunction August 20, 2023 23:15
increased,Vascular endothelial dysfunction leads to Angiogenesis dysfunction August 28, 2023 05:01
Angiogenesis dysfunction leads to Increase, Vascular disrupting effects August 28, 2023 05:03


A concise and informative summation of the AOP under development that can stand-alone from the AOP page. The aim is to capture the highlights of the AOP and its potential scientific and regulatory relevance. More help

BACKGROUND: CVDs are the main cause of morbidity and mortality worldwide. Vascular network is an important channel of chemical’s ADME process and an important target of toxic effect. However, evidence inference information on the AOPs frameworks for the vascular toxic mechanisms remains limited. We collect toxicological information in literature from the following aspects: (1) In the screening of model organisms, aquatic organisms were mainly selected in vivo, supplemented by chicken embryos and mice, while cell lines were mainly selected in vitro. (2) The study focused on vascular toxicology, which are all closely related to human health hazards. (3) Molecular events and apical endpoint (MIEs, KEs, and AOs) contained changes in cellular function, pathways, transcription and expression, or organ status. In this hypothetical AOP network, the postulated molecular initiating event (MIE) may be invoked by effects on the inhibition of Nrf2. Downstream key events (KE) include Activation of PPAR, Oxidative stress, Abnormal expression of NO, Activation of MMP-2 MMP-9, Activation of angiopoietin like protein 4, Activation of Angiogenic cytokines, Vascular endothelial dysfunction. KE relationships (KERs) leading to Angiogenesis dysfunction. The severity of adverse outcomes (vascular disrupting effects) would ultimately vary by anatomical region, organ system, and physiological state when an MIE is invoked. In addition, it was considered that the results obtained in this investigation may potentially guide future vascular toxicological studies and enhance risk assessment.

AOP Development Strategy


Used to provide background information for AOP reviewers and users that is considered helpful in understanding the biology underlying the AOP and the motivation for its development.The background should NOT provide an overview of the AOP, its KEs or KERs, which are captured in more detail below. More help

 This AOP focuses on the vascular disrupting effect. The demethylation of PPAR promotor plays an important role in the vasculogenesis and angiogenesis. The postulated AOP may be invoked by effects on the demethylation of PPAR promotor. Downstream key events (KE) include Activation of PPAR, Oxidative stress, Abnormal expression of NO, Activation of MMP-2 MMP-9, Activation of angiopoietin like protein 4, Activation of Angiogenic cytokines, Vascular endothelial dysfunction. KE relationships (KERs) lead to Angiogenesis dysfunction. The severity of adverse outcomes (vascular disrupting effects) would ultimately vary by anatomical region, organ system, and physiological state when an MIE is invoked. Furthermore, to better elucidate the AOP of vascular disrupting effect better, the established AOPs are included. 


Provides a description of the approaches to the identification, screening and quality assessment of the data relevant to identification of the key events and key event relationships included in the AOP or AOP network.This information is important as a basis to support the objective/envisaged application of the AOP by the regulatory community and to facilitate the reuse of its components.  Suggested content includes a rationale for and description of the scope and focus of the data search and identification strategy/ies including the nature of preliminary scoping and/or expert input, the overall literature screening strategy and more focused literature surveys to identify additional information (including e.g., key search terms, databases and time period searched, any tools used). More help

Summary of the AOP

This section is for information that describes the overall AOP.The information described in section 1 is entered on the upper portion of an AOP page within the AOP-Wiki. This is where some background information may be provided, the structure of the AOP is described, and the KEs and KERs are listed. More help


