Trace elements and cancer risk: a review of the epidemiologic evidence

Serum Levels of Zinc and Copper in Patients with Endometrial Cancer: a Systematic Review and Meta-analysis

Endometrial cancer (EC) is the leading gynecologic cancer in developed nations. Recent studies suggest that trace elements like zinc and copper may be involved in cancer development due to their involvement in essential biological processes. However, there is inconsistency regarding their serum levels in EC patients. This review sought to systematically analyze and quantify the differences in serum concentrations of zinc and copper between patients with EC and healthy controls through a meta-analysis. A comprehensive search in PubMed, Embase, Scopus, and Google Scholar was performed. Studies comparing serum zinc and/or copper concentrations between confirmed EC patients and healthy controls were included. The quality of the papers was appraised using Newcastle-Ottawa Scale. Synthesis of data was done using standardized mean differences (SMD) at 95% confidence intervals (CIs) employing RevMan software. Five studies, including 433 patients with EC and 448 healthy controls, were analyzed. Meta-analysis showed a substantial decrease in serum zinc concentrations in EC patients against controls (SMD, - 0.91; 95% CI, [- 1.73, - 0.08]; p = 0.03). Serum copper levels were slightly higher in EC patients (SMD, 0.27; 95% CI, [- 0.66, 1.20]), but the difference was not statistically substantial (p = 0.57). The analysis showed reduced serum zinc levels in EC patients, suggesting the potential of zinc as a biomarker. The non-significant trend of higher copper levels requires further investigation to conclusively determine copper's role in EC. Future studies should explore the mechanisms underlying trace element imbalances.

Gallstone Physicochemical Properties and Heavy Metal Concentrations Associated with Gallbladder Carcinogenesis in Assam, India

Gallbladder cancer (GBC) is an aggressive malignancy, with gallstone disease (GSD) recognized as the primary risk factor. Although the precise mechanism linking GSD to GBC remains unclear, evidence suggests that gallstone characteristics play a significant role. This study investigates the physicochemical characteristics of gallstones critical for GBC development. We analyzed 40 gallstone samples from 30 GSD and 10 GBC with GSD (GBCGS) patients using advanced spectroscopic and imaging techniques such as fourier transform infrared (FTIR), powder X-ray diffraction (PXRD), nuclear magnetic resonance (NMR), and scanning electron microscopy energy-dispersive X-ray (SEM-EDX)). Subsequently, elemental analysis of 10 gallstones each from GBCGS and GSD was conducted via inductively coupled plasma-mass spectrometry (ICP-MS). Gallstones from the GSD group were identified as cholesterol (70%), mixed (13.3%), pigment (6.7%), and calcium carbonate (10%), while the GBCGS group included only cholesterol (70%) and mixed (30%) types. Cholesterol was the dominant organic component in most gallstones, with the cholesterol and mixed types exhibiting highly crystalline phases characterized by a stacked plate-like microstructure, particularly prominent in the GBCGS group. Additionally, the GBCGS group revealed significantly higher concentrations of carcinogenic elements such as arsenic, chromium, mercury, iron, and lead (p < 0.05), suggesting their accumulation in the gallbladder and gallstones. Consequently, our findings highlight that the physicochemical properties of cholesterol-rich gallstones and exposure to carcinogenic elements play a key role in the pathogenesis of GBC in Assam. These results emphasize the need for further research into cholesterol dysregulation and its link to elemental toxicity.

Mechanisms of Heavy Metal Cadmium (Cd)-Induced Malignancy

The environmental pollution of cadmium is worsening, and its significant carcinogenic effects on humans have been confirmed. Cadmium can induce cancer through various signaling pathways, including the ERK/JNK/p38MAPK, PI3K/AKT/mTOR, NF-κB, and Wnt. It can also cause cancer by directly damaging DNA and inhibiting DNA repair systems, or through epigenetic mechanisms such as abnormal DNA methylation, LncRNA, and microRNA. However, the detailed mechanisms of Cd-induced cancer are still not fully understood and require further investigation.

THE PLASMA CONCENTRATIONS OF ESSENTIAL TRACE ELEMENTS IN WOMEN WITH CANCER OF BREAST- OR CERVIX

Background

Derangement of trace elements which could be due to systemic inflammation or oxidative stress is thought to be directly or indirectly involved in carcinogenesis.

Aim

To evaluate plasma trace elements in female patients with cancer of breast- or cervix.

Material and Methods

This study was carried out in the Departments of Immunology and Radiation Oncology, University of Ibadan, Nigeria. Thirty (30) patients with cervical cancer, 30 patients with breast cancer and 30 age-matched females without cancer as control were included in the study. Plasma separated from venous blood was analysed for the concentrations of zinc (Zn), iron (Fe), selenium (Se) and copper (Cu) using Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES). The sixty cancer patients were newly diagnosed and in a stable state.

Results

The mean plasma levels of Fe and Cu were significantly reduced in patients with breast cancer- or cervical cancer compared with control. The plasma concentrations of Fe, Cu, Zn and Se were significantly reduced in all patients having breast cancer and those in stage 2 compared with cervical cancer patients.

Conclusion

Available data further support a previous suggestion that blood levels of metal varies with different cancers. Thus, a need for differential supplementation based on cancer types when modulation of trace element levels becomes a therapeutic option.

Nickel removal from synthetic wastewater by novel zeolite-doped magnesium- iron- and zinc-oxide nanocomposites by hydrothermal-calcination technique

This study aims to modify raw zeolite with metal oxide nanocomposites to remove nickel (Ni) ions from synthetic wastewater. Novel zeolite-doped magnesium oxide (MgO), iron oxide (Fe3O4), and zinc oxide (ZnO) nanocomposites were synthesized by hydrothermal-calcination methods. The novel zeolite-doped metal oxide nanocomposites were used as adsorbents to remove Ni (II) ions from synthetic wastewater. Several advanced techniques, including X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), and vibrating sample magnetometer (VSM) were applied to study the structural, morphological, chemical, and magnetic properties of the prepared materials. Doped zeolite with ZnO, MgO, and Fe3O4 significantly enhances the removal of Ni (II) ions from synthetic wastewater. The zeolite-doped MgO + Fe3O4 + ZnO sample achieved a Ni (II) ions removal efficiency of 99.6%, compared to 58.9% for raw zeolites. The removal efficiencies of Ni (II) ions (Ci = 30 mg/L) from highest to lowest were 99.56%, 99.53%, 91.4%, 67.8%, and 58.93% by zeolite-doped MgO + Fe3O4 + ZnO, zeolite-doped MgO, zeolite-doped ZnO, zeolite-doped Fe3O4, and raw zeolite sample, respectively. The highest adsorption capacity was 17.13 mg/g of zeolite-doped MgO + Fe3O4 + ZnO samples. The experimental adsorption data collected were fitted using five isotherm models, and four kinetic models. The Langmuir adsorption isotherm model and the pseudo-second-order kinetic model provided the best fit for the experimental adsorption data. This suggests that the adsorption process is complex, possibly involving electron interactions between the active sites of doped zeolite and Ni (II) species. The obtained data indicates that zeolite-doped with MgO, Fe3O4, and ZnO notably enhances the adsorptive properties of Ni (II) from synthetic wastewater. The obtained thermodynamic values confirmed that the adsorption process is spontaneous and endothermic, with increased randomness at the solid-solution interface during the adsorption process.

Serum and urinary cadmium and zinc profiles in breast cancer patients and their association with estrogen and HER-2 receptors, and redox status

BACKGROUND

Cadmium, a metal implicated in environmental toxicity, is linked to tumor growth and cancer. On the other hand, zinc plays an essential function in oxidative stress and can counteract cadmium toxicity and carcinogenicity. This research aims to evaluate the urine and serum values of cadmium and zinc in breast cancer (BC) patients and their association with estrogen (ER) and HER-2 receptors, and redox status.

METHODS

Forty BC patients and thirty healthy subjects participated in this study. Cadmium and zinc levels were measured in serum and urine samples by atomic absorption spectrophotometer. Redox status markers were determined by colorimetric methods.

RESULTS

The amount of cadmium in the BC patients was substantially greater than in the healthy subjects. Zinc levels were significantly lower in patients with BC compared to controls. Breast cancer patients with ER-positive tumors had significantly higher urinary cadmium concentrations (U-Cd) compared to patients with ER-negative tumors. There was no significant difference between the parameters of redox status and the value of cadmium and zinc between patients with BC in the HER-2 subgroup. Malondialdehyde levels in the serum were substantially greater in BC patients than in healthy subjects. Total thiol level and catalase and superoxide dismutase activity in serum were considerably lower in BC patients than in healthy subjects.

CONCLUSIONS

The etiology of BC may be due to a disturbance in redox status and levels of elements. Increasing U-Cd and lowering zinc levels in the serum could be the risk factors for BC.

