Innovative health risk assessments of heavy metals based on bioaccessibility due to the consumption of traditional animal medicines

Spatial distribution and the ecological risks posed by heavy metals and total petroleum hydrocarbons (TPHs) in the sediments of mangrove and coral habitats of Northeast Persian Gulf

BACKGROUND

Heavy metals and total petroleum hydrocarbons (TPHs) are important pollutants in the aquatic ecosystem, and their long-term resistance, bio-accumulation, and bio-magnification during the food chain may cause adverse ecological and health risks.

METHODS

In here, the distribution and risk assessment of six heavy metals Cd, Pb, Ni, Cu, Zn, Cr, and TPHs were performed in the sediments of 32 regions situated in two mangroves (Tiab and Azini estuaries, Hara Mangrove forest protected area) and coral habitats (Larak and Hengam Islands) in Northeast of the Persian Gulf during 2020-2021. An atomic absorption device was used to determine the concentrations of heavy metals. Ecological risk of heavy metals is assessed through indices contamination factor (CF), contamination degree (CD), modified contamination degree (MCD), pollution load index (PLI), potential ecological risk index (PERI), and geoaccumulation index (Igeo). The spatial distribution of heavy metals was mapped through the inverse distance weighting (IDW) method in ArcMap.

RESULTS

The concentration of heavy metals indicated significant differences in spatial distribution. The maximum concentration of Cd 1.64 ± 0.001, Cr 18.41 ± 0.41 and Cu 40.5 ± 0.28 µg/g was observed at the regions situated in the Hara Mangrove forest protected area. Azini estuary had the maximum value of Zn 94.61 ± 30.74 and TPHs 4.47 ± 1.93 µg/g and finally, the highest value of concentration Ni 135.22 ± 1.85 µg/g and Pb 17.87 ± 2.17 g/gµ was found in Tiab estuary. The studied regions in the Tiab estuary and Hara Mangrove forest protected area were more contaminated than others and had considerable risks of Ni and Cd. Average ecological indices indicated the sediments of these areas especially Tiab, Hara Mangrove forest protected area, and Azini are moderately to considerably contaminated with Cd and Ni. Tiab was identified as the most contaminated area and all stations except Hengam Island were exposed to considerable ecological risks. Cadmium was found to be the riskiest heavy metal in the investigated region. The distribution of TPHs indicated there is no pollution of TPHs in the region. In all studied stations, the PELq (Toxicity of TPHs) and CF values showed the absence of potential risks of TPHs in sediments.

CONCLUSIONS

The findings indicated considerable contamination of Cd and Ni in the mangrove areas, especially Tiab, and it seems necessary to identify, manage, and control possible sources of contamination.

New vision for TCM quality control: Elemental fingerprints and key ingredient combination strategy for identification and evaluation of TCMs

The quality control of Traditional Chinese Medicine (TCM) is crucial for ensuring its efficacy and safety. Traditional methods, however, have limitations in fully capturing the natural essence of TCM, thus hindering the comprehensive exhibition of its authenticity. Addressing this challenge requires the establishment of a scientific and reasonable quality control system, which poses significant complexities due to the TCM unique attributes. Our research team conducted in-depth exploration of the elemental fingerprints of TCM, amassing a robust theoretical and practical foundation. In this review, we presented a comprehensive review of the core value, advanced technologies, and classic cases of elemental fingerprints. We introduced a novel perspective that integrated inorganic and organic components, overcoming traditional paradigms. The review analysis highlighted unique role of elemental fingerprints in revealing the scientific connotation of TCM. Furthermore, we proposed an innovative strategy for identifying key components, which effectively addressed the limitations of traditional methods and elevated the overall evaluation standards for TCM. This strategy was supported by emerging technologies such as artificial intelligence, metallomics, and hyperspectral imaging. Looking ahead, the application prospects of the combined strategy of elemental fingerprints and key components were promising. It not only provided a solid foundation for the formulation of TCM quality control strategies but also introduced new methodologies and tools to the field of regulatory science and scientific oversight of TCM.