Molecular Initiating Events (MIE)
An MIE is a specialised KE that represents the beginning (point of interaction between a prototypical stressor and the biological system) of an AOP. More help
Key Events (KE)
A measurable event within a specific biological level of organisation. More help
Adverse Outcomes (AO)
An AO is a specialized KE that represents the end (an adverse outcome of regulatory significance) of an AOP. More help
Type Event ID Title Short name
KE 2165 Activation of PPAR Activation of PPAR
KE 1969 Increase, Oxidative Stress Increase, Oxidative Stress
KE 2166 Abnormal expression of NO Abnormal expression of NO
KE 2167 Activation of MMP-2 MMP-9 Activation of MMP-2 MMP-9
KE 2168 Activation of angiopoietin like protein 4 Activation of angiopoietin like protein 4
KE 2169 Activation of Angiogenic cytokines Activation of Angiogenic cytokines
KE 1928 increased,Vascular endothelial dysfunction increased,Vascular endothelial dysfunction
KE 2181 Angiogenesis dysfunction Angiogenesis dysfunction
AO 2161 Increase, Vascular disrupting effects Increase, Vascular disrupting effects

Relationships Between Two Key Events (Including MIEs and AOs)

This table summarizes all of the KERs of the AOP and is populated in the AOP-Wiki as KERs are added to the AOP.Each table entry acts as a link to the individual KER description page. More help

Network View

This network graphic is automatically generated based on the information provided in the MIE(s), KEs, AO(s), KERs and Weight of Evidence (WoE) summary tables. The width of the edges representing the KERs is determined by its WoE confidence level, with thicker lines representing higher degrees of confidence. This network view also shows which KEs are shared with other AOPs. More help

Prototypical Stressors

A structured data field that can be used to identify one or more “prototypical” stressors that act through this AOP. Prototypical stressors are stressors for which responses at multiple key events have been well documented. More help

Life Stage Applicability

The life stage for which the AOP is known to be applicable. More help
Life stage Evidence
All life stages High

Taxonomic Applicability

Latin or common names of a species or broader taxonomic grouping (e.g., class, order, family) can be selected.In many cases, individual species identified in these structured fields will be those for which the strongest evidence used in constructing the AOP was available. More help
Term Scientific Term Evidence Link
human Homo sapiens High NCBI
mouse Mus musculus High NCBI
zebrafish Danio rerio High NCBI

Sex Applicability

The sex for which the AOP is known to be applicable. More help
Sex Evidence
Mixed High

Overall Assessment of the AOP

Addressess the relevant biological domain of applicability (i.e., in terms of taxa, sex, life stage, etc.) and Weight of Evidence (WoE) for the overall AOP as a basis to consider appropriate regulatory application (e.g., priority setting, testing strategies or risk assessment). More help

The biological plausibility of KERs is strong due to the available mechanistic evidence present in studies from a wide variety of taxa. The postulated molecular initiating event (MIE) for this AOP may be invoked by effects on the inhibition of Nrf2, and the key events (KEs) including Activation of PPAR, Oxidative stress, Abnormal expression of NO, Activation of MMP-2 MMP-9, Activation of angiopoietin like protein 4, Activation of Angiogenic cytokines, Vascular endothelial dysfunction. KE relationships (KERs) lead to Angiogenesis dysfunction, which is consistent with established biological understanding. Support for the essentiality of the key events can be obtained from a wide diversity of taxonomic groups, with lab rats, mice, cell lines, and zebrafish. Some studies provided evidence such as antagonism, knock-outs, or knock-ins to probe the necessity of MIE and KE. Furthermore, the AOP can be anticipated based on broader chemical-specific knowledge. However, more studies are needed to explore dose concordance, incidence concordance, and temporal concordance. 

Domain of Applicability

Addressess the relevant biological domain(s) of applicability in terms of sex, life-stage, taxa, and other aspects of biological context. More help
  1. Life Stage Applicability

The AOPs are not life stage specific

  1. Taxonomic Applicability


Scientific Term




Homo sapiens



Mus musculus



Danio rerio



  1. Sex Applicability


Essentiality of the Key Events

The essentiality of KEs can only be assessed relative to the impact of manipulation of a given KE (e.g., experimentally blocking or exacerbating the event) on the downstream sequence of KEs defined for the AOP. Consequently, evidence supporting essentiality is assembled on the AOP page, rather than on the independent KE pages that are meant to stand-alone as modular units without reference to other KEs in the sequence. The nature of experimental evidence that is relevant to assessing essentiality relates to the impact on downstream KEs and the AO if upstream KEs are prevented or modified. This includes: Direct evidence: directly measured experimental support that blocking or preventing a KE prevents or impacts downstream KEs in the pathway in the expected fashion. Indirect evidence: evidence that modulation or attenuation in the magnitude of impact on a specific KE (increased effect or decreased effect) is associated with corresponding changes (increases or decreases) in the magnitude or frequency of one or more downstream KEs. More help

