Stevioside mitigates lead toxicity in thinlip mullet juveniles: Impacts on growth, metabolism, and immune function

This study investigates the impact of varying concentrations of stevioside in the presence of lead (Pb) exposure on multiple aspects of thinlip mullet (Liza ramada) juveniles. Over 60 days, a total of 540 juvenile L. ramada with an initial weight of 3.5 ± 0.13 g were evenly distributed into six groups, each consisting of three replicates. The experimental diet consisted of varying levels of stevioside (150, 250, 350, and 450 mg/kg diet), with a consistent concentration of lead (Pb) set at 100 µg/kg diet. Stevioside demonstrated a positive influence on growth parameters, with the 450 mg/kg +Pb treatment showing the highest values. Biochemical parameters remained stable, but lead-exposed fish without stevioside displayed signs of potential liver damage and metabolic issues. Stevioside supplementation, especially at higher doses (≥250 mg/kg), reversed these negative effects, restoring biochemical markers to healthy control levels. Lead exposure significantly suppressed antioxidant enzyme activities, but co-administration of stevioside exhibited a dose-dependent protective effect, with 250, 350, and 450 mg/kg groups showing activities comparable to the healthy control. Lead-exposed fish without stevioside demonstrated attenuation of the immune response, but stevioside supplementation reversed these effects, particularly at ≥250 mg/kg. Stev (≥250 mg/kg) reduced IL-1β and hepcidin expression, contrasting dose-dependent upregulation in lower dosages and lead-only group. Histological examinations of the intestine and liver supported these findings. In conclusion, stevioside, especially at 450 mg, positively impacted growth, biochemical parameters, antioxidant activity, immune response, and gene expression in L. ramada exposed to lead, suggesting its potential to mitigate lead toxicity in aquaculture. Additional research is warranted to investigate the long-term impacts of stevioside supplementation and its prospective implementation in aquaculture.

Recuperative Effects of Cinnamon (Cinnamomum zeylanicum) in Catla catla After Sub-Lethal Exposure to Lead

This research was conducted to validate the beneficial effects of incorporating dietary cinnamon (Cinnamomum zeylanicum) powder (CzP) in alleviating lead (Pb) poisoning in fish. Healthy Catla catla individuals (16.36 ± 0.19 g/fish) were distributed across 18 tanks in triplicate groups. The experimental groups were as follows: Control group: fish without supplementation or exposure to Pb; positive control group: fish without supplementation but exposed to 1 mg/L Pb; 5 g/kg CzP along with 1 mg/L Pb exposure; 10 g/kg CzP along with 1 mg/L Pb exposure; 15 g/kg CzP along with 1 mg/L Pb exposure; and 20 g/kg CzP along with 1 mg/L Pb exposure. The trial continued for a period of 60 days. Waterborne Pb had a deleterious effect on fish growth performance, body composition, blood profile, and digestive enzyme activity, along with elevated Pb accumulation in various tissues. Conversely, consumption of cinnamon effectively mitigated the toxic potential of Pb and enhanced fish longevity. Notably, 10 g/kg CzP boosted growth, improved carcass quality, reversed blood indices, restored enzyme function in the gut, and mitigated Pb accumulation in tissues. In summary, the findings revealed that incorporating 10 g/kg of CzP as a dietary supplement in C. catla aquaculture could effectively counteract heavy metal toxicity.

Influence of lead-induced toxicity on the inflammatory cytokines

Lead (Pb2+) is a hazardous heavy metal that is pervasive in the human environment as a result of anthropogenic activity, and poses serious health risks, particularly in children. Due to its innumerable unique physical and chemical properties, it has various applications; therefore, it has become a common environmental pollutant. Lead may cause oxidative stress, and accumulating evidence indicates that oxidative stress influences the pathophysiology of lead poisoning, also called plumbism. The immune system is continually exposed to various environmental pathogens and xenobiotics, including heavy metals such as lead, and appears to be one of the most vulnerable targets. After being exposed to lead, cells are subjected to oxidative stress as a result of reactive oxygen species (ROS) production. When the generation and consumption of ROS are out of equilibrium, various cell structures, particularly phospholipids are disrupted leading to lipid peroxidation. Various inflammatory signalling pathways are activated as a consequence, along with reduced disease resistance, inflammation, autoimmunity, sensitization and disruption of the cell-mediated and humoral immune systems. Lead negatively affects the metabolism of cytokines, including the interleukins IL-2, IL-1b, IL-6, IL-4, IL-8, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN), as well as the expression and functioning of inflammatory enzymes such as cyclooxygenases. However, the cause of toxicity depends on the kind of lead, dosage, route of entry, exposure period, age, host and genetic predisposition.

Lead exposure is related to higher infection rate with the gapeworm in Norwegian house sparrows (Passer domesticus)

Anthropogenic pollution is identified as an important threat to bird and other wildlife populations. Many metals and toxic elements, along with poly- and perfluoroalkyl substances (PFASs) are known to induce immunomodulation and have previously been linked to increased pathogen prevalence and infectious disease severity. In this study, the house sparrow (Passer domesticus) was investigated at the coast of Helgeland in northern Norway. This population is commonly infected with the parasitic nematode "gapeworm" (Syngamus trachea), with a prevalence of 40-60 % during summer months. Gapeworm induces severe respiratory disease in birds and has been previously demonstrated to decrease survival and reproductive success in wild house sparrows. The aim of this study was to investigate whether a higher exposure to pollution with PFASs, metals and other elements influences gapeworm infection in wild house sparrows. We conducted PFASs and elemental analysis on whole blood from 52 house sparrows from Helgeland, including analyses of highly toxic metals such as lead (Pb), mercury (Hg) and arsenic (As). In addition, we studied gapeworm infection load by counting the parasite eggs in faeces from each individual. We also studied the expression of microRNA 155 (miR155) as a key regulator in the immune system. Elevated blood concentrations of Pb were found to be associated with an increased prevalence of gapeworm infection in the house sparrow. The expression of miR155 in the plasma of the house sparrow was only weakly associated with Pb. In contrast, we found relatively low PFASs concentrations in the house sparrow blood (∑ PFASs 0.00048-354 μg/L) and PFASs were not associated to miR155 nor infection rate. The current study highlights the potential threat posed by Pb as an immunotoxic pollutant in small songbirds.

