Toxic metal (Cd, Hg, Mn, Pb) partition in the maternal/foetal unit: A systematic mini - review of recent epidemiological studies

Association of blood metals with anxiety among adults: A nationally representative cross-sectional study

BACKGROUND

Previous evidence demonstrated the inconsistent associations between metals and anxiety. The purpose of this study was to evaluate the individual and joint effects of blood lead (Pb), cadmium (Cd), mercury (Hg), selenium (Se) and manganese (Mn) on anxiety in the general population.

METHODS

Data of 4000 participants (aged≥20 years) in the study were retrieved from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. Multiple logistic regression, restricted cubic splines (RCS) logistic analysis, and weighted quantile sum (WQS) regression were fitted to explore the possible effects of single and mixed metal exposures on anxiety. Moreover, this association was assessed by smoking group.

RESULTS

In the study, 24.60 % of participants were in an anxiety state. In logistic regression, blood Pb, Cd, Hg, Se and Mn were not significantly associated with anxiety in all participants. After stratified by smoking group, blood Cd was positively associated with anxiety in the current smoking group [P = 0.029, OR (95 %): 1.708(1.063, 3.040)], whereas not in other groups. In RCS regression, we observed a linear dose-response effect of blood Cd on anxiety stratified by smoking group. In WQS analysis, mixed metal exposures were positively associated with anxiety [P = 0.033, OR (95 %): 1.437(1.031, 2.003)], with Cd (33.69 %) contributing the largest weight to the index.

CONCLUSIONS

Our study showed that excessive exposure to Cd is a significant risk factor for anxiety, and the co-exposures to Pb, Cd, Hg, Se and Mn were positively related with the risk of anxiety in current smokers.

Possible Risk Factors and Their Potential Associations with Combined Heavy Metal Exposures in Pregnant Women in the Republic of Suriname

Background

The exposure of pregnant women to multiple environmental pollutants may be more disadvantageous to birth outcomes when compared to single-compound contaminations.

Objective

This study investigated the mixed exposures to mercury, manganese, or lead in 380 pregnant Surinamese women. The factors that might be associated with the heavy metal exposures and the relative risk of the potential factors to cause the mixed exposures were explored. The influencing factors of exposures to mixed contaminants assessed were living in Suriname's rural regions, several parts of which are contaminated with heavy metals emitted from artisanal and small-scale gold mining and agricultural activities; the consumption of potentially contaminated foods; advanced maternal age; as well as a relatively low formal educational level and monthly household income.

Methods

Descriptive statistics were used to calculate frequency distributions and χ2-contingency analyses to calculate associations and relative risks (RR) with 95% confidence intervals (CI).

Findings

Blood levels of two or three of the heavy metals above public health limits were observed in 36% of the women. These women were more often residing in the rural regions, primarily consumed potentially contaminated food items, were 35 years or older, were lower educated, and more often had a lower household income. However, only living in the rural regions (RR = 1.48; 95% CI 1.23-1.77) and a low household income (RR = 1.38; 95% CI 1.15-1.66) significantly increased the risk of exposure exceeding levels of concern to two or three of the heavy metals (by 48% and 38%, respectively).

Conclusion

More comprehensive pharmacological, ecological, and epidemiological studies about exposures to mixed heavy metal contaminations in pregnant women are warranted.

Reference intervals for cd, hg, Mn and Pb in the general children population (3-14 years) of Kinshasa, Democratic Republic of Congo (DRC) between June 2019 and June 2020

The reference intervals (RIs), proposed by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and the International Union of Pure and Applied Chemistry (IUPAC), were derived for Cd, Hg, Mn and Pb in the blood and urine of the children population living in Kinshasa (n = 200, aged 3-14 years with 97 girls). Levels of metals were measured using coupled plasma mass (ICP-MS). In blood, the proposed RIs [P5-P95 (GM)] were 0.022-1.112 μg/L (0.074), 35.69-144.50 μg/L (71.43), 0.060 to 1.161 μg/L (0.208) and 6.597-15.740 μg/L (9.882) for Cd, Pb, Hg and Mn, respectively. Urinary levels [(P5-P95 (GM)] were 0.082-1.530 μg/L (0.366) for Cd, 1.827-18.500 μg/L (5.458) for Pb, 0.323-1.953 μg/L (0.709) for Hg and 0.070 to 1.703 μg/L (0.186) for Mn. As compared to the CDC updated blood Pb reference value (35 μg/L), Pb levels remain higher of public health concern. Cd and Mn levels were similar to those found in the same city in 2015 and databases involving non-occupationally exposed populations from other countries. Hg levels significantly lower than those found in the same city in 2015, probably due to exclusion criteria of metal exposure applying in the present survey (occupationally exposed to the studied metals, smoking habits, amalgam tooth fillings, fish consumption habit more than one time per week, etc.). These background metal exposures will be useful for future occupational and/or environmental surveys as well as undertaking a reliable regulation of chemical exposure in Kinshasa via a national HBM program.