Elements in trace amount with a significant role in human physiology: a tumor pathophysiological and diagnostic aspects

Cancer has a devastating impact globally regardless of gender, age, and community, which continues its severity to the population due to the lack of efficient strategy for the cancer diagnosis and treatment. According to the World Health Organisation report, one out of six people dies due to this deadly cancer and we need effective strategies to regulate it. In this context, trace element has a very hidden and unexplored role and require more attention from investigators. The variation in concentration of trace elements was observed during comparative studies on a cancer patient and a healthy person making them an effective target for cancer regulation. The percentage of trace elements present in the human body depends on environmental exposure, food habits, and habitats and could be instrumental in the early diagnosis of cancer. In this review, we have conducted inclusive analytics on trace elements associated with the various types of cancers and explored the several methods involved in their analysis. Further, intricacies in the correlation of trace elements with prominent cancers like prostate cancer, breast cancer, and leukaemia are represented in this review. This comprehensive information on trace elements proposes their role during cancer and as biomarkers in cancer diagnosis.

Quantifying the noncarcinogenic and carcinogenic risks resulting from the inhalation of PM2.5-bound metals: A multicity analysis and implications for public health

Toxic metals in PM2.5 represent a growing public health concern because of their potential health effects. Ambient PM2.5 samples were collected from five provinces around Bangkok from December 2020 to December 2021. The concentrations of PM2.5 and metals (arsenic, cadmium, chromium, cobalt, nickel, lead, and vanadium) were analyzed. The noncarcinogenic and carcinogenic risks were evaluated via Monte Carlo simulations in four age groups (0 to <6, 6 to <12, 12 to <18, 18-70 years), with a dataset comprising 2282 heavy metal assays within the particulate matter. Significantly higher PM2.5 concentrations were detected in provinces with higher factory densities, as well as higher concentrations during haze periods than during non-haze periods. The HI values for all age groups and provinces were lower than 1, indicating acceptable noncarcinogenic risks. The carcinogenic risks from PM2.5-bound metals varied between 7.08×10-7 and 4.29×10-6, indicating increased cancer risks, for preschool children and adults. Cancer risk was highest in industrial areas, followed by areas with dense traffic, and lowest in agricultural areas. The results indicated that Thailand's current air quality regulations, which primarily provide only lead limits, are insufficient considering the high carcinogenic potential of other metals. The Monte Carlo simulation results confirmed that lowering Thailand's 24-h PM2.5 standard from 37.5 to either 25 or 15 µg m-3, as specified in the 2021 World Health Organization guidelines, would decrease cancer risk by 9.63-43.18 %.

Heavy-metal associated breast cancer and colorectal cancer hot spots and their demographic and socioeconomic characteristics

PURPOSE

Cancer registries offer an avenue to identify cancer clusters across large populations and efficiently examine potential environmental harms affecting cancer. The role of known metal carcinogens (i.e., cadmium, arsenic, nickel, chromium(VI)) in breast and colorectal carcinogenesis is largely unknown. Historically marginalized communities are disproportionately exposed to metals, which could explain cancer disparities. We examined area-based metal exposures and odds of residing in breast and colorectal cancer hotspots utilizing state tumor registry data and described the characteristics of those living in heavy metal-associated cancer hotspots.

METHODS

Breast and colorectal cancer hotspots were mapped across Kentucky, and area-based ambient metal exposure to cadmium, arsenic, nickel, and chromium(VI) were extracted from the 2014 National Air Toxics Assessment for Kentucky census tracts. Among colorectal cancer (n = 56,598) and female breast cancer (n = 77,637) diagnoses in Kentucky, we used logistic regression models to estimate Odds Ratios (ORs) and 95% Confidence Intervals to examine the association between ambient metal concentrations and odds of residing in cancer hotspots, independent of individual-level and neighborhood risk factors.

RESULTS

Higher ambient metal exposures were associated with higher odds of residing in breast and colorectal cancer hotspots. Populations in breast and colorectal cancer hotspots were disproportionately Black and had markers of lower socioeconomic status. Furthermore, adjusting for age, race, tobacco and neighborhood factors did not significantly change cancer hotspot ORs for ambient metal exposures analyzed.

CONCLUSION

Ambient metal exposures contribute to higher cancer rates in certain geographic areas that are largely composed of marginalized populations. Individual-level assessments of metal exposures and cancer disparities are needed.

Trace Element Concentrations of Arsenic and Selenium in Toenails and Risk of Prostate Cancer among Pesticide Applicators

Prostate cancer is a common cancer among males in the US, but little is known about its risk factors, including trace elements. The primary aim of this study was to examine prostate cancer and its association with arsenic and selenium in toenails. We conducted a small, nested case-control study of men residing in Iowa within the Agricultural Health Study cohort, where we also collected toenail samples to test for arsenic and other trace elements. Toenail samples were sent for neutron activation analysis aimed at long-lived trace elements, including arsenic. Logistic regression was used to estimate odds ratios (ORs) for trace element exposures and prostate cancer. A total of 66 prostate cancer cases and 173 healthy controls returned questionnaires, over 99% of which included toenail samples. An increased risk was seen for the highest levels of arsenic (OR = 3.4 confidence interval (CI) of 1.3-8.6 and OR = 2.2, 95% CI of 0.9-5.6) and the highest level of selenium (2.0, 95% CI of 1.0-4.0). These data also show detectable levels of over 50% for 14 of 22 elements detected in the toenails. The association seen here with arsenic and prostate cancer further supports ecological studies finding an association with community levels of arsenic and prostate cancer incidence and mortality.

Selenium, Zinc, and Plasma Total Antioxidant Status and the Risk of Colorectal Adenoma and Cancer

Selenium (Se), zinc (Zn), and copper (Cu) are known to be involved in carcinogenesis and participate in the defence against reactive oxygen species (ROS). This study aimed to evaluate the clinical utility of serum Se, Zn, and Cu concentrations and plasma total antioxidant status (TAS) in the diagnosis of colorectal cancer (CRC) and colorectal adenoma (CRA) in a population of low Se and borderline Zn status. Based on clinical examination and colonoscopy/histopathology, the patients (n = 79) were divided into three groups: colorectal cancer (n = 30), colorectal adenoma (n = 19), and controls (CONTROL, n = 30). The serum Se concentration was lower in the CRC group than in the CRA group (by 9.1%, p < 0.0001) and the CONTROL group (by 7.9%, p < 0.0001). In turn, the serum Zn concentration was decreased in the CRA group (by 17.9%, p = 0.019) when compared to the CONTROL group. Plasma TAS was lower in the CRC group (by 27.8%, p = 0.017) than in the CONTROL group. In turn, the serum Zn concentration was decreased in the CRA group when compared to the CONTROL group. Plasma TAS was lower in the CRC group than in the CONTROL group. ROC (receiver operating characteristic) curve analysis revealed that the Se level was of the highest diagnostic utility for the discrimination of the CRC group from both the CRA group (area under ROC curve (AUC) 0.958, sensitivity 84.21%, specificity 100%) and the CONTROL group (AUC 0.873, sensitivity 100%, specificity 66.67%). The Zn and TAS levels were significantly accurate in the differentiation between the groups. An individualised risk of colorectal adenoma and cancer approach could comprise Se, Zn, and TAS assays in the population.

Zinc and aging: a narrative review of the effects on hematopoiesis and its link with diseases

There has been a global increase in the older population in recent decades and, as age advances, complex metabolic and epigenetic changes occur in the organism, and these may trigger some health complications commonly found among this population. Additionally, several changes occur in older people that can reduce the dietary intake or the process of nutrient absorption. In this way, tissues with high nutrient requirements are more affected. Hematopoiesis is the process of formation, development, and maturation of blood cells and is a process with a high turnover. This high demand makes the integrity of the hematopoietic process susceptible to various factors that impair physiological function, such as aging and micronutrient bioavailability. Among these micronutrients, Zinc is considered an important micronutrient, playing diverse roles across various tissues and cell types. Some of the alterations in hematopoiesis that appear as a consequence of aging and due to insufficient micronutrient intake are well described in the literature; however, not much is known about how zinc deficiency contributes towards the development of diseases seen in aging. Considering the importance of zinc to act on several biological processes, this narrative review discusses several studies related to the physiological requirements, deficiency, or excess of zinc, including studies in experimental models and humans, and aimed to shed light on the relationship between zinc and the regulation of hematopoietic tissue, exploring possible links between this mineral with common disorders that appear during aging.

Characterization of airborne endotoxin in personal exposure to fine particulate matter (PM2.5) and bioreactivity for elderly residents in Hong Kong

The heavy metals and bioreactivity properties of endotoxin in personal exposure to fine particulate matter (PM2.5) were characterized in the analysis. The average personal exposure concentrations to PM2.5 were ranged from 6.8 to 96.6 μg/m3. The mean personal PM2.5 concentrations in spring, summer, autumn, and winter were 32.1±15.8, 22.4±11.8, 35.3±11.9, and 50.2±19.9 μg/m3, respectively. There were 85 % of study targets exceeded the World Health Organization (WHO) PM2.5 threshold (24 hours). The mean endotoxin concentrations ranged from 1.086 ± 0.384-1.912 ± 0.419 EU/m3, with a geometric mean (GM) varied from 1.034 to 1.869. The concentration of iron (Fe) (0.008-1.16 μg/m3) was one of the most abundant transition metals in the samples that could affect endotoxin toxicity under Toll-Like Receptor 4 (TLR4) stimulation. In summer, the interleukin 6 (IL-6) levels showed statistically significant differences compared to other seasons. Spearman correlation analysis showed endotoxin concentrations were positively correlated with chromium (Cr) and nickel (Ni), implying possible roles as nutrients and further transport via adhering to the surface of fine inorganic particles. Mixed-effects model analysis demonstrated that Tumor necrosis factor-α (TNF-α) production was positively associated with endotoxin concentration and Cr as a combined exposure factor. The Cr contained the highest combined effect (0.205-0.262), suggesting that Cr can potentially exacerbate the effect of endotoxin on inflammation and oxidative stress. The findings will be useful for practical policies for mitigating air pollution to protect the public health of the citizens.

