Glutamine Is a Superior Protector Against Lead-Induced Hepatotoxicity in Rats via Antioxidant, Anti-inflammatory, and Chelating Properties

Lead acetate-motivated oxidative stress can affect all organ systems, particularly the liver. Glutamine (Gln) has both antioxidant and chelating properties. Therefore, we investigated for the first time the effect of Gln on the biochemical and histopathological alternations in a rat model of lead toxicity. Thirty-two rats were divided into four groups (eight rats in each): untreated normal, lead poisoning, and two similar groups receiving Gln (0.1% in drinking water for 4 weeks). To induce lead poisoning, rats received 50 mg/L lead acetate in drinking water for 4 weeks. Oxidative stress indices (total glutathione, the ratio of reduced glutathione to oxidized glutathione, advanced protein oxidation products, malondialdehyde, and ferric ion reducing power) and inflammatory markers (hepatic nuclear factor-kβ expression, interleukin 1β level, and myeloperoxidase activity) were measured. Furthermore, biochemical markers of hepatotoxicity (alanine transaminase, aspartate transaminase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, total protein, albumin, and globulins) were measured. Histopathological examination evaluated lead-induced liver damage. The treatment compensated lead-induced biochemical and histopathological alternations in rat liver. Furthermore, it decreased lead acetate level, the NF-kβ gene expression, oxidative stress, and inflammatory markers. Moreover, the treatment elevated total glutathione and reduced glutathione in the sera and liver homogenates of treated groups (p < 0.001). Glutamine could protect the liver against lead intoxication via antioxidant, anti-inflammatory, and chelating properties. In addition, its downregulating effect on the hepatic NF-kβ signaling pathway confirms its hepatoprotective activity.

Retained bullets and lead toxicity: a systematic review

INTRODUCTION

Lead toxicity secondary to retained bullet(s) (RB) after a penetrating gunshot wound is a rare but likely underdiagnosed condition, given the substantial number of firearm injuries in the United States. There is currently no consensus on the indications for surveillance, chelation, or surgical intervention.

OBJECTIVE

The purpose of our review is to summarize the literature on systemic lead toxicity secondary to RBs to help guide clinicians in the management of these patients.

METHODOLOGY

The primary literature search was conducted in Medline (PubMed), EMBASE, Cochrane, and CENTRAL using the following MESH terms: "chelation" and "lead poisoning" or "lead toxicity" or "lead" and "bullet" or "missile" or "gunshot", or "bullet".

RESULTS

The search identified 1,082 articles. After exclusions, a total of 142 articles were included in our final review, the majority of which were case reports. Several factors appear to increase the risk of developing lead toxicity including the location of the RB, the presence of a fracture or recent trauma, number of fragments, hypermetabolic states, and bullet retention duration. Particularly, RBs located within a body fluid compartment like an intra-articular space appear to be at a substantially higher risk of developing lead toxicity. Even though patients with lead toxicity from RBs will have similar symptoms to patients with lead toxicity from other sources, the diagnosis of lead poisoning may occur months or years after a gunshot wound. Symptomatic patients with high blood lead levels (BLLs) tended to improve with a combination of chelation and surgical removal of RBs.

CONCLUSIONS

We suggest surveillance with serial BLLs should be performed. Patients with intra-articular RBs appear to be at increased risk of lead toxicity and if possible, early surgical removal of the RBs is warranted, especially given that signs of toxicity are vague, and patients may not have access to follow-up. Long-term chelation should not be used as a surgical alternative and management should be multidisciplinary.

Presumed retinal lead poisoning: a case report

PURPOSE

To describe a case of presumed retinal lead poisoning.

METHODS

Clinical examination, optical coherence tomography, fundus autofluorescence, fluorescein angiography, and electroretinography were used to study a 42-year-old male with the complaint of bilateral reduced vision following systemic lead poisoning.

RESULTS

The fundus examination showed venous tortuosity, as well as macular atrophy, and pigmentary changes in his both eyes. Optical coherence tomography revealed retinal thinning, outer retinal and retinal pigment epithelium atrophy, as well as foveal schitic changes. Blue autofluorescence showed moderately hypoautofluorescence in peripapillary area of both eyes. Fluorescein angiogram showed a leopard-like pattern of hypo- and hyperfluorescence in the posterior pole. Electroretinogram showed a moderate reduction in photopic and scotopic responses.

