Are 20-hydroxyecdysone and related genes potential biomarkers of sublethal exposure to lipid-altering contaminants?

In Daphnia magna, 20-hydroecdysone (20E) is the main molting hormone and its metabolism is of interest to identify new biomarkers of exposure to contaminants. The present study aimed to (i) assess baseline levels of 20E and transcription levels of four related-genes (shade, neverland, ultraspiracle, and ecdysteroid receptor); and (ii) evaluate effects in D. magna after 21 days of exposure to fenarimol (anti-ecdysteroid) and a mixture of gemfibrozil and clofibric acid (lipid-lowering drugs) at sublethal concentrations. Endpoints included transcription of the target genes and quantification of 20E, mortality, and reproduction of daphnids. Baseline results showed that average responses were relatively similar and did not vary more than 2-fold. However, intra-day variation was generally high and could be explained by sampling individuals with slightly different stages of their development. Exposure tests indicated a significant decrease in daphnid reproduction following chronic exposure to a concentration of 565 µg/L of fenarimol. However, no difference was observed between the control and exposed groups for any of the investigated genes, nor for the levels of 20E after 21 days of exposure. Following exposition to gemfibrozil and clofibric acid at 1 µg/L, no changes were observed for the measured parameters. These results suggest that changes in transcription levels of the target genes and concentrations of 20E may not be sensitive endpoints that can be used as biomarkers of sublethal exposure to the target compounds in D. magna. Measuring multiple time points instead of a single measure as well as additional molecular endpoints obtained from transcriptomic and metabolomic studies could afford more insights on the changes occurring in exposed daphnids to lipid-altering compounds and identify efficient biomarkers of sublethal exposure.

Metabolism of clofibric acid in zebrafish embryos (Danio rerio) as determined by liquid chromatography-high resolution-mass spectrometry.

The zebrafish embryo (ZFE) is increasingly used in ecotoxicology research but detailed knowledge of its metabolic potential is still limited. This study focuses on the xenobiotic metabolism of ZFE at different life-stages using the pharmaceutical compound clofibric acid as study compound. Liquid chromatography with quadrupole-time-of-flight mass spectrometry (LC-QToF-MS) is used to detect and to identify the transformation products (TPs). In screening experiments, a total of 18 TPs was detected and structure proposals were elaborated for 17 TPs, formed by phase I and phase II metabolism. Biotransformation of clofibric acid by the ZFE involves conjugation with sulfate or glucuronic acid, and, reported here for the first time, with carnitine, taurine, and aminomethanesulfonic acid. Further yet unknown cyclization products were identified using non-target screening that may represent a new detoxification pathway. Sulfate containing TPs occurred already after 3h of exposure (7hpf), and from 48h of exposure (52hpf) onwards, all TPs were detected. The detection of these TPs indicates the activity of phase I and phase II enzymes already at early life-stages. Additionally, the excretion of one TP into the exposure medium was observed. The results of this study outline the high metabolic potential of the ZFE with respect to the transformation of xenobiotics. Similarities but also differences to other test systems were observed. Biotransformation of test chemicals in toxicity testing with ZFE may therefore need further consideration.

Clofibric acid and gemfibrozil removal in membrane bioreactors.

The removal of two blood lipid regulators, clofibric acid (CLA) and gemfibrozil (GFZ), was evaluated using two identical aerobic membrane bioreactors with 6.5 L effective volume each. Polysulfone ultrafiltration hollow fiber membranes were submerged in the reactors. Different operating conditions were tested varying the organic load (F/M), hydraulic residence time (HRT), biomass concentration measured as total suspended solids in the mixed liquor (MLTSS) and the sludge retention time (SRT). Complete GFZ removal was obtained with F/M of 0.21-0.48 kg COD kgTSS⁻¹ d⁻¹, HRT of 4-10 hours, SRT of 10-32 d and MLTSS of 6-10 g L⁻¹. The GFZ removal can be attributed to biodegradation and there was no accumulation of the compound in the biomass. The CLA removals improved with the SRT and HRT increase and F/M decrease. Average removals of 78-79% were obtained with SRT 16-32 d, F/M of 0.21-0.34 kgCOD kgTSS⁻¹ d⁻¹, HRT of 7-10 hours and MLTSS of 6-10 g L⁻¹. Biodegradation was found to be the main removal pathway.