To breathe or not to breathe: Inhalational exposure to heavy metals and related health risk

This study reviewed scientific literature on inhalation exposure to heavy metals (HMs) in various indoor and outdoor environments and related carcinogenic and non-carcinogenic risk. A systematic search in Web of Science, Scopus, PubMed, Embase, and Medline databases yielded 712 results and 43 articles met the requirements of the Population, Exposure, Comparator, and Outcomes (PECO) criteria. Results revealed that HM concentrations in most households exceeded the World Health Organization (WHO) guideline values, indicating moderate pollution and dominant anthropogenic emission sources of HMs. In the analyzed schools, universities, and offices low to moderate levels of air pollution with HMs were revealed, while in commercial environments high levels of air pollution were stated. The non-carcinogenic risk due to inhalation HM exposure exceeded the acceptable level of 1 in households, cafes, hospitals, restaurants, and metros. The carcinogenic risk for As and Cr in households, for Cd, Cr, Ni, As, and Co in educational environments, for Pb, Cd, Cr, and Co in offices and commercial environments, and for Ni in metros exceeded the acceptable level of 1 × 10-4. Carcinogenic risk was revealed to be higher indoors than outdoors. This review advocates for fast and effective actions to reduce HM exposure for safer breathing.

The key role of major and trace elements in the formation of five common urinary stones

BACKGROUND

Urolithiasis has emerged as a global affliction, recognized as one of the most excruciating medical issues. The elemental composition of stones provides crucial information, aiding in understanding the causes, mechanisms, and individual variations in stone formation. By understanding the interactions between elements in various types of stones and exploring the key role of elements in stone formation, insights are provided for the prevention and treatment of urinary stone disease.

METHODS

This study collected urinary stone samples from 80 patients in Beijing. The chemical compositions of urinary stones were identified using an infrared spectrometer. The concentrations of major and trace elements in the urinary stones were determined using Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS), respectively. The data were processed using correlation analysis and Principal Component Analysis (PCA) methods.

RESULTS

Urinary stones are categorized into five types: the calcium oxalate (CO) stone, carbonate apatite (CA) stone, uric acid (UA) stone, mixed CO and CA stone, and mixed CO and UA stone. Ca is the predominant element, with an average content ranging from 2.64 to 27.68% across the five stone groups. Based on geochemical analysis, the high-content elements follow this order: Ca > Mg > Na > K > Zn > Sr. Correlation analysis and PCA suggested significant variations in the interactions between elements for different types of urinary stones. Trace elements with charges and ionic structures similar to Ca may substitute for Ca during the process of stone formation, such as Sr and Pb affecting the Ca in most stone types except mixed stone types. Moreover, the Mg, Zn and Ba can substitute for Ca in the mixed stone types, showing element behavior dependents on the stone types.

CONCLUSION

This study primarily reveals distinct elemental features associated with five types of urinary stones. Additionally, the analysis of these elements indicates that substitutions of trace elements with charges and ion structures similar to Ca (such as Sr and Pb) impact most stone types. This suggests a dependence of stone composition on elemental behavior. The findings of this study will enhance our ability to address the challenges posed by urinary stones to global health and improve the precision of interventions for individuals with different stone compositions.

Serum and tissue metallome of pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) patients have late presentation at the time of diagnosis and a poor prognosis. Metal dyshomeostasis is known to play a role in cancer progression. However, the blood and tissue metallome of PDAC patients has not been assessed. This study aimed to determine the levels of essential and toxic metals in the serum and pancreatic tissue from PDAC patients. Serum samples were obtained from PDAC patients before surgical resection. Tissue (tumor and adjacent normal pancreas) were obtained from the surgically resected specimen. Inductively coupled plasma-mass spectrometry (ICP-MS) analysis was performed to quantify the levels of 10 essential and 3 toxic metals in these samples. Statistical analysis was performed to identify dysregulated metals in PDAC and their role as potential diagnostic and prognostic biomarkers. Significantly decreased serum levels of magnesium, potassium, calcium, iron, zinc, selenium, arsenic, and mercury and increased levels of molybdenum were shown to be associated with PDAC. There were significantly decreased levels of zinc, manganese and molybdenum, and increased levels of calcium and selenium in the pancreatic tumor tissue compared with the adjacent normal pancreas. Notably, lower serum levels of calcium, iron, and selenium, and higher levels of manganese, were significantly associated with a poor prognosis (i.e., overall survival) in PDAC patients. In conclusion, this is the first study to comprehensively assess the serum and tissue metallome of PDAC patients. It identified the association of metals with PDAC diagnosis and prognosis.

Concentration of trace elements in blood of Polish patients with prostate cancer

The goal of the study was to analyse the concentrations of chemical elements (Fe, Ni, As, Cd, Pb, Hg, Cr, Zn) which are important for the determination of environmental toxins (e.g. resulting from smoking, exposure to harmful agents at work) in Polish patients with prostate cancer. The study covered 66 patients with diagnosed prostate cancer and 64 healthy volunteers over 50 years old. The analysis of the concentrations of selected chemical elements in whole blood was performed using inductively coupled plasma mass spectrometry (ICP-MS). In their blood, the patients with cancer had a significantly higher concentration of only one of the examined elements: arsenic. Additionally, the study group had lower concentrations of chromium, zinc, but also cadmium and lead, which are commonly regarded as carcinogenic. Taking into consideration the control group of healthy subjects of this study, we can assume that the subjects with prostate cancer were exposed to higher levels of arsenic, and that exposure to this element may be associated with an increased risk of cancer.

Trace elements in hair or fingernail and gastroesophageal cancers: results from a population-based case-control study

BACKGROUND

Growing evidence suggests that environmental factors probably play important roles in the development of gastroesophageal cancers (GOC), however, the effects of trace elements on GOC remain unclear.

OBJECTIVE

To assess the effect of trace elements on GOC and the effect modification by other factors.

METHODS

Hair and fingernail samples were collected from GOC cases and controls in a population-based case-control study in Taixing, China, and were used to detect the concentrations of 12 trace elements using inductively coupled plasma mass spectrometry. Unconditional logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for concentrations of 12 trace elements in association with GOC after adjusting the other factors.

RESULTS

A total of 830 hair samples (581 controls and 249 cases) and 895 fingernail samples (559 controls and 336 cases) were included. Compared to the lowest-tertile concentration, the higher tertiles of Ca, Zn, Fe, Al, Cr, Pb, Se, and V were positively associated with GOC, while the higher tertiles of Mg, Mn, Sr, and As were inversely associated with GOC. Significant interactions between the hair level of Cr and two other risk factors, including smoking (P for interaction = 0.044) and alcohol drinking (P for interaction = 0.028), were observed in association with GOC.

SIGNIFICANCE

The current study reveals that these 12 trace elements in hair and fingernails are associated with GOC to varying degrees. Further studies and animal experiments are needed to clarify the associations and explore potential mechanisms.

IMPACT STATEMENT

The role of trace elements in the development or inhibition of gastroesophageal cancers (GOC) remains unclear. In this study, we further explored the associations between 12 trace elements and GOC based on a population-based case-control study conducted in Taixing, China. Higher levels of Ca, Zn, Fe, Al, Cr, Pb, Se, and V were positively associated with increased GOC, while inverse associations between higher levels of Mg, Mn, Sr, As, and GOC were observed. Observed associations were consistent in hair and fingernail samples. Moreover, interaction effects between hair level of Cr and smoking or alcohol drinking were identified.

Toenail arsenic species and metallome profiles associated with breast, cervical, prostate, and skin cancer prevalence in the Atlantic Partnership for Tomorrow's Health cohort

Introduction

Chronic exposure to arsenic through drinking water has been linked to several cancers. The metabolism of arsenic is thought to play a key role in arsenic-related carcinogenesis as metabolites of varying toxicity are produced and either stored in or excreted from the body. Atlantic Canada has the highest age-standardized incidence rates of all cancers in the country. This may be due to its high levels of environmental arsenic and the prevalence of unregulated private wells for water consumption. Here, we aimed to characterize the profiles of arsenic species and metallome in the toenails of four cancer groups, compare them to healthy participants (N = 338), and assess potential associations between the profiles with cancer prevalence.

Methods

This study employed a case-control design. Toenail samples and questionnaire data from cases (breast, cervical, prostate, and skin cancers) and controls were sourced from the Atlantic Partnership for Tomorrow's Health (PATH) cohort study. The levels of arsenic species were measured using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) paired with High Performance Liquid Chromatography (HPLC) and total concentrations of metallome (23 metals) were determined by ICP-MS separately. Multivariate analyses were conducted to compare cases with controls within each cancer group.

Results

Arsenic speciation profiles varied by cancer type and were significantly different between cases and controls in the breast (p = 0.0330), cervical (p = 0.0228), and skin (p = 0.0228) cancer groups. In addition, the profiles of metallome (nine metals) were significantly differentiated in the prostate (p = 0.0244) and skin (p = 0.0321) cancer groups, with higher zinc concentrations among cases compared to controls.

