Early PFAS exposure linked to increased intestinal inflammation in children

New research from the Icahn School of Medicine at Mount Sinai has found that exposure to per- and polyfluoroalkyl substances (PFAS) during pregnancy and early childhood is associated with higher levels of intestinal inflammation in childhood later in life.

The study, published in Clinical Gastroenterology and Hepatology, tracked children from three birth cohorts in the United States and Mexico for up to 11 years.

Researchers found that higher exposure to PFAS before and shortly after birth was consistently linked to elevated levels of faecal calprotectin, a recognised biomarker of intestinal inflammation.

The findings suggest that environmental exposure during critical stages of development could influence long-term gut health and potentially increase susceptibility to inflammatory bowel disease (IBD).

While the study does not prove PFAS cause IBD, it strengthens evidence that early-life exposure may play a role in disease development.

Researchers analysed PFAS exposure before birth

PFAS, often referred to as “forever chemicals,” are widely used in consumer and industrial products including non-stick cookware, food packaging, stain-resistant textiles, and firefighting foams.

Their resistance to degradation allows them to persist in the environment and accumulate in the human body over time.

To investigate the potential health impacts of these chemicals, researchers measured PFAS concentrations in maternal blood collected during pregnancy, umbilical cord blood, and newborn dried blood spot samples. Children from the participating birth cohorts were then monitored throughout childhood.

Using advanced untargeted chemical analysis, the team detected PFAS in all early-life biological samples, confirming widespread exposure across the study population.

Elevated biomarker points to intestinal inflammation

The researchers focused on faecal calprotectin, a protein released during inflammation in the gastrointestinal tract.

The biomarker is commonly used in clinical practice to assess disease activity in patients with IBD and can indicate inflammation before symptoms appear.

Across all three cohorts, children with higher prenatal and early-life PFAS exposure consistently showed increased faecal calprotectin levels.

Importantly, the association was observed for both long-established PFAS compounds and newer replacement chemicals that have increasingly entered commercial use following restrictions on older substances.

This suggests that a broad range of PFAS may influence children’s gut health rather than a small number of individual chemicals.

Rather than analysing single compounds in isolation, the researchers evaluated PFAS as complex chemical mixtures, providing a more realistic representation of how people are exposed through their everyday environments.

Implications for IBD research

Inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, develops through a combination of genetic susceptibility and environmental influences. While inherited risk factors are well established, they do not fully explain why some individuals develop the disease.

The new findings add to growing evidence that environmental contaminants encountered during early development may contribute to biological changes associated with future disease risk.

Researchers emphasise that elevated faecal calprotectin should not be interpreted as a diagnosis or prediction that a child will develop IBD. Instead, it is a sensitive indicator of intestinal inflammation that has previously been associated with increased future IBD risk.

Because the research was observational, it cannot establish a direct cause-and-effect relationship between PFAS exposure and intestinal inflammation.

Long-term monitoring will continue

The research team plans to continue following participants as they grow older to determine whether children with higher early-life PFAS exposure and persistent intestinal inflammation are more likely to develop IBD in adolescence or adulthood.

The study also highlights the potential value of public health measures aimed at reducing PFAS exposure during pregnancy and early childhood, particularly as concerns continue to grow over the widespread presence of these persistent chemicals in the environment.