A Systematic Review on the Hemolytic Effect of Bisphenol-A on Human Erythrocytes (<em>In-vitro</em>)

Abstract

Bisphenol A (BPA) is a high-production volume industrial chemical, and human exposure to BPA is essentially ubiquitous with the increased use of BPA-associated products. Though the ubiquitous nature of BPA exposure has resulted in circulating levels of BPA, as reported in numerous biomonitoring studies, a limited number of studies have been carried out to investigate the impact of BPA on human red blood cells. Yet the findings remain ambiguous. Thus, this study aimed to systematically review the published literature on the hemolytic activity of BPA on human erythrocytes. A systematic review of published literature was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) approach. A comprehensive search of the literature was undertaken using Google Scholar, PubMed and Research Gate for studies published from 2015 to September 2023. The keywords "human erythrocytes", "Bisphenol-A", "in vitro", and "hemolysis" were included in the search. The search identified a total of 933 articles (PubMed = 3, research gate=99, and Google Scholar = 831). After following the exclusion and inclusion criteria, four full papers were entitled to review. In these four studies, they have incubated isolated human red blood cells with varying concentrations for different durations. BPA showed a dose-dependent and time-dependent hemolytic activity in-vitro on human erythrocytes. Reasons for BPA-induced hemolysis in erythrocytes involve the generation of reactive oxygen species. As there are contradictory observations, meta-analysis is recommended. However, no comprehensive investigations have been carried out to evaluate the impact of BPA on human red blood cells under physiological concentrations so far. Consequently, it is recommended that further research in this area be undertaken to provide a more robust understanding of the physiological implications of BPA exposure on red blood cell function.