CONCLUSIONS

The most probable diagnosis of this case is early onset retinal lead poisoning.

Antioxidative, anti-inflammatory and anti-apoptotic action of ellagic acid against lead acetate induced testicular and hepato-renal oxidative damages and pathophysiological changes in male Long Evans rats

Lead (Pb), is an environmental toxicant, causes multi-organ dysfunction including reproductive impairments. This study designed to investigate the prospective antioxidative, anti-inflammatory and anti-apoptotic effects of ellagic acid (EA) on Pb-mediated testicular and hepato-renal toxicity. Four experimental groups of five male Long-Evans rats each were used: control, Pb (60 mg/kg), EA (30 mg/kg), and Pb + EA groups. All groups were given their respective treatment orally for 30 days. Pb exposure altered body and organs weight, food and water consumption, rectal temperature, Pb residue levels in tissues, liver and kidney function, sperm quality parameters, serum metabolic and hematology profiles, and impaired the oxidative/antioxidative balance in the testicular and hepato-renal tissue, as shown by the decreased antioxidant proteins (superoxide dismutase, catalase, glutathione peroxidase, and reduced glutathione) and increased the oxidative (MDA, lipid hydroperoxides, conjugated dienes, protein carbonyl, fragmented DNA and GSH:GSSG ratio) stress and inflammatory (IL-1, IL-6, TNF-α, prostaglandin, LTB4, NO, myeloperoxidase, LDH) markers. Moreover, a dysregulation in the stress response (HSP-70) and apoptotic-regulating proteins (BAX, BCL-2, and active Caspase-3) were recorded upon Pb exposure. Remarkably, EA oral administration reduced the Pb residue levels in tissues, improved the liver and kidney function, revived the spermatogenesis and sperm quality, restored redox homeostasis, suppressed the oxidative stress, inflammatory and apoptotic responses in the liver, kidney and testis tissue. Our findings point out that EA can be used as a phyto-chelator to overcome the adverse effects of Pb exposure due to its potent antioxidant, anti-inflammatory, and anti-apoptotic effects.

Application and validation of a biotic ligand model for calculating acute toxicity of lead to Moina dubia in lakes of Hanoi, Vietnam

It is increasingly being recognized that biotic ligand models (BLMs) can successfully predict the toxicity of divalent metals toward aquatic biota applied to temperate freshwater ecosystems. However, studies on the eutrophic lakes in tropical regions toward native tropical organisms, including Moina, are relatively limited. In this study, Moina dubia, the native organism of the Hanoi eutrophic urban lakes, were used in toxicological studies of lead (Pb); 24-h EC₅₀ value of Pb was 523.19 µg/L under optimal living conditions for M. dubia in the laboratory. The constant binding of Pb²⁺ on M. dubia surface sites (log K_PbBL = 2.38) was significantly low. Other stability constants were obtained under experiments as logK_CaBL = 2.48, logK_MgBL = 2.80, logK_NaBL = 2.35, logK_KBL = 2.49, and logK_HBL = 3.026. A BLM was developed to calculate the acute toxicity (EC₅₀-24 h) of lead on M. dubia based on the condition of the urban lakes of Hanoi. Validation with toxicity data in synthetic medium showed a coefficient determination of 79.16% and a mean absolute percentage error (MAPE) of 10.2%, while the validation with the toxicity data with natural water medium from 11 Hanoi lakes showed a coefficient determination of 73.7% and a MAPE of 13.66%. The BLM worked well with water at a pH of 7.0 to 8.0, but failed with water at a pH above 8.0. Eutrophic conditions proved to have a significant effect on the toxicity of lead on local zooplankton.

Abdominal pain caused by lead toxicity due to over the counter herbal medicines: A case series