Spotlight on the accumulation of heavy metals in Traditional Chinese medicines: A holistic view of pollution status, removal strategies and prospect

The accumulation of heavy metal in circulating TCMs has attracted widespread attention because the security and therapeutic efficacy are inevitably imperiled by the survival ecological environment and human production activities. How to reduce the pollution level and improve the toxicity damage becomes an urgent issue. This article provides a comprehensive overview of the current status of heavy metal contamination over a thousand types of single herbal (botanical, animal and mineral medicines) and TCM preparations published over nearly two decades. The survey revealed that growth ecosystems (soil, water sources), anthropogenic factors (harvesting, processing, storage), specific varieties and medicinal parts utilized as well as the inherent resistance capacity are the key factors that affect the accumulation of heavy metals in TCMs. And Pb, Cu and Cr are the major cumulative elements for botanicals, while mineral and animal medicines are dominated by As and Cu elements, respectively. Ongoing efforts aimed at mitigating the level and translocation rate of heavy metals by optimized cultivation processes, appropriate processing methodologies and advanced adsorption techniques are effective removal strategies. And the prospects of TCMs as a detoxifying agent for heavy metal toxicity damage posed development potential. Besides, the correlation between the speciation of arsenic (As) and chromium (Cr) and their toxicity should also be elaborated in order to provide effective references for standardizing drug dosage and cycle. And the imperative from the perspective of improving limitations standards of HMs for animal medicines, external preparations and folk medicines as well as exploring the interaction mechanisms between heavy metals and active ingredients of TCMs provides the direction for the follow-up study.

Bioaccessibility and bioavailability of exogenous and endogenous toxic substances in traditional Chinese medicine and their significance in risk assessment

Scientific risk assessment of exogenous and endogenous toxic substances in traditional Chinese medicine (TCM) is of great significance. The present review comprises a comprehensive summary of progress in the health risk assessment of harmful exogenous substances in TCMs. Such substances include heavy metals, pesticide residues, biotoxins, and endogenous toxic components involving pyrrolizidine alkaloids. The review also discusses the strengths and weaknesses of various bioaccessibility and bioavailability models, and their applications in risk assessment. Future avenues of risk assessment research are highlighted, including further exploration of risk assessment parameters, innovation of bioaccessibility and bioavailability techniques, enhancement of probabilistic risk assessment combined with bioavailability, improvement of cumulative risk assessment strategies, and formulation of strategies for reducing relative bioavailability (RBA) values in TCMs. Such efforts represent an attempt to develop a risk assessment system that is capable of evaluating the exogenous and endogenous toxic substances in TCMs to ensure its safe use in clinics, and to promote the sustainable development of the TCM industry.

Refined Cumulative Risk Assessment of Pb, Cd, and as in TCM Decoction Based on Bioavailability through In Vitro Digestion/MDCK Cells

In this study, the oral bioavailability of Pb, Cd, and As in three types of traditional Chinese medicines (TCMs) and TCM decoctions were investigated through in vitro PBET digestion/MDKC cell model. Furthermore, a novel cumulative risk assessment model associated with co-exposure of heavy metal(loid)s in TCM and TCM decoction based on bioavailability was developed using hazard index (HI) for rapid screening and target organ toxicity dose modification of the HI (TTD) method for precise assessment. The results revealed that the bioavailability of Pb, Cd, and As in three types of TCM and TCM decoction was 5.32-72.49% and 4.98-51.97%, respectively. After rapid screening of the co-exposure health risks of heavy metal(loid)s by the HI method, cumulative risk assessment results acquired by TTD method based on total metal contents in TCMs indicated that potential health risks associated with the co-exposure of Pb, Cd, and As in Pheretima aspergillum (E. Perrier) and Oldenlandia diffusa (Willd.) Roxb were of concern. However, considering both the factors of decoction and bioavailability, TTD-adjusted HI outcomes for TCMs in this study were <1, indicating acceptable health risks. Collectively, our innovation on cumulative risk assessment of TCM and TCM decoction provides a novel strategy with the main purpose of improving population health.