Effects of the lipid regulating drug clofibric acid on PPARα-regulated gene transcript levels in common carp (Cyprinus carpio) at pharmacological and environmental exposure levels.

In mammals, the peroxisome proliferator-activated receptor α (PPARα) plays a key role in regulating various genes involved in lipid metabolism, bile acid synthesis and cholesterol homeostasis, and is activated by a diverse group of compounds collectively termed peroxisome proliferators (PPs). Specific PPs have been detected in the aquatic environment; however little is known on their pharmacological activity in fish. We investigated the bioavailability and persistence of the human PPARα ligand clofibric acid (CFA) in carp, together with various relevant endpoints, at a concentration similar to therapeutic levels in humans (20mg/L) and for an environmentally relevant concentration (4µg/L). Exposure to pharmacologically-relevant concentrations of CFA resulted in increased transcript levels of a number of known PPARα target genes together with increased acyl-coA oxidase (Acox1) activity, supporting stimulation of lipid metabolism pathways in carp which are known to be similarly activated in mammals. Although Cu,Zn-superoxide dismutase (Sod1) activity was not affected, mRNA levels of several biotransformation genes were also increased, paralleling previous reports in mammals and indicating a potential role in hepatic detoxification for PPARα in carp. Importantly, transcription of some of these genes (and Acox1 activity) were affected at exposure concentrations comparable with those reported in effluent discharges. Collectively, these data suggest that CFA is pharmacologically active in carp and has the potential to invoke PPARα-related responses in fish exposed in the environment, particularly considering that CFA may represent just one of a number of PPAR-active compounds present to which wild fish may be exposed.

A simple and sensitive method for the determination of fibric acids in the liver by liquid chromatography.

Fibrates are used in biochemical and pharmacological studies as bioactive tools. Nevertheless, most studies have lacked information concerning the concentrations of fibric acids working inside tissues because a simple and sensitive method is not available for their quantitation. This study aimed to develop a simple and sensitive bioanalytical method for the quantitation of clofibric, bezafibric and fenofibric acids in samples of very small portions of tissues. Fibric acids were extracted into n-hexane-ethyl acetate from tissue homogenates (10 mg of liver, kidney or muscle) or serum (100 µL) and were derivatized with 4-bromomethyl-6,7-dimethoxycoumarin, followed by HPLC with fluorescence detection. These compounds were separated isocratically on a reversed phase with acetonitrile-water. Standard analytical curves were linear over the concentration range of 0.2-20 nmol/10 mg of liver. Precision and accuracy were within acceptable limits. Recovery from liver homogenates ranged from 93.03 to 112.29%. This method enabled the quantitation of fibric acids in 10 mg of liver from rats treated with clofibric acid, bezafibric acid or fenofibrate. From these analytical data, it became clear that there was no large difference in ratio of acyl-CoA oxidase 1 (Acox1) mRNA level to fibric acid content in the liver among the three fibric acids, suggesting that these three fibric acids have similar potency to increase expression of the Acox1 gene, which is a target of peroxisome proliferator-activated receptor α. Thus, the proposed method is a simple, sensitive and reliable tool for the quantitation of fibric acids working in vivo inside livers.

Fate of pharmaceutical compounds in hydroponic mesocosms planted with Scirpus validus.