Yucca schidigera Extract Mitigates the Oxidative Damages, Inflammation, and Neurochemical Impairments in the Brains of Quails Exposed to Lead

The present study explored the neurotoxic impacts of lead (Pb) and the potential alleviating effect of Yucca schidigera extract (YSE) in Japanese quails. About 360 adult Japanese quails (8 weeks old) were used. Quails were randomly distributed to six groups with 4 replicates each: the control group (fed basal diet, BD), the BD + YSE1 and BD + YSE2 groups (BD + 100 and 200 mg/kg diet of YSE, respectively), the Pb group (BD + 100 mg/kg Pb), and the Pb + YSE1 and Pb + YSE2 groups (BD + Pb + 100 and 200 mg/kg YSE, respectively). This feeding trial lasted for 8 weeks. The exposure to Pb in the diet induced oxidative damage stress in the brain of exposed quails reflected by the significant increase in the oxidative markers including malonaldehyde (MDA) and protein carbonyl (PC) and the significant reduction in the activities of antioxidants including catalase (CAT), superoxide dismutase (SOD), and the reduced glutathione (GSH). Brain neurochemistry and enzyme activities were also altered following Pb exposure. Pb significantly reduced serotonin, dopamine, norepinephrine, GABA, Ach, and Na + /K + -ATPase activities. Pb dietary intoxication markedly increased brain inflammatory biomarkers, including tumor necrosis factor (TNF-α), myeloperoxidase, and nitric oxide. Peripherally, Pb toxicity decreased the amino acid neurotransmitters (glutamic acid, glycine, and aspartic acid) in the serum of birds. At the transcriptomic level, Pb exposure upregulated the transcription patterns of CASP3, TNF-α, HSP70, and IL-1β. The single effect of YSE maintained that all the assessed parameters were not changed compared to the control. Interestingly, the YSE co-supplementation with Pb alleviated the Pb-induced neuro-oxidative damages by lowering the lipid, protein, and DNA damage, and the inflammatory biomarkers.

Levilactobacillus brevis MZ384011 and Levilactobacillus brevis MW362779 can mitigate lead induced hepato-renal damage by regulating visceral dispersion and fecal excretion

Heavy metal pollution is a global issue. Current study provides evidence on Pb toxicity ameliorative potential and safe nature of Levilactobacillus brevis MZ384011 (S1) and Levilactobacillus brevis MW362779 (S2), isolated from carnivore gut and human milk, respectively. In a 60-days experiment, the rats were distributed into six groups. G-I, G-V and G-VI were kept on normal diet, while GII-IV were fed on lead nitrate (500 mg/kg) supplemented food, throughout experiment. After confirmation of Pb toxicity in GII-IV at 15th day, S1 was orally administered to G-III and G-V while S2 was given to G-IV and G-VI at a dose of 1 × 109 CFU/animal/day. On day 60 of experiment, positive control (G-II) displayed significant reduction in body weight, total protein, albumin, globulin, mineral profile, erythrocyte count, hemoglobin, hematocrit and hematological indices and elevation in leukocyte count, alanine aminotransferase, aspartate aminotransferase, bilirubin, uric acid and creatinine along with alterations in hepato-renal architecture. With reference to G-II, the G-III and G-IV displayed significant improvement in all aforementioned parameters, 40-60% reduction in tissue Pb levels (blood, liver, kidney and adipose tissue) and elevation in fecal Pb contents (p = 0.000). The groups V and VI did not show any sign of toxicity. The findings confirm that strains are safe for biological application and can reverse Pb toxicity by facilitating fecal Pb excretion and reducing its systemic dispersal. To best of our information this is the first report on Pb toxicity ameliorative role of Levilactobacillus brevis from human milk, the safest source.

Dynamic alterations of locomotor activity and the microbiota in zebrafish larvae with low concentrations of lead exposure

Lead (Pb) is a ubiquitous heavy metal associated with developmental and behavioral disorders. The establishment of pioneer microbiota overlaps with the development of the brain during early life, and Pb-induced developmental neurotoxicity may be partially caused by early-life microbiota dysbiosis. This study investigated the locomotor activity and the microbiota in developing zebrafish at multiple developmental time points (five days post fertilization [5 dpf], 6 dpf, and 7 dpf) under exposure to low concentrations of lead (0.05 mg/L). Time-dependent reductions in the number of activities and the average movement distance of larvae compared to the control were observed following Pb exposure. Furthermore, Pb exposure significantly altered the composition of the gut microbiota of zebrafish larvae. At the phylum level, the abundance of Proteobacteria decreased from 5 to 7 dpf, while that of Actinobacteria increased in the control groups. At the class level, the proportion of Alphaproteobacteria decreased, while that of Actinobacteria increased in the control groups. Notably, all showed the opposite trend in Pb groups. A correlation analysis between indices of locomotor activity and microbial communities revealed genus-level features that were clearly linked to the neurobehavioral performance of zebrafish. Seven genera were significantly correlated with the two performance indicators of the locomotion analysis, namely Rhodococcus, Deinococcus, Bacillus, Bosea, Bradyrhizobium, Staphylococcus, and Rhizobium. Rhizobium was dominant in zebrafish and increased in the Pb groups in a time-dependent manner. In addition, the expression levels of bdnf, trkb1, trkb2, and p75ntr changed in zebrafish from 5 to 7 dpf under Pb exposure. Collectively, these results suggest that Pb-induced neurotoxicity could potentially be treated by targeting the gut microbiota.

Polysaccharide from Sparassis latifolia alleviates intestinal barrier dysfunction in mice exposed to lead

Exposure to lead can have harmful effects on the intestines and gut microbiota, leading to toxicity. This study aimed to explore the protective role of Sparassis latifolia polysaccharide (SLP) in safeguarding the intestinal barrier of Kunming mice exposed to lead. The findings indicated that SLP effectively alleviates intestinal lesions, increases the density of cupped cells in the intestine, and reduces inflammation in both serum and the small intestine. Furthermore, SLP maintains the expression of key genes such as ZO-1, Occludin, Claudin-1, Lyz, Ang4, and ZO-2, as well as proteins like claudin-1 and Occludin-1. Furthermore, SLP positively impacts the diversity and richness of microorganisms in the mouse gut microbiota at both the genus and gate levels. It also increases the levels of short-chain fatty acids (SCFAs), including acetic acid, butyric acid, and propionic acid, to varying degrees. In summary, SLP plays a role in alleviating the impaired small intestinal barrier in lead-exposed mice by modulating the intestinal flora, which is consistent with reduced lead absorption. This modulation enhances the integrity of the intestinal barrier, suppresses inflammation, and facilitates the excretion of lead.