A novel bioaccessibility-based probabilistic risks assessment of potentially toxic elements (PTEs) in earthworm

Introduction: Early risk assessment studies usually based on total heavy metal (loid) contents, inevitably leading to an overestimation of the health risks. In addition, inputs are represented as single-point estimates in deterministic models, leading to underestimation or overestimation of the health risks. Methods: To overcome these barriers, a novel probabilistic risk assessment strategy based on the combinational use of bioaccessibility and Monte Carlo simulation was developed to assess heavy metal (loid) associated health risks of earthworms in this study. To obtain a realistic and robust probabilistic risk assessment, heavy metal (loid) exposure duration and frequency were determined using our questionnaire data. Results: As a result, the mean gastrointestinal bioaccessibility was in the order: Cd > As > Cu > Hg. The mean hazard index (HI) values for investigated metal (loid)s were 0.65 and 0.59 for male and female, respectively, demonstrating an acceptable health risk in an average community. However, the 90th percentile of HI values was 1.87 and 1.65 for male and female, respectively. And the total non-cancer risks of heavy metal (loid) exposure exceeded the acceptable threshold for 19.9% and 17.8% of male and female, respectively. In addition, the total cancer risk (TCR) value through co-exposure to As and Cd suggested that the carcinogenic risks may be of concern for average exposure population. Sensitivity analyses revealed that the exposure frequency and bioaccessible As concentration were the dominant contributors to the total risk variance, which provided meaningful implications for environmental management. Conclusion: Altogether, the refined strategy based on bioaccessibility and Monte Carlo simulation is the first of its kind, such effort attempts to scientifically guide the rational clinic use of TCM and the improvement of population-health.

Innovative accumulative risk assessment strategy of co-exposure of As and Pb in medical earthworms based on in vivo-in vitro correlation

Recent studies on risks assessment of heavy metal(loid) are usually based on their total concentrations. Nevertheless, such an analysis does not assess their real amounts absorbed by human body. To scientifically assess the health risks, in this study medical earthworms were analyzed for relative bioavailability (RBA) of arsenic (As) and lead (Pb) using a multiple gavage mouse model with liver, kidneys, brain, and leg bones as biomarkers for the first time. Metal(loid) bioaccessibility was determined using in vitro physiologically based extraction (PBET) assay. We are the first to develop a novel accumulative health risk assessment strategy by combinational analyzing bioavailability of heavy metal(loid) levels to calculate target organ toxicity dose (TTD) modification of the HI and total cancer risk (TCR), which has capacity to evaluate the health risks of co-exposure of Pb and As in medical earthworms. As a result, As-RBA ranged from 7.2% to 45.1%, and Pb-RBA ranged from 16.1% to 49.8%. Additionally, As and Pb bioaccessibility varied from 6.7% to 48.3% and 7.8% to 52.5%, respectively. Moreover, strong in vivo-in vitro correlations (IVIVCs) were observed between metal-RBA and bioaccessibility, indicating the robustness of the in vitro PBET assay to predict metal-RBA in medical earthworms. The refined accumulative assessment strategy revealed that when adjusted by heavy metal(loid) bioavailability, the TTD modification of HI method typically exhibited an acceptable health risk caused by the co-exposure of Pb and As for cardiovascular, hematological, neurological, and renal system. The TCR levels associated with exposure to Pb and As due to the ingestion of medical earthworms were also acceptable after adjustment by bioavailability. Collectively, our innovation on accumulative risk assessment based on in vivo-in vitro correlation provides a novel approach engaging in assessing the risks due to co-exposure of As and Pb in medical earthworms.

Decreased in vitro bioaccessibility of Cd and Pb in an acidic Ultisol through incorporation of crop straw-derived biochar

Studies analyzing the in vitro bioaccessibility (BAc) of heavy metals in biochar-amended soils are currently lacking. The present study aimed to assess the metal BAc in Cd- and Pb-spiked acidic Ultisol samples treated individually with 2% (w/w) maize, rice, wheat, soybean, and pea straw-derived biochar. The results indicate that the Cd-BAc simulated in gastric phase (GP) decreased from 78.4% to 66.5-72.3% and the Pb-BAC decreased from 74.3% to 67.2-69.2%; however, the Cd-BAc in the intestinal phase (IP) decreased from 35.6% to 27.9-33.5% and the Pb-BAc decreased from 34.7% to 29.7-32.9% after 120 d of incubation with biochar application compared to the un-amended Ultisol. The Cd- and Pb-BAc in both GP and IP were significantly negatively correlated with soil pH, CEC, and organic carbon (P < 0.05), which increased after biochar application. The soybean straw-derived biochar amendment has the greatest potential to decrease the BAc of Cd and Pb in the GP and IP, owing to the highest level of CEC, SOC, TC and TN among all soil samples. Moreover, the BAc was positively correlated with the exchangeable, and exchangeable + carbonate-bound Cd and Pb fractions (P < 0.05), indicating these fractions had a dominant influence on the BAc of cationic heavy metals. Therefore, crop straw-derived biochar amendment can decrease the BAc of Cd and Pb in acidic Ultisol, and thus mitigate the health risks posed by these metals from incidental ingestion.