A systematic approach to assess the fate of selected pharmaceuticals (carbamazepine, naproxen, diclofenac, clofibric acid and caffeine) in hydroponic mesocosms is described. The overall objective was to determine the kinetics of depletion (from solution) and plant uptake for these compounds in mesocosms planted with S. validus growing hydroponically. The potential for translocation of these pharmaceuticals from the roots to the shoots was also assessed. After 21 days of incubation, nearly all of the caffeine, naproxen and diclofenac were eliminated from solution, whereas carbamazepine and clofibric acid were recalcitrant to both photodegradation and biodegradation. The fact that the BAFs for roots for carbamazepine and clofibric acid were greater than 5, while the BAFs for naproxen, diclofenac and caffeine were less than 5, implied that the latter two compounds although recalcitrant to biodegradation, still had relatively high potential for plant uptake. Naproxen was sensitive to both photodegradation (30-42%) and biodegradation (>50%), while diclofenac was particularly sensitive (>70%) to photodegradation alone. No significant correlations (p > 0.05) were found between the rate constants of depletion or plant tissue levels of the pharmaceuticals and either log Kow or log Dow.

Biodegradation of clofibric acid and identification of its metabolites.

Clofibric acid (CLF) is the pharmaceutically active metabolite of lipid regulators clofibrate, etofibrate and etofyllinclofibrate, and it is considered both environmentally persistent and refractory. This work studied the biotransformation of CLF in aerobic sequencing batch reactors (SBRs) with mixed microbial cultures, monitoring the efficiency of biotransformation of CLF and the production of metabolites. The maximum removal achieved was 51% biodegradation (initial CLF concentration=2 mg L(-1)), where adsorption and abiotic removal mechanisms were shown to be negligible, showing that CLF is indeed biodegradable. Tests showed that the observed CLF biodegradation was mainly carried out by heterotrophic bacteria. Three main metabolites were identified, including α-hydroxyisobutyric acid, lactic acid and 4-chlorophenol. The latter is known to exhibit higher toxicity than the parent compound, but it did not accumulate in the SBRs. α-Hydroxyisobutyric acid and lactic acid accumulated for a period, where nitrite accumulation may have been responsible for inhibiting their degradation. A metabolic pathway for the biodegradation of CLF is proposed in this study.

The role of microbial adaptation and biodegradable dissolved organic carbon on the attenuation of trace organic chemicals during groundwater recharge.

It is widely recognized that efficient biological attenuation of bulk organic matter and trace organic chemicals (TOrC) can occur in managed aquifer recharge (MAR) systems receiving reclaimed water. The heterotrophic microbial activity in these subsurface systems is a function of the availability of biodegradable dissolved organic carbon (BDOC) present in reclaimed water. This study examined the influence of environmental factors, such as BDOC-rich (>1.6 mg/L) and BDOC-starving (<1mg/L) conditions and microbial adaptation, on the attenuation of TOrC, including clofibric acid, dichlorprop, gemfibrozil, ibuprofen, ketoprofen, mecoprop, and naproxen, within soil-columns mimicking groundwater recharge. Under conditions that were characterized by a lack of BDOC and a biocommunity that was not yet adapted to these conditions, attenuation of biodegradable TOrC was less than 15%. After a three-month adaptation period, biotransformation increased to more than 80% for the biodegradable TOrC. This suggests that adaptation likely initiates enzyme expressions that eventually results in TOrC transformations even under seemingly less favorable conditions (i.e., lack of biodegradable carbon). For both non-adapted (stressed) and adapted conditions in the presence of higher concentrations of BDOC and travel times of 7 days, the degree of biotransformation was variable across compounds but generally exceeded 25%. This suggests that BDOC above a minimum level (>1.6 mg/L) can provide favorable microbial conditions resulting in TOrC removal, even for non-adapted systems. However, it is noteworthy that adapted MAR systems that were fed with low BDOC levels performed similarly or better with respect to TOrC biotransformation than systems that received BDOC levels above 1.6 mg/L. These findings are important for field-scale applications. They suggest that MAR facilities that are microbiologically active and are fed with highly treated water with effluent concentrations of less than 1 mg/L (i.e., nanofiltration permeate) can still attenuate biodegradable TOrC.