The biological plausibility of KERs is strong due to the available mechanistic evidence present in studies from a wide variety of taxa. The demethylation of PPAR promotor causes oxidative stress and a variety of cellular responses.  The essentiality of KERs is strong due to many evidence from different controlled experimental designs with controls.  Exposure to a various of chemical stressors has induced oxidative stress from PPAR activation.  Support for the essentiality of the key events can be obtained from a wide diversity of taxonomic groups, with lab rats, mice, cell lines, and zebrafish. The empirical support of KERs is largely found in toxicological studies derived from reference chemicals with dose-response and temporal concordance assessed. Furthermore, weight of evidence for the MIE and AO are strong, the intermediate KEs have in some cases strong evidence but in other cases, weaker evidence, due to the lack of quantitative information.

Evidence Assessment

Addressess the biological plausibility, empirical support, and quantitative understanding from each KER in an AOP. More help

The QWOE approach is an analytical method that utilizes causality criteria to assess the evidence-supported postulated AOP[4]. Firstly, the hypothesis of action was presented and the quantitative evaluation of evidence ranging from no evidence (0) to strong for each category (3, strong and −3, strong counter) utilizing the evolved MIEs, KEs, and KERs. Subsequently, a ranked importance-based numerical weight was assigned to Bradford Hill causal considerations, and the composite score and confidence score for MIEs, KEs, and entire AOP were evaluated.

  Assigned weight  Qualitative rating              
    MIE KE1 KE2 KE3 KE4 KE5 KE6 KE7
Biological plausibility Some in vivo and in vitro evidence suggest that the chemicals can cause the vascular toxicity
Essentiality empirical support 0.4 1 1 1 1 1 1 1 1
Dose and incidence concordance 0.2 3 3 3 3 2 2 2 3
Empirical support temporal concordance 0.2 3 3 3 3 2 2 2 3
Consistency across test systems 0.1 3 3 3 3 2 2 2 3
Analogy mutiple studies support KE and KER 0.1 3 3 3 3 3 3 3 3
Score 1 2.2 2.2 2.2 2.2 1.7 1.7 1.7 2.2
AOP Score 0.670833                

Known Modulating Factors

Modulating factors (MFs) may alter the shape of the response-response function that describes the quantitative relationship between two KES, thus having an impact on the progression of the pathway or the severity of the AO.The evidence supporting the influence of various modulating factors is assembled within the individual KERs. More help
Modulating Factor (MF) Influence or Outcome KER(s) involved

Quantitative Understanding

Optional field to provide quantitative weight of evidence descriptors.  More help

Optional field to provide quantitative weight of evidence descriptors.  

Considerations for Potential Applications of the AOP (optional)

Addressess potential applications of an AOP to support regulatory decision-making.This may include, for example, possible utility for test guideline development or refinement, development of integrated testing and assessment approaches, development of (Q)SARs / or chemical profilers to facilitate the grouping of chemicals for subsequent read-across, screening level hazard assessments or even risk assessment. More help


List of the literature that was cited for this AOP. More help

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[2]        CHEN C A, WANG T Y, VARADHARAJ S, et al. S-glutathionylation uncouples eNOS and regulates its cellular and vascular function [J]. Nature, 2010, 468(7327): 1115-8.

[3]        GIUSTARINI D, DALLE-DONNE I, MILZANI A, et al. Analysis of GSH and GSSG after derivatization with N-ethylmaleimide [J]. Nature protocols, 2013, 8(9): 1660-9.

[4]        DUMITRESCU C, BIONDI R, XIA Y, et al. Myocardial ischemia results in tetrahydrobiopterin (BH4) oxidation with impaired endothelial function ameliorated by BH4 [J]. Proceedings of the National Academy of Sciences of the United States of America, 2007, 104(38): 15081-6.