In the last three decades, the use of herbal medications has been increasing for the treatment of various chronic disorders. Studies in the past have shown that many of these medicines could contain high levels of heavy metals, including lead. Therefore, we planned this study to evaluate the possibility of lead toxicity as the underlying cause in patients consuming these unnamed herbal medicines among patients presenting with significant abdominal pain. (Unexplained abdominal pain means pain in abdomen in which no etiology could be ascertained after all possible routine and specialized investigations including computerized axial tomography [CT] of the abdomen and upper gastrointestinal [UGI] endoscopy/colonoscopy). This is an observational case series of prospectively maintained data of all patients having unexplained abdominal pain and found to have an elevated blood lead level from 2011 to 2019. Lead toxicity was diagnosed when its blood lead level was >25 μg/dL. Total sixty-six patients with unexplained abdominal pain from 2011 to 2019 were recruited. Out of the sixty-six patients, seventeen had elevated blood lead levels. All seventeen patients had a history of ingestion of herbal medicines for more than 6 months. Among the seventeen patients, eight were taking it for infertility and sexual dysfunction, six for diabetes, two for arthritis and one for hypertension. Basophilic stippling was seen in one patient. Fourteen patients had low hemoglobin with a median value of 9.7 g/dL. Mean serum blood lead level was 87.1 μg/dL. None of them required anti-chelating agent. Lead toxicity owing to herbal medicine is not uncommon cause of unexplained abdominal pain. Most of these patients do not require a chelating agent for treatment. There is a need to bring these herbal medicines under strict regulations for displaying its constituents and their concentrations.

Defective mitophagy and induction of apoptosis by the depleted levels of PINK1 and parkin in Pb and β-amyloid peptide induced toxicity

Exposure to lead (Pb), an environmental pollutant, is closely associated with the development of neurodegenerative disorders through oxidative stress induction and alterations in mitochondrial function. Damaged mitochondria could be one of the reasons for the progression of Alzheimer's Disease (AD). Mitophagy is vital in keeping the cell healthy. To know its role in Pb-induced AD, we investigated the PINK1/parkin dependent pathway by studying specific mitophagy marker proteins such as PINK1 and parkin in differentiated SH-SY5Y cells. Our data have indicated a significant reduction in the levels of PINK1 and parkin in cells exposed to Pb and β-amyloid peptides, both Aβ (25-35) and Aβ (1-40) individually and in different combinations, resulting in defective mitophagy. Also, the study unravels the status of mitochondrial permeability transition pore (MPTP), mitochondrial mass, mitochondrial membrane potential (MMP) and mitochondrial ROS production in cells treated with individual and different combination of Pb and Aβ peptides. An increase in mitochondrial ROS production, enhanced MPTP opening, depolarization of membrane potential and reduced mitochondrial mass in the exposed groups were observed. Also, in the present study, we found that Pb and β-amyloid peptides could trigger apoptosis by activating the Bak protein, which releases the cytochrome c from mitochondria through MPTP that further activates the AIF (apoptosis inducing factor) and caspase-3 proteins in the cytosol. The above findings reveal the potential role of mechanisms like PINK1/parkin mediated mitophagy and dysfunctional mitochondria mediated apoptosis in Pb induced neurotoxicity.

Parental Lead Exposure Promotes Neurobehavioral Disorders and Hepatic Dysfunction in Mouse Offspring

Lead (Pb) induces neurotoxicity in both children and adults. Children are more vulnerable to Pb toxicity than adults. Little is known about the effects of Pb on the mental health of the children who are prenatally exposed. Therefore, we designed an animal experiment to compare the adverse effects of Pb on neurobehavioral and hepatic functions between Pb-exposed (Pb mice) and parental Pb-exposed (P-Pb mice) group mice. Mice were treated with Pb-acetate (10 mg/kg bodyweight/day) via drinking water. Male mice from unexposed parents treated with Pb for 90 days were defined as Pb mice, whereas male mice from Pb-exposed parents treated with Pb for further 90 days were defined as P-Pb mice. Anxiety-like behavior and spatial memory and learning were assessed by elevated plus maze and Morris water maze. Serum hepatic enzyme activities and butyrylcholinesterase activity were measured by an analyzer. P-Pb mice displayed increased anxiety-like behavior and memory and learning impairments compared to Pb mice. BChE activity was significantly decreased in P-Pb mice compared to Pb mice. Pb levels in the brains of P-Pb mice were significantly higher than those of Pb mice. The activities of serum hepatic enzymes of P-Pb mice were also higher than those of Pb mice. Additionally, histopathology data revealed that hepatic tissue injury was more pronounced in P-Pb mice than in Pb mice. Thus, the results suggest that persistent exposure to Pb from fetus to adult causes more severe neurobehavioral changes and hepatic toxicities than adult exposure only.

