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Yazdani M, Distante S, Mørkrid L, Ulvik RJ, Bolann BJ. Bloodlettings in Hemochromatosis Result in Increased Blood Lead (Pb) Concentrations. Biol Trace Elem Res 2022; 201:3193-3201. [PMID: 36168081 PMCID: PMC10160177 DOI: 10.1007/s12011-022-03424-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/12/2022] [Indexed: 11/02/2022]
Abstract
Hemochromatosis is a hereditary disorder, most often associated with mutations of the HFE (High FErrum) gene. If left untreated, it can result in severe parenchymal iron accumulation. Bloodletting is the mainstay treatment. We have previously shown that treatment of hemochromatosis by repeated bloodlettings may induce changes in the serum levels of several trace elements. The aim of this work was to evaluate if whole blood concentrations of the environmental pollutants lead (Pb), mercury (Hg), and cadmium (Cd) could be affected by bloodlettings. We recruited 28 patients and 21 healthy individuals (control group). Whole blood and urine levels of Pb, Hg, and Cd were measured before the start and after the completion of treatment using inductively coupled plasma mass spectrometry, together with serum iron and liver function tests. Concentrations of blood Pb, but not Hg or Cd, were significantly increased after treatment. The increase in Pb was higher in C282Y homozygous patients than in the other patients, and it was positively correlated with the serum concentration of alkaline phosphatase. Bloodlettings in hemochromatosis result in an increase in the blood concentration of Pb. Augmented absorption due to iron loss or Pb mobilization from bone may contribute to the higher blood Pb level.
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Affiliation(s)
- Mazyar Yazdani
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Sonia Distante
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Lars Mørkrid
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rune J Ulvik
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Section of Hematology, Haukeland University Hospital, Bergen, Norway
| | - Bjørn J Bolann
- Department of Clinical Science, University of Bergen, Bergen, Norway.
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.
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Chen CJ, Lin TY, Wang CL, Ho CK, Chuang HY, Yu HS. Interactive Effects between Chronic Lead Exposure and the Homeostatic Iron Regulator Transport HFE Polymorphism on the Human Red Blood Cell Mean Corpuscular Volume (MCV). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E354. [PMID: 30691187 PMCID: PMC6388122 DOI: 10.3390/ijerph16030354] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/01/2019] [Accepted: 01/12/2019] [Indexed: 12/16/2022]
Abstract
Research has shown that long-term exposure to lead harms the hematological system. The homeostatic iron regulator HFE (hemochromatosis) mutation, which has been shown to affect iron absorption and iron overload, is hypothesized to be related to lead intoxication in vulnerable individuals. The aim of our study was to investigate whether the HFE genotype modifies the blood lead levels that affect the distributions of serum iron and other red blood cell indices. Overall, 121 lead workers and 117 unexposed age-matched subjects were recruited for the study. The collected data included the blood lead levels, complete blood count, serum iron, total iron binding capacity, transferrin, and ferritin, which were measured during regular physical examinations. All subjects filled out questionnaires that included demographic information, medical history, and alcohol and tobacco consumption. HFE genotyping for C282Y and H63D was determined using polymerase chain reaction and restriction fragment length polymorphism (PCR/RFLP). The mean blood lead level in lead workers was 19.75 µg/dL and was 2.86 µg/dL in unexposed subjects. Of 238 subjects, 221 (92.9%) subjects were wild-type (CCHH) for HFE C282Y and H63D, and 17 (7.1%) subjects were heterozygous for a H63D mutation (CCHD). Multiple linear regression analysis showed that blood lead was significantly negatively associated with hemoglobin (Hb), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular volume (MCV), whereas the HFE variant was associated negatively with MCV and positively with ferritin. An interactive influence on MCV was identified between blood lead and HFE variants. Our research found a significant modifying effect of the HFE variant, which possibly affected MCV. The HFE H63D heterozygous (CCHD) variant seemed to provide a protective factor against lead toxicity. Future studies should focus on competing binding proteins between iron and lead influenced by gene variation.
