Inflammation biomarkers associated with arsenic exposure by drinking water and respiratory outcomes in indigenous children from three Yaqui villages in southern Sonora, México

Toxic metals and pediatric clinical immune dysfunction: A systematic review of the epidemiological evidence

BACKGROUND

Children are at high risk for exposure to toxic metals and are vulnerable to their effects. Significant research has been conducted evaluating the role of these metals on immune dysfunction, characterized by biologic and clinical outcomes. However, there are inconsistencies in these studies. The objective of the present review is to critically evaluate the existing literature on the association between toxic metals (lead, mercury, arsenic, and cadmium) and pediatric immune dysfunction.

METHODS

Seven databases (PubMed (NLM), Embase (Elsevier), CINAHL (Ebsco), Web of Science (Clarivate Analytics), ProQuest Public Health Database, and ProQuest Environmental Science Collection) were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in February 2024. Rayaan software identified duplicates and screened by title and abstract in a blinded and independent review process. The remaining full texts were reviewed for content and summarized. Exclusions during the title, abstract, and full-text reviews included: 1) not original research, 2) not epidemiology, 3) did not include toxic metals, 4) did not examine an immune health outcome, or 5) not pediatric (>18 years). This systematic review protocol followed the PRISMA guidelines. Rayaan was used to screen records using title and abstract by two blinded and independent reviewers. This process was repeated for full-text article screening selection.

RESULTS

The search criteria produced 7906 search results; 2456 duplicate articles were removed across search engines. In the final review, 79 studies were included which evaluated the association between toxic metals and outcomes indicative of pediatric immune dysregulation.

CONCLUSIONS

The existing literature suggests an association between toxic metals and pediatric immune dysregulation. Given the imminent threat of infectious diseases demonstrated by the recent COVID-19 epidemic in addition to increases in allergic disease, understanding how ubiquitous exposure to these metals in early life can impact immune response, infection risk, and vaccine response is imperative.

Adverse Health Effects of the Long-Term Simultaneous Exposure to Arsenic and Particulate Matter in a Murine Model

PM2.5 and arsenic are two of the most hazardous substances for humans that coexist worldwide. Independently, they might cause multiple organ damage. However, the combined effect of PM2.5 and arsenic has not been studied. Here, we used an animal model of simultaneous exposure to arsenic and PM2.5. Adult Wistar rats were exposed to PM2.5, As, or PM2.5 + As and their corresponding control groups. After 7, 14, and 28 days of exposure, the animals were euthanized and serum, lungs, kidneys, and hearts were collected. Analysis performed showed high levels of lung inflammation in all experimental groups, with an additive effect in the coexposed group. Besides, we observed cartilaginous metaplasia in the hearts of all exposed animals. The levels of creatine kinase, CK-MB, and lactate dehydrogenase increased in experimental groups. Tissue alterations might be related to oxidative stress through increased GPx and NADPH oxidase activity. The findings of this study suggest that exposure to arsenic, PM2.5, or coexposure induces high levels of oxidative stress, which might be associated with lung inflammation and heart damage. These findings highlight the importance of reducing exposure to these pollutants to protect human health.

Update of the risk assessment of inorganic arsenic in food

The European Commission asked EFSA to update its 2009 risk assessment on arsenic in food carrying out a hazard assessment of inorganic arsenic (iAs) and using the revised exposure assessment issued by EFSA in 2021. Epidemiological studies show that the chronic intake of iAs via diet and/or drinking water is associated with increased risk of several adverse outcomes including cancers of the skin, bladder and lung. The CONTAM Panel used the benchmark dose lower confidence limit based on a benchmark response (BMR) of 5% (relative increase of the background incidence after adjustment for confounders, BMDL05) of 0.06 μg iAs/kg bw per day obtained from a study on skin cancer as a Reference Point (RP). Inorganic As is a genotoxic carcinogen with additional epigenetic effects and the CONTAM Panel applied a margin of exposure (MOE) approach for the risk characterisation. In adults, the MOEs are low (range between 2 and 0.4 for mean consumers and between 0.9 and 0.2 at the 95th percentile exposure, respectively) and as such raise a health concern despite the uncertainties.