Biosorption of hazardous waste from the municipal wastewater by marine algal biomass

Lead is one of the highly toxic heavy metals causes various diseases even at very lower concentrations to human and affects eco-system. It is mainly released into the water through industrial activities. Phytoremediation is useful to degrade, reduce, metabolize and assimilate lead from wastewater. In this study, Turbinaria ornata was collected from the sea and dried biomass was used for biosorption of heavy metals. Adsorption of heavy metal was maximum after 100 min incubation with alga powder at acidic pH (4.5). The interactive effects of lead concentration, contact times, pH, biomass concentration and agitation speed was evaluated by a two-level full factorial design. Initial lead concentration, agitation speed and biomass concentration were the most important variables affecting lead removal (p < 0.001) were selected for optimization using central composite rotatable design. Lead removal was found to be maximum (99.8%) in optimized conditions: initial lead 99.8 mg/L, 250 rpm agitation speed and 16.2 g/L biomass concentrations. Municipal wastewater was collected and lead concentration (0.013 mg/L) and physiochemical factors were analyzed. Algal biomass removed >98.5% lead form the wastewater within 10 min in an optimized condition. The present study confirmed the potential application of T. ornata for the removal of lead from contaminated environment.

Potential ameliorative effect of dietary quercetin against lead-induced oxidative stress, biochemical changes, and apoptosis in laying Japanese quails

Lead (Pb) is a widespread environmental pollutant which is a toxic threat to human and animal health. The present study was designed to evaluate the ameliorative role of quercetin in laying quails exposed to Pb. A total of 112 birds were randomly divided into four groups. The control group was fed with basal diet, the Pb group was fed with ration supplemented with Pb at the dose of 100 mg/kg (as Pb (II) acetate trihydrate), the Quercetin group was fed with ration supplemented with quercetin at the dose of 400 mg/kg, and the Pb+ Quercetin group was fed with ration supplemented with Pb at the dose of 100 mg/kg and quercetin at dose of 400 mg/kg. Results showed that serum total protein, glucose, albumin, and blood urea nitrogen (BUN) values of the Pb + Quercetin group partially improved with quercetin supplementation. Meanwhile, serum creatinine values of the Pb + Quercetin group was found to be significantly lower than that of the Pb group. Aspartate aminotransferase (AST) and alanine transaminase (ALT) enzyme activities in the Quercetin and Pb + Quercetin groups were similar to those of the Control group, unlike the Pb group. Moreover, alkaline phosphatase (ALP) enzyme activity of the Pb + Quercetin group significantly improved with the addition of quercetin. We also found that malondialdehyde (MDA) levels of the kidney, liver, and heart were significantly reduced by quercetin supplementation. The glutathione, catalase, and glutathione peroxidase activities of the kidney, liver, and heart tissue were increased by quercetin supplementation. These results were in line with the observed apoptotic markers. The expression of caspase-3 and caspase-9 were significantly decreased by quercetin supplementation. It may be concluded that dietary supplementation with quercetin ameliorates the toxic effects of Pb exposure by alleviating oxidative stress, biochemical changes, and apoptosis in quails.

Mechanisms associated with the dysregulation of mitochondrial function due to lead exposure and possible implications on the development of Alzheimer's disease

Lead (Pb) is a multimedia contaminant with various pathophysiological consequences, including cognitive decline and neural abnormalities. Recent findings have reported an association of Pb toxicity with Alzheimer's disease (AD). Studies have revealed that mitochondrial dysfunction is a pathological characteristic of AD. According to toxicology reports, Pb promotes mitochondrial oxidative stress by lowering complex III activity in the electron transport chain, boosting reactive oxygen species formation, and reducing the cell's antioxidant defence system. Here, we review recent advances in the role of mitochondria in Pb-induced AD pathology, as well as the mechanisms associated with the mitochondrial dysfunction, such as the depolarisation of the mitochondrial membrane potential, mitochondrial permeability transition pore opening; mitochondrial biogenesis, bioenergetics and mitochondrial dynamics alterations; and mitophagy and apoptosis. We also discuss possible therapeutic options for mitochondrial-targeted neurodegenerative disease (AD).

