Assessing the impact of perfluoroalkyl substances on liver health: a comprehensive study using multi-donor human liver spheroids

BACKGROUND: Although per- and polyfluoroalkyl substances (PFAS) have been linked to chronic liver diseases, the specific cellular and molecular mechanisms by which different PFAS contribute to human liver dysfunction remain unclear. This study aims to elucidate those mechanisms. METHODS: We exposed a multi-donor human liver spheroid model composed of multiple cell types to 20 µM of PFHxS, PFOA, PFOS, or PFNA for seven days, followed by single-cell RNA sequencing and lipid staining. RESULTS: PFAS impacted liver spheroids in a compound- and sex-specific manner. PFOA and PFHxS increased lipid accumulation, while PFOS and PFNA triggered multiple cancer-related pathways. PFOA upregulated de novo lipogenesis, particularly in female-derived hepatocytes, whereas PFHxS downregulated lipid transportation and efflux pathways across all hepatocytes. PFNA upregulated pathways involved in cell cycle progression, oxidative stress, DNA repair, and inflammation in hepatocytes from both sexes. Notably, 61.3% of the PFNA-exposed cells expressed a transcriptomic cancer signature. PFOS predominantly affected male-derived hepatocytes, showing a mild effect. All compounds impaired immune-related pathways in T/NK and Kupffer cells. Furthermore, PFAS exposure reduced cell-cell communication and elicited cellular interactions involved in angiogenesis, apoptosis, cell proliferation and adhesion, lipid metabolism, and inflammation. CONCLUSIONS: Our findings suggest that PFAS disrupt liver metabolism and may promote pro-oncogenic signaling through compound- and sex-specific mechanisms. These insights enhance our understanding of PFAS hepatotoxicity and underscore the importance of considering sex as a biological variable in future toxicological and public health assessments.