The Development of Fe3O4-Monolithic Resorcinol-Formaldehyde Carbon Xerogels Using Ultrasonic-Assisted Synthesis for Arsenic Removal of Drinking Water

Inorganic arsenic in drinking water from groundwater sources is one of the potential causes of arsenic-contaminated environments, and it is highly toxic to human health even at low concentrations. The purpose of this study was to develop a magnetic adsorbent capable of removing arsenic from water. Fe3O4-monolithic resorcinol-formaldehyde carbon xerogels are a type of porous material that forms when resorcinol and formaldehyde (RF) react to form a polymer network, which is then cross-linked with magnetite. Sonication-assisted direct and indirect methods were investigated for loading Fe3O4 and achieving optimal mixing and dispersion of Fe3O4 in the RF solution. Variations of the molar ratios of the catalyst (R/C = 50, 100, 150, and 200), water (R/W = 0.04 and 0.05), and Fe3O4 (M/R = 0.01, 0.03, 0.05, 0.1, 0.15, and 0.2), and thermal treatment were applied to evaluate their textural properties and adsorption capacities. Magnetic carbon xerogel monoliths (MXRF600) using indirect sonication were pyrolyzed at 600 °C for 6 h with a nitrogen gas flow in the tube furnace. Nanoporous carbon xerogels with a high surface area (292 m2/g) and magnetic properties were obtained. The maximum monolayer adsorption capacity of As(III) and As(V) was 694.3 µg/g and 1720.3 µg/g, respectively. The incorporation of magnetite in the xerogel structure was physical, without participation in the polycondensation reaction, as confirmed by XRD, FTIR, and SEM analysis. Therefore, Fe3O4-monolithic resorcinol-formaldehyde carbon xerogels were developed as a potential adsorbent for the effective removal of arsenic with low and high ranges of As(III) and As(V) concentrations from groundwater.

HIF-1α Mediates Arsenic-Induced Metabolic Reprogramming in Lung Bronchial Epithelial Cells

Arsenic is a common environmental pollutant that can cause damage to multiple systems and organs in the body. The lungs are particularly sensitive to arsenic exposure, and respiratory disease is thought to be the leading cause of death from arsenic poisoning. Our previous study found that human bronchial epithelial (HBE) cells treated with NaAsO₂ exhibited mitochondrial dysfunction accompanied by elevated HIF-1α; however, the molecular mechanism was unclear. The aim of the current study was to confirm the role of HIF-1α in arsenic-induced mitochondrial damage. The results of this study indicated that NaAsO₂ treatment induced mitochondrial ultrastructure impairment and depolarization of the mitochondrial membrane potential. Furthermore, NaAsO₂ induced a significant decrease in basal respiration, maximal respiration, spare respiratory capacity, ATP (adenosine-triphosphate)-associated mitochondrial respiration and proton leakage in HBE cells (P < 0.05), while promoting an increase in ECAR (extracellular acidification rate) values. To clarify the role of HIF-1α, the effect of HIF-1α siRNA on NaAsO₂-induced glycolysis in HBE cells was examined, and the results showed that HIF-1α siRNA reversed the NaAsO₂-induced elevation in PKM2 (Tyr105), HIF-1α, GLUT1 and HK2 protein expression and decreased the NaAsO₂-mediated glycolysis level, glycolytic capacity and glycolytic reserve. These findings suggest that targeting metabolic dysregulation has significant implications for targeting arsenic-induced lung injury and that HIF-1α is an exciting new therapeutic target for the treatment of arsenic-induced lung injury.