Toxic effects of lead (Pb), cadmium (Cd) and tetracycline (TC) on the growth and development of Triticum aestivum: A meta-analysis

The environmental issue of lead (Pb), cadmium (Cd), and tetracycline (TC) contamination in cereal crops has become a growing concern worldwide. An in-depth understanding of this issue would be of importance to promote effective management strategies for heavy metals and antibiotics worldwide. The present study was conducted to assess the toxic effects of heavy metals (Cd, Pb) and antibiotics (TC) on Triticum aestivum (T. aestivum, common wheat) based on studies conducted in the past 22 years. Data pertaining to the growth and development of T. aestivum were extracted and analyzed from 89 publications spanning from 2000 to 2022. Our results showed that Pb, Cd and TC significantly reduced growth and development by 11 %, 9 %, and 5 %, respectively. Additionally, significant accumulation of Cd (42 %) and Pb (17 %) was observed in T. aestivum samples, although there was little change in TC accumulation, which showed limited absorption, accumulation, and translocation of TC in wheat plants. Pb had the greatest impact on the yield of T. aestivum, followed by Cd, while TC had no apparent effect. Furthermore, exposure to Cd, Pb and TC reduced the photosynthetic rate due to chlorophyll reduction, with Cd having the most pronounced effect (58 %), followed by Pb (37 %) and TC (8 %). Cd exposure also significantly enhanced gaseous exchange (37 %) compared to TC and Pb, which reduced gaseous exchange by 4 % and 10 %, respectively. However, the treatments with TC (>50-100 mgL-1), Pb (>1000-2000 mg L-1) and Cd (>500-1000 mg L-1) increased the defense system of T. aestivum samples by 38 %, 15 %, and 11 %, respectively. The obtained findings have significant implications for risk assessment, pollution prevention, and remediation strategies to address soil contamination from Pb, Cd and TC in farmland.

Expression deregulation of genes related to DNA repair and lead toxicity in occupationally exposed industrial workers

OBJECTIVE

Globally millions of people working in various industries and are exposed to different toxins which may affect their genetic stability and DNA integrity. Present study was designed to estimate the expression variation of genes related to DNA repair (XRCC1, PARP1) and lead toxicity (ALAD) in exposed industrial workers.

METHODS

About 200 blood samples were collected from workers of brick kiln, welding, furniture and paint industry (50/industry) along with age and gender matched controls. mRNA expression of genes was measured using RT-PCR. Serum levels of total ROS, POD, TBAR activity was calculated. Blood lead levels were estimated by atomic absorption spectrometer.

RESULTS

Relative expression of XRCC1 and PARP1 gene was significantly (P < 0.001) upregulated, while ALAD gene expression was downregulated in exposed group compared to control. Expression of XRCC1 and PARP1 was increased (P < 0.001) in exposed workers with > 30 year age compared to control with > 30 year age. Same was observed when < 30 year age group of control and exposed was compared. Likewise, XRCC1 and PARP1 expression was increased (P < 0.001) in exposed workers with > 30 year age compared to workers with < 30 year age. Whereas, ALAD gene showed significant (P < 0.01) decrease in > 30 year age workers compared to control of same age and exposed with < 30 year of age. Relative expression of XRCC1 and PARP1 was increased (P < 0.001) in exposed smokers compared to exposed non-smokers and control smokers. Whereas, ALAD gene expression reduced (P < 0.001) significantly in both groups. Blood lead content was higher (P < 0.001) in exposed group compared to control. Strong correlation was observed between XRCC1, PARP1 and ALAD gene versus age, total exposure duration, exposure per day and lead deposition. ROS, TBARS and POD activity was higher (P < 0.01) in exposed group compared to control group.

CONCLUSION

Present study suggested deregulation of genes related to DNA repair and lead intoxication in exposed group compared to controls. Strong correlation was observed between selected genes and demographic parameters. Present results revealed altered activity of oxidative stress markers which would induce oxidative damage to DNA integrity and limit the function of repair enzymes.

Ameliorative effects of Dunaliella salina microalgae on nanoparticle (ZnO NPs)-induced toxicity in fish

Dunaliella salina (D. salina) is a well-known microalga that contains considerable amounts of nutritious and medicinal bioactive components. This work studied the modulatory role of D. salina against zinc oxide nanoparticle (ZnO NPs)-induced neurotoxic effects in adult zebrafish. Fishes were subjected to 0.69 mg L-1 (1/5th 96-h LC50) for 4 weeks; then, fishes were supplemented with D. salina in the diet for 2 weeks at two levels (15 and 30%). Exposure to ZnO NPs induced a significant increase in the levels of reactive oxygen species (ROS), hydrogen peroxide (H2O2), malondialdehyde (MDA), and 8-hydroxy-2-deoxyguanosine (8-OH-dG) while accompanied with downregulation of antioxidant genes in the brain of exposed fishes. Brain neurochemistry and enzyme activities were also altered following ZnO NP exposure. ZnO NPs significantly reduced the neurotransmitters and acetylcholinesterase (AchE) activity while increasing Alzheimer's disease-related proteins and inflammatory response via upregulation of tumor necrosis factor (TNF-α). Additionally, ZnO NPs increased the indices of brain's DNA oxidative damage, increasing brain tissue's metallothionein (MT) and zinc residues. ZnO NPs upregulated the transcription patterns of apoptosis-related genes (casp3 and p53). D. salina dietary co-supplementation with ZnO NPs alleviated the ZnO NPsZnO NP-induced neuro-oxidative damages by lowering the lipid, DNA damage, and inflammatory biomarkers. Besides, D. salina alleviating responses were linked with increasing the levels of the assessed antioxidants. Conclusively, D. salina dietary supplementation induced potential alleviating effects of the ZnO NP-induced neurotoxicity in adult zebrafish.

Zinc and α-tocopherol protect the antral follicles and endogenous antioxidants of female albino rats (Rattus norvegicus) against lead toxicity

BACKGROUND

Lead impairs female reproductive health because it can induce oxidative stress. Zinc as an antioxidant produces an enzyme system that helps neutralize free radicals. α-Tocopherol has an antagonistic effect that reduces oxidative stress. This study aimed to demonstrate the effects of zinc (Zn) and α-tocopherol on the ovarian endogenous antioxidants and antral follicles of albino rats (Rattus norvegicus) exposed to lead acetate (Pb(C2H3O2)2).

METHODS

Twenty-five female Wistar rats were divided into five groups, namely groups K (control), P0, P1, P2, and P3. Following exposure and treatment for 21 days with different combinations, the albino rats were necropsied, and their ovaries were removed for subsequent histopathological preparations and endogenous antioxidant analysis. Observations were made on the ovary, including an antral follicle count and diameter calculations. Analysis of the superoxide dismutase (SOD) levels (560 nm wavelength) and malondialdehyde MDA-TBA (532 nm wavelength) were performed by a spectrophotometer. The data were analyzed using a one-way ANOVA and least significant difference (LSD) test with the SPSS V24 software.

RESULTS

The highest SOD enzyme expression in the albino rat ovaries was in P0 (17.23 ± 5.34), and the lowest was in P3 (4.21 ± 0.76). The lowest MDA level was observed in the control group (K) and P3 compared to the other groups. The highest average antral follicle count and diameter were found in the albino rats exposed to 1.5 mg/kg BW lead acetate, and treated with 0.54 mg/kg BW zinc sulfate and 100 mg/kg BW α-tocopherol (group P3) compared to the other groups. The mechanisms of action of zinc and α-tocopherol work synergistically to decrease free radicals and ovarian damage.

CONCLUSION

The results showed that a combination of 0.54 mg/kg BW zinc (Zn) and 100 mg/kg BW α-tocopherol can maintain the number and diameter of the antral follicles and reduce ovarian SOD expression and MDA levels in albino rats exposed to lead acetate.