Conclusion

History of cancer diagnosis was associated with specific profiles of arsenic species and metallome. Our results indicate that arsenic methylation and zinc levels, as measured in toenails, may be an important biomarker for cancer prevalence. Further research is needed to use toenails as a prognostic measure of arsenic-and other metal-induced cancer.

Associations of trace element levels in paired serum, whole blood, and tissue: an example of esophageal squamous cell carcinoma

Previous studies have extensively explored impacts of trace elements on human beings and complex relationships with cancers. However, contradictory conclusions may be more challenging to explain due to biological specimen differences. To investigate the distribution of trace elements inside body, we collected serum, whole blood and tissues from 77 patients with esophageal squamous cell carcinoma (ESCC), as well as serum and whole blood from 100 healthy individuals, and determined the concentrations of 13 elements (Al, V, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Sr, Cd, and Pb) with inductively coupled plasma-mass spectrometry (ICP-MS). Al, Ni, Cu, Sr, and Cd variations between patients and controls were found to be inconsistent in serum and blood. Concentrations of Cu, As, Se, and Sr in serum were positively correlated with that in whole blood in both case and control group (r_s >0.450, P <0.01). Elements in serum had a higher accuracy (87.0%) than whole blood (74.0%) in classifying ESCC patients and healthy individuals with discriminant analysis. As, Cd, and Pb concentrations in cancerous tissues were positively correlated with those in normal epithelium (r_s =0.397, 0.571, and 0.542, respectively), while Mn, Cu, and Se accumulated in malignant tissues, with V, Cr, Co, Ni, Sr, and Cd partitioning in normal epithelium (all P <0.05). Thus, certain elements in blood, such as Cu, As, Se, and Sr, were useful in assessing element exposure burdens and accumulation tendency of some elements (Mn, Cu and Se, etc.) was uncovered in tumors. Our investigation demonstrated the variations in trace element distribution for frequently used specimens and further evidence of etiological mechanism is necessary.

Identification of arsenic spatial distribution by hydrogeochemical processes represented by different ion ratios in the Hohhot Basin, China

The Hohhot Basin, a typical inland basin of the Yellow River Basin in China, has high concentrations of arsenic (As) in its shallow groundwater, while the factors dominating the distribution of high arsenic levels remain to be further identified. An analysis of the ratio of hydrogeochemical compositions can help to reveal the spatial characteristics of the shallow groundwater environmental conditions and the distribution of high-arsenic water (As >10 μg/L). In this study, a total of 170 samples of shallow groundwater in the Hohhot Basin were collected and water samples with As >10 μg/L accounted for 29.4% of the total. Based on the slope changes of the cumulative frequency curves of (HCO₃^- + CO₃^2-)/SO₄^2-, Ca²⁺/(HCO₃^- + CO₃^2-), Ca²⁺/Mg²⁺, and Na⁺/Ca²⁺, the groundwater in the study area can be categorized into six different zones according to the environmental characteristics including redox condition, water recharge intensity, and cation exchange level. The result shows that the groundwater in the front of the piedmont alluvial plain and platform is in a weak reducing condition with high lateral recharge intensity, fast runoff, and weak cation exchange. In the Dahei River alluvial plain, which serves as the groundwater discharge zone, the groundwater runoff is sluggish with poor lateral recharge, sufficient exchange between cations in the groundwater and the aquifer matrix, and enhanced reducibility. The degree of oxidation increased in the groundwater near the Hasuhai Lake and the drainage canal, which adverse to the arsenic enrichment. High-arsenic groundwater is mainly distributed in aquifers of (HCO₃^- + CO₃^2-)/SO₄² > 10, Na⁺/Ca²⁺ > 13, and Ca²⁺/(HCO₃^- + CO₃^2-) < 0.1, which represent the strong reducing condition, low surface water recharge intensity, and strong cation exchange condition. Reductive dissolution of iron oxide, strong evaporation and concentration process, and competition from phosphate in aquifers jointly lead to the release of arsenic into groundwater.

New Iron Metabolic Pathways and Chelation Targeting Strategies Affecting the Treatment of All Types and Stages of Cancer

There is new and increasing evidence from in vitro, in vivo and clinical studies implicating the pivotal role of iron and associated metabolic pathways in the initiation, progression and development of cancer and in cancer metastasis. New metabolic and toxicity mechanisms and pathways, as well as genomic, transcription and other factors, have been linked to cancer and many are related to iron. Accordingly, a number of new targets for iron chelators have been identified and characterized in new anticancer strategies, in addition to the classical restriction of/reduction in iron supply, the inhibition of transferrin iron delivery, the inhibition of ribonucleotide reductase in DNA synthesis and high antioxidant potential. The new targets include the removal of excess iron from iron-laden macrophages, which affects anticancer activity; the modulation of ferroptosis; ferritin iron removal and the control of hyperferritinemia; the inhibition of hypoxia related to the role of hypoxia-inducible factor (HIF); modulation of the function of new molecular species such as STEAP4 metalloreductase and the metastasis suppressor N-MYC downstream-regulated gene-1 (NDRG1); modulation of the metabolic pathways of oxidative stress damage affecting mitochondrial function, etc. Many of these new, but also previously known associated iron metabolic pathways appear to affect all stages of cancer, as well as metastasis and drug resistance. Iron-chelating drugs and especially deferiprone (L1), has been shown in many recent studies to fulfill the role of multi-target anticancer drug linked to the above and also other iron targets, and has been proposed for phase II trials in cancer patients. In contrast, lipophilic chelators and their iron complexes are proposed for the induction of ferroptosis in some refractory or recurring tumors in drug resistance and metastasis where effective treatments are absent. There is a need to readdress cancer therapy and include therapeutic strategies targeting multifactorial processes, including the application of multi-targeting drugs involving iron chelators and iron-chelator complexes. New therapeutic protocols including drug combinations with L1 and other chelating drugs could increase anticancer activity, decrease drug resistance and metastasis, improve treatments, reduce toxicity and increase overall survival in cancer patients.

Evaluation of trace elements in essential thrombocytosis and reactive thrombocytosis

BACKGROUND

Trace elements (TE) are vital for cellular mechanisms at biological, chemical and molecular levels. The effects of TE in diagnosis, progression and treatment of essential thrombocytosis (ET), which is one of the chronic myeloproliferative neoplasms is a rare clonal stem cell disease characterized by increased thrombocyte numbers with impaired function, have not been elucidated in detail yet. The aim of the present study was to investigate the effects of TE alterations in an ET model and the efficacy of TE in ET treatment protocol by means of a vast number of TE.

METHODS

Study groups were categorized as patients with ET diagnosis (ET group, n:30), patients with reactive thrombocytosis secondary to iron deficiency anemia (IDA-RT) (IDA-RT group, n:30) and healthy controls (HC group, n:30). Serum levels of copper (Cu), iron (Fe), cobalt (Co), chromium (Cr), aluminum (Al), silicon (Si), nickel (Ni), zinc (Zn), selenium (Se), manganese (Mn), boron (B) and magnesium (Mg) were analyzed utilizing inductively coupled plasma-optical emission spectrophotometer instrument (ICP-OES). Statistical analysis was evaluated using SPSS 23.0.

RESULTS

ET group had statistically higher serum levels of Co and Mg (p < 0.05), Ni and Mn (p < 0.001), and lower Si (p < 0.05) than IDA-RT group. ET group had statistically higher serum levels of Co and Mn (p < 0.05), and Ni (p < 0.001), and lower Al, Si and Se (p < 0.001) than HC group. Serum levels of Fe, Al and Se (p < 0.001), and Mg (p < 0.01), and Zn (p < 0.05) in IDA-RT group were significantly lower than HC group.

CONCLUSION

This novel study pointed out that alterations of many serum TE by means of both increment or decrement might have close relationship with mechanisms and complications of ET onset and follow-up. We consider that further research of TE would elucidate ethiopathogenesis and prognosis of ET. Thus, analysis of serum trace elements in essential thrombocytosis patients may be an important protocol by means of diagnosis, treatment and follow-up intervals.

Trace elements in indoor dust-Children's health risk considering overall daily exposure

Indoor dust presents an important source of daily exposure to toxic elements. The present study reports for the first time the levels of Al, As, Cd, Co, Cr, Cu, Fe, Mn, Mo, Ni, Pb, Sb, Sn, Se, Sr, Tl, V, and Zn measured in dust samples collected from 10 kindergartens and 21 cars from Zagreb, Croatia. Based on the obtained data, we assessed the health risks from overall daily exposure to trace elements for children aged 2-6 years taking into account three pathways of dust intake-ingestion, dermal absorption, and inhalation. The median concentration of most elements was significantly higher in dust obtained from cars compared to kindergartens, especially in the cases of Co (11.62 vs. 3.60 mg kg^-1 ), Cr (73.55 vs. 39.89 mg kg^-1 ), Cu (186.33 vs. 26.01 mg kg^-1 ), Mo (8.599 vs. 0.559 mg kg^-1 ), Ni (37.05 vs. 17.38 mg kg^-1 ), and Sn (9.238 vs. 1.159 mg kg^-1 ). Oral intake was identified as the most important exposure pathway, except for Cr, Ni, and Sb where dermal contact was the main route of exposure. Health risk assessment indicated that no adverse effects are expected from overall exposure to trace elements. Although the cases of high exposure to toxic elements are not common in areas with no significant environmental pollutants, due to the health threat they may present even at low levels, their status should be carefully monitored.