Composition of Three Common Chinese Herbal Medicines and the Influence of Preparation Types on the Bioaccessibility of Trace Elements

The high concentration of trace elements in Chinese herbal medicine (CHM) is an important research topic for quality control. This study investigated the total concentration of trace elements in three herbs used as both medicine and supplementary food, including Astragalus membranaceus, Glycyrrhiza, and Isatidis. Further, the effects of different preparation ways, such as decoct, granule, and oral liquid, on the bioaccessibility of trace elements in CHM were disclosed. Results indicated that the total concentrations of trace elements in these three herbs were lower than the medical standards, but the concentrations of As and Pb in CHMs were higher than the standards for supplementary food. Different preparations ways affect bioaccessibility. Powder and oral liquid show a high bioaccessibility possibly because of the grinding process and the repeated extraction with ethanol. Among the three different CHMs, Isatidis showed higher bioaccessibility of As, which may be related to the sulfur fumigation process of this CHM. The three investigated CHMs were found to be safe as medicine but presented risks as supplementary food. The apparent influence of preparation procedures on the bioaccessibility of trace elements indicated that it is necessary to appropriately regulate preparation processes for CHMs.

Integrating Multi-Type Component Determination and Anti-Oxidant/-Inflammatory Assay to Evaluate the Impact of Pre-Molting Washing on the Quality and Bioactivity of Cicadae Periostracum

Cicadae Periostracum (CP) is a traditional Chinese medicinal herb derived from the slough that is molted from the nymph of the insect Cryptotympana pustulata Fabricius. Washing with water to remove residual silt is a primary processing method of CP that is recommended by the Chinese Pharmacopoeia, but how washing methods affect the quality and bioactivity of CP is unknown. In this study, the quality and bioactivity of non-washed CP (CP-NW), post-molting-washed CP (CP-WAT), and pre-molting-washed CP (CP-WBT) were comparatively investigated. The quality of these CP samples was evaluated in terms of the UPLC-QTOF-MS/MS-based chemical profiling and semi-quantification of 39 N-acetyldopamine oligomers (belonging to six chemical types), the HPLC-UV-based quantification of 17 amino acids, the ICP-MS-based quantification of four heavy metals, and the contents of ash; the bioactivities of the samples were compared regarding their anti-oxidant and anti-inflammatory activities. It was found that, compared with CP-NW, both CP-WBT and CP-WAT had significantly lower contents of ash and heavy metals. Moreover, compared with CP-WAT, CP-WBT contained lower levels of total ash, acid-insoluble ash, and heavy metals and higher contents of N-acetyldopamine oligomers and amino acids. It also had enhanced anti-oxidant and anti-inflammatory activities. A Spearman's correlation analysis found that the contents of N-acetyldopamine oligomers and free amino acids were positively correlated with the anti-oxidant/-inflammatory activities of CP. All these results suggest that pre-molting washing can not only remove the residual silt but can also avoid the loss of the bioactive components and assure higher bioactivities. It is concluded that pre-molting washing could enhance the quality and bioactivity of CP and should be a superior alternative method for the primary processing of qualified CP.

