1. Academic Validation
  2. Perfluorooctanoic Acid Exposure Causes Macrophage Ammonia Retention and Induces Spontaneous Miscarriages

Perfluorooctanoic Acid Exposure Causes Macrophage Ammonia Retention and Induces Spontaneous Miscarriages

  • Adv Sci (Weinh). 2026 Jan 4:e06994. doi: 10.1002/advs.202506994.
Yongbo Zhao 1 2 Yijun Zhang 2 Hanyu Rao 2 Jiani Sun 2 Zhiyi Pan 2 Liping Jin 1 3 Yan Zhao 1
Affiliations

Affiliations

  • 1 Obstetrics & Gynecology Hospital of Fudan University, Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases, Shanghai, China.
  • 2 Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
  • 3 The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Abstract

Spontaneous miscarriage, the most prevalent complication of early pregnancy, poses substantial risks to maternal health worldwide. Perfluorooctanoic acid (PFOA) is a ubiquitous environmental persistent organic pollutant. Human epidemiological studies have linked PFOA exposure to spontaneous miscarriages, yet the underlying mechanisms have been rarely explored. In this study, we found PFOA exposure induced embryonic absorption in pregnant mice by causing ammonia retention in macrophages. Excessive ammonia disrupted mitochondrial function and compromised lysosomal integrity, which ultimately impaired macrophage function. Furthermore, lysosomal dysfunction reduced secretion of Cathepsin B (CTSB) and led to decreased macrophage infiltration and diminished trophoblast invasion. Mechanistically, PFOA exposure led to macrophages ammonia retention by promoting the glutaminolysis through the upregulation of Glutaminase (GLS) expression. By downregulating the inhibitor of DNA binding protein 3 (ID3), PFOA enhanced nuclear translocation and DNA-binding affinity of transcription factor 12 (TCF12), which directly activated Glutaminase (GLS) transcription to fuel glutamine catabolism. Collectively, our findings delineated a previously unrecognized pathway linking environmental PFOA exposure to spontaneous miscarriage via ammonia-driven macrophage impairment.

Keywords

ammonia retention; macrophage; perfluorooctanoic acid; spontaneous miscarriage.

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