A human PBMC-based new approach method reveals PFAS-driven T-cell proliferation and immune dysregulation

Immunotoxicity has emerged as a key health concern for per- and polyfluoroalkyl substances (PFAS), with animal studies showing reduced T-dependent antibody responses (TDAR) and epidemiological studies reporting decreased vaccine antibody titres. Notably, immunotoxicity is considered one of the most sensitive endpoints for PFAS exposure and has been used to inform regulatory guidance and health-based values. Given that more than 14,000 PFAS exist and are highly environmentally persistent, evaluating the immunotoxicity of individual compounds is critical but impractical, highlighting the need for efficient, human-relevant test systems that provide mechanistically informative, immune-relevant endpoints. Here, we assessed immunomodulatory effects of six PFAS analogues using an in vitro human peripheral blood mononuclear cell (PBMC) model. Two immune stimuli were applied, including lipopolysaccharide (LPS) to trigger innate responses and phytohemagglutinin (PHA) to simulate T-cell-mediated adaptive immune activation. Critically, several PFAS analogues enhanced T-cell proliferation following PHA activation, while a non-inclusive but overlapping subset of analogues suppressed cytokine secretion in response to PHA and LPS. Transcriptomic analyses indicate reduced B-cell identity and immunoglobulin gene expression alongside increased expression of genes associated with T-cell activation and proliferation. These findings implicate a dysregulated coordination between T- and B-cell responses as a potential mechanism underlying PFAS-associated immunotoxicity. Overall, the human PBMC model demonstrated that it is a cost-effective and ethical method for identifying and characterizing key events (KEs) in the adverse outcome pathway (AOP) for PFAS-induced immunotoxicity and has the potential to be refined and incorporated into a robust new approach method (NAM) to assess the next generation of commercial PFAS.