Novel Integrated Tiered Cumulative Risk Assessment of Heavy Metals in Food Homologous Traditional Chinese Medicine Based on a Real-Life-Exposure Scenario

In order to serve population health better, the first integrated tiered decision tree for cumulative risk assessment of co-exposure of Pb-, Cd-, and As-associated health risks in food homologous traditional Chinese medicine (TCM) was designed, after measuring their concentrations by inductively coupled plasma-mass spectroscopy (ICP-MS). Basically, our three-step decision tree involving hazard quotient (HQ), hazard index (HI), and target-organ toxicity dose (TTD) modification of the HI method was developed to evaluate the potential risks of 949 batches of 15 types of food homologous TCM. To acquire a real-life exposure scenario, the cumulative risk assessment model was established by optimizing key parameters, such as ingestion rates, frequency, and duration of exposure to food homologous TCM based on questionnaire data. As a result, the mean concentrations of Pb, Cd, and As in 949 batches of food homologous TCM were 0.896, 0.133, and 0.192 mg/kg, respectively. The HQ values of As for Angelica sinensis (Oliv.) Diels and Houttuynia cordata Thunb. were 1.04 and 1.01, respectively, for females. Other HQs of Pb, Cd, or As in food homologous TCM were lower than 1 for both males and females. However, after rapid screening of the co-exposure health risks of heavy metals by the HI method, cumulative risk assessment results acquired by TTD modification of the HI method implied that the potential health risks associated with the co-exposure of Pb, Cd, and As in Lonicera japonica Thunb. and Houttuynia cordata Thunb. ingested as both TCM and food were of concern in the clinic. Additionally, the cumulative risks of Pb, Cd, and As in Mentha canadensis L., Chrysanthemum indicum L., and Zaocys dhumnades (Cantor) only used as food exceeded the human tolerance dose. Collectively, our innovation on the tiered strategy of decision tree based on a real-life exposure scenario provides a novel approach engaging in the cumulative risk assessment of heavy metals in food homologous TCM. All in all, such effort attempts to scientifically guide the rational use of TCM in the treatment of the complex diseases and the improvement of population health.

Novel bioavailability-based risk assessment of Cd in earthworms and leeches utilizing in vitro digestion/Caco-2 and MDCK cells

In the present study, the oral bioavailability of cadmium (Cd) in earthworms and leeches was investigated through in vitro physiologically based extraction test (PBET) digestion/Caco2 and MDKC cell models. We are the first to create an innovative assessment strategy which has capacity to offer a more precise evaluation of Cd-associated health risks in traditional animal medicines (TAMs), by combinational usage of bioavailable Cd levels, the duration and frequency of the exposure to TAMs obtained by questionnaire data, as well as safety factor of TAMs. Our data showed that the percentage of bioavailability for Caco-2 cells in earthworms and leeches ranged from 3.29 to 14.17% and 4.32 to 12.61%, respectively. The percentage of bioavailability of MDCK cells in earthworms and leeches ranged from 4.83 to 15.74% and 6.53 to 15.04%, respectively. After adjusting by the bioavailability of Cd to target hazard quotient (THQ), excitingly, our findings manifested that the health risks induced by the ingestion of earthworms and leeches were acceptable in the clinic. Our key findings suggest that bioavailability characterization cannot be ruled out and health risks should be assessed on the basis of the bioavailable Cd levels rather than total levels. Our novel strategy provides insight into the bio-accumulation of Cd in organisms as well as a more realistic and accurate assessment of Cd-associated health risks in TAMs, with the main purpose of improving public health by scientifically using TAMs.

Ecological and health risk assessment of heavy metals in soil and Chinese herbal medicines

As medicinal plants can accumulate harmful metals from the native soil, people's consumption of these materials may cause the human body to accumulate toxic metal elements. This has given rise to people's concerns about the quality and safety of Chinese medicinal materials. This research aims to determine the levels of Cr, Ni, Cu, Zn, As, Cd, Hg and Pb in four medicinal plant species (Aster tataricus L.f., Salvia miltiorrhiza Bge, Radix Aucklandiae, Scutellaria baicalensis Georgi) and their native soil. All samples were collected from Qian'an city, beside Yanshan Mountain Range in Tangshan city, east Hebei Province, north China. The contents of heavy metals we detected in the soil conformed to the current limits. However, the Cd and Hg in the soil had a very high potential ecological risk because of their contents higher than the base level of local soil. The contents of Cu, Cd, Hg and Pb in some medicinal herbs exceeded the standards. The content of Cu in Radix Aucklandiae exceeded the standard by 3 times, and others exceeded the standard by less than one time. The comprehensive health risk assessment of heavy metals with chronic non-carcinogenic effects for human body showed that none of the four medicinal herbs can create a health risk. Thus, there is no strong positive correlation between heavy metal pollution in medicinal herbs and that in the native soil. Further research should be investigated to the connection between the heavy metal levels in the soil and plants, and the comprehensive effects of soil, air and irrigation water on heavy metal pollution of Chinese herbal medicines. We also recommend that Chinese herbal medicines should be cultivated and gathered only from controlled or uncontaminated areas.

