Effect of pesticide exposure on systemic inflammatory biomarkers: a meta-analysis, and trial sequential analysis

Human pesticide exposure results in the development of several chronic diseases, including cardiometabolic, carcinogenic, neurological, and autoimmune processes. The induction of oxidative stress, subsequent tissue injury, and inflammatory response are widely accepted mechanisms related to environmental pollutants-induced diseases. In this line, several studies have been reported on the induction of systematic inflammatory state related to pesticide exposure. Nevertheless, there needs to be a consensus on the best inflammatory biomarker for measuring in response to pesticide exposure, and sources of risk of bias need to be assessed for future studies. This meta-analysis assessed whether pesticide exposure can start an inflammatory response in humans. A systematic review was performed focused on original reports that analyzed the relationship between human pesticide exposure and pro-inflammatory biomarkers. Fifteen studies were analyzed. The present meta-analysis included 3172 participants. The pooled analysis suggested that pesticide exposure can induce an inflammatory response and indicates that standardized clinical inflammatory biomarkers such as C-reactive protein are more recommended than hematological index or pro-inflammatory cytokines. Moreover, the need to consider multivariate statistical analysis is noted. The results suggested that pesticide-induced inflammatory response could be considered a mechanism through pesticide-induced diseases. These findings contribute to our understanding of the health effects of pesticide exposure and show the need for performing future studies to explore this area further, potentially leading to improved public health strategies.

The online version contains supplementary material available at 10.1007/s40201-025-00949-x.