Derivation of benchmark doses for male reproductive toxicity in a subacute low-level Pb exposure model in rats

The objectives of the study were to simulate low-level Pb exposure scenario in an animal model and to examine reproductive adverse effects. Based on obtained data, we have performed Benchmark dose (BMD)-response modelling. Male Wistar rats were randomized in seven groups (n = 6): one control and six treated with: 0.1, 0.5, 1, 3, 7, and 15 mg Pb/kg body weight, daily for 28 days by oral gavage. The rats were sacrificed and the blood and testes were used for further analysis of testosterone levels in serum, testicular essential metal levels and histological analysis. The Pb treatment led to a dose-dependent decrease of serum testosterone levels with a negative trend (BMDI 0.17-6.13 mg Pb/kg). Increase of Zn (dose-dependent, BMDI 0.004-19.7 mg Pb/kg) and Cu and a decrease of Mn testicular levels were also detected with unscathed histology of the testes. The presented results might be used in further evaluation of the point of departure in human health risk assessment for Pb.

Multidimensional analysis of the essential elements in pregnant women's whole blood and characterization of maternal status by elemental pattern

BACKGROUND

During pregnancy, the fetus needs to obtain a lot of nutrients from the mother, but the micronutrient deficiencies in pregnancy are not clear at present, and there is no reliable basis for nutrient intake and supplement. The purpose of this study was to understand the levels of essential elements in whole blood of pregnant women during various pregnancy stages at different ages and in different regions, to evaluate the deficiency of essential elements in Chinese pregnant women, and to explore the feasibility of using the elemental pattern to characterize maternal status.

METHODS

Whole blood samples of 11222 healthy pregnant women enrolled in different areas of China from Jan-Dec 2019, were analyzed for concentrations of six essential elements including Mn, Cu, Zn, Ca, Mg, and Fe, using the inductively coupled plasma mass spectrometer. A retrospective comparative study during different pregnancy periods at different ages and in different regions in whole blood essential elements content from non-pregnant normal women and pregnant normal women was developed using multivariate statistical analysis. Principal component analysis evaluation elemental pattern was used to characterize pregnancy status of pregnant women.

RESULTS

In general, the levels of six essential elements in whole blood of pregnant women can satisfy the needs of normal physiological activities. With the development of pregnancy, the contents of Cu and Mn increased, while the contents of Fe and Mg decreased, and the contents of Zn and Ca have no noteworthy change. At the same gestation stage, the Cu content in whole blood of elderly pregnant women was higher. There were some differences in whole blood essential elements content of pregnant women in different regions. Principal component analysis and heat map analysis showed the feasibility of using bioinformatics research strategies to identify different pregnancies.

CONCLUSIONS

There are differences in the content of whole blood essential elements of women at different stages of pregnancy in different regions. It was found that there was no obvious deficiency in whole blood essential elements levels of pregnant women in recent years. The pattern of essential elements has a certain application potential in the evaluation of pregnancy and pregnant women's health status.

Environmental toxicants and placental function

The placenta is a temporary endocrine organ that facilitates gas, nutrient, and waste exchange between maternal and fetal compartments, partially shielding the fetus from potentially hazardous environmental toxicants. However, rather than being "opaque", the placenta is translucent or even transparent to some potential fetal developmental hazards, including toxic trace elements (TEs), perfluoroalkyl and polyfluoroalkyl substances (PFAS), and environmental phenols (EPs) to which women with pregnancy are frequently exposed. These agents are both passively and actively transferred to the fetal compartment, where endocrine disruption, oxidative stress, and epigenetic changes may occur. These pathologies may directly impact the fetus or deposit and accumulate in the placenta to indirectly impact fetal development. Thus, it is critical for clinicians to understand the potential placental toxicity and transfer of widely distributed environmental agents ubiquitous during pregnancy. With such knowledge, targeted interventions and clinical recommendations can be developed to limit those risks.