Comparison Process of Blood Heavy Metals Absorption Linked to Measured Air Quality Data in Areas with High and Low Environmental Impact

Air pollution is a problem shared by the entire world population, and researchers have highlighted its adverse effects on human health in recent years. The object of this paper was the relationship between the pollutants’ concentrations measured in the air and the quantity of pollutant itself inhaled by the human body. The area chosen for the study has a high environmental impact given the significant presence on the territory of polluting activities. The Acerra area (HI) has a waste-to-energy plant and numerous industries to which polluting emissions are attributed. This area has always been the subject of study as the numbers of cancer patients are high. A survey on male patients to evaluate the heavy metals concentrations in the blood was conducted in the two areas and then linked to its values aero-dispersed. Using the air quality data measured by the monitoring networks in two zones, one with high environmental impact (HI) and one with low environmental impact (LI), the chronicle daily intake (CDI) of pollutants inhaled by a single person was calculated. The pollutants considered in this study are PM10 and four heavy metals (As, Cd, Ni, Pb) constituting the typical particulates of the areas concerned. The CDI values calculated for the two zones are significantly higher in the HI zone following the seasonal pollution trend.

Environmental Influences on the Behavioural and Emotional Outcomes of Children: A Network Analysis

Background: Intellectual developmental disorders are a serious source of health morbidity with negative consequences for adults as well as children. However, there is limited evidence on the environmental, trace element, behavioural, and emotional outcomes in children. Here, we investigated whether there is any association between child behaviour and emotional outcomes and micronutrients using network analysis. Methods: A cross-sectional study was conducted in 9-year-old children within a Pacific Island Families study birth cohort. Elemental concentration was determined in children’s toenails after acid digestion and analysed using inductively coupled plasma mass spectrometry. We used network analysis to identify closely associated trace elements and tested the directions and strength of these trace elements. MANCOVA were used to identify the significant associations between individual elements and the behavioural/emotional function of the children using the children behaviour checklist (CBCL). At the final step, quantile regression analysis was used to assess and quantify the identified associations between CBCL function scores and manganese, adjusted by sex, ethnicity, and standardized BMI. Results: Three major nutrient networks were identified. In the Mn network, Mn was strongly positively associated with Al (0.63) and Fe (r = 0.65) and moderately associated with Pb (r = 0.45) and Sb (r = 0.42). Al was also strongly associated with Fe (r = 0.9). Children in the second or third clinical group, with an elevated externalized CBCL score, had a much higher mean and median level of Mn as compared to the normal range group. The aggression score was significantly associated with Mn concentration and sex. Higher Mn concentrations were associated with a higher aggression score. A 1 ug/g unit increase in Mn was associated with a 2.44-fold increase (95% confidence interval: 1.55–4.21) in aggression score, and boys had higher median aggression score than girls (difference: 1.7, 95% CI: 0.9–2.8). Attention and rule breaking scores were both significantly associated with Mn concentration. Higher Mn concentrations were associated with higher attention behaviour problem and rule breaking scores. A 1 ug/g unit increase in Mn was found to be associated with a 1.80-fold increase (95% confidence interval: 1.37–2.82) in attention score, and a 1.46-fold increase (95% confidence interval: 1.01–1.74) in the rule breaking score. Thought score was not significantly associated with Mn concentration (p = 0.13) but was significantly lower in boys (p = 0.004). Conclusions: Exceeding Mn levels is potentially toxic and has been identified to be associated with worse externalized children’s behavioural health and emotional well-being. Future studies are necessary to find the exposure paths so that advice shall be provided to family and care providers in public health and environmental protection.

Tracing of Heavy Metals Embedded in Indoor Dust Particles from the Industrial City of Asaluyeh, South of Iran

Assessment of indoor air quality is especially important, since people spend substantial amounts of time indoors, either at home or at work. This study analyzes concentrations of selected heavy metals in 40 indoor dust samples obtained from houses in the highly-industrialized Asaluyeh city, south Iran in spring and summer seasons (20 samples each). Furthermore, the health risk due to exposure to indoor air pollution is investigated for both children and adults, in a city with several oil refineries and petrochemical industries. The chemical analysis revealed that in both seasons the concentrations of heavy metals followed the order of Cr > Ni > Pb > As > Co > Cd. A significant difference was observed in the concentrations of potential toxic elements (PTEs) such as Cr, As and Ni, since the mean (±stdev) summer levels were at 60.2 ± 9.1 mg kg−1, 5.6 ± 2.7 mg kg−1 and 16.4 ± 1.9 mg kg−1, respectively, while the concentrations were significantly lower in spring (17.6 ± 9.7 mg kg−1, 3.0 ± 1.7 mg kg−1 and 13.5 ± 2.4 mg kg−1 for Cr, As and Ni, respectively). Although the hazard index (HI) values, which denote the possibility of non-carcinogenic risk due to exposure to household heavy metals, were generally low for both children and adults (HI < 1), the carcinogenic risks of arsenic and chromium were found to be above the safe limit of 1 × 10−4 for children through the ingestion pathway, indicating a high cancer risk due to household dust in Asaluyeh, especially in summer.

A Bibliometric Analysis of Research on Selenium in Drinking Water during the 1990-2021 Period: Treatment Options for Selenium Removal

A bibliometric analysis based on the Scopus database was carried out to summarize the global research related to selenium in drinking water from 1990 to 2021 and identify the quantitative characteristics of the research in this period. The results from the analysis revealed that the number of accumulated publications followed a quadratic growth, which confirmed the relevance this research topic is gaining during the last years. High research efforts have been invested to define safe selenium content in drinking water, since the insufficient or excessive intake of selenium and the corresponding effects on human health are only separated by a narrow margin. Some important research features of the four main technologies most frequently used to remove selenium from drinking water (coagulation, flocculation and precipitation followed by filtration; adsorption and ion exchange; membrane-based processes and biological treatments) were compiled in this work. Although the search of technological options to remove selenium from drinking water is less intensive than the search of solutions to reduce and eliminate the presence of other pollutants, adsorption was the alternative that has received the most attention according to the research trends during the studied period, followed by membrane technologies, while biological methods require further research efforts to promote their implementation.

Air-polluted environmental heavy metal exposure increase lung cancer incidence and mortality: A population-based longitudinal cohort study

BACKGROUND

An increased risk of lung cancer has been observed due to exposure to certain environmental heavy metals. This study elucidated the role of air-polluted heavy metals in the development of lung cancer.

METHODS

A longitudinal cohort study involving the general population was conducted to compare heavy metal content among lung cancer patients. The urine concentrations of heavy metals were measured. Questionnaire surveys were designed to collect exposure-related demographic and lifestyle data of the study subjects.

RESULTS

Participants residing near the petrochemical industrial area with higher air Cd concentration had relatively higher urinary concentration of Cd. After adjusting for sociodemographic and behavioral factors, tobacco smoking and air pollution remained as potential sources of Cd exposure. An increased prevalence of lung cancer was observed in the highly polluted zone. The risk of lung cancer incidence increased 1.25-fold for each 1 μg/g-creatinine increase in urine Cd level. Patients with lung cancer had significantly higher urinary Cd concentrations. Lung cancer patients with higher urinary Cd level had significantly poor survival (urine Cd level ≥ 1.58 vs <1.58 μg/g-creatinine; survival, medium, 192.0 vs 342.5 days, p < 0.001). At the longitudinal follow-up, participants with higher urinary Cd level had a higher risk of lung cancer incidence (urine Cd level ≥ 1.58 vs <1.58 μg/g-creatinine: 3.91% v.s. 0.87%, hazard ratio: 4.65, p < 0.001).

CONCLUSIONS

Accumulation of Cd could be a risk of lung cancer occurrence. High exposure to Cd may result in poor prognosis in lung cancer patients.

The possible role of arsenic and gene-arsenic interactions in susceptibility to breast cancer: a systematic review

The roles of many environmental contaminants in increasing breast cancer risk remain controversial. Arsenic (As) is a major global environmental contaminant and carcinogen. We conducted a systematic review of the role of As and gene-arsenic interactions in susceptibility to breast cancer. Following a systematic literature search using well-defined inclusion/exclusion criteria, a total of 15 epidemiologic studies (two meta-analyses, three systematic reviews, three cohort studies, two case-control studies, and five cross-sectional studies) were reviewed. In addition, several animal, in vitro, in vivo, and in silico (i.e., computer modeling) studies provided mechanistic insights into the association between As and breast cancer. Our review suggests a possible overall main effect of As on breast cancer risk. The evidence for an effect of gene-As interactions on breast cancer risk is strong. Studies that measured levels of As metabolites among participants and/or evaluated interactions between As exposure and genetic or epigenetic factors generally reported positive associations with breast cancer risk. Our analysis of the Comparative Toxicogenomics and the Ingenuity Pathway Analysis Databases provided further evidence for As-gene interactions and their effects on breast cancer-related biologic pathways. Our findings provide potential leads for future epidemiologic studies of As-associated cancer risks and interventions to reduce population exposure.

