O flúor pode ser considerado um agente genotóxico in vivo? Uma revisão sistemática
Data
2023-09-22
Autores
Drummond, Giovana Wagner Branda 
Orientadores
Ribeiro, Daniel Araki
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
O objetivo deste estudo foi realizar uma revisão sistemática (RS) para investigar a literatura científica sobre os efeitos genotóxicos da exposição ao flúor (EF). As diretrizes do PRISMA-P foram utilizadas nesse cenário. A ferramenta PICOS (Participantes, Intervenção, Comparação, Desfecho e Desenho do estudo) adotou responder à seguinte questão: "O flúor pode ser considerado um agente químico genotóxico in vivo?" As bases de dados utilizadas para este estudo foi PubMed/Medline, SCOPUS e Web of Science. A qualidade dos estudos incluídos foi avaliada por meio do EPHP (Effective Public Health Practice Project). Um total de 20 estudos foram selecionados para avaliar a genotoxicidade induzida pelo flúor. 7 estudos demonstraram resultado positivo enquanto 13 estudos demonstraram resultados negativos. Após a revisão dos vinte estudos, 2 foram classificados como fracos, 4 foram considerados moderados e 14 foram considerados fortes, de acordo com a EPHPP. Dos 20 somente 16 estudos foram incluídos na metanálise devido a classificação como fraco e não descrição adequada de desvio padrão. A metanálise dos estudos de micronúcleos (MN) em fígado e medula óssea não mostrou diferença estatisticamente significativa (p=0,07). Nos estudos de troca de cromátides irmãs (ECS) em linfócitos também não diferiram estatisticamente significativamente (p=0,80). Para o ensaio de cometa (SCGEA), os estudos revelaram diferença estatisticamente significante com F em relação ao controle nos rins (SMD=2.09, 95% CI, 0.74 to 3.45, p<0.001), com Tau2=1,44; Chi2=566,38 e p=0,002, de modo que os estudos selecionados foram considerados heterogêneos e o I² de 87% indicou alta heterogeneidade. Em conjunto, foi estabelecido que a genotoxicidade do flúor é limitada e dose dependente.
The goal of this study was to perform systematic review (SR) to investigate the scientific literature regarding the genotoxicity effects of fluoride exposure (FE). PRISMA-P guidelines was used in this setting. The PICOS (Participants, Intervention, Comparison, Outcome, and Study Design) tool has adopated to answer the following question: “Could fluoride be considered a genotoxic chemical agent in vivo?” The search of databases used for this study was PubMed/Medline, SCOPUS and Web of Science. The quality of included studies was assessed using the EPHPP (Effective Public Health Practice Project). A total of 20 studies were selected for evaluating the genotoxicity induced by fluoride. 7 studies have revealed that FE induces genotoxicity and. 13 studies demonstrated negative results. After reviewing the twenty studies, 2 was classified as weak, 4 were considered moderate and 14 were considered strong, according to the EPHPP. Of the 20, only 16 studies were included in the meta-analysis due to poor classification and not properly description of standard deviation. The meta-analysis of micronucleus (MN) studies in liver MN and bone marrow MN showed no statistically significant difference (p=0.07). The sister chromatid exchange (SCE) studies on lymphocytes also did not differ significantly statistically (p=0.80). For single cell gel electrophoresis assay (SCGEA), studies revealed a statistically significant difference with FE compared to control in kidney (SMD=2.09, 95% CI, 0.74 to 3.45, p<0.001), with a Tau2=1.44; Chi2=566.38, and p=0.002, so that the selected manuscripts were considered heterogeneous and the I² of 87% indicated high heterogeneity. Taken together, it has been established that genotoxicity of fluoride is limited and dose dependent.
The goal of this study was to perform systematic review (SR) to investigate the scientific literature regarding the genotoxicity effects of fluoride exposure (FE). PRISMA-P guidelines was used in this setting. The PICOS (Participants, Intervention, Comparison, Outcome, and Study Design) tool has adopated to answer the following question: “Could fluoride be considered a genotoxic chemical agent in vivo?” The search of databases used for this study was PubMed/Medline, SCOPUS and Web of Science. The quality of included studies was assessed using the EPHPP (Effective Public Health Practice Project). A total of 20 studies were selected for evaluating the genotoxicity induced by fluoride. 7 studies have revealed that FE induces genotoxicity and. 13 studies demonstrated negative results. After reviewing the twenty studies, 2 was classified as weak, 4 were considered moderate and 14 were considered strong, according to the EPHPP. Of the 20, only 16 studies were included in the meta-analysis due to poor classification and not properly description of standard deviation. The meta-analysis of micronucleus (MN) studies in liver MN and bone marrow MN showed no statistically significant difference (p=0.07). The sister chromatid exchange (SCE) studies on lymphocytes also did not differ significantly statistically (p=0.80). For single cell gel electrophoresis assay (SCGEA), studies revealed a statistically significant difference with FE compared to control in kidney (SMD=2.09, 95% CI, 0.74 to 3.45, p<0.001), with a Tau2=1.44; Chi2=566.38, and p=0.002, so that the selected manuscripts were considered heterogeneous and the I² of 87% indicated high heterogeneity. Taken together, it has been established that genotoxicity of fluoride is limited and dose dependent.
Descrição
Citação
DRUMMOND, Giovana Wagner Branda. O flúor pode ser considerado um agente genotóxico in vivo? Uma revisão sistemática. 2023. 41 f. Dissertação (Mestrado em Bioprodutos e Bioprocessos) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2023.