Non-malignant respiratory illness associated with exposure to arsenic compounds in the environment

Arsenic (As), a toxic metalloid, primarily originates from both natural and anthropogenic activities. Reports suggested that millions of people globally exposed to high levels of naturally occurring As compounds via inhalation and ingestion. There is evidence that As is a well-known lung carcinogen. However, there has been relatively little evidence suggesting its non-malignant lung effects. This review comprehensively summarises current experimental and clinical studies implicating the association of As exposure and the development of several non-malignant lung diseases. Experimental studies provided evidence that As exposure induces redox imbalance, apoptosis, inflammatory response, epithelial-to-mesenchymal transition (EMT), and affected normal lung development through alteration of the components of intracellular signaling cascades. In addition, we also discuss the sources and possible mechanisms of As influx and efflux in the lung. Finally, current experimental studies on treatment strategies using phytochemicals and our perspective on future research with As are also discussed.

Transcriptome analysis of the toxicity response of green macroalga Caulerpa lentillifera J. Agardh to high dissolved arsenite

Arsenic (As) is a hazardous pollutant that negatively impacts the physiological functions of alga. So far, a detailed understanding of algal response to As stress is still lacking. In this study, a transcriptome analysis was performed to illustrate the toxicity response of Caulerpa lentillifera J. Agardh, an edible algae with rich nutrition, to arsenite [As(III)], a toxic form of As. Totally, 1913 differentially expressed genes (DEGs) were screened, of which 642 were up- and 1271 were downregulated in C. lentillifera under As(III) stress (30 mg·L^-1) compared with control. As(III) stress promoted the growth of C. lentillifera at low concentration (0.1 mg·L^-1) and inhibited the growth at high concentration (≥ 0.5 mg·L^-1). Multiple DEGs involved in oxidoreductase activities were significantly affected by As(III), and several DEGs related to antioxidant enzyme activity were downregulated, resulting in suffering from oxidative stress in C. lentillifera. Results also showed that As(III) stress inhibited chlorophyll and carotenoid synthesis, destroyed the integrity of chloroplasts, and interfered with the absorption of light energy, thereby inhibiting photosynthesis in C. lentillifera. The highly enriched ABC transporter-related genes involved in the detoxification process were upregulated under As(III) stress, indicating their critical role in the resistance to As stress in C. lentillifera. The gene expressions for 10 selected DEGs were confirmed by qRT-PCR, showing the reliability of the data revealed by RNA sequencing. Our novel work illustrated the toxicity of C. lentillifera under As(III) stress at the molecular level, serving as a basis for future investigations on the prevention and treatment of such pollutants.

Flavonoids against non-physiologic inflammation attributed to cancer initiation, development, and progression—3PM pathways

Inflammation is an essential pillar of the immune defense. On the other hand, chronic inflammation is considered a hallmark of cancer initiation and progression. Chronic inflammation demonstrates a potential to induce complex changes at molecular, cellular, and organ levels including but not restricted to the stagnation and impairment of healing processes, uncontrolled production of aggressive ROS/RNS, triggered DNA mutations and damage, compromised efficacy of the DNA repair machinery, significantly upregulated cytokine/chemokine release and associated patho-physiologic protein synthesis, activated signaling pathways involved in carcinogenesis and tumor progression, abnormal tissue remodeling, and created pre-metastatic niches, among others. The anti-inflammatory activities of flavonoids demonstrate clinically relevant potential as preventive and therapeutic agents to improve individual outcomes in diseases linked to the low-grade systemic and chronic inflammation, including cancers. To this end, flavonoids are potent modulators of pro-inflammatory gene expression being, therefore, of great interest as agents selectively suppressing molecular targets within pro-inflammatory pathways. This paper provides in-depth analysis of anti-inflammatory properties of flavonoids, highlights corresponding mechanisms and targeted molecular pathways, and proposes potential treatment models for multi-level cancer prevention in the framework of predictive, preventive, and personalized medicine (PPPM / 3PM). To this end, individualized profiling and patient stratification are essential for implementing targeted anti-inflammatory approaches. Most prominent examples are presented for the proposed application of flavonoid-conducted anti-inflammatory treatments in overall cancer management.