Urinary alkoxyacetic acids and renal effects of exposure to ethylene glycol ethers

Epidemiology of Kidney Stones

In the past two decades, major breakthroughs that improve our understanding of the pathophysiology and therapy of kidney stones (KS) have been lacking. The disease continues to be challenging for patients, physicians, and healthcare systems alike. In this context, epidemiological studies are striving to elucidate the worldwide changes in the patterns and the burden of the disease and identify modifiable risk factors that contribute to the development of kidney stones. Our expanding knowledge of the epidemiology of kidney stones is of paramount importance and largely upgrades the modern management of the disease. In this paper, we review the variables affecting prevalence and incidence, including age, gender, race, ethnicity, occupation, climate, geography, systemic diseases, diabetes, vascular disease, chronic kidney disease, and dietary risk factors relevant to kidney stones.

Curcumin alleviated oxidation stress injury by mediating osteopontin in nephrolithiasis rats

PURPOSE

To explore the role and mechanism of curcumin (Cur) in reducing oxidative stress damage in rats with nephrolithiasis induced by ethylene glycol (EG).

METHODS

Thirty male rats were divided into normal control, model, positive (10% potassium citrate), Cur-10 (10 mg/kg curcumin) and Cur-20 (20 mg/kg curcumin) groups.

RESULTS

The results of kidney tissue section stained by hematoxylin-eosin and von Kossa showed that curcumin treatment can inhibit the formation of kidney stones. The biochemical test results showed that the urea (Ur), creatinine (Cr), uric acid (UA), inorganic phosphorus and Ca2+ concentrations in urine decreased after being treated with curcumin. There were significant differences between different doses of curcumin (P < 0.05). Compared with the Cur-10 group, Cur-20 had a more significant inhibitory effect on malondialdehyde (MDA) (P < 0.05). In addition, reverse transcription polymerase chain reaction (PCR) detection and immunohistochemical results indicated that the osteopontin (OPN) in the kidney was significantly reduced after curcumin treatment.

CONCLUSIONS

Curcumin could reduce the oxidative stress damage caused by EG-induced kidney stones.

Epidemiology of Urolithiasis with Sex and Working Status Stratification Based on the National Representative Cohort in Republic of Korea

Background

This study aimed to estimate the annual prevalence and incidence of urolithiasis stratified by work status based on a large nationwide sample.

Methods

This study used data from the National Health Insurance Service-National Sample Cohort from 2002 to 2015. The prevalence and incidence of urolithiasis were estimated based on work status and gender stratification. The risk of urolithiasis among workers was calculated using age-standardized incidence ratio with stratification of work type.

Results

The prevalence of urolithiasis was significantly higher in workers than in non-workers, especially men, during the follow-up period. The total estimated number of urolithiasis cases was 41,086 and the overall incidence of urolithiasis was 0.3%. The age-standardized incidence ratio of urolithiasis was significantly higher among the total workers (1.14; 95% confidence interval, 1.13-1.16), self-employed workers (1.08; 95% confidence interval, 1.06-1.11), and paid workers (1.19; 95% confidence interval, 1.17-1.21) than among the non-working population.

Conclusions

Workers, especially paid workers and men, were vulnerable to urolithiasis. Further studies are required to investigate the effects of working conditions on urolithiasis.

Firefighters' exposure to perfluoroalkyl acids and 2-butoxyethanol present in firefighting foams

The aim of this study was to assess eight firefighters' exposure to Sthamex 3% AFFF (aqueous film forming foam) in the simulation of aircraft accidents at Oulu airport in Finland. Study was conducted in 2010 before limitation for the use of PFOA and PFOS in AFFFs. Due to prospective limitation also eight commercially available AFFFs were evaluated from occupational and environmental point of view to find substitutive AFFFs for future. The firefighters' exposure to twelve perfluoroalkyl acids (PFAS) was analyzed in order to observe the signs of accumulation during three consecutive training sessions. The firefighters' short-term exposure to 2-butoxyethanol (EGBE) was analyzed by urinalysis of 2-butoxyacetic acid (2-BAA). For the background information also the concentration of PFAS in used AFFF-liquid was analyzed. Fire fighters' serum PFHxS and PFNA concentrations seemed to increase during the three training sessions although they were not the main PFAS in used AFFF. The statistical significance for the elevations was not able to test due to limited size of test group. In two training sessions, the average urinary excretions of 2-BAA exceeded the reference limit of the occupationally unexposed population. In the evaluations of the firefighting foams, non-fluorine based products were favored and the alcohol resistance properties of foams were recommended for consideration due to the increasing use of biofuels.