Clofibric acid increases the formation of oleic acid in endoplasmic reticulum of the liver of rats.

The effects of 2-(4-chlorophenoxy)-2-methylpropionic acid (clofibric acid) on the formation of oleic acid (18:1) from stearic acid (18:0) and utilization of the 18:1 formed for phosphatidylcholine (PC) formation in endoplasmic reticulum in the liver of rats were studied in vivo. [¹4C]18:0 was intravenously injected into control Wistar male rats and rats that had been fed on a diet containing 0.5% (w/w) clofibric acid for 7 days; and the distribution of radiolabeled fatty acids among subcellular organelles, microsomes, peroxisomes, and mitochondria, was estimated on the basis of correction utilizing the yields from homogenates of marker enzymes for these organelles. The radioactivity was mostly localized in microsomes and the radiolabeled fatty acids present in microsomes were significantly increased by the treatment of rats with clofibric acid. The formation of radiolabeled 18:1 in microsomes markedly increased and incorporations of the formed [¹4C]18:1 into PC and phosphatidylethanolamine in microsomes were augmented in response to clofibric acid. The [¹4C]18:1 incorporated into PC was mostly located at the C-2 position, but not the C-1 position, of PC, and the radioactivity in 18:1 at the C-2 position of PC was strikingly increased by clofibric acid. These results obtained from the in vivo experiments directly link the findings that clofibric acid treatment induces microsomal stearoyl-CoA desaturase and 1-acylglycerophosphocholine acyltransferase in the liver and the findings that the treatment with the drug elevated absolute mass and mass proportion of 18:1 at the C-2 position, but not the C-1 position, of PC in the liver together.

Assessment of plant-driven removal of emerging organic pollutants by duckweed.

Constructed treatment wetlands have the potential to reclaim wastewaters through removal of trace concentrations of emerging organic pollutants, including pharmaceuticals, personal care products, and pesticides. Flask-scale assessments incorporating active and inactivated duckweed were used to screen for plant-associated removal of emerging organic pollutants in aquatic plant systems. Removals of four of eight pollutants, specifically atrazine, meta-N,N-diethyl toluamide (DEET), picloram, and clofibric acid, were negligible in all experimental systems, while duckweed actively increased aqueous depletion of fluoxetine, ibuprofen, 2,4-dichlorophenoxyacetic acid, and triclosan. Active plant processes affecting depletion of experimental pollutants included enhancement of microbial degradation of ibuprofen, uptake of fluoxetine, and uptake of degradation products of triclosan and 2,4-dichlorophenoxyacetic acid. Passive plant processes, particularly sorption, also contributed to aqueous depletion of fluoxetine and triclosan. Overall, studies demonstrated that aquatic plants contribute directly and indirectly to the aqueous depletion of emerging organic pollutants in wetland systems through both active and passive processes.

The effect of structure and a secondary carbon source on the microbial degradation of chlorophenoxy acids.

Pseudomonas putida, Aspergillus niger, Bacillus subtilis, Pseudomonas fluorescens, Sphingomonas herbicidovorans and Rhodococcus rhodochrous growing on glucose in a medium containing one of three chlorophenoxy acids at a concentration of 0.1 g L(-1) (clofibric acid, (R)-2-(4-chloro-2-methylphenoxy)propionic acid (mecoprop or MCPP) and 4-chloro-2-methylphenoxyacetic acid (MCPA)) degraded these compounds to varying degrees; from nonmeasurable to almost complete removal. These results with the addition of glucose (2.5 g L(-1)) as an easy to use carbon source indicated the formation of metabolites different from results reported in the literature for growth studies in which the chlorophenoxy acid was the sole carbon source. The metabolite, 4-chloro-2-methylphenol, which had been reported previously, was only observed in trace amounts for MCPP and MCPA in the presence of S. herbicidovorans and glucose. In addition, three other compounds (M1, M3 and M4) were observed. It is suggested that these unidentified metabolites resulted from ring opening of the metabolite 4-chloro-2-methylphenol (M2). The rate of biodegradation of the chlorophenoxy acids was influenced by the degree of steric hindrance adjacent to the internal oxygen bond common to all three compounds. The most hindered compound, clofibric acid, was converted to ethyl clofibrate by R. rhodochrous but was not degraded by any microorganisms studied. The more accessible internal oxygen bonds of the other two chlorophenoxy acids, MCPP and MCPA, were readily broken by S. herbicidovorans.