Analysis of dietary exposure and risk assessment of pesticide residues in roots and rhizomes of Chinese herbs

Medicine food homologous (MFH) plants provide therapeutic and health care effects through diet. Thus, a risk assessment system for hazardous ingredient residues is urgently required to ensure their safe use. In this study, the pesticide contamination of six root and rhizome Chinese herbs, Ginseng Radix et Rhizoma, Panacis Quinquefolii Radix, Pseudostellariae Radix, Salviae Miltiorrhizae Radix et Rhizoma, Codonopsis Radix, and Glehniae Radix, and the risks associated with their intake were investigated. A total of 420 MFH plant samples collected from 22 provinces in China were tested, and 61 pesticides were detected in 413 samples. Multiple pesticide residues were detected in each MFH sample, with contents ranging from 0.0002 to 3.010 mg/kg dry weight. Carbendazim (≥47.14%) and propham (≥40%) were the most frequently detected pesticides. Risk assessment determined by hazard quotients indicated that the risks were acceptable, with no short- or long-term adverse health effects. However, considering the high incidence of residues and the detection of unregistered or even prohibited pesticides, strict supervision of soil quality and pesticide application (particularly cadusafos) in MFH plant cultivation are recommended to aid in monitoring MFH plant quality and ensuring diet and drug safety. PRACTICAL APPLICATION: Ensure the diet and drug safety of Chinese herbs.

Tracing the heavy metals zinc, lead and nickel in banana shrimp (Penaeus merguiensis) from the Persian Gulf and human health risk assessment

Seafood has long been considered a unique source of nutrition. However, increasing trends in consumption of marine products must be considered, especially in potentially polluted environments such as the Persian Gulf. This study was undertaken to analyse the level of heavy metal contamination of nickel (Ni), zinc (Zn), and lead (Pb) in shrimp (Penaeus merguiensis) captured from the northern Persian Gulf. The concentration of heavy metals in the muscle of shrimp followed the order Zn > Ni > Pb. The content of Zn and Ni was higher than recommended standard limits by the FAO/WHO. The combined impact of all metals was lower than the acceptable limit of 1 in shrimp. The carcinogenic risk for Ni was higher than the unacceptable value. In total, our finding indicated no potential health risk from the daily consumption of this species. However, long-term consumption of shrimp can pose a risk of carcinogenic effects of nickel. Continuous monitoring of these trace metals in seafood is necessary to ensure the quality of seafood and food safety.

Bioaccessibility-corrected health risk of heavy metal exposure via shellfish consumption in coastal region of China

A systematic investigation into bioaccessible heavy metals in shellfish Crassostrea ariakensis, Chlamys farreri, and Sinonovacula constricta from coastal cities Shenzhen, Zhoushan, Qingdao, and Dandong was carried out to assess the potential health risk to residents in coastal regions in China. The bioaccessible fractions of heavy metals were (μg‧g-1): Zn (0.63-15.01), Cu (0.10-12.91), Cd (0.01-0.64), As (0.11-0.33), Cr (0.07-0.12), Pb (0.01-0.03). The bioaccessibilities of heavy metals were Cr 61.86%, inorganic As (iAs) 60.44%, Pb 55.74%, Cu 46.83%, Zn 28.16%, and Cd 24.99%. As for child and adult, the bioaccessibility-corrected estimated daily intakes were acceptable and the non-carcinogenic risks posed by heavy metals were not obvious. The carcinogenic risks posed by bioaccessible heavy metals at the fifth percentile were 10-fold higher than the acceptable level (10-4), with iAs and Cd to be the major contributors, regardless of child or adult. The probabilistic estimation showed the low risk of shellfish consumption, which was verified by higher values of maximum allowable consumption rate and monthly meals at the 95 percentile; while some control of consumption rate and monthly meals was necessary for reducing heavy metal exposure of most shellfish samples, except for the safe consumption of S. constricta for both child and adult in Qingdao and Shenzhen, China.