[5]        ZHANG J M, AN J. Cytokines, inflammation, and pain [J]. International anesthesiology clinics, 2007, 45(2): 27-37.

[6]        BRAUNERSREUTHER V, VIVIANI G L, MACH F, et al. Role of cytokines and chemokines in non-alcoholic fatty liver disease [J]. World journal of gastroenterology, 2012, 18(8): 727-35.

[7]        CULLEN S P, HENRY C M, KEARNEY C J, et al. Fas/CD95-induced chemokines can serve as "find-me" signals for apoptotic cells [J]. Molecular cell, 2013, 49(6): 1034-48.

[8]        LI J, QUAN X, LEI S, et al. PFOS Inhibited Normal Functional Development of Placenta Cells via PPARγ Signaling [J]. Biomedicines, 2021, 9(6).

[9]        WEI Y, GONG J, XU Z, et al. Nrf2 in ischemic neurons promotes retinal vascular regeneration through regulation of semaphorin 6A [J]. Proceedings of the National Academy of Sciences of the United States of America, 2015, 112(50): E6927-36.

[10]       ZHONG X, YU Y, WANG C, et al. Hippocampal proteomic analysis reveals the disturbance of synaptogenesis and neurotransmission induced by developmental exposure to organophosphate flame retardant triphenyl phosphate [J]. J Hazard Mater, 2021, 404(Pt B): 124111.

[11]       ZHONG X, WU J, KE W, et al. Neonatal exposure to organophosphorus flame retardant TDCPP elicits neurotoxicity in mouse hippocampus via microglia-mediated inflammation in vivo and in vitro [J]. Archives of toxicology, 2020, 94(2): 541-52.

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[13]       ZHANG Y, ZHAO H J, XIA X R, et al. Hypoxia-induced and HIF1α-VEGF-mediated tight junction dysfunction in choriocarcinoma cells: Implications for preeclampsia [J]. Clinica chimica acta; international journal of clinical chemistry, 2019, 489: 203-11.

[14]       LI S J, SHANG T, LI S Y, et al. [Effects of peroxisome proliferator-activated receptor gamma and its ligands on cytotrophoblast invasion in first trimester of pregnancy and mechanism thereof] [J]. Zhonghua yi xue za zhi, 2007, 87(3): 174-8.

[15]       SOLIMAN E, BEHAIRY S F, EL-MARAGHY N N, et al. PPAR-γ agonist, pioglitazone, reduced oxidative and endoplasmic reticulum stress associated with L-NAME-induced hypertension in rats [J]. Life sciences, 2019, 239: 117047.

[16]       ZHANG B, HAO Z, ZHOU W, et al. Formononetin protects against ox-LDL-induced endothelial dysfunction by activating PPAR-γ signaling based on network pharmacology and experimental validation [J]. Bioengineered, 2021, 12(1): 4887-98.

[17]       VAN DEN DUNGEN M W, MURK A J, KOK D E, et al. Persistent organic pollutants alter DNA methylation during human adipocyte differentiation [J]. Toxicology in vitro : an international journal published in association with BIBRA, 2017, 40: 79-87.

[18]       LYU G, GUAN Y, ZHANG C, et al. TGF-β signaling alters H4K20me3 status via miR-29 and contributes to cellular senescence and cardiac aging [J]. Nature communications, 2018, 9(1): 2560.

[19]       COSTANTINO S, PANENI F, MITCHELL K, et al. Hyperglycaemia-induced epigenetic changes drive persistent cardiac dysfunction via the adaptor p66(Shc) [J]. International journal of cardiology, 2018, 268: 179-86.

[20]       VARSHAVSKY J R, ROBINSON J F, ZHOU Y, et al. Organophosphate Flame Retardants, Highly Fluorinated Chemicals, and Biomarkers of Placental Development and Disease During Mid-Gestation [J]. Toxicological sciences : an official journal of the Society of Toxicology, 2021, 181(2): 215-28.

[21]       MEI Y, THOMPSON M D, COHEN R A, et al. Endoplasmic Reticulum Stress and Related Pathological Processes [J]. Journal of pharmacological & biomedical analysis, 2013, 1(2): 1000107.