Oxidation of atenolol, propranolol, carbamazepine and clofibric acid by a biological Fenton-like system mediated by the white-rot fungus Trametes versicolor.

Biological advanced oxidation of the pharmaceuticals clofibric acid (CA), carbamazepine (CBZP), atenolol (ATL) and propranolol (PPL) is reported for the first time. Extracellular oxidizing species were produced through a quinone redox cycling mechanism catalyzed by an intracellular quinone reductase and any of the ligninolytic enzymes of Trametes versicolor after addition of the lignin-derived quinone 2,6-dimethoxy-1,4-benzoquinone (DBQ) and Fe(3+)-oxalate in the medium. Time-course experiments with approximately 10mg L(-1) of initial pharmaceutical concentration resulted in percent degradations above 80% after 6h of incubation. Oxidation of pharmaceuticals was only observed under DBQ redox cycling conditions. A similar degradation pattern was observed when CBZP was added at the environmentally relevant concentration of 50 microg L(-1). Depletion of DBQ due to the attack of oxidizing agents was assumed to be the main limiting factor of pharmaceutical degradation. The main degradation products, that resulted to be pharmaceutical hydroxylated derivatives, were structurally elucidated. The detected 4- and 7-hydroxycarbamazepine intermediates of CBZP degradation were not reported to date. Total disappearance of intermediates was observed in all the experiments at the end of the incubation period.

Application of the combination index (CI)-isobologram equation to study the toxicological interactions of lipid regulators in two aquatic bioluminescent organisms.

Pharmaceuticals in the aquatic environment do not appear singly and usually occur as complex mixtures, whose combined effect may exhibit toxicity to the aquatic biota. We report an environmental application of the combination index (CI)-isobologram equation, a method widely used in pharmacology to study drug interactions, to determine the nature of toxicological interactions of three fibrates toward two aquatic bioluminescent organisms, Vibrio fischeri and the self-luminescent cyanobacterial recombinant strain Anabaena CPB4337. The combination index-isobologram equation method allows computerized quantitation of synergism, additive effect and antagonism. In the Vibrio test, the fibrate combinations showed antagonism at low effect levels that turned into an additive effect or synergism at higher effect levels; by contrast, in the Anabaena test, the fibrate combinations showed a strong synergism at the lowest effect levels and a very strong antagonism at high effect levels. We also evaluated the nature of the interactions of the three fibrates with a real wastewater sample in the cyanobacterial test. We propose that the combination index-isobologram equation method can serve as a useful tool in ecotoxicological assessment.

Degradation and adsorption of selected pharmaceuticals and personal care products (PPCPs) in agricultural soils.

Pharmaceuticals and personal care products (PPCPs) are emerging contaminants in the environment, which have drawn popular concerns recently. Most studies on the environmental fate of PPCPs have focused on their behaviors during wastewater treatment processes, in aquatic environments, and in the sludge, however, little is known about their behavior in agricultural soils. In this study, adsorption and degradation of six selected PPCPs, including clofibric acid, ibuprofen, naproxen, triclosan, diclofenac and bisphenol A have been investigated in the laboratory using four US agricultural soils associated with reclaimed wastewater reuse. Adsorption test using a batch equilibrium method demonstrated that adsorption of all tested chemicals in soils could be well described with Freundlich equation, and their adsorption affinity on soil followed the order of triclosan>bisphenol A>clofibric acid>naproxen>diclofenac>ibuprofen. Retardation factor (R(F)) suggested that ibuprofen had potential to move downward with percolating water, while triclosan and bisphenol A were readily retarded in soils. Degradation of selected PPCPs in soils generally followed first-order exponential decay kinetics, with half-lives ranging from 0.81 to 20.44 d. Degradation of PPCPs in soils appeared to be influenced by the soil organic matter and clay contents. Sterilization generally decreased the degradation rates, indicating microbial activity played a significant role in the degradation in soils. The degradation rate constant decreased with increasing initial chemical concentrations in soil, implying that the microbial activity was inhibited with high chemical loading levels.