Automated lead toxicity prediction using computational modelling framework

Background

Lead, an environmental toxicant, accounts for 0.6% of the global burden of disease, with the highest burden in developing countries. Lead poisoning is very much preventable with adequate and timely action. Therefore, it is important to identify factors that contribute to maternal BLL and minimise them to reduce the transfer to the foetus. Literacy and awareness related to its impact are low and the clinical establishment for biological monitoring of blood lead level (BLL) is low, costly, and time-consuming. A significant contribution to an infant's BLL load is caused by maternal lead transfer during pregnancy. This acts as the first pathway to the infant's lead exposure. The social and demographic information that includes lifestyle and environmental factors are key to maternal lead exposure.

Results

We propose a novel approach to build a computational model framework that can predict lead toxicity levels in maternal blood using a set of sociodemographic features. To illustrate our proposed approach, maternal data comprising socio-demographic features and blood samples from the pregnant woman is collected, analysed, and modelled. The computational model is built that learns from the maternal data and then predicts lead level in a pregnant woman using a set of questionnaires that relate to the maternal's social and demographic information as the first point of testing. The range of features identified in the built models can estimate the underlying function and provide an understanding of the toxicity level. Following feature selection methods, the 12-feature set obtained from the Boruta algorithm gave better prediction results (kNN = 76.84%, DT = 74.70%, and NN = 73.99%).

Conclusion

The built prediction model can be beneficial in improving the point of care and hence reducing the cost and the risk involved. It is envisaged that in future, the proposed methodology will become a part of a screening process to assist healthcare experts at the point of evaluating the lead toxicity level in pregnant women. Women screened positive could be given a range of facilities including preliminary counselling to being referred to the health centre for further diagnosis. Steps could be taken to reduce maternal lead exposure; hence, it could also be possible to mitigate the infant's lead exposure by reducing transfer from the pregnant woman.

Assessment of Blood Lead Level of School Children in 10 Cities of India: A Cross-Sectional Study

OBJECTIVES

To assess the blood lead level (BLL) of school children in 10 cities of India.

METHODS

This multi-centric cross-sectional study enrolled participants from randomly selected schools. Data on demographic details, socioeconomic status (SES) and anthropometric indicators was collected. Samples were collected for assessment of lead level in blood. Inductively coupled plasma-optical emission spectrometry technique was used to assess BLL.

RESULTS

From April 2019 through February 2020, 2247 participants were recruited from sixty schools (62.6% government schools) with equal gender distribution. The overall median (interquartile range) BLL was 8.8 (4.8, 16.4) µg/dl. The highest median (interquartile range) BLL was in Manipal 30.6 (23.0, 46.7) and lowest in Dibrugarh 4.8 (3.2, 7.0). Overall, 82.5% of participants had BLL above ≤4 µg/dl. Significant negative correlation was observed between BLL and SES (correlation= -0.24, p <0.001), anthropometric indicators (correlation= -0.11, p <0.001), hemoglobin level (correlation= -0.045, p = 0.03) and multivariate regression model showed association with gender, SES and anthropometric indicators.

CONCLUSIONS

BLL are elevated in urban school going children and there is intercity variation. Hence, urgent focus is needed to reduce exposure to lead in India.

Renal-protective effect of Asparagus officinalis aqueous extract against lead-induced nephrotoxicity mouse model

Lead is one of the cursed substances that threaten all human life. Lead poisoning can occur through food or water contaminations and it is hard to be detected. This incognito metal accumulates over time and resides in the liver, kidneys, and brain tissues leading to serious medical conditions, affecting organ functions, causing failure, kidney tubule degeneration, and destroying neuronal development. However, known metal chelators have bad negative effects. Asparagus officinalis (AO) is a promising herb; its root extract exhibited antioxidant, antiapoptotic, protective, and immunomodulatory activities. Inspired by those reasons, this study investigated to which extent Asparagus extract affected male mice's renal toxicity caused by lead acetate (LA) and antioxidant defense system. This work screened for its nephroprotective activity in four mouse groups: negative and positive control, LA group with renal injury, and diseased but pretreated mice with AO extract (AOE). Kidney index and kidney function biomarkers were evaluated. Antioxidant activities, lipid peroxidation, superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), glutathione peroxidase (GPx), nitric oxide (NO), and reduced glutathione (GSH) were also tested. Furthermore, inflammatory cytokine (tumor necrosis factor-α (TNF-α), interleukin-1 β (IL-1β), and the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB)), inducible nitric oxide synthase (iNOS), renal pro-apoptotic protein (Bax), antiapoptotic protein (Bcl-2), and caspase-3 levels were evaluated. The results showed that LA administration induced oxidative stress, renal inflammation, apoptosis, and renal histopathological alteration. However, due to its antioxidant activities, AOE was found to restrain oxidative stress, therefore preventing inflammation and apoptosis. Collectively, AOE perfectly clogged lead poisoning sneaking, stopped the bad deterioration, and succeeded to protect kidney tissues from toxicity, inflammation, and apoptosis.

Take the lead

A 23-year-old previously healthy woman presented with headache, generalized seizures, ataxia, encephalopathy, abdominal pain, nausea, and vomiting culminating in a 40-pound weight loss. A contrasted magnetic resonance imaging scan of the brain showed T2/FLAIR hyperintensities in the sulci of the occipital and parietal lobes, a punctate focus of restricted diffusion along the inferior aspect of the left caudate head and an empty sella. A lumbar puncture showed an opening pressure of 55 cm H2O, and kidney, ureter, and bladder X ray showed a radiopaque particle in the colon. Serum lead level was 85 mcg/dL (<3.5). Blood smear showed foreign bodies identified as lead particles in the blood with basophilic stippling of RBCs. She was treated with chelation therapy and bowel irrigation and eventually recovered. Further investigation indicated that she was being slowly poisoned by her husband, a chiropractor who had access to lead.

Screening and Identification of Probiotic Lactobacilli from the Infant Gut Microbiota to Alleviate Lead Toxicity

Lead (Pb2+) exposure cause a potential hazard to human health and the ecological environment; however, prevention and treatment of Pb2+ toxicity remain problems. The aim of this study is to isolate a novel probiotic lead (Pb2+)-resistant Lactobacillus strain from the infant gut microbiota and to determine whether they have the probiotic properties and investigate its preventive and therapeutic effects in the early-life Pb2+ exposure mouse model. In the present study, a total of 64 Pb2+-resistant colonies were isolated from the infant gut microbiota. Of these colonies, SYF-08, identified as Lacticaseibacillus casei, exhibited a Pb2+-binding capacity and Pb2+ tolerance. The in vivo study showed that SYF-08 treatment could effectively reduce Pb2+ levels in the blood, alleviate Pb2+ enrichment in bone and brain tissues, and recover the intestinal and brain damage in both dams and offspring. SYF-08 treatment also improved the antioxidant index in the liver and kidney tissues, while increasing the diversity of the intestinal microbiota of the offspring. The results of the in vitro and in vivo studies suggest that SYF-08, isolated from infant fecal samples, is a promising candidate probiotic against Pb2+ toxicity.