Plant Polyphenols: Potential Antidotes for Lead Exposure

Lead is one of the most common heavy metal elements and has high biological toxicity. Long-term lead exposure will induce the contamination of animal feed, water, and food, which can cause chronic lead poisoning including nephrotoxicity, hepatotoxicity, neurotoxicity, and reproductive toxicity in humans and animals. In the past few decades, lead has caused widespread concern because of its significant threat to health. A large number of in vitro and animal experiments have shown that oxidative stress plays a key role in lead toxicity, and endoplasmic reticulum (ER) stress and the mitochondrial apoptosis pathway can also be induced by lead toxicity. Therefore, plant polyphenols have attracted attention, with their advantages of being natural antioxidants and having low toxicity. Plant polyphenols can resist lead toxicity by chelating lead with their special chemical molecular structure. In addition, scavenging active oxygen and improving the level of antioxidant enzymes, anti-inflammatory, and anti-apoptosis are also the key to relieving lead poisoning by plant polyphenols. Various plant polyphenols have been suggested to be useful in alleviating lead toxicity in animals and humans and are believed to have good application prospects.

Protective role of yeast beta-glucan on lead acetate-induced hepatic and reproductive toxicity in rats

Lead (Pb) is one of the most common environmental pollutants and causes adverse effects on human and animal health. This study aimed to evaluate the protective role of beta-glucan against hepatic and reproductive toxicity induced by lead acetate. A total of 28 Sprague Dawley male rats were distributed into four groups (n = 7). The control group was intraperitoneally injected saline (1 ml/kg b.w.) daily for 21 days, the Pb group was intraperitoneally injected lead acetate (15 mg/kg b.w.) daily for 21 days, the beta-glucan group was orally administrated beta-glucan (50 mg/kg b.w.) daily for 21 days, and the Pb + beta-glucan group was intraperitoneally injected lead acetate (15 mg/kg b.w.) daily following the oral administration of beta-glucan (50 mg/kg b.w.) daily for 21 days. Results showed that feed intake in the Pb + beta-glucan group was significantly increased in comparison with that of the Pb group (p < 0.001). We also found that liver malondialdehyde (MDA) level was increased significantly in the Pb group (p < 0.01), while glutathione (GSH) level (p < 0.05), glutathione peroxidase (GSH-Px) (p < 0.05), and catalase (CAT) (p < 0.01) activities were reduced when they were compared with control. Moreover, Pb administration increased expression of pro-apoptotic protein Bax, the ratio of Bax/Bcl-2, and decreased the expression of the antiapoptotic protein Bcl-2 (p < 0.01). Also, Pb was found to cause a significant decrease in sperm motility (p < 0.01) and sperm concentration (p < 0.05) but increase in sperm tails and total sperm anomalies (p < 0.05). These findings were partially preserved by the administration of beta-glucan. Taken together, these results indicated that beta-glucan has the potential to alleviate the Pb-induced toxicity.

Health repercussions of environmental exposure to lead: Methylation perspective

Lead (Pb) exposure has been a major public health concern for a long time now due to its permanent adverse effects on the human body. The process of lead toxicity has still not been fully understood, but recent advances in Omics technology have enabled researchers to evaluate lead-mediated alterations at the epigenome-wide level. DNA methylation is one of the widely studied and well-understood epigenetic modifications. Pb has demonstrated its ability to induce not just acute deleterious health consequences but also alters the epi-genome such that the disease manifestation happens much later in life as supported by Barkers Hypothesis of the developmental origin of health and diseases. Furthermore, these alterations are passed on to the next generation. Based on previous in-vivo, in-vitro, and human studies, this review provides an insight into the role of Pb in the development of several human disorders.

Genetic susceptibility of δ-ALAD associated with lead (Pb) intoxication: sources of exposure, preventive measures, and treatment interventions

Delta-aminolevulinic acid dehydratase (δ-ALAD) is involved in the synthesis of haem and exhibits a polymorphic nature. δ-ALAD polymorphism produces two alleles, namely δ-ALAD-1 and δ-ALAD-2, which in turn produce three different phenotypes, namely δ-ALAD1-1, δ-ALAD1-2, and δ-ALAD2-2. δ-ALAD gene is more susceptible to lead (Pb) toxicity than any other genes. Its genotype and phenotype frequencies change with respect to different geographical areas and extent of Pb exposure. The δ-ALAD-2 allele dominancy is linked with high concentration of lead in the body. It has also been thought that the δ-ALAD-2 allele can provoke Pb toxicity by producing a protein that binds more tightly with Pb than δ-ALAD-1 protein. However, few evidences suggest that δ-ALAD-2 may reduce harmful effects by increasing excretion of Pb from the body, thus producing its unavailability towards pathophysiologic alterations. However, the recent evidences have supported that the individuals who are heterozygote for the δ-ALAD-1 allele may be associated with a higher risk of long-term Pb toxicity. In this regard, the individuals who are exposed at occupational levels are among the most frequent study population. The main objective of our study was to explore the gene susceptibility associated with Pb poisoning. Moreover, this study also summarizes various sources of Pb exposure and thereafter outlined multiple strategies to minimize the Pb toxicity in order to save the exposed residential communities.