Probing the fibrate binding specificity of rat liver fatty acid binding protein.

Liver-fatty acid binding protein (L-FABP) is found in high levels in enterocytes and is involved in cytosolic solubilization of fatty acids. In addition, L-FABP has been shown to bind endogenous and exogenous lipophilic compounds, suggesting that it may also play a role in modulating their absorption and disposition within enterocytes. Previously, we have described binding of L-FABP to a range of drugs, including a series of fibrates. In the present study, we have generated structural models of L-FABP-fibrate complexes and undertaken thermodynamic analysis of the binding of fibrates containing either a carboxylic acid or ester functionality. Analysis of the current data reveals that both the location and the energetics of binding are different for fibrates that contain a carboxylate compared to those that do not. As such, the data presented in this study suggest potential mechanisms that underpin molecular recognition and dictate specificity in the interaction between fibrates and L-FABP.

Ability of white-rot fungi to remove selected pharmaceuticals and identification of degradation products of ibuprofen by Trametes versicolor.

A screening using four white-rot fungi (Trametes versicolor, Irpex lacteus, Ganoderma lucidum and Phanerochaete chrysosporium) was performed on the degradation of 10 mg L(-1) of ibuprofen (IBU, anti-inflammatory), clofibric acid (CLOFI, lipid regulator) and carbamazepine (CARBA, antiepileptic/analgetic) after 7 d of incubation. Whereas IBU was extensively degraded by all the fungi tested, T. versicolor was the only strain able to degrade either CLOFI (approximately 91%) and CARBA (approximately 58%), although the latter was also degraded by G. lucidum (approximately 47%). In vitro experiments using manganese peroxidase and laccase-mediator system showed that extracellular fungal enzyme systems did not appear to play a role in the first step of degradation. However, our in vivo studies using the cytochrome P450 inhibitors 1-aminobenzotriazole and piperonyl butoxide suggested that the cytochrome P450 system may be involved in the first step of CLOFI and CARBA oxidation by T. versicolor. During the very early stages of IBU degradation by T. versicolor, two hydroxylated metabolites were detected: 1-hydroxy ibuprofen and 2-hydroxy ibuprofen. These byproducts were subsequently degraded by the fungus to 1,2-dihydroxy ibuprofen, that was not reported in biological systems to date. Furthermore, these results are of particular interest because CLOFI and CARBA are highly persistent in the aquatic environment and they pass unchanged or poorly transformed in wastewater treatment plants.

Effects of fibrates, anti-inflammatory drugs and antidepressants in the fish hepatoma cell line PLHC-1: cytotoxicity and interactions with cytochrome P450 1A.

Effects of 11 pharmaceuticals belonging to three therapeutic classes (lipid regulators from the fibrate group, non-steroidal anti-inflammatory drugs and anti-depressives from the selective serotonin reuptake inhibitors group) were assessed in the fish hepatoma cell line (PLHC-1) by looking at cytotoxicity and interactions with cytochrome P450 1A (CYP1A) function. Among the tested pharmaceuticals, fluoxetine and paroxetine exerted cytotoxic effects, cell viability decreased to 52% and 6% after 24 h of exposure to 20 microM fluoxetine and paroxetine, respectively. The cytotoxicity of both compounds was modulated by cytochrome P450 inhibitors and was dramatically reduced when culture medium was supplemented with reduced glutathione and vitamin E succinate. Additionally, exposure of PLHC-1 cells to some pharmaceuticals led to an early and transient induction of ethoxyresorufin O-deethylase (EROD) activity: bezafibrate and antidepressants induced EROD activity at a concentration of 1 microM whereas clofibrate, ibuprofen and naproxen acted as inducers at a higher concentration (10 microM). These effects might be of toxicological concern since alterations of CYP1A may affect xenobiotic metabolism and toxicity.