[22]       ZHAO Y, ZHAO H, XU H, et al. Perfluorooctane sulfonate exposure induces preeclampsia-like syndromes by damaging trophoblast mitochondria in pregnant mice [J]. Ecotoxicology and environmental safety, 2022, 247: 114256.

[23]       DU Y, CAI Z, ZHOU G, et al. Perfluorooctanoic acid exposure increases both proliferation and apoptosis of human placental trophoblast cells mediated by ER stress-induced ROS or UPR pathways [J]. Ecotoxicology and environmental safety, 2022, 236: 113508.

[24]       CUI J, WANG P, YAN S, et al. Perfluorooctane Sulfonate Induces Dysfunction of Human Umbilical Vein Endothelial Cells via Ferroptosis Pathway [J]. Toxics, 2022, 10(9).

[25]       BLAKE B E, RICKARD B P, FENTON S E. A High-Throughput Toxicity Screen of 42 Per- and Polyfluoroalkyl Substances (PFAS) and Functional Assessment of Migration and Gene Expression in Human Placental Trophoblast Cells [J]. Frontiers in toxicology, 2022, 4: 881347.

[26]       BONATO M, CORRà F, BELLIO M, et al. Pfas environmental pollution and antioxidant responses: An overview of the impact on human field [J]. International Journal of Environmental Research and Public Health, 2020, 17(21): 1-45.

[27]       SONKAR R, KAY M K, CHOUDHURY M. PFOS Modulates Interactive Epigenetic Regulation in First-Trimester Human Trophoblast Cell Line HTR-8/SV(neo) [J]. Chemical research in toxicology, 2019, 32(10): 2016-27.

[28]       JIANG J, CHEN D Y, LIU Z T, et al. Effect of N-Perfluorooctane on Hypoxia/Reoxygenation Injury in Human Umbilical Vein Endothelial Cells [J]. Acta Cardiologica Sinica, 2016, 32(6): 716-22.

[29]       LIAO Y, WANG J, HUANG Q S, et al. Evaluation of cellular response to perfluorooctane sulfonate in human umbilical vein endothelial cells [J]. Toxicology in vitro : an international journal published in association with BIBRA, 2012, 26(3): 421-8.

[30]       QIAN Y, DUCATMAN A, WARD R, et al. Perfluorooctane sulfonate (PFOS) induces reactive oxygen species (ROS) production in human microvascular endothelial cells: role in endothelial permeability [J]. Journal of toxicology and environmental health Part A, 2010, 73(12): 819-36.

[31]       MARINELLO W P, MOHSENI Z S, CUNNINGHAM S J, et al. Perfluorobutane sulfonate exposure disrupted human placental cytotrophoblast cell proliferation and invasion involving in dysregulating preeclampsia related genes [J]. FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 2020, 34(11): 14182-99.

[32]       DANGUDUBIYYAM S V, MISHRA J S, ZHAO H, et al. Perfluorooctane sulfonic acid (PFOS) exposure during pregnancy increases blood pressure and impairs vascular relaxation mechanisms in the adult offspring [J]. Reproductive toxicology (Elmsford, NY), 2020, 98: 165-73.

[33]       DU Y, CAI Z, ZHANG H, et al. Nitric oxide mediates disruption of human placental trophoblast invasion induced by perfluorobutane sulfonate [J]. Environmental pollution (Barking, Essex : 1987), 2021, 283: 117137.

[34]       DANGUDUBIYYAM S V, MISHRA J S, SONG R, et al. Maternal perfluorooctane sulfonic acid exposure during rat pregnancy causes hypersensitivity to angiotensin II and attenuation of endothelium-dependent vasodilation in the uterine arteries † [J]. Biology of reproduction, 2022, 107(4): 1072-83.

[35]       YANG H, LAI H, HUANG J, et al. Polystyrene microplastics decrease F-53B bioaccumulation but induce inflammatory stress in larval zebrafish [J]. Chemosphere, 2020, 255: 127040.