N,N'bis-(2-mercaptoethyl) isophthalamide (NBMI) exerts neuroprotection against lead-induced toxicity in U-87 MG cells

N,N'-bis(2-mercaptoethyl)isophthalamide (NBMI) is a novel lipophilic heavy metal chelator and thiol redox antioxidant. This study was designed to investigate the neuroprotective activity of NBMI in U-87 MG cells exposed to lead acetate (PbAc). Cells were pretreated with NBMI for 24 h prior to a 48 h exposure to PbAc. Cell death (55%, p < 0.0001) and reduction of intracellular GSH levels (0.70-fold, p < 0.005) induced by 250 µM Pb were successfully attenuated by NBMI pretreatment at concentrations as low as 10 µM. A similar pretreatment with the FDA-approved Pb chelator dimercaptosuccinic acid (DMSA) proved ineffective, indicating a superior PKPD profile for NBMI. Pretreatment with NBMI successfully counteracted Pb-induced neuroinflammation by reducing IL-1β (0.59-fold, p < 0.05) and GFAP expression levels. NBMI alone was also found to significantly increase ferroportin expression (1.97-fold, p < 0.05) thereby enhancing cellular ability to efflux heavy metals. While no response was observed on the apoptotic pathway, this study demonstrated for the first time that necrotic cell death induced by Pb in U-87 MG cells is successfully attenuated by NBMI. Collectively these data demonstrate NBMI to be a promising neuroprotective compound in the realm of Pb poisoning.

Environmental assessment of pediatric Lead exposure in Tehran; a prospective cross-sectional study

BACKGROUND

Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities.

METHODS

In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places.

RESULTS

Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft², 250 μg/ft². Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026).

CONCLUSION

Children's playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.

Prevalence of lead toxicity in adolescents in Kuwait

Background

Elevated blood lead level (EBLL) is a public health problem in both developing and industrialized countries. Being a petrochemical-based economy, lead (Pb) levels are expected to be high in Kuwait, but systematic data on population exposure are lacking. This study aimed at determining the prevalence of EBLL in adolescents in Kuwait.

Methods

Adolescents (N = 1385; age range 11–16 years) were cross-sectionally selected from public middle schools from all Governorates of Kuwait, utilizing multistage cluster random sampling. Pb in whole blood was analyzed by inductively coupled plasma mass spectrometry. Distribution of blood Pb levels (BLL) among Governorates and sexes were compared by non-parametric tests and the prevalence of EBLL (defined as BLL above the CDC reference level of ≥5 μg/dL) was estimated by χ² test. Binary logistic regression was used for assessing the association between EBLL and Governorate.

Results

Median (IQR) BLL was 5.1(3.6–7.1) μg/dL [4.9 (3.8–6.5) μg/dL in males and 5.4 (3.3–7.6) μg/dL in females; p = 0.001]. In the overall sample, 51% had BLL ≥5 μg/dL; 13% had ≥10 μg/dL and 3% > 20 μg/dL. Prevalence of EBLL was 47% in males and 56% in females (p < 0.001). EBLLs were clustered in Al-Asima, Al-Ahmadi (in both sexes); Al-Jahra (in males) and Mubarak Al-Kabeer (in females) Governorates.

Conclusions

EBLL is a significant public health problem in adolescents in Kuwait. Urgent public health intervention is required in areas with EBLL, and the sources of exposure need to be identified for prevention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11210-z.

High Blood Lead Levels: An Increased Risk for Development of Brain Hyperintensities among Type 2 Diabetes Mellitus Patients