Behaviour of pharmaceutical products and biodegradation intermediates in horizontal subsurface flow constructed wetland. A microcosm experiment.

Horizontal subsurface flow constructed wetlands (SSFCWs) are a cost-effective and sustainable alternative to conventional wastewater treatment plants (WWTPs) for sanitation in small communities. SSFCWs are designed to remove suspended solids and organic matter from wastewater but there is little information on the effect of the characteristics of organic matter on the removal efficiency of specific contaminants. In this paper, carbamazepine, ibuprofen and clofibric acid were continuously injected into two SSFCW microcosms fed with synthetic wastewater containing different organic matter sources: dissolved (glucose) and particulate (starch). The response curves of carbamazepine and ibuprofen were compared with that of clofibric acid, which was used as a conservative tracer. The removal efficiencies were found to be independent of the organic matter type (i.e. dissolved or particulate). Carbamazepine was removed inefficiently (5%) by bed sorption, whereas ibuprofen was removed by degradation (51%). In addition, the behaviour of the two main ibuprofen biodegradation intermediates (carboxy and hydroxy derivatives) supported that the main ibuprofen elimination pathway occurs in aerobic conditions.

Dyslipidemia as a risk factor for erectile dysfunction.

Erectile dysfunction (ED) is a common condition with a significant effect on quality of life. The prevalence of ED increases with age and other risk factors (hypertension, diabetes, smoking, coronary heart disease, dyslipidemia and depression). Nitric oxide (NO) activity is adversely affected, in penile and vascular tissue, by these risk factors. Endothelial dysfunction and a reduced generation or bioavailability of NO have emerged as major pathophysiological mechanisms in ED. Hyperlipidemia may impair erectile function by affecting endothelial and smooth muscle cells of the penis. Oxidized low-density lipoprotein is a causative factor for the impaired relaxation response of the corpus cavernosum. Elevated serum cholesterol and reduced high density lipoprotein cholesterol levels are associated with an increased risk of ED. It follows that treating dyslipidemia could have a beneficial effect on ED. Phosphodiesterase type 5 inhibitors are now considered as first line treatment for ED. There is evidence that statins improve responses to these drugs. ED is considered as a warning sign of silent or early vascular disease. The use of statins may be beneficial in these patients.

Selection of a support matrix for the removal of some phenoxyacetic compounds in constructed wetlands systems.

The efficiency of constructed wetlands systems in the removal of pollutants can be significantly enhanced by using a support matrix with a greater capacity to retain contaminants by sorption phenomena, ionic exchange or other physico-chemical processes. The aim of this work was to evaluate the efficiencies of 3 different materials, Light Expanded Clay Aggregates [LECA] (in two different particle sizes), Expanded Perlite and Sand, for the removal from water of one pharmaceutical compound (clofibric acid) and one pesticide (MCPA). Both belong to the class of phenoxyacetic compounds. In addition, relationships were established between the compounds' removal efficiencies and the physico-chemical properties of each material. LECA exhibited a high sorption capacity for MCPA, while the capacity for clofibric acid was more modest, but still significant. In contrast, perlite had a very limited sorption capacity while sand did not exhibit any sorption capacity for any of the compounds. LECA with smaller particle sizes showed higher efficiencies than larger grade LECA and can achieve efficiencies near 100% for the lower concentrations in the order of 1 mg l(-1). However, the use of these smaller particle media at larger scales may present problems with hydraulic conductivities. The results show that expanded clay presents important advantages in laboratory studies and could be used as a filter medium or a support matrix in constructed wetlands systems.