Transcriptomics-based analysis of co-exposure of cadmium (Cd) and 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) indicates mitochondrial dysfunction induces NLRP3 inflammasome and inflammatory cell death in renal tubular epithelial cells

Environmental pollution often releases multiple contaminants resulting in as yet largely uncharacterized additive toxicities. Cadmium (Cd) is a widespread pollutant that induces nephrotoxicity in animal models and humans. However, the combined effect of Cd in causing nephrotoxicity with 2,2',4,4'-tetrabromodiphenyl ether (BDE-47), a typical congener of polybrominated diphenyl ethers (PBDEs), has not been evaluated and mechanisms are not completely clear. Here, we applied transcriptome sequencing analysis to investigate the combined toxicity of Cd and BDE-47 in the renal tubular epithelial cell lines HKCs. Cd or BDE-47 exposure decreased cell viability in a dose-dependent manner, and exhibited cell swelling and rounding similar to necrosis, which was exacerbated by co-exposure. Transcriptomic analysis revealed 2191, 1331 and 3787 differentially-expressed genes following treatment with Cd, BDE-47 and co-exposure, respectively. Interestingly, functional annotation and enrichment analyses showed involvement of pathways for oxidative stress, NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome and inflammatory cell death for all three treatments. Examination of indices of mitochondrial function and oxidative stress in HKC cells showed that the levels of reactive oxygen species (ROS), malondialdehyde (MDA) and intracellular calcium ion concentration [Ca²⁺]i were elevated, while superoxide dismutase (SOD) and mitochondrial membrane potential (MMP) were decreased. The ratio of apoptotic and necrotic cells and intracellular lactate dehydrogenase (LDH) release were increased by Cd or BDE-47 exposure, and was aggravated by co-exposure, and was attenuated by ROS scavenger N-Acetyl-L-cysteine (NAC). NLRP3 inflammasome and pyroptosis pathway-related genes of NLRP3, adaptor molecule apoptosis-associated speck-like protein (ASC), caspase-1, interleukin-18 (IL-18) and IL-1β were elevated, while gasdermin D (GSDMD) was down-regulated, and protein levels of NLRP3, cleaved caspase-1 and cleaved GSDMD were increased, most of which were relieved by NAC. Our data demonstrate that exposure to Cd and BDE-47 induces mitochondrial dysfunction and triggers NLRP3 inflammasome and GSDMD-dependent pyroptosis leading to nephrotoxicity, and co-exposure exacerbates this effect, which could be attenuated by inhibiting ROS. This study provides a further mechanistic understanding of kidney damage, and co-exposure impact is worthy of concern and should be considered to improve the accuracy of environmental health assessment.

Non-linear associations between metabolic syndrome and four typical heavy metals: Data from NHANES 2011-2018

Previous studies have found that heavy metals are associated with metabolic syndrome (MetS), although findings are inconsistent. Further, investigations into potential associations that consider age- or gender-specific effects and dose-response associations for metal exposure and MetS are rare. In this study, we explore the associations between blood levels of typical heavy metals [lead (Pb), cadmium (Cd), mercury (Hg) and manganese (Mn)] and MetS among adults using logistic regression analysis and restricted cubic splines (RCS) logistic analysis using data from the US National Health and Nutrition Examination Survey 2011-2018. After adjusting for covariates, higher levels of blood Pb, Cd and Hg were associated with lower risks of MetS in participants overall, and in all subgroup analyses, by logistic regression analysis (all P-values <0.05); in contrast, higher levels of blood Mn had a higher risk of MetS only in the age group of 30-49 years (P-values <0.05). We also found non-linear associations of heavy metal levels in blood with risk of MetS in participants overall, in specific age groups and in both genders, using RCS logistic regressions (all P-values <0.05). In addition, the non-linear associations of Pb and Hg we observed in different subgroups differed. In conclusion, blood levels of four heavy metals were associated with the risk of MetS through a variety of non-linear patterns.