The current study was aimed to ascertain the effect of blood lead level on brain tissues in patients with type 2 diabetes. A total of 300 human participants ages 27 to 60 years with type 2 diabetes (n = 150) and healthy individuals (n = 150) were included in this study. The serum samples were used for measuring HbA1c and fasting blood glucose. Blood lead level was measured using flame atomic absorption spectrophotometer. Magnetic resonance imaging sub-analysis was used to assess the brain hyperintensities. Brain hyperintensities were found in 55% of patients with diabetes and 6% of non-diabetic control group subjects. The deep white matter hyperintensities were observed in 45% of diabetic patients, while the subcortical hyperintensities were noted in 10% of cases. Entorhinal cortex changes (31%) and hippocampus changes (42%) were noted in diabetic patients with brain hyperintensities. Diabetic patients with brain hyperintensities showed higher blood lead levels, HbA1c, and fasting blood sugar (p < 0.0001) as compared with healthy volunteers. A higher correlation (R² = 0.8922) was found between deep white matter hyperintensities' size and blood lead levels. In nutshell, persistence of high blood lead level in diabetic patients may progress to brain hyperintensities which may consequently lead to cognitive, behavioral changes and Alzheimer's disease.

Sublethal toxicity of PbI2 in perovskite solar cells to fish embryos (Danio rerio and Oryzias latipes): Deformity and growth inhibition

Pb-based perovskite in solar cells is a source of PbI₂. The objective of this study was to characterize the embryonic toxicity of PbI₂, a potentially leachable chemical and hazardous material, for two fish species (zebrafish and Japanese medaka). A series of measurements were performed to assess mortality, abnormalities (deformities and other pathological changes), hatchability, and growth inhibition. The results obtained showed that the toxicities observed were predominantly associated with Pb²⁺ and I^-. Therefore, given the potential ecotoxicity of PbI₂, precautions should be taken to prevent its release during the breakage and disposal of Pb-based perovskite solar cells.

The Case For Cadmium and Lead Heavy Metal Screening

Exposure to cadmium and lead is widespread, and is related to environmental contamination, occupational sources, food, tobacco and other consumer products. Lower socioeconomic status increases the risk of heavy metal exposure and the diseases associated with cadmium and lead toxicity. Concurrent toxicity with both cadmium and lead is likely but has not often been assessed. There is now substantial evidence linking cadmium and lead to many diseases including hypertension, diabetes mellitus, obesity, cancer, coronary artery disease, chronic kidney disease (CKD) and lung disease. Both chronic renal failure and ischemic heart disease patients have been treated separately in recent studies with calcium disodium ethylenediaminetetraacetic acid (Ca EDTA) chelation therapy. In patients with CKD, serum creatinine 1.5-4.0 mg/dL, and increased body lead burden, weekly low dose chelation with Ca EDTA slowed the rate of decline in renal function in diabetics and non-diabetics. In patients with a history of myocardial infarction, the Trial to Assess Chelation Therapy (TACT) study showed that Ca EDTA chelation decreased the likelihood of cardiovascular events, particularly in diabetics. Ca EDTA chelation administered carefully at lower dosage (<50 mg/kg per week) is generally safe. In the past, acute renal failure associated with much higher dosage was reported. We suggest that the preponderance of the evidence favors a more activist approach towards diagnosis and possible intervention in heavy metal toxicity.

Methyl jasmonate ameliorates lead toxicity in Oryza sativa by modulating chlorophyll metabolism, antioxidative capacity and metal translocation

Lead (Pb) not only negatively alters plant growth and yield but may also have potentially toxic risks to human health. Nevertheless, the interaction between rice (Oryza sativa L.) plants and the molecular cell dynamics induced by lead-methyl jasmonate (MJ) remains unknown. Here, plants were hydroponically exposed to Pb (150 and 300 µM) alone or in combination with 0.5 and 1 µM MJ. The application of MJ modulated the expression of the HMAs, PCS1, PCS2 and ABCC1 genes, thereby immobilizing the Pb in the roots and lessening its translocation to the aerial parts of the rice plant. The supplementation of MJ improved the growth and yield of Pb-stressed rice by adjusting the proline and chlorophyll metabolism, increasing the phytochelatins (PCs) accumulation and diminishing the accumulation of Pb in the shoots. the application of MJ alleviated the oxidative stress of rice plants exposed to Pb toxicity by enhancing the activity of antioxidant enzymes and enzymes of the glyoxalase system (glyoxalase I and II) and decreasing the endogenous levels of malondialdehyde (MDA), hydrogen peroxide (H2O2) and methylglyoxal (MG). Therefore, the results of the present study could provide a molecular insight and cellular interplay scheme for the development of a promising strategy in Pb-contaminated areas to produce healthy food.