Polybrominated diphenyl ethers and the multi-element profile of house dust in Croatia: Indoor sources, influencing factors of their accumulation and health risk assessment for humans

Given the large amount of time people spend indoors today, human exposure to indoor contaminants causes increasing public health concerns. The present study reports for the first time the levels of 7 polybrominated diphenyl ether (PBDE) congeners, and 18 trace elements measured in dust samples collected in 68 households from Zagreb, Croatia. Based on the obtained data from dust analysis and the questionnaire on the house characteristics and habits of the residents, we aimed to assess the possible indoor sources of PBDEs/elements, and the associated health risks. Mass concentrations of ΣPBDE ranged from 0.16 and 200.09 ng g^-1 dust (median 4.19 ng g^-1 dust). The most frequently detected congeners were BDE-99 and BDE-183 found in >88% of samples, while for trace elements, Al, Fe, Zn, Mn and Cu were found at the highest concentrations (enumerated in the descending order). The regression analysis indicated that renovation, number of residents and hours spent using electronic devices are significant predictors for determining PBDE dust concentrations, while the house age, and the house area were identified as the most important contributors for most trace elements. Our health risk assessment considering dust ingestion and dermal absorption of analyzed dust indicated that no adverse health effects are expected in toddlers and adults from exposure to PBDEs or trace elements in house dust. However, calculating the worst case exposure scenario based on the maximum measured concentrations and high dust intake rates, it was estimated that there is a risk of potential adverse health effects for Co (HI > 1). Even though the cases of high exposure to toxic elements from dust are sporadic, and not common among the general population, this exposure scenario should be included whenever assessing the background exposure of children.

Trace elements under the spotlight: A powerful nutritional tool in cancer

Cancer is the second leading cause of death worldwide. Research on the relationships between trace elements (TE) and the development of cancer or its prevention is a field that is gaining increasing relevance. This review provides an evaluation of the effects of TE (As, Al, B, Cd, Cr, Cu, F, I, Pb, Li, Mn, Hg, Mo, Ni, Se, Si, Sn, V and Zn) intake and supplementation in cancer risk and prevention, as well as their interactions with oncology treatments. Advancements in the knowledge of TE, their dietary interactions and their main food sources can provide patients with choices that will help them to improve their quality of life and therapy outcomes. This approach could open new opportunities for treatments based on the integration of conventional therapies (chemotherapy, radiotherapy, and immunotherapy) and dietary interventions that provide advanced personalized treatments.

Copper content in ascitic fluid is associated with angiogenesis and progression in ovarian cancer

BACKGROUND

Ascites is associated with the poor prognosis of malignant tumors. The biological importance of the changes in the content of trace elements in the ascitic fluid is unknown. Herein, we analyzed trace elements in the ascitic fluid of patients with ovarian tumors and used cultured cells to determine the copper (Cu)-induced changes in gene expression in ovarian cancer.

METHODS

Inductively coupled plasma mass spectrometry (ICP-MS) was used to compare ascitic fluid trace element levels in patients with benign ovarian tumors (n = 22) and borderline/malignant tumors (n = 5) for primary screening. Cu levels were validated using atomic absorption spectrometry (AAS) in 88 benign, 11 borderline, and 25 malignant ovarian tumor patients. To confirm Cu-induced gene expression changes, microarray analysis was performed for Cu-treated OVCAR3, A2780, and Met5A cells. The vascular endothelial growth factor (VEGF) concentration in the cell supernatant or ascitic fluid (ovarian cancer samples) was measured using ELISA.

RESULTS

ICP-MS showed that Co, Ni, Cu, Zn, As, Se, and Mo levels significantly increased in patients with malignant/borderline ovarian tumors compared to those in patients with benign ovarian tumors. AAS showed that malignant ovarian tumors were independently associated with elevated levels of Cu in ascites adjusted for age, body mass index, alcohol, smoking, and supplement use (p < 0.001). Microarray analysis of both Cu-treated ovarian cancer cell lines OVCAR3 and A2780 and the mesothelial cell line Met-5A revealed the upregulation of the angiogenesis biological process. Real-time polymerase chain reaction and ELISA demonstrated that an increased Cu content significantly enhanced VEGF mRNA expression and protein secretion in OVCAR3, A2780, and Met-5A cells. VEGF levels and clinical stages of the tumors correlated with the ascitic fluid Cu content in patients with malignant ovarian tumors (correlation coefficient 0.445, 95 % confidence interval [CI]: 0.069-0.710, p = 0.023 and correlation coefficient 0.406, 95 % CI: 0.022-0.686, p = 0.040, respectively).

CONCLUSION

Cu levels significantly increased in patients with malignant ovarian cancer. Cu induced angiogenic effects in ovarian cancer and mesothelial cells, which affected ascites fluid production. This study clarifies the link between elevated Cu in ascites and malignant ovarian tumor progression. Strategies to decrease Cu levels in the ascitic fluid may help downregulate VEGF expression, thereby improving the prognosis of ovarian malignancies.

Evaluating tissue levels of the eight trace elements and heavy metals among esophagus and gastric cancer patients: A comparison between cancerous and non-cancerous tissues

BACKGROUND

Considering the affecting role of environmental factors including trace elements and heavy metals on the upper gastrointestinal (GI) cancers, there is paucity of empirical research in tissue evaluations.

OBJECTIVES

The present study aimed to measure the tissue content of some trace elements and heavy metals such as zinc (Zn), chromium (Cr), manganese (Mn), tin (Sn), copper (Cu), aluminum (Al), lead (Pb), and iron (Fe) in esophagus and gastric cancerous tissues compared to the adjacent healthy tissues.

METHODS

In a cross-sectional study, the aforementioned trace elements and heavy metals were evaluated among patients with esophagus and gastric cancers. During endoscopy, multiple samples were taken from cancerous lesions and the adjacent healthy tissues. The classic flame atomic absorption spectroscopy (FAAS) method was employed as the study framework.

RESULTS

Fifty patients with the mean age of 53.92 ± 8.73 were enrolled in the current study. Thirteen patients suffered from esophageal cancer and thirty-seven patients were afflicted with gastric cancer. The results revealed significant differences in the median concentrations of Zn, Cr, Sn and, Cu (P < 0.05) between the two groups. Although there were no significant changes in the tissue content in the esophageal samples, in the median concentrations of Zn, Cr and, Sn (P < 0.05) in gastric tissues, significant differences were observed. Further, the results indicated that gender enacted an affecting role in the level of some trace elements and heavy metals.

CONCLUSION

The tissue contents of some elements were altered in gastric and esophageal cancers; this difference may reflect the underlying mechanism of cellular changing during the tumorigenesis or direct exposure of these elements. It seems that under the shade of other coexisting risk factors, larger cohort studies are suggested to be conducted to investigate other probable aspects in this area of interest.

Serum Selenium Level and 10-Year Survival after Melanoma

Melanoma is one of the most aggressive human malignancies. The determination of prognostic biomarkers is important for the early detection of recurrence and for the enrollment of the patients into different treatment regimens. Herein, we report the 10-year survival of 375 melanoma patients depending on their serum selenium levels. The study group was followed up from the date of melanoma diagnosis until death or 2020. Patients were assigned to one of four categories, in accordance with the increasing selenium level (I-IV quartiles). The subgroup with low selenium levels had a significant lower survival rate in relation to patients with high selenium levels, HR = 8.42; p = 0.005 and HR = 5.83; p = 0.02, for uni- and multivariable models, respectively. In the univariable analysis, we also confirmed the association between Breslow thickness, Clark classification and age at melanoma prognosis. In conclusion, a low serum selenium level was associated with an increased mortality rate in the 10 years following melanoma diagnosis. Future studies in other geographic regions with low soil selenium levels should be conducted to confirm our findings.

The Relationship between Serum Trace Elements and Oxidative Stress of Patients with Different Types of Cancer

OBJECTIVE

Many studies have identified causal and promotive roles of oxidative stress (OxS) and oxidative damage caused by OxS in the occurrence and progression of cancer. Many biomarkers in the blood circulation of patients may change correspondingly with the development of tumors. This study is aimed at investigating the correlation between OxS and serum trace element (TE) levels of patients with different types of cancer.

METHODS

1143 different types of cancer patients and 178 healthy controls from Mar. 2018 to Aug. 2020 in Mianyang Central Hospital were involved in this study. Their levels of OxS parameters (including total oxidant status (TOS), total antioxidant status (TAS), and oxidant stress index (OSI)) and the concentrations of serum TEs (including Cu, Zn, Fe, and Se) were determined.

RESULTS

Compared with healthy controls, all types of cancer patients had higher TOS level (all P adj < 0.001) and OSI level (z = 6.228 ~ 9.909, all P adj < 0.001) and lower TAS level (all P adj < 0.001). Compared with healthy controls, the changes of four TE levels in serum were different in different types of cancer patients, among which Cu increased in all groups, but there was no statistical difference in gastric and brain cancer; Se decreased in all groups, but there was no statistical difference in gastric, colorectal, esophageal, and other cancer; Zn was significantly decreased in breast cancer patients (P adj < 0.001); there was no statistical difference in the change of Fe in liver, kidney, and other cancer. Spearman correlation showed that the change of Cu concentration was most closely related to the three OxS parameters and was strongly correlated in the observed several types of tumors (r s > 0.6). Multinomial logistic regression showed that the risks of different tumors are related to the level change of multiple TEs and OxS parameters (ORTOS = 1.19 ~ 2.82, OROSI = 2.56 ~ 4.70, ORTAS = 0.20 ~ 0.46, ORCu = 0.73 ~ 1.44, ORZn = 0.81 ~ 0.91, ORFe = 0.68 ~ 1.18, and ORSe = 0.22 ~ 0.45, all P < 0.006).