Co-supplementation of Zinc and Calcium Suppresses Bio-absorption of Lead in Sprague Dawley Rats

Lead (Pb) is a widespread environmental toxicant and its toxicity causes huge health impacts. The present study was conducted to examine the protective role of zinc (Zn) and calcium (Ca) supplements against bio-absorption of Pb in blood and organs including the liver and kidney. Hence, Sprague Dawley rats were divided in to five groups. G₁ served as negative control and was provided with standard diet, G₂ as positive control receiving standard diet + PbAc (20 mg/kg BW), G₃ was provided with standard diet + PbAc (20 mg/kg BW) + ZnSO₄ (20 mg/kg BW), G₄ with standard diet + PbAc (20 mg/kg BW) + CaCO₃ (7.5 g/kg BW) whereas G₅ was fed on standard diet + PbAc (20 mg/kg BW) + ZnSO₄ (20 mg/kg BW) + CaCO₃ (7.5 g/kg BW). The salts were provided as solution, dissolved in 0.5 mL distilled water via orogastric tube. After 35 days, the overnight fasted rats were decapitated, and blood and organs were collected for analysis of levels of metals and liver and kidney function tests. The results depicted significant decrease in Pb concentration in blood and organs while increase in Zn and Ca absorption was observed as a result of Zn and Ca supplementation with Zn being better than Ca alone, specially however, combined effect of these supplements was more profound in improving liver and kidney stress biomarkers and maintained the normal architecture of renal and hepatic parenchyma. It was concluded that Zn and Ca co-supplementation hinder Pb absorption in blood, the liver, and kidney thus suggesting that their intake may protect from Pb toxicity.

Naringin administration mitigates oxidative stress, anemia, and hypertension in lead acetate-induced cardio-renal dysfunction in cockerel chicks

Lead is one of the major pollutants that is harmful to both animals and humans. It is found in every aspect of the environment such as the air, water, and soil. This pollutant affects both wild and domestic birds. Naringin has an active principle called flavonoid that has been found to have medicinal properties, mostly because of its antioxidant and metal chelating properties. This study was carried out to investigate the protective effect of naringin as an antioxidant against lead-induced anemia, cardio and nephrotoxicity, and hypertension. This study also aimed at elucidating the use of naringin as a heavy metal binder in poultry feed. Thirty-six cockerel chicks were used for this study, and randomly grouped into six groups per group; group A served as the control, group B received Pb-only (300 ppm), group C (Pb and naringin; 80 mg/kg), group D (Pb and naringin; 160 mg/kg), group E (naringin 80 mg/kg), and group F (naringin 160 mg/kg), respectively, for 8 weeks. Lead (Pb) was administered via drinking water, while naringin was administered via oral gavage. Lead acetate intoxication precipitated anemia as indicated by significant reductions in the values of PCV, RBC, and Hb concentration in lead-treated chicks when compared with the controls. Also, lead administration induced hypertension together with increased oxidative stress, depletion of the antioxidant defense system, reduced nitric oxide production, and an increase in high blood pressure. Immunohistochemistry indicated high expressions of cardiac troponin, renal angiotensin-converting enzymes, and renal neutrophil gelatinase-associated lipocalin. Treatment with naringin corrected anemia, reduced oxidative stress, improved antioxidant system, reduced high blood pressure, and offered protection against lead acetate-induced cardio-renal dysfunction in cockerel chicks. We recommend that naringin should be incorporated poultry feeds as a metal binder.

Exposure of combination of environmental pollutant, lead (Pb) and β-amyloid peptides causes mitochondrial dysfunction and oxidative stress in human neuronal cells

Exposure to the environmental pollutant lead (Pb) has been linked to Alzheimer's disease (AD), in which mitochondrial dysfunction is a pathological consequence of neuronal degeneration. The toxicity of Pb in combination with β-amyloid peptides (1-40) and (25-35) causes selective death in neuronal cells. However, the precise mechanism through which Pb induces Alzheimer's disease, particularly mitochondrial damage, is unknown. Changes in mitochondrial mass, membrane potential, mitochondrial complex activities, mitochondrial DNA and oxidative stress were examined in neuronal cells of human origin exposed to Pb and β-amyloid peptides (1-40) and (25-35) individually and in different combinations. The results showed depolarization of mitochondrial membrane potential, decrease in mitochondrial mass, ATP levels and mtDNA copy number in Pb and β-amyloid peptides (1-40) and (25-35) exposed cells. Also, significant reductions in the expression of mitochondrial electron transport chain (ETC) complex proteins (ATP5A, COXIV, UQCRC2, SDHB, NDUFS3), as well as down regulation of ETC complex gene expressions such as COXIV, ATP5F1 and NDUFS3 and antioxidant gene expressions like MnSOD and Gpx4 were observed in exposed cells. Furthermore, Pb and β-amyloid peptides exposure resulted in elevated mitochondrial malondialdehyde levels and a decrease in mitochondrial GSH levels. Our findings suggest that Pb toxicity could be one of the causative factors for the mitochondrial dysfunction and oxidative stress in Alzheimer's disease progression.

Anti-apoptotic properties of N-Acetyl cysteine and its effects on of Liver X receptor and Sirtuin 1 expression in the liver of rats exposed to Lead

BACKGROUND

This study aimed to evaluate the expression of Liver X receptor (Lxr), Sirtuin 1 (Sirt1), apoptotic-related genes, and the protective role of N-acetylcysteine (NAC) in the liver of rats treated with Lead (Pb).

METHODS

Rats were randomly divided into 5 groups, including G1 (control), G2 (single dose of Pb), G3 (continuous dose of Pb), G4 (single dose of Pb + NAC), and G5 (continuous dose of Pb + NAC). Lipid profiles and liver specific enzymes were assessed. Expression of Lxr, Sirt1, Bax and Caspase-3 genes was considered using RT-PCR.

RESULTS

Exposure to Pb caused a significant accumulation of Pb in the blood and liver tissue, increase in serum AST, ALT and ALP enzymes, as well as lipid profiles. Chronic exposure to Pb caused a significant decrease in Lxr (3.15-fold; p < 0.001) and Sirt1 (2.78-fold; p = 0.009), but significant increase in expression of Bax (4.49-fold; p < 0.001) and Caspase-3 (4.10-fold; p < 0.001) genes when compared to the control. Combined therapy with Pb + NAC in rats caused a significant decrease in AST, ALT and ALP values (28.93%, 20.80% and 28.86%, respectively) in the blood as compared to rats treated with Pb alone. Co-treated with Pb + NAC significantly increased the expression of Lxr (1.72-fold; p = 0.043) and Sirt1 (2.45-fold; p = 0.008), but decreased the expression of Bax (1.96-fold; p = 0.03) and Caspase 3 (2.22-fold; p = 0.029) genes when compared to rats treated with Pb alone.