Increased serum levels of cadmium are associated with an elevated risk of cardiovascular disease in adults

Previous studies have determined the effects of exposure to certain heavy metals on cardiovascular disease (CVD); however, the association between cadmium exposure and CVD in adults remains unclear. The relationship between serum levels of cadmium and the risk of CVD was studied by analyzing available data from 38,223 different participants of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. After adjusting for all covariates, we found that higher serum cadmium concentrations were positively related to both the overall risk of CVD (odds ratio (OR): 1.45; 95% confidence interval (CI): 1.22, 1.72; p for trend <0.001) and the risks of its subtypes, including congestive heart failure, coronary heart disease, heart attack, and stroke. Elevated cadmium levels were associated with increased levels of lipids and inflammatory factors, including blood triglycerides, total cholesterol, white blood cells (WBCs), and C-reactive protein (CRP). Our study provided epidemiological evidence that cadmium may increase the risk of CVD by elevating blood lipids and inflammation.

Uma revisão de escopo de revisões sistemáticas sobre exposição humana ao mercúrio

Resumo: Introdução: a promulgação da Convenção de Minamata no Brasil em 2018 incentivou o cumprimento dos seus objetivos em reduzir o uso e a poluição por mercúrio. Objetivo: caracterizar a produção científica sobre exposição humana ao mercúrio e identificar lacunas de conhecimento a fim de subsidiar a tomada de decisão em saúde. Métodos: revisão de escopo de revisões sistemáticas e metanálises, sem restrição de idioma ou data de publicação, utilizando as bases PubMed, BVS e Cochrane Library. Resultados: 71 estudos atenderam aos critérios de elegibilidade, com 40 revisões sistemáticas, 30 metanálises e 1 overview. Amálgama dentário e contaminação alimentar e ambiental por atividades que utilizam mercúrio foram as fontes de exposição mais mencionadas. Os temas mais estudados contaram com transtornos mentais e comportamentais, assim como uso de biomarcadores e testes neurocomportamentais relacionados à exposição ao mercúrio. Discussão: lacunas como a exposição ocupacional ao mercúrio, uso em práticas tradicionais e em cosméticos apontam para a necessidade de mais estudos. As revisões identificadas podem oferecer subsídios para sínteses de evidências e protocolos de atenção à saúde de populações expostas, assim como para a elaboração de políticas públicas que visem o controle do uso e da exposição ao mercúrio.

A review on adsorptive separation of toxic metals from aquatic system using biochar produced from agro-waste

Water is a basic and significant asset for living beings. Water assets are progressively diminishing due to huge populace development, industrial activities, urbanization and rural exercises. Few heavy metals include zinc, copper, lead, nickel, cadmium and so forth can easily transfer into the water system either direct or indirect activities of electroplating, mining, tannery, painting, fertilizer industries and so forth. The different treatment techniques have been utilized to eliminate the heavy metals from aquatic system, which includes coagulation/flocculation, precipitation, membrane filtration, oxidation, flotation, ion exchange, photo catalysis and adsorption. The adsorption technique is a better option than other techniques because it can eliminate heavy metals even at lower metal ions concentration, simplicity and better regeneration behavior. Agricultural wastes are low-cost biosorbent and typically containing cellulose have the ability to absorb a variety of contaminants. It is important to note that almost all agro wastes are no longer used in their original form but are instead processed in a variety of techniques to improve the adsorption capacity of the substance. The wide range of adsorption capacities for agro waste materials were observed and almost more than 99% removal of toxic pollutants from aquatic systems were achieved using modified agro-waste materials. The present review aims at the water pollution due to heavy metals, as well as various heavy metal removal treatment procedures. The primary objectives of this research is to include an overview of adsorption and various agriculture based adsorbents and its comparison in heavy metal removal.

Efficient removal of nitrate, manganese, and tetracycline by a polyvinyl alcohol/sodium alginate with sponge cube immobilized bioreactor

The co-existence of nitrate, manganese (Mn), and antibiotics are of a wide concern. In this study, a denitrifying and manganese-oxidizing Zoogloea Q7 bacterium was immobilized using polyvinyl alcohol/sodium alginate with sponge cube (PVA/SA@sponge cube) in the reactor. The optimal operation parameters of the bioreactor were explored. Maximum nitrate, Mn(II), and tetracycline (TC) removal efficiencies of 93.00, 72.34, and 57.32% were achieved with HRT of 10 h, pH of 6.5, Mn(II) concentration of 20 mg L^-1, and TC of 1 mg L^-1, respectively. Fluorescence excitation-emission matrix (EEM) proved that the microorganism in the bioreactor was greatly active. Scanning electron microscope (SEM) images demonstrated that Zoogloea Q7 was commendably immobilized on the novel material. X-ray diffraction (XRD) analysis suggested that the bioprecipitate was mainly composed of MnO₂ and MnCO_3. Through high-throughput analysis, Zoogloea sp. Q7 was considered to be the dominant bacteria present in the bioreactor.