CONCLUSIONS

The OxS exists in the occurrence and development of cancer, which may be related to the changes of certain trace elements. In order to evaluate OxS correctly, it is necessary to detect TAS and TOS and at the same time, their ratio OSI should be detected. Assessment of markers representing the overall level of OxS and TEs may guarantee improved the monitoring of disease occurrence and development risk in cancer patients.

Health risk assessment of exposure to toxic elements resulting from consumption of dried wild-grown mushrooms available for sale

Mushrooms exhibit a high ability to accumulate potentially toxic elements. The legal regulations in force in the European Union countries do not define the maximum content of elements in dried wild-grown mushrooms. This study presents the content of mercury (Hg), lead (Pb), cadmium (Cd) and arsenic (As) determined in dried wild-grown mushrooms (Boletus edulis and Xerocomus badius) available for sale. Moreover, the health risk associated with their consumption is assessed. The inductively coupled plasma mass spectrometry (Cd, Pb, As) and atomic absorption spectrometry (Hg) were used. The mean Hg, Cd, Pb and As concentration in Boletus edulis was 3.039±1.092, 1.983±1.145, 1.156±1.049 and 0.897±0.469 mg/kg and in Xerocomus badius 0.102±0.020, 1.154±0.596, 0.928±1.810 and 0.278±0.108 mg/kg, respectively. The maximum value of the hazard index (HI) showed that the consumption of a standard portion of dried Boletus edulis may have negative consequences for health and corresponded to 76.2%, 34.1%, 33% and 4.3% of the maximum daily doses of Hg, Cd, Pb and As, respectively. The results indicate that the content of toxic elements in dried wild-grown mushrooms should be monitored. The issue constitutes a legal niche where unfavourable EU regulations may pose a threat to food safety and consumer health.

The Interplay between Oxidative Stress, Inflammation and Angiogenesis in Bladder Cancer Development

In 2018, 550,000 people were diagnosed with bladder cancer (BC), of which nearly 200,000 people died. Moreover, men are 4 times more likely than women to be diagnosed with BC. The risk factors include exposure to environmental and occupational chemicals, especially tobacco smoke, benzidine and genetic factors. Despite numerous studies, the molecular basis of BC development remains unclear. A growing body of evidence suggests that inflammation, oxidant-antioxidant imbalance and angiogenesis disorders may play a significant role in the development and progression of bladder cancer. The patients with bladder cancer were characterised by an increased level of reactive oxygen species (ROS), the products of lipid peroxidation, proinflammatory cytokines and proangiogenic factors as compared to controls. Furthermore, it was shown that polymorphisms localised in genes associated with these pathways may modulate the risk of BC. Interestingly, ROS overproduction may induce the production of proinflammatory cytokines, which finally activated angiogenesis. Moreover, the available literature shows that both inflammation and oxidative stress may lead to activation of angiogenesis and tumour progression in BC patients.

Nutrition, one-carbon metabolism and arsenic methylation in Bangladeshi adolescents

BACKGROUND

Over 57 million people in Bangladesh are chronically exposed to arsenic-contaminated drinking water. Ingested inorganic arsenic (InAs) undergoes hepatic methylation generating monomethyl- (MMAs) and dimethyl- (DMAs) arsenic species in a process that facilitates urinary As (uAs) elimination. One-carbon metabolism (OCM), a biochemical pathway that is influenced by folate and vitamin B12, facilitates the methylation of As. OCM also supports nucleotide and amino acid synthesis, particularly during periods of rapid growth such as adolescence. While folate supplementation increases As methylation and lowers blood As (bAs) in adults, little data is available for adolescents.

OBJECTIVES

To examine the associations between OCM-related micronutrients and As methylation in Bangladeshi adolescents chronically exposed to As-contaminated drinking water.

METHODS

We conducted a cross-sectional study of 679 Bangladeshi adolescents, including 320 boys and 359 girls aged 14-16 years. Nutritional status was assessed by red blood cell (RBC) folate, plasma folate, plasma B12 and homocysteine (Hcys). Arsenic-related outcomes included blood arsenic (bAs), urinary arsenic (uAs), and urinary arsenic metabolites expressed as a percentage of total urinary As: %InAs, %MMAs, %DMAs.

RESULTS

Boys had significantly lower B12, higher Hcys, higher bAs, higher uAs, higher %MMAs, and a trend toward lower RBC folate compared to girls. Therefore, regression analyses controlling for water As and BMI were sex stratified. Among girls, RBC folate was inversely associated with bAs, plasma B12 was inversely associated with uAs, and plasma Hcys was inversely associated with %MMA. Among boys, plasma folate was inversely associated with %InAs and positively associated with %DMA, RBC folate was inversely associated with %InAs and positively associated with %MMA, while Hcys was positively associated with %InAs.

CONCLUSIONS

These findings suggest that associations between OCM nutritional status, bAs, and distribution of As metabolites in adolescents are similar to previously reported observations in adults and in children. The As methylation findings are statistically significant among boys but not among girls; this may be related to estrogen which more strongly influences OCM in females. The inverse association between Hcys and %MMA in girls is somewhat unexpected given that Hcys is known to be an indicator of impaired OCM and low folate/B12 in adults. Overall, these results indicate that the associations between OCM-related micronutrients and arsenic methylation in adolescents are generally similar to prior findings in adults, though these associations may differ by sex. Additionally, these findings suggest that more investigation into the role of Hcys in adolescent physiology is needed, perhaps particularly for girls. Additional studies are needed to evaluate the impact of OCM and As methylation on As-related adverse health outcomes (such as cancer and cardiovascular disease) in people exposed to As during adolescence.

Serum Selenium Level Predicts 10-Year Survival after Breast Cancer

In a recent prospective study, we reported an association between a low serum selenium level and five-year survival among breast cancer patients. We now have updated the cohort to include 10-year survival rates. A blood sample was obtained from 538 women diagnosed with first primary invasive breast cancer between 2008 and 2015 in the region of Szczecin, Poland. Blood was collected before initiation of treatment. Serum selenium levels were quantified by mass spectroscopy. Each patient was assigned to one of four quartiles based on the distribution of serum selenium levels in the whole cohort. Patients were followed from diagnosis until death or last known alive (mean follow-up 7.9 years). The 10-year actuarial cumulative survival was 65.1% for women in the lowest quartile of serum selenium, compared to 86.7% for women in the highest quartile (p < 0.001 for difference). Further studies are needed to confirm the protective effect of selenium on breast cancer survival. If confirmed this may lead to an investigation of selenium supplementation on survival of breast cancer patients.

Dysregulation of ferroptosis may involve in the development of non-small-cell lung cancer in Xuanwei area

The Xuanwei area of Yunnan Province, China, is one of the regions suffering from the highest occurrence and mortality rate of lung cancer in the world. Local residents tend to use bituminous coal as domestic fuel, which causes serious indoor air pollution and is established as the main carcinogen. After the local government carried out furnace and stove reform work, lung cancer rate including incidence and mortality among residents remains high. We herein wonder if there are specific mechanisms at protein level for the development of non-small-cell lung cancer (NSCLC) in this area. We investigated the changes of protein profiling in tumour of the patients from Xuanwei area. Tandem mass tag (TMT) was employed to screen the differential proteins between carcinoma and para-carcinoma tissues. We identified a total of 422 differentially expressed proteins, among which 162 proteins were significantly up-regulated and 260 were downregulated compared to para-carcinoma tissues. Many of the differentially expressed proteins were related to extracellular matrix (ECM)-receptor interaction, focal adhesion, PI3K/AKT pathway and ferroptosis. Further experiments on the two differential proteins, thioredoxin 2 (TXN2) and haptoglobin (HP), showed that the change of their expressions could make the lung cancer cell lines more resistant to erastin or RSL-induced ferroptosis in vitro, and promote the growth of tumour in nude mice. In conclusion, this study revealed that aberrant regulation of ferroptosis may involve in the development of lung cancer in Xuanwei area.

Trace Elements Status and Metallothioneins DNA Methylation Influence Human Hepatocellular Carcinoma Survival Rate

Background

Mechanisms underlying hepatocellular carcinoma (HCC) development are largely unknown. The role of trace elements and proteins regulating metal ions homeostasis, i.e. metallothioneins (MTs), recently gained an increased interest. Object of the study was to investigate the role of promoter DNA methylation in MTs transcriptional regulation and the possible prognostic significance of serum trace elements in HCC.

Methods

Forty-nine HCC patients were enrolled and clinically characterized. Cu, Se, and Zn contents were measured by Inductively Coupled Plasma Mass Spectrometry in the serum and, for a subset of 27 patients, in HCC and homologous non-neoplastic liver (N) tissues. MT1G and MT1H gene expression in hepatic tissues was assessed by Real-Time RT-PCR and the specific promoter DNA methylation by Bisulfite-Amplicon Sequencing.