CONCLUSION

Chronic exposure to Pb is strongly associated with accumulation of Pb in the blood and liver, hepatic cells apoptosis, down-expression of Lxr and Sirt1 genes and consequently liver injury and abnormal lipid profiles. NAC reversed the Pb-induced toxicity on the liver tissue.

Combined application of asparagine and thiourea improves tolerance to lead stress in wheat by modulating AsA-GSH cycle, lead detoxification and nitrogen metabolism

Lead (Pb), like other heavy metals, is not essentially required for optimal plant growth; however, plants uptake it from the soil, which poses an adverse effect on growth and yield. Asparagine (Asp) and thiourea (Thi) are known to assuage the negative impacts of heavy metal pollution on plant growth; however, combined application of Asp and Thi has rarely been tested to discern if it could improve wheat yield under Pb stress. Thus, this experimentation tested the role of individual and combined applications of Asp (40 mM) and Thi (400 mg/L) in improving wheat growth under lead (Pb as PbCl₂, 0.1 mM) stress. Lead stress significantly reduced plant growth, chlorophyll contents and photosystem system II (PSII) efficiency, whereas it increased Pb accumulation in the leaves and roots, leaf proline contents, phytochelatins, and oxidative stress related attributes. The sole or combined application of Asp and Thi increased the vital antioxidant biomolecules/enzymes, including reduced glutathione (GSH), ascorbic acid (AsA), ascorbate peroxsidase (APX), catalase (CAT), superoxide dismutase (SOD), glutathione S-transferase (GST), dehydroascorbate reductase (DHAR), and glutathione reductase (GR). Furthermore, the sole or the combined application of Asp and Thi modulated nitrogen metabolism by stimulating the activities of nitrate and nitrite reductase, glutamate synthase (GOGAT) and glutamine synthetase (GS). Asp and Thi together led to improve plant growth and vital physiological processes, but lowered down Pb accumulation compared to those by their sole application. The results suggest that Asp and Thi synergistically can improve wheat growth under Pb-toxicity.

Glutamine Is a Superior Protector Against Lead-Induced Hepatotoxicity in Rats via Antioxidant, Anti-inflammatory, and Chelating Properties

Lead acetate-motivated oxidative stress can affect all organ systems, particularly the liver. Glutamine (Gln) has both antioxidant and chelating properties. Therefore, we investigated for the first time the effect of Gln on the biochemical and histopathological alternations in a rat model of lead toxicity. Thirty-two rats were divided into four groups (eight rats in each): untreated normal, lead poisoning, and two similar groups receiving Gln (0.1% in drinking water for 4 weeks). To induce lead poisoning, rats received 50 mg/L lead acetate in drinking water for 4 weeks. Oxidative stress indices (total glutathione, the ratio of reduced glutathione to oxidized glutathione, advanced protein oxidation products, malondialdehyde, and ferric ion reducing power) and inflammatory markers (hepatic nuclear factor-kβ expression, interleukin 1β level, and myeloperoxidase activity) were measured. Furthermore, biochemical markers of hepatotoxicity (alanine transaminase, aspartate transaminase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, total protein, albumin, and globulins) were measured. Histopathological examination evaluated lead-induced liver damage. The treatment compensated lead-induced biochemical and histopathological alternations in rat liver. Furthermore, it decreased lead acetate level, the NF-kβ gene expression, oxidative stress, and inflammatory markers. Moreover, the treatment elevated total glutathione and reduced glutathione in the sera and liver homogenates of treated groups (p < 0.001). Glutamine could protect the liver against lead intoxication via antioxidant, anti-inflammatory, and chelating properties. In addition, its downregulating effect on the hepatic NF-kβ signaling pathway confirms its hepatoprotective activity.

Retained bullets and lead toxicity: a systematic review

INTRODUCTION

Lead toxicity secondary to retained bullet(s) (RB) after a penetrating gunshot wound is a rare but likely underdiagnosed condition, given the substantial number of firearm injuries in the United States. There is currently no consensus on the indications for surveillance, chelation, or surgical intervention.

OBJECTIVE

The purpose of our review is to summarize the literature on systemic lead toxicity secondary to RBs to help guide clinicians in the management of these patients.

METHODOLOGY

The primary literature search was conducted in Medline (PubMed), EMBASE, Cochrane, and CENTRAL using the following MESH terms: "chelation" and "lead poisoning" or "lead toxicity" or "lead" and "bullet" or "missile" or "gunshot", or "bullet".

RESULTS

The search identified 1,082 articles. After exclusions, a total of 142 articles were included in our final review, the majority of which were case reports. Several factors appear to increase the risk of developing lead toxicity including the location of the RB, the presence of a fracture or recent trauma, number of fragments, hypermetabolic states, and bullet retention duration. Particularly, RBs located within a body fluid compartment like an intra-articular space appear to be at a substantially higher risk of developing lead toxicity. Even though patients with lead toxicity from RBs will have similar symptoms to patients with lead toxicity from other sources, the diagnosis of lead poisoning may occur months or years after a gunshot wound. Symptomatic patients with high blood lead levels (BLLs) tended to improve with a combination of chelation and surgical removal of RBs.

CONCLUSIONS

We suggest surveillance with serial BLLs should be performed. Patients with intra-articular RBs appear to be at increased risk of lead toxicity and if possible, early surgical removal of the RBs is warranted, especially given that signs of toxicity are vague, and patients may not have access to follow-up. Long-term chelation should not be used as a surgical alternative and management should be multidisciplinary.

Presumed retinal lead poisoning: a case report

PURPOSE

To describe a case of presumed retinal lead poisoning.

METHODS

Clinical examination, optical coherence tomography, fundus autofluorescence, fluorescein angiography, and electroretinography were used to study a 42-year-old male with the complaint of bilateral reduced vision following systemic lead poisoning.

RESULTS

The fundus examination showed venous tortuosity, as well as macular atrophy, and pigmentary changes in his both eyes. Optical coherence tomography revealed retinal thinning, outer retinal and retinal pigment epithelium atrophy, as well as foveal schitic changes. Blue autofluorescence showed moderately hypoautofluorescence in peripapillary area of both eyes. Fluorescein angiogram showed a leopard-like pattern of hypo- and hyperfluorescence in the posterior pole. Electroretinogram showed a moderate reduction in photopic and scotopic responses.

CONCLUSIONS

The most probable diagnosis of this case is early onset retinal lead poisoning.