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Affiliation(s)
- Chien-Juan Chen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
| | - Ting-Yi Lin
- Master Program of Public Health, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
| | - Chao-Ling Wang
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
| | - Chi-Kung Ho
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
| | - Hung-Yi Chuang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
| | - Hsin-Su Yu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
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Loréal O, Cavey T, Bardou-Jacquet E, Guggenbuhl P, Ropert M, Brissot P. Iron, hepcidin, and the metal connection. Front Pharmacol 2014; 5:128. [PMID: 24926268 PMCID: PMC4045255 DOI: 10.3389/fphar.2014.00128] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/13/2014] [Indexed: 12/20/2022] Open
Abstract
Identification of new players in iron metabolism, such as hepcidin, which regulates ferroportin and divalent metal transporter 1 expression, has improved our knowledge of iron metabolism and iron-related diseases. However, from both experimental data and clinical findings, "iron-related proteins" appear to also be involved in the metabolism of other metals, especially divalent cations. Reports have demonstrated that some metals may affect, directly or indirectly, the expression of proteins involved in iron metabolism. Throughout their lives, individuals are exposed to various metals during personal and/or occupational activities. Therefore, better knowledge of the connections between iron and other metals could improve our understanding of iron-related diseases, especially the variability in phenotypic expression, as well as a variety of diseases in which iron metabolism is secondarily affected. Controlling the metabolism of other metals could represent a promising innovative therapeutic approach.
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Affiliation(s)
- Olivier Loréal
- INSERM UMR 991, Iron and the Liver Team Rennes, France ; Faculty of Medicine, University of Rennes1 Rennes, France ; CHU Pontchaillou, French Reference Centre for Rare Iron Overload Diseases of Genetic Origin, University Hospital-Rennes Rennes, France
| | - Thibault Cavey
- INSERM UMR 991, Iron and the Liver Team Rennes, France ; Faculty of Medicine, University of Rennes1 Rennes, France ; Biochemistry and Enzymology Laboratory, Centre Hospitalier Universitaire Rennes, France
| | - Edouard Bardou-Jacquet
- INSERM UMR 991, Iron and the Liver Team Rennes, France ; Faculty of Medicine, University of Rennes1 Rennes, France ; CHU Pontchaillou, French Reference Centre for Rare Iron Overload Diseases of Genetic Origin, University Hospital-Rennes Rennes, France
| | - Pascal Guggenbuhl
- INSERM UMR 991, Iron and the Liver Team Rennes, France ; Faculty of Medicine, University of Rennes1 Rennes, France ; Department of Rheumatology, Centre Hospitalier Universitaire Rennes, France
| | - Martine Ropert
- INSERM UMR 991, Iron and the Liver Team Rennes, France ; CHU Pontchaillou, French Reference Centre for Rare Iron Overload Diseases of Genetic Origin, University Hospital-Rennes Rennes, France ; Biochemistry and Enzymology Laboratory, Centre Hospitalier Universitaire Rennes, France
| | - Pierre Brissot
- INSERM UMR 991, Iron and the Liver Team Rennes, France ; Faculty of Medicine, University of Rennes1 Rennes, France ; CHU Pontchaillou, French Reference Centre for Rare Iron Overload Diseases of Genetic Origin, University Hospital-Rennes Rennes, France
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Hopkins MR, Ettinger AS, Hernández-Avila M, Schwartz J, Téllez-Rojo MM, Lamadrid-Figueroa H, Bellinger D, Hu H, Wright RO. Variants in iron metabolism genes predict higher blood lead levels in young children. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:1261-6. [PMID: 18795173 PMCID: PMC2535632 DOI: 10.1289/ehp.11233] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Accepted: 04/23/2008] [Indexed: 05/21/2023]
Abstract