Quality, composition and health-protective properties of citrus honey: A review

Citrus honey is one of the most important monofloral honeys produced and consumed worldwide. This honey has pleasant sensorial characteristics, which include light color and typical aroma and flavor. Besides that, several constituents such as minerals, phenolic and volatile compounds, amino acids, sugars, enzymes, vitamins, methylglyoxal and organic acids are found in citrus honey. Moreover, potential biological properties have been associated with citrus honey. All these factors make it highly desired by consumers, increasing its market value, which can stimulates the practice of fraud. Also, citrus honey is susceptible to contamination and to inadequate processing. All these factors can compromise the quality, safety and authenticity of citrus honey. In this sense, this review aims to update and to discuss, for the first time, the data available in the literature about the physicochemical and the sensorial characteristics, composition, health properties, contamination, authenticity and adulteration of citrus honey. With this background, we aim to provide data that can guide future researches related to this honey.

Human placental cell line HTR-8/SVneo accumulates cadmium by divalent metal transporters DMT1 and ZIP14

Cadmium (Cd) is a global pollutant that accumulates in the placenta and can cause placental dysfunction. Although iron transporters have been suggested to participate in placental Cd uptake, it is still unknown which transporters are actually involved in this process. We specifically aimed to study the role of three iron transporters in the uptake of Cd into the placental cell line HTR-8/SVneo. For this purpose, Divalent Metal Transporter (DMT)1 and ZRT/IRT like protein (ZIP)8 and ZIP14 were downregulated and changes in cellular Cd levels analysed in relation to controls. As clearly shown by the reduction of the Cd content by ∼60% in DMT1- and ZIP14-downregulated cells, the two proteins are essential for Cd accumulation in HTR-8/SVneo cells. Using a validated antibody, we show DMT1 to be localised in situ in trophoblast and stromal cells. We further wanted to investigate how placental cells cope with Cd loading and which metallothionein (MT) isoforms they express. Cd-exposed cells accumulate Cd in a dose-dependent manner and upregulate MT2A accordingly (up to 15-fold induction upon 5 μM CdCl₂ treatment for 72 h). 5 μM Cd exposure for 72 h decreased cell number to 60%, an effect that was aggravated by MT2A depletion (cell number reduced to 30%) indicating additive effects. In conclusion, our data suggest that DMT1 and ZIP14 are required for Cd uptake into human placental cells that upregulate MT2A to store and detoxify the metal. Cd storage in the placenta reduces Cd transport to the fetus, which, however, could impair placental functions and fetal development.

Effects of Cadmium, Lead, and Mercury on the Structure and Function of Reproductive Organs

Reproductive organs are essential not only for the life of an individual but also for the survival and development of the species. The response of reproductive organs to toxic substances differs from that of other target organs, and they may serve as an ideal “barometer” for the deleterious effects of environmental pollution on animal and human health. The incidence of infertility, cancers, and associated maladies has increased in the last fifty years or more, while various anthropogenic activities have released into the environment numerous toxic substances, including cadmium, lead, and mercury. Data from epidemiological studies suggested that environmental exposure to cadmium, lead, and mercury may have produced reproductive and developmental toxicity. The present review focused on experimental studies using rats, mice, avian, and rabbits to demonstrate unambiguously effects of cadmium, lead, or mercury on the structure and function of reproductive organs. In addition, relevant human studies are discussed. The experimental studies reviewed have indicated that the testis and ovary are particularly sensitive to cadmium, lead, and mercury because these organs are distinguished by an intense cellular activity, where vital processes of spermatogenesis, oogenesis, and folliculogenesis occur. In ovaries, manifestation of toxicity induced by cadmium, lead, or mercury included decreased follicular growth, occurrence of follicular atresia, degeneration of the corpus luteum, and alterations in cycle. In testes, toxic effects following exposure to cadmium, lead, or mercury included alterations of seminiferous tubules, testicular stroma, and decrease of spermatozoa count, motility and viability, and aberrant spermatozoa morphology.