Antioxidative, anti-inflammatory and anti-apoptotic action of ellagic acid against lead acetate induced testicular and hepato-renal oxidative damages and pathophysiological changes in male Long Evans rats

Lead (Pb), is an environmental toxicant, causes multi-organ dysfunction including reproductive impairments. This study designed to investigate the prospective antioxidative, anti-inflammatory and anti-apoptotic effects of ellagic acid (EA) on Pb-mediated testicular and hepato-renal toxicity. Four experimental groups of five male Long-Evans rats each were used: control, Pb (60 mg/kg), EA (30 mg/kg), and Pb + EA groups. All groups were given their respective treatment orally for 30 days. Pb exposure altered body and organs weight, food and water consumption, rectal temperature, Pb residue levels in tissues, liver and kidney function, sperm quality parameters, serum metabolic and hematology profiles, and impaired the oxidative/antioxidative balance in the testicular and hepato-renal tissue, as shown by the decreased antioxidant proteins (superoxide dismutase, catalase, glutathione peroxidase, and reduced glutathione) and increased the oxidative (MDA, lipid hydroperoxides, conjugated dienes, protein carbonyl, fragmented DNA and GSH:GSSG ratio) stress and inflammatory (IL-1, IL-6, TNF-α, prostaglandin, LTB4, NO, myeloperoxidase, LDH) markers. Moreover, a dysregulation in the stress response (HSP-70) and apoptotic-regulating proteins (BAX, BCL-2, and active Caspase-3) were recorded upon Pb exposure. Remarkably, EA oral administration reduced the Pb residue levels in tissues, improved the liver and kidney function, revived the spermatogenesis and sperm quality, restored redox homeostasis, suppressed the oxidative stress, inflammatory and apoptotic responses in the liver, kidney and testis tissue. Our findings point out that EA can be used as a phyto-chelator to overcome the adverse effects of Pb exposure due to its potent antioxidant, anti-inflammatory, and anti-apoptotic effects.

Application and validation of a biotic ligand model for calculating acute toxicity of lead to Moina dubia in lakes of Hanoi, Vietnam

It is increasingly being recognized that biotic ligand models (BLMs) can successfully predict the toxicity of divalent metals toward aquatic biota applied to temperate freshwater ecosystems. However, studies on the eutrophic lakes in tropical regions toward native tropical organisms, including Moina, are relatively limited. In this study, Moina dubia, the native organism of the Hanoi eutrophic urban lakes, were used in toxicological studies of lead (Pb); 24-h EC₅₀ value of Pb was 523.19 µg/L under optimal living conditions for M. dubia in the laboratory. The constant binding of Pb²⁺ on M. dubia surface sites (log K_PbBL = 2.38) was significantly low. Other stability constants were obtained under experiments as logK_CaBL = 2.48, logK_MgBL = 2.80, logK_NaBL = 2.35, logK_KBL = 2.49, and logK_HBL = 3.026. A BLM was developed to calculate the acute toxicity (EC₅₀-24 h) of lead on M. dubia based on the condition of the urban lakes of Hanoi. Validation with toxicity data in synthetic medium showed a coefficient determination of 79.16% and a mean absolute percentage error (MAPE) of 10.2%, while the validation with the toxicity data with natural water medium from 11 Hanoi lakes showed a coefficient determination of 73.7% and a MAPE of 13.66%. The BLM worked well with water at a pH of 7.0 to 8.0, but failed with water at a pH above 8.0. Eutrophic conditions proved to have a significant effect on the toxicity of lead on local zooplankton.

Abdominal pain caused by lead toxicity due to over the counter herbal medicines: A case series

In the last three decades, the use of herbal medications has been increasing for the treatment of various chronic disorders. Studies in the past have shown that many of these medicines could contain high levels of heavy metals, including lead. Therefore, we planned this study to evaluate the possibility of lead toxicity as the underlying cause in patients consuming these unnamed herbal medicines among patients presenting with significant abdominal pain. (Unexplained abdominal pain means pain in abdomen in which no etiology could be ascertained after all possible routine and specialized investigations including computerized axial tomography [CT] of the abdomen and upper gastrointestinal [UGI] endoscopy/colonoscopy). This is an observational case series of prospectively maintained data of all patients having unexplained abdominal pain and found to have an elevated blood lead level from 2011 to 2019. Lead toxicity was diagnosed when its blood lead level was >25 μg/dL. Total sixty-six patients with unexplained abdominal pain from 2011 to 2019 were recruited. Out of the sixty-six patients, seventeen had elevated blood lead levels. All seventeen patients had a history of ingestion of herbal medicines for more than 6 months. Among the seventeen patients, eight were taking it for infertility and sexual dysfunction, six for diabetes, two for arthritis and one for hypertension. Basophilic stippling was seen in one patient. Fourteen patients had low hemoglobin with a median value of 9.7 g/dL. Mean serum blood lead level was 87.1 μg/dL. None of them required anti-chelating agent. Lead toxicity owing to herbal medicine is not uncommon cause of unexplained abdominal pain. Most of these patients do not require a chelating agent for treatment. There is a need to bring these herbal medicines under strict regulations for displaying its constituents and their concentrations.

Defective mitophagy and induction of apoptosis by the depleted levels of PINK1 and parkin in Pb and β-amyloid peptide induced toxicity

Exposure to lead (Pb), an environmental pollutant, is closely associated with the development of neurodegenerative disorders through oxidative stress induction and alterations in mitochondrial function. Damaged mitochondria could be one of the reasons for the progression of Alzheimer's Disease (AD). Mitophagy is vital in keeping the cell healthy. To know its role in Pb-induced AD, we investigated the PINK1/parkin dependent pathway by studying specific mitophagy marker proteins such as PINK1 and parkin in differentiated SH-SY5Y cells. Our data have indicated a significant reduction in the levels of PINK1 and parkin in cells exposed to Pb and β-amyloid peptides, both Aβ (25-35) and Aβ (1-40) individually and in different combinations, resulting in defective mitophagy. Also, the study unravels the status of mitochondrial permeability transition pore (MPTP), mitochondrial mass, mitochondrial membrane potential (MMP) and mitochondrial ROS production in cells treated with individual and different combination of Pb and Aβ peptides. An increase in mitochondrial ROS production, enhanced MPTP opening, depolarization of membrane potential and reduced mitochondrial mass in the exposed groups were observed. Also, in the present study, we found that Pb and β-amyloid peptides could trigger apoptosis by activating the Bak protein, which releases the cytochrome c from mitochondria through MPTP that further activates the AIF (apoptosis inducing factor) and caspase-3 proteins in the cytosol. The above findings reveal the potential role of mechanisms like PINK1/parkin mediated mitophagy and dysfunctional mitochondria mediated apoptosis in Pb induced neurotoxicity.