Results

Patients with Cu serum concentration above the 80^th percentile had a significantly decreased survival rate (P < 0.001) with a marked increased hazard ratio for mortality (HR 6.88 with 95% CI 2.60-18.23, P < 0.001). Se and Zn levels were significantly lower in HCC as compared to N tissues (P < 0.0001). MT1G and MT1H gene expression was significantly down-regulated in HCC as compared to N tissues (P < 0.05). MTs promoter was hypermethylated in 9 out of the 19 HCC tissues showing MTs down-regulation and methylation levels of three specific CpGs paralleled to an increased mortality rate among the 23 patients analyzed (P = 0.015).

Conclusions

MT1G and MT1H act as potential tumor suppressor genes regulated through promoter DNA methylation and, together with serum Cu concentrations, be related to survival rate in HCC.

Tumor Microenvironment Biosensors for Hyperpolarized Carbon-13 Magnetic Resonance Spectroscopy

Hyperpolarization (HP) of a carbon-13 molecule via dynamic nuclear polarization (DNP) involves polarization at low temperature, followed by a dissolution procedure producing a solution with highly polarized spins at room temperature. This dissolution DNP method significantly increases the signal-to-noise ratio (SNR) of nuclear magnetic resonance (NMR) over 10,000-fold and facilitates the use of magnetic resonance spectroscopy (MRS) to image not only metabolism but also the extracellular microenvironment. The extracellular tumor microenvironment (TME) closely interacts with tumor cells and stimulates their growth and metastasis. Thus, the ability to detect pathological changes in the TME is pivotal for the detection and study of cancers. This review highlights the potential use of MRS to study features of the TME-elevated export of lactate, reduced interstitial pH, imbalanced redox equilibrium, and altered metal homeostasis. The promising outcomes of both in vitro and in vivo assays suggest that DNP-MRS may be a useful technique to study aspects of the TME. With continued improvements, this tool has the potential to study the TME and provide guidance for accurate patient stratification and precise personal therapy. Graphical Abstract.

Is low-level metal exposure related to testicular cancer?

Disruption of element homeostasis may contribute to increased susceptibility of men to cancer development. Whether environmental low-level metal exposure could contribute to the pathogenesis of testicular cancer is unknown. Comparison of the level of 18 elements in whole blood, serum and urine and parameters of oxidative stress/antioxidant status between men with testicular germ cell tumors (TGCT) and healthy men showed significant difference between the groups in most parameters. The results of linear discriminant analysis with a discrimination rate of 96% indicated whole blood Ca, Co, Cu, Fe, K, Mg, Na and Zn, serum Ca, Cu, Na and Ni, and urine Cd, Co, Fe and Mn being the strongest predictors of illness. TGCT patients had a significant increase in serum and blood Cu and decrease in serum Fe and blood Zn with cancer progression. Significantly higher concentrations of Al, As, Pb, and Ni in whole blood/serum of men with TGCT confirm the hypothesis that low-level environmental exposure to these elements may contribute to cancer development. Relationship between elements concentrations and treatment outcomes should be carefully monitored during cancer treatment since high concentrations of commonly used platinum-based chemotherapeutics may additionally disturb the homeostasis of elements.

Delineating colorectal cancer distribution, interaction, and risk prediction by environmental risk factors and serum trace elements

The burden of colorectal cancer (CRC) is increasing worldwide especially in developing countries. This phenomenon may be attributable to lifestyle, dietary and environmental risk factors. We aimed to determine the level of 25 trace elements, their interaction with environmental risk factors, and subsequently develop a risk prediction model for CRC (RPM CRC). For the discovery phase, we used a hospital-based case-control study (CRC and non-CRC patients) and in the validation phase we analysed pre-symptomatic samples of CRC patients from The Malaysian Cohort Biobank. Information on the environmental risk factors were obtained and level of 25 trace elements measured using the ICP-MS method. CRC patients had lower Zn and Se levels but higher Li, Be, Al, Co, Cu, As, Cd, Rb, Ba, Hg, Tl, and Pb levels compared to non-CRC patients. The positive interaction between red meat intake ≥ 50 g/day and Co ≥ 4.77 µg/L (AP 0.97; 95% CI 0.91, 1.03) doubled the risk of CRC. A panel of 24 trace elements can predict simultaneously and accurate of high, moderate, and low risk of CRC (accuracy 100%, AUC 1.00). This study provides a new input on possible roles for various trace elements in CRC as well as using a panel of trace elements as a screening approach to CRC.

Arsenic Exposure and Breast Cancer Risk: A Re-Evaluation of the Literature

Arsenic is a widespread environmental contaminant and recognized carcinogen for the skin, bladder and lungs. In recent years, there has been an increasing number of studies that have investigated the effects of arsenic exposure and cancer risk at other sites, including the breast. However, to date, the association between arsenic exposure and breast cancer risk remains unclear. This article will provide an overview of arsenic metabolism, the clinically important biomarkers commonly used to assess arsenic exposure, and review the epidemiologic studies examining the role of arsenic exposure on breast cancer risk. Given the large burden of disease associated with breast cancer, it is of the upmost importance to identify risk factors and preventative strategies that could reduce cancer incidence. Limiting exposure to endemic environmental toxins, such as arsenic, represents one such strategy. More studies are required to better ascertain this relationship and to develop the public policy necessary to significantly reduce breast cancer incidence.

Comprehensive analysis of the expression of SLC30A family genes and prognosis in human gastric cancer

The solute carrier 30 (SLC30) family genes play a fundamental role in various cancers. However, the diverse expression patterns, prognostic value, and potential mechanism of SLC30A family genes in gastric cancer (GC) remain unknown. Herein, we analyzed the expression and survival data of SLC30A family genes in GC patients using multiple bioinformatic approaches. Expression data of SLC30A family genes for GC patients were extracted from the Cancer Genome Atlas (TCGA) and genetic alteration frequency assessed by using cBioportal database. And validated the expression of SLC30A family genes in GC tissues and corresponding normal tissues. The prognostic value of SLC30A family genes in gastric cancer patients were explored using Kaplan–Meier plotter database. Functional enrichment analysis performed using DAVID database and clusterProfiler package. And ssGSEA algorithm was performed to explore the relationship between the SLC30A family genes and the infiltration of immune cells. We found that the median expression levels of SLC30A1-3, 5–7, and 9 were significantly upregulated in gastric cancer tissues compared to non-cancerous tissues, while SLC30A4 was downregulated. Meanwhile, SLC30A1-7, and 9 were significantly correlated with advanced tumor stage and nodal metastasis status, SLC30A5-7, and 9–10 were significantly related to the Helicobacter pylori infection status of GC patients. High expression of five genes (SLC30A1, 5–7, and 9) was significantly correlated with better overall survival (OS), first progression survival (FPS), and post progression survival (PPS). Conversely, upregulated SLC30A2-4, 8, and 10 expression was markedly associated with poor OS, FP and PPS. And SLC30A family genes were closely associated with the infiltration of immune cells. The present study implied that SLC30A5 and 7 may be potential biomarkers for predicting prognosis in GC patients, SLC30A2 and 3 play an oncogenic role in GC patients and could provide a new strategy for GC patients treatment.

Compositions and mobility of major, δD, δ18O, trace, and REEs patterns in water sources at Benue River Basin-Cameroon: implications for recharge mechanisms, geo-environmental controls, and public health

Hydro-geochemical data are required for understanding of water quality, provenance, and chemical composition for the 2,117,700 km² Niger River Basin. This study presents hydro-geochemical analysis of the Benue River Basin, a major tributary of the Niger River. The distribution of major ions, Si, δD, and δ¹⁸O, trace and rare-earth elements (TE and REEs, respectively) composition in 86 random water samples, revealed mixing of groundwater with surface water to recharge shallow aquifers by July and September rains. Equilibration of groundwater with kaolinite and montmorillonites, by incongruent dissolution, imprints hydro-chemical signatures that vary from Ca + Mg - NO₃ in shallow wells to Na + K - HCO₃ in boreholes and surface waters, with undesirable concentrations of fluoride identified as major source of fluorosis in the local population. Our results further indicate non-isochemical dissolution of local rocks by water, with springs, wells and borehole waters exhibiting surface water-gaining, weakest water-rock interaction, and strongest water-rock interaction processes, respectively. Poorly mobile elements (Al, Th and Fe) are preferentially retained in the solid residue of incongruent dissolution, while alkalis, alkaline earth and oxo-anion-forming elements (U, Mo, Na, K, Rb, Ca, Li, Sr, Ba, Zn, Pb) are more mobile and enriched in the aqueous phase, whereas transition metals display an intermediate behavior. Trace elements vary in the order of Ba > Sr > Zn > Li > V > Cu > Ni > Co > As > Cr > Sc > Ti > Be > Pb > Cd, with potentially harmful elements such as Cd, As, and Pb mobilized in acidic media attaining near-undesirable levels in populated localities. With the exception of Y, REEs distribution in groundwater in the order of Eu > Sm > Ce > Nd > La > Gd > Pr > Dy > Er > Yb > Ho > Tb > Tm differs slightly with surface water composition. Post-Archean Average Australian Shale-normalized REEs patterns ranging from 1.08 to 199 point to the dissolution of silicates as key sources of trace elements to groundwater, coupled to deposition by eolian dust.