[Hormone replacement therapy: toxicity of glycol ethers]

Glycol ethers (GE) belong to two main series: series E, which include ethylene glycol ethers (EGE) and series P which include propylene glycol ethers (PGE). GE are widely used as solvents in a large number of industrial, household and cosmetic applications. EGE can be found in water paints, varnishes, inks, household products. Severe adverse effects have been noted with pharmaceutical formulations containing diethylene glycol monoethyl-ethers and this led to withdrawal from the French market. The toxicity of GE depends on the molecular weight and the metabolites generated. It can manifest following acute or chronic exposure by disorders of the nervous system, bone marrow, immune system, kidneys as well as fertility, reproduction and embryofetal development. Several EGE are mutagenic. The carcinogenic risk is not known. The most toxic derivatives EGME, EGMEA, EGEE and EGEEA alter male and female fertility, and induce malformations. Taking these toxic effects into consideration, what is the place of GE as absorption promoting agents? An example is DEGEE, which facilitates estradiol penetration when used as a gel in the treatment of estrogen deficiency. This review is intended to address this issue.

Percutaneous absorption of 5 glycol ethers through human skin in vitro

Absorption across full thickness human skin was evaluated in vitro for five selected glycol ethers. Skin membranes were settled on static diffusion cells and both neat and 50% water diluted glycol ethers were applied on the donor chamber for 8 h. The amount of glycol ethers permeated into the receptor fluid was measured by gas chromatograph equipped with flame ionization detector (GC-FID). For neat solvents, permeation coefficient Kp ranged from 0.06 to 0.83 cm h(-1) 10(-3) respectively for DEGBEA and EGMEA while for 50% v/v diluted glycol ethers it varied from 0.08 to 1.81 cm h(-1) 10(-3) respectively for DPGME and EGMEA. These experiments show a statistically significant (Student's t-test, P <0.05) increase in permeation coefficients from neat to 50% water diluted glycol ethers and the same trend can be observed in fluxes and lag times. Only DPGME show an opposite behaviour. These results confirm the good ability of these solvents of permeating the skin and show that they could represent a risk for their potential dermal absorption both for workers and for occasional exposures, since the average lag time is 1.57 h.

Clinical toxicologic implications of ethylene glycol and glycolic acid poisoning

Metabolic pathways have been elucidated for various chemical and solvent exposures in humans. Clinical laboratory analyses in most chemical and solvent exposures are directed toward identification and quantitation of unchanged substance in serum or whole blood. For example, most laboratories routinely screen for unchanged ethylene glycol in suspected poisonings and quantitate ethylene glycol in positive cases even though toxicity from ethylene glycol exposure (including central nervous system depression, acute renal failure, and elevated anion gap metabolic acidosis) is primarily caused by one metabolite-glycolic acid. One objective of this manuscript is to describe the authors' clinical experience with glycolic acid analysis in ethylene glycol human poisonings. Recommended clinical laboratory tests for small hospitals and toxicology reference laboratories are presented to rule out or confirm ethylene glycol exposure. Another concern with laboratory support in ethylene glycol poisoning is correct identification of ethylene glycol because analysis of this substance is often problematic. In one case laboratories incorrectly identified an organic acid from an inherited metabolic disease as ethylene glycol, and in another case the intentional ethylene glycol poisoning of an infant was determined to be the results of an endogenous organic acid. The most robust analytical methods for determining ethylene glycol and glycolic acid are chromatographic methods. Ideally, screening methods for ethylene glycol should be confirmed by another method based on a different principle of analysis or include simultaneous metabolite analysis (glycolic acid). In centers where several ethylene glycol cases present annually, toxicology laboratories supporting these centers should incorporate glycolic acid monitoring in their ethylene glycol screening programs and include analysis of both ethylene glycol and glycolic acid during treatment (hemodialysis) in all confirmed poisonings. Measurement of glycolic acid provides important diagnostic and prognostic information that one cannot correlate with the amount of ethylene glycol in serum or whole blood.