BACKGROUND Given the association between iron deficiency and lead absorption, we hypothesized that variants in iron metabolism genes would predict higher blood lead levels in young children. OBJECTIVE We examined the association between common missense variants in the hemochromatosis (HFE) and transferrin (TF) genes and blood lead levels in 422 Mexican children. METHODS Archived umbilical cord blood samples were genotyped for HFE (H63D and C282Y) and TF (P570S) variants. Blood lead was measured at 24, 30, 36, 42, and 48 months of age. A total of 341 subjects had at least one follow-up blood lead level available and data available on covariates of interest for inclusion in the longitudinal analyses. We used random-effects models to examine the associations between genotype (HFE, TF, and combined HFE + TF) and repeated measures of blood lead, adjusting for maternal blood lead at delivery and child's concurrent anemia status. RESULTS Of 422 children genotyped, 17.7, 3.3, and 18.9% carried the HFE H63D, HFE C282Y, and TF P570S variants, respectively. One percent of children carried both the HFE C282Y and TF P570S variants, and 3% of children carried both the HFE H63D and TF P570S variants. On average, carriers of either the HFE (beta = 0.11, p = 0.04) or TF (beta = 0.10, p = 0.08) variant had blood lead levels that were 11% and 10% higher, respectively, than wild-type subjects. In models examining the dose effect, subjects carrying both variants (beta = 0.41, p = 0.006) had blood lead 50% higher than wild-type subjects and a significantly higher odds of having a blood lead level > 10 microg/dL (odds ratio = 18.3; 95% confidence interval, 1.9-177.1). CONCLUSIONS Iron metabolism gene variants modify lead metabolism such that HFE variants are associated with increased blood lead levels in young children. The joint presence of variant alleles in the HFE and TF genes showed the greatest effect, suggesting a gene-by-gene-by-environment interaction.
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Affiliation(s)
- Marianne R. Hopkins
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Children’s Hospital Boston, Boston, Massachusetts, USA
| | - Adrienne S. Ettinger
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Channing Laboratory, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Address correspondence to A.S. Ettinger, Harvard School of Public Health, HSPH Landmark Center, 401 Park Dr., Rm. 421-West, Boston, MA 02215 USA. Telephone: (617) 384-8834. Fax: (617) 384-8745. E-mail:
| | | | - Joel Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Channing Laboratory, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Martha María Téllez-Rojo
- Division of Program Evaluation and Biostatistics, Center of Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Héctor Lamadrid-Figueroa
- Division of Program Evaluation and Biostatistics, Center of Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - David Bellinger
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Neurology, Children’s Hospital Boston, Boston, Massachusetts, USA
| | - Howard Hu
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Robert O. Wright
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Children’s Hospital Boston, Boston, Massachusetts, USA
- Channing Laboratory, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Hu H, Shine J, Wright RO. The challenge posed to children's health by mixtures of toxic waste: the Tar Creek superfund site as a case-study. Pediatr Clin North Am 2007; 54:155-75, x. [PMID: 17306689 PMCID: PMC1862721 DOI: 10.1016/j.pcl.2006.11.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In the United States, many of the millions of tons of hazardous wastes that have been produced since World War II have accumulated in sites throughout the nation. Citizen concern about the extent of this problem led Congress to establish the Superfund Program in 1980 to locate, investigate, and clean up the worst sites nationwide. Most such waste exists as a complex mixture of many substances. This article discusses the issue of toxic mixtures and children's health by focusing on the specific example of mining waste at the Tar Creek Superfund Site in Northeast Oklahoma.
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Affiliation(s)
- Howard Hu
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Room 1518, Vaughan Building (SPH-I), 109 S. Observatory St., Ann Arbor, MI 48109-2029, USA.