[36]       HAN R, HU M, ZHONG Q, et al. Perfluorooctane sulphonate induces oxidative hepatic damage via mitochondria-dependent and NF-κB/TNF-α-mediated pathway [J]. Chemosphere, 2018, 191: 1056-64.

[37]       WANG C, NIE X, ZHANG Y, et al. Reactive oxygen species mediate nitric oxide production through ERK/JNK MAPK signaling in HAPI microglia after PFOS exposure [J]. Toxicol Appl Pharmacol, 2015, 288(2): 143-51.

[38]       JIAO X, LIU N, XU Y, et al. Perfluorononanoic acid impedes mouse oocyte maturation by inducing mitochondrial dysfunction and oxidative stress [J]. Reproductive toxicology (Elmsford, NY), 2021, 104: 58-67.

[39]       WANG D, TAN Z, YANG J, et al. Perfluorooctane sulfonate promotes atherosclerosis by modulating M1 polarization of macrophages through the NF-κB pathway [J]. Ecotoxicology and environmental safety, 2023, 249: 114384.

[40]       LIN C Y, CHEN P C, LO S C, et al. The association of carotid intima-media thickness with serum Level of perfluorinated chemicals and endothelium-platelet microparticles in adolescents and young adults [J]. Environ Int, 2016, 94: 292-9.

[41]       ZHU T R, CAO J, HONG J W, et al. [Effects of PFOS on inflammatory factors in human placental trophoblast cells] [J]. Zhonghua lao dong wei sheng zhi ye bing za zhi = Zhonghua laodong weisheng zhiyebing zazhi = Chinese journal of industrial hygiene and occupational diseases, 2020, 38(7): 481-4.

[42]       YU Y, WANG C, ZHANG X, et al. Perfluorooctane sulfonate disrupts the blood brain barrier through the crosstalk between endothelial cells and astrocytes in mice [J]. Environmental pollution (Barking, Essex : 1987), 2020, 256: 113429.

[43]       SZILAGYI J T, FREEDMAN A N, KEPPER S L, et al. Per- and Polyfluoroalkyl Substances Differentially Inhibit Placental Trophoblast Migration and Invasion In Vitro [J]. Toxicological Sciences, 2020, 175(2): 210-9.

[44]       TIEN P T, LIN H J, TSAI Y Y, et al. Perfluorooctanoic acid in indoor particulate matter triggers oxidative stress and inflammation in corneal and retinal cells [J]. Scientific reports, 2020, 10(1): 15702.

[45]       MIDIC U, GOHEEN B, VINCENT K A, et al. Changes in gene expression following long-term in vitro exposure of Macaca mulatta trophoblast stem cells to biologically relevant levels of endocrine disruptors [J]. Reproductive toxicology (Elmsford, NY), 2018, 77: 154-65.

[46]       OJO A F, PENG C, NG J C. Genotoxicity assessment of per- and polyfluoroalkyl substances mixtures in human liver cells (HepG2) [J]. Toxicology, 2022, 482: 153359.

[47]       HAUFE D, DAHMEN K G, TIEBEL O, et al. Effect of perfluorohexane on the expression of cellular adhesion molecules and surfactant protein A in human mesothelial cells in vitro [J]. Artificial cells, blood substitutes, and immobilization biotechnology, 2011, 39(4): 239-46.

[48]       SIRANGELO I, IANNUZZI C, VILASI S, et al. W7FW14F apomyoglobin amyloid aggregates-mediated apoptosis is due to oxidative stress and AKT inactivation caused by Ras and Rac [J]. Journal of cellular physiology, 2009, 221(2): 412-23.

[49]       HYöTYLäINEN T, BODIN J, DUBERG D, et al. Lipidomic Analyses Reveal Modulation of Lipid Metabolism by the PFAS Perfluoroundecanoic Acid (PFUnDA) in Non-Obese Diabetic Mice [J]. Frontiers in genetics, 2021, 12: 721507.

[50]       LIU H, SUN W, ZHOU Y, et al. iTRAQ-based quantitative proteomics analysis of Sprague-Dawley rats liver reveals perfluorooctanoic acid-induced lipid metabolism and urea cycle dysfunction [J]. Toxicology letters, 2022, 357: 20-32.