Perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorononanoic acid (PFNA) increase triglyceride levels and decrease cholesterogenic gene expression in human HepaRG liver cells

Arch Toxicol. 2020 Sep;94(9):3137-3155. doi: 10.1007/s00204-020-02808-0. Epub 2020 Jun 25.


Per- and polyfluoroalkyl substances (PFASs) are omnipresent in the environment, food chain, and humans. Epidemiological studies have shown a positive association between serum levels of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS), and increased serum cholesterol and, in some cases, also triglyceride levels. However, causality has been questioned, as animal studies, as well as a human trial, showed a decrease in serum cholesterol and no effects or a decrease in plasma triglycerides. To obtain more insight into the effects of PFASs on these processes, the present study investigated the effects of PFOA, PFOS, and perfluorononanoic acid (PFNA) on intracellular triglyceride and cholesterol levels in human HepaRG liver cells. DNA microarray analyses were performed to provide insight into underlying mechanisms. All PFASs induced an increase in cellular triglyceride levels, but had no effect on cholesterol levels. Gene set enrichment analysis (GSEA) of the microarray data indicated that gene sets related to cholesterol biosynthesis were repressed by PFOA, PFOS, and PFNA. Other gene sets commonly affected by all PFAS were related to PERK/ATF4 signaling (induced), tRNA amino-acylation (induced), amino acid transport (induced), and glycolysis/gluconeogenesis (repressed). Moreover, numerous target genes of peroxisome proliferator-activated receptor α (PPARα) were found to be upregulated. Altogether, the present study shows that PFOA, PFOS, and PFNA increase triglyceride levels and inhibit cholesterogenic gene expression in HepaRG cells. In addition, the present study indicates that PFASs induce endoplasmic reticulum stress, which may be an important mechanism underlying some of the toxic effects of these chemicals.

Keywords: Cholesterol; HepaRG cells; PFASs; Transcriptomics; Triglycerides.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alkanesulfonic Acids / toxicity
  • Caprylates / toxicity
  • Cholesterol
  • Environmental Pollutants / toxicity*
  • Fatty Acids
  • Fluorocarbons / toxicity*
  • Gene Expression / drug effects
  • Hepatocytes
  • Humans
  • Liver
  • PPAR alpha
  • Triglycerides / metabolism*


  • Alkanesulfonic Acids
  • Caprylates
  • Environmental Pollutants
  • Fatty Acids
  • Fluorocarbons
  • PPAR alpha
  • Triglycerides
  • perfluoro-n-nonanoic acid
  • perfluorooctanoic acid
  • Cholesterol
  • perfluorooctane sulfonic acid