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Wright RO, Silverman EK, Schwartz J, Tsaih SW, Senter J, Sparrow D, Weiss ST, Aro A, Hu H. Association between hemochromatosis genotype and lead exposure among elderly men: the normative aging study. ENVIRONMENTAL HEALTH PERSPECTIVES 2004; 112:746-50. [PMID: 15121519 PMCID: PMC1241970 DOI: 10.1289/ehp.6581] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Because body iron burden is inversely associated with lead absorption, genes associated with hemochromatosis may modify body lead burden. Our objective was to determine whether the C282Y and/or H63D hemochromatosis gene (HFE) is associated with body lead burden. Patella and tibia lead levels were measured by K X-ray fluorescence in subjects from the Normative Aging Study. DNA samples were genotyped for C282Y and H63D using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP). A series of multivariate linear regression models were constructed with bone or blood lead as dependent variables; age, smoking, and education as independent variables; and C282Y or H63D as independent risk factors and/or effect modifiers. Of 730 subjects, 94 (13%) carried the C282Y variant and 183 (25%) carried the H63D variant. In the crude analysis, mean tibia, patella, and blood lead levels were consistently lower in carriers of either HFE variant compared with levels in subjects with wild-type genotypes. In multivariate analyses that adjusted for age, smoking, and education, having an HFE variant allele was an independent predictor of significantly lower patella lead levels (p < 0.05). These data suggest that HFE variants have altered kinetics of lead accumulation after exposure. Among elderly men, subjects with HFE variants had lower patella lead levels. These effects may be mediated by alterations in lead toxicokinetics via iron metabolic pathways regulated by the HFE gene product and body iron stores.
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Affiliation(s)
- Robert O Wright
- Department of Pediatrics, Children's Hospital, Boston, Massachusetts 02115, USA.
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Tsukahara T, Ezaki T, Moriguchi J, Furuki K, Fukui Y, Ukai H, Okamoto S, Sakurai H, Ikeda M. No significant effect of iron deficiency on cadmium body burden or kidney dysfunction among women in the general population in Japan. Int Arch Occup Environ Health 2003; 76:275-81. [PMID: 12719983 DOI: 10.1007/s00420-003-0432-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2002] [Accepted: 12/07/2002] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine if iron-deficient conditions modify body burden or health effects of cadmium among women in the general population in Japan. METHODS In 2002, 1,482 women aged 20 to 74 years in six prefectures in Japan provided informed consent to participate in this study. They offered peripheral blood and spot urine samples, and answered questionnaires on their social habits and health conditions. Never-smoking, non-pregnant and non-lactating healthy women (1,190 subjects) were selected from the volunteers. Blood samples were analyzed for serum iron, ferritin and total iron-binding capacity (TIBC) in addition to red blood cell (RBC) counts and hemoglobin (Hb) concentration as markers of anemia and iron deficiency. Urine samples were analyzed for cadmium (Cd), alpha(1)-microglobulin (alpha(1)-MG), beta(2)-microglobulin (beta(2)-MG) as markers of Cd burden and Cd-induced tubular dysfunction; the measures were expressed after being corrected for creatinine (cr) as, e.g., Cd-Ucr. RESULTS The subjects were classified into anemic (37 women) and iron-deficient (388 women) groups separately from healthy controls (765 women), taking ferritin (<20 ng/ml) and Hb (<10 g/100 ml) as classification indicators. Strictly matched pairs (with regard to age and prefecture) were established for 36 anemic and 280 iron-deficient cases. Comparison between the cases and the matched controls showed that serum iron was lower and TIBC was higher in accordance with lower levels of ferritin and Hb in the anemic and iron-deficient groups, although the RBC count was only slightly reduced (the anemic group) or stayed essentially unchanged (the iron-deficient group). In contrast, no significant increase in Cd-Ucr, alpha(1)-MG, or beta(2)-MG was observed in either the anemic group or the iron-deficient group compared with the matched controls. Cd-Ucr in one case of clinical anemia, however, tended to be higher than the levels among women of the same age range and from the same prefecture. Her alpha(1)-MG-Ucr and beta(2)-MG-Ucr, however, remained un-elevated. CONCLUSIONS The current level of iron deficiency among women in the general population in Japan may not induce significant increase in Cd body burden or Cd-induced tubular dysfunction.
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Affiliation(s)
- T Tsukahara
- Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, 604-8472 Kyoto, Japan
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