Improved method to measure urinary alkoxyacetic acids

OBJECTIVES

To simplify the current preparation of samples, and to improve the specificity and reliability of the conventional analytical methods to measure urinary alkoxyacetic acids.

METHODS

Samples containing alkoxyacetic acids including methoxy, ethoxy, and butoxyacetic acids (MAA, EAA, and BAA) were acidified with HCl and extracted with a mixed solvent of methylene chloride and isopropyl alcohol, then analysed by gas chromatography/mass spectrometry (GC/MS).

RESULTS

Optimal results were obtained when pH was 1.05-1.45, the ratio of methylene chloride and isopropyl alcohol was 2:1, and when extraction time was 10 minutes. Over the concentration range 0.3-200 micrograms/ml, MAA, EAA, and BAA could be determined with a pooled coefficient of variation (nine concentrations, six replicate samples) of 5.55%, 6.37%, and 6.41%, respectively. Urine samples were stable for at least 5 months and 3 freeze-thaw cycles at -20 degrees C. The limits of detection of MAA, EAA, and BAA were 0.055, 0.183, and 0.009 microgram/ml, respectively. The matrix effect of urine samples was negligible for MAA and EAA, but were marginally significant for BAA. The average recoveries of alkoxyacetic acids were 99%-101%. In urine samples MAA from 15 exposed workers showed a strong linear correlation (r = 0.999, slope = 1.01) between the new GC/MS method and Sakai's GC method.

CONCLUSIONS

The simplified non-derivatisation pretreatment of samples coupled with GC/MS can provide a specific, sensitive, simple, safe, and reliable method for the biological monitoring of occupational exposure of ethylene glycol ethers.

Isolation and separation of proteoglycans

Proteoglycans contain a polypeptide core and an oligosaccharide chain composed of aminohexoses and uronic acid. The glycan chain is attached to the polypeptide in a bond to serine hydroxyl. The glycan chains may contain up to 200 disaccharide units and the proteoglycan molecular mass ranges from a few thousands to millions. Their physiological functions are related to barriers limiting diffusion across the membranes, articular lubrification, blood coagulation and cellular adhesion. The tissue proteoglycans can be extracted with 4 M guanidine hydrochloride and purified with chromatographic techniques. The soluble proteoglycans can be precipitated with cetylpyridinium chloride, purified by chromatography or by dialysis. All proteoglycan species are amenable to electrophoresis on polyacrylamide gels, and after blotting on polyvinylidene fluoride membranes, they can be stained for glycans. Proteoglycan analyses have shown their value in clinical mucopolysaccharidosis diagnostics, in occupational toxicology and in coagulation studies. Experimental applications include cell adhesion studies in tumor biology, regeneration in neurosciences or maturation of skin and kidneys.

Urinary NAG and GAG as biomarkers of renal effects in exposure to 2-alkoxyalcohols and their acetates

Many sensitive biomarkers are available for the surveillance of the early health effects of chemicals on humans. This study was conducted to evaluate the usefulness of glycosaminoglycans (GAG) as biomarkers of early kidney effects in exposure to 2-alkoxyethanols and their acetates. GAG were compared with effects on the urinary beta-N-acetylglycosaminidase activity (NAG). According to the results of the present study, the excretion rate of GAG was higher among women than men. On the other hand, the excretion rate of GAG was lower among exposed subjects than among the controls, and the level was decreased at the tested levels of exposure. The NAG activity was higher in most of the exposed groups than in the controls. The data indicated that an appropriate urinary limit value for ethoxyacetic acid was 30 mmol/mol creatinine in postshift samples and that this value corresponded to an 8-hour exposure level of 2 cm3/m3 2-ethoxyethylacetate. Urinary butoxyacetic acid excretion of 60 mmol/mol creatinine corresponded to the inhalation exposure level of 5 cm3/m3 2-butoxyethanol and its acetate in postshift samples.