Adaptive epigenetic response of glutathione (GSH)-related genes against lead (Pb)-induced toxicity, in individuals chronically exposed to the metal

It is well known that one of the most outstanding adverse effects related to lead (Pb) exposure is oxidative stress; moreover, recent findings suggest that disturbances of the redox status of cells are associated with epigenetic responses, and metabolism of glutathione (GSH) plays an important role in this process. This study aimed to assess Pb exposure on % methylation of GSH-related genes' promoter regions (%CH₃-CpG) and their influence on biomarkers of oxidative stress, in workers exposed to the metal. One hundred nine male workers participated in the study; ICP-MS determined blood lead levels (BLL); biochemical parameters related to redox status, named GSH, glutathione peroxidase (GPX) and glutathione-S-transferase (GST) were quantified by UV/Vis spectrophotometry. Determination of %CH₃-CpG of genes GCLC, GPX1, GSR, and GSTP1 were done by pyrosequencing. Inverse associations were seen between BLL and %CH₃-CpG-GCLC, and %CH₃-CpG-GSTP1. Moreover, metal exposure did not impact GSH, GPX, and GST; however, negative associations were observed between %CH₃-CpG-GPX1 and %CH₃-CpG-GSTP1, and the activities of GPX and GST, respectively. Taken together, our results give further evidence about adaptive epigenetic response to avoid oxidative damage induced by Pb exposure, allowing a better understanding of the molecular mechanisms related to the metal toxicity.

Transcriptome Analysis of the Hepatopancreas in the Litopenaeus vannamei Responding to the Lead Stress

Lead (Pb) is one of the most hazardous pollutants and toxic heavy metal in marine environment. The molecular mechanisms of Pb toxicity in aquatic organism are not well understood. In this study, hepatopancreas transcriptome of Litopenaeus vannamei (L. vannamei) was characterized by a comparison between control and Pb exposure samples using RNA-Seq approach. Hepatopancreas morphology of L. vannamei was also assessed. The result reveals that compared with the control group, an increase in the number of B cells was observed following Pb exposure in L. vannamei. Transcriptome data showed that a total of 1593 genes were recognized to be differentially expressed including 1278 up-regulated and 315 down-regulated genes. These genes were mainly associated with energy metabolism, cell apoptosis, exogenous microbial infection, cell junction, and cell adhesion. Fifteen ribosomal protein genes (RPS3, RPS13, RPSA, RPL11, RPS2, RPL8, RPS23, RPL3, RPL5, RPS6, RPS4X, RPS18, RPL19, RPL9, RPL6) were identified as the common hubs of protein-protein interaction (PPI) networks, as well as part of modules of the PPI network. Besides ribosomal protein, we identified differential expression genes (DEGs) including GAPDH, EEF1A1, HSPA8, UBC, and EEF1G as the common hubs of PPI networks. These findings may have important implications for understanding the adverse biological effects of Pb and its toxic mechanisms, as yet not clearly defined, and provide potential biomarkers of Pb exposure in hepatopancreas of L. vannamei, which might be useful for monitoring aquatic environments and assessing the health of the marine ecosystem.

Binding Capacities and Antioxidant Activities of Lactobacillus plantarum and Pichia kudriavzevii Against Cadmium and Lead Toxicities

The cadmium and lead binding capacities and antioxidant activities of Lactobacillus plantarum and Pichia kudriavzevii were evaluated in vitro and in vivo. Lactic acid bacteria and yeasts obtained from fermenting cassava mash and maize slurry were screened for tolerance to cadmium and lead at 500-1050 mg ml^-1 screened for probiotic potentials and antioxidant activities such as 2,2-diphenyl-1-picrylhydrazyl and ferric reducing antioxidant properties. The in vivo studies were carried out in male Wistar rats. The strains identified as Lactobacillus plantarum ML05 and Pichia kudriavzevii FY05 demonstrated the best probiotic potentials and antioxidant activities. Alterations in antioxidant capacities were positive in the treatment groups. The histopathology displayed positive changes in the renal tubules and glomeruli, hypertrophy, with normal capsular spaces without inflammation in the kidney, while the liver sinusoids appear normal in the rats administered with L. plantarum ML05 and P. kudriavzevii FY05 while the infected and not treated showed cell necrosis induced by toxicities. Our results provided new evidence that Lactobacillus plantarum and Pichia kudriavzevii have different biological actions on the heavy metals binding capacities and antioxidant activities in experimental animals. This study suggests that these microorganisms can be considered dietary therapeutics against cadmium and lead toxicities.