Assessment for Subclinical Kidney Damage in Workers Exposed to Low Concentrations of Hydrocarbons

It has been suggested the risk of hydrocarbon-induced chronic nephropathy is negligible at low exposure levels. The first purpose of the study was to test this hypothesis by selecting a population slightly exposed to hydrocarbons. Moreover, as hypertension might be associated with an increased excretion of nephrotoxic mercapturates, the association between blood pressure and urinary concentration of S-phenylmercapturic acid (S-PMA) was also examined. Lifetime exposure assessment, main tests of subclinical kidney damage, and statistical approach were taken from a previous study that had included primarily moderately or heavily exposed workers and had found hydrocarbon-induced nephrotoxic effects. No nephrotoxic effect of exposure could be ascertained in the present study. S-PMA concentration was not increased in hypertensive workers. Thus, the risk of hydrocarbon-induced chronic nephropathy might be extremely low in workers slightly exposed to hydrocarbons. The negative results of some studies might be due to the low lifetime hydrocarbon exposures of the study populations.

Biomonitoring of technical grade 1-alkoxy-2-propanol acetates by analysing urinary 2-alkoxypropionic acids

Today commercially available 1-alkoxy-2-propanol acetates contain a harmful isomer 2-alkoxy-1-propanol acetates, which makes up less than 20% of the commercial product. This harmful isomer provides a means with which to study the toxicity and exposure to alkoxypropanols. Assessing exposure to technical grade 1-alkoxy-2-propanol acetates through the biological monitoring of urinary 2-alkoxypropionic acids has been found to be the most accurate method. The method developed in this study provides a procedure for the simultaneous urinalysis of methoxyacetic acid (MAA), ethoxyacetic acid (EAA), butoxyacetic acid (BAA), oxalic acid (OA), 2-methoxypropionic acid (2-MPA) and 2-ethoxypropionic acid (2-EPA). This possibility is very valuable in workplaces where workers are exposed simultaneously to different glycol ethers. This study was conducted among 54 silkscreen printers, who gave a urine sample to be analysed using a capillary gas chromatograph for 2-MPA and 2-EPA. The mean urinary concentrations of 2-MPA and 2-EPA were 1.27 (S.D. = 1.60) nmol/mol creatinine (median = 0.53, n = 26) and 1.23 (S.D. = 2.31) mmol/mol creatinine (median = 0.26, n = 39), respectively. The urinary excretion of 2-MPA and 2-EPA immediately after shift was linearly dependent on the preceding technical grade 1-methoxy-2-proponol acetate (7 = 0.16x + 0.26, n = 26 R2 = 0.78) and technical grade 1-ethoxy-2-propanol acetate (y = 2.05x - 0.09, n = 39, R2 = 0.68) respective exposure, as measured in the workers' breathing zone. According to the results of this study it is possible to monitor exposure to the technical grade 1-methoxy-2-propanol acetate and technical grade 1-ethoxy-2-propanol acetate through urinalysis of 2-MPA and 2-EPA.

Biological monitoring of occupational exposure to 1-methoxy-2-propanol

At the end of a workweek 23 silkscreen printers gave a urine sample for capillary gas chromatographic analysis for 1,2-propanediol. The mean concentration was 2.52 (S.D. 2.01) mmol mol creatinine(-1) (median=1.76, n=23). The urinary excretion of 1,2-propanediol was linearly dependent on the preceding 1-methoxy-2-propanol exposure measured in the worker's breathing zone [y=0.99+0.28x, n=23, r=0.67, where y is the urinary 1,2-propanediol concentration, in mmol mol creatinine(-1) and x is the concentration, in cm3 m(-3), of 1-methoxy-2-propanol (90.2%), 1-ethoxy-2-propyl acetate (5.8%), 1-methoxy-2-propyl acetate (2.1%) and 1-ethoxy-2-propanol (1.9%) in the air].