Parental Lead Exposure Promotes Neurobehavioral Disorders and Hepatic Dysfunction in Mouse Offspring

Lead (Pb) induces neurotoxicity in both children and adults. Children are more vulnerable to Pb toxicity than adults. Little is known about the effects of Pb on the mental health of the children who are prenatally exposed. Therefore, we designed an animal experiment to compare the adverse effects of Pb on neurobehavioral and hepatic functions between Pb-exposed (Pb mice) and parental Pb-exposed (P-Pb mice) group mice. Mice were treated with Pb-acetate (10 mg/kg bodyweight/day) via drinking water. Male mice from unexposed parents treated with Pb for 90 days were defined as Pb mice, whereas male mice from Pb-exposed parents treated with Pb for further 90 days were defined as P-Pb mice. Anxiety-like behavior and spatial memory and learning were assessed by elevated plus maze and Morris water maze. Serum hepatic enzyme activities and butyrylcholinesterase activity were measured by an analyzer. P-Pb mice displayed increased anxiety-like behavior and memory and learning impairments compared to Pb mice. BChE activity was significantly decreased in P-Pb mice compared to Pb mice. Pb levels in the brains of P-Pb mice were significantly higher than those of Pb mice. The activities of serum hepatic enzymes of P-Pb mice were also higher than those of Pb mice. Additionally, histopathology data revealed that hepatic tissue injury was more pronounced in P-Pb mice than in Pb mice. Thus, the results suggest that persistent exposure to Pb from fetus to adult causes more severe neurobehavioral changes and hepatic toxicities than adult exposure only.

Biosorption of hazardous waste from the municipal wastewater by marine algal biomass

Lead is one of the highly toxic heavy metals causes various diseases even at very lower concentrations to human and affects eco-system. It is mainly released into the water through industrial activities. Phytoremediation is useful to degrade, reduce, metabolize and assimilate lead from wastewater. In this study, Turbinaria ornata was collected from the sea and dried biomass was used for biosorption of heavy metals. Adsorption of heavy metal was maximum after 100 min incubation with alga powder at acidic pH (4.5). The interactive effects of lead concentration, contact times, pH, biomass concentration and agitation speed was evaluated by a two-level full factorial design. Initial lead concentration, agitation speed and biomass concentration were the most important variables affecting lead removal (p < 0.001) were selected for optimization using central composite rotatable design. Lead removal was found to be maximum (99.8%) in optimized conditions: initial lead 99.8 mg/L, 250 rpm agitation speed and 16.2 g/L biomass concentrations. Municipal wastewater was collected and lead concentration (0.013 mg/L) and physiochemical factors were analyzed. Algal biomass removed >98.5% lead form the wastewater within 10 min in an optimized condition. The present study confirmed the potential application of T. ornata for the removal of lead from contaminated environment.

Potential ameliorative effect of dietary quercetin against lead-induced oxidative stress, biochemical changes, and apoptosis in laying Japanese quails

Lead (Pb) is a widespread environmental pollutant which is a toxic threat to human and animal health. The present study was designed to evaluate the ameliorative role of quercetin in laying quails exposed to Pb. A total of 112 birds were randomly divided into four groups. The control group was fed with basal diet, the Pb group was fed with ration supplemented with Pb at the dose of 100 mg/kg (as Pb (II) acetate trihydrate), the Quercetin group was fed with ration supplemented with quercetin at the dose of 400 mg/kg, and the Pb+ Quercetin group was fed with ration supplemented with Pb at the dose of 100 mg/kg and quercetin at dose of 400 mg/kg. Results showed that serum total protein, glucose, albumin, and blood urea nitrogen (BUN) values of the Pb + Quercetin group partially improved with quercetin supplementation. Meanwhile, serum creatinine values of the Pb + Quercetin group was found to be significantly lower than that of the Pb group. Aspartate aminotransferase (AST) and alanine transaminase (ALT) enzyme activities in the Quercetin and Pb + Quercetin groups were similar to those of the Control group, unlike the Pb group. Moreover, alkaline phosphatase (ALP) enzyme activity of the Pb + Quercetin group significantly improved with the addition of quercetin. We also found that malondialdehyde (MDA) levels of the kidney, liver, and heart were significantly reduced by quercetin supplementation. The glutathione, catalase, and glutathione peroxidase activities of the kidney, liver, and heart tissue were increased by quercetin supplementation. These results were in line with the observed apoptotic markers. The expression of caspase-3 and caspase-9 were significantly decreased by quercetin supplementation. It may be concluded that dietary supplementation with quercetin ameliorates the toxic effects of Pb exposure by alleviating oxidative stress, biochemical changes, and apoptosis in quails.

Mechanisms associated with the dysregulation of mitochondrial function due to lead exposure and possible implications on the development of Alzheimer's disease

Lead (Pb) is a multimedia contaminant with various pathophysiological consequences, including cognitive decline and neural abnormalities. Recent findings have reported an association of Pb toxicity with Alzheimer's disease (AD). Studies have revealed that mitochondrial dysfunction is a pathological characteristic of AD. According to toxicology reports, Pb promotes mitochondrial oxidative stress by lowering complex III activity in the electron transport chain, boosting reactive oxygen species formation, and reducing the cell's antioxidant defence system. Here, we review recent advances in the role of mitochondria in Pb-induced AD pathology, as well as the mechanisms associated with the mitochondrial dysfunction, such as the depolarisation of the mitochondrial membrane potential, mitochondrial permeability transition pore opening; mitochondrial biogenesis, bioenergetics and mitochondrial dynamics alterations; and mitophagy and apoptosis. We also discuss possible therapeutic options for mitochondrial-targeted neurodegenerative disease (AD).

Plant Polyphenols: Potential Antidotes for Lead Exposure

Lead is one of the most common heavy metal elements and has high biological toxicity. Long-term lead exposure will induce the contamination of animal feed, water, and food, which can cause chronic lead poisoning including nephrotoxicity, hepatotoxicity, neurotoxicity, and reproductive toxicity in humans and animals. In the past few decades, lead has caused widespread concern because of its significant threat to health. A large number of in vitro and animal experiments have shown that oxidative stress plays a key role in lead toxicity, and endoplasmic reticulum (ER) stress and the mitochondrial apoptosis pathway can also be induced by lead toxicity. Therefore, plant polyphenols have attracted attention, with their advantages of being natural antioxidants and having low toxicity. Plant polyphenols can resist lead toxicity by chelating lead with their special chemical molecular structure. In addition, scavenging active oxygen and improving the level of antioxidant enzymes, anti-inflammatory, and anti-apoptosis are also the key to relieving lead poisoning by plant polyphenols. Various plant polyphenols have been suggested to be useful in alleviating lead toxicity in animals and humans and are believed to have good application prospects.

Protective role of yeast beta-glucan on lead acetate-induced hepatic and reproductive toxicity in rats

Lead (Pb) is one of the most common environmental pollutants and causes adverse effects on human and animal health. This study aimed to evaluate the protective role of beta-glucan against hepatic and reproductive toxicity induced by lead acetate. A total of 28 Sprague Dawley male rats were distributed into four groups (n = 7). The control group was intraperitoneally injected saline (1 ml/kg b.w.) daily for 21 days, the Pb group was intraperitoneally injected lead acetate (15 mg/kg b.w.) daily for 21 days, the beta-glucan group was orally administrated beta-glucan (50 mg/kg b.w.) daily for 21 days, and the Pb + beta-glucan group was intraperitoneally injected lead acetate (15 mg/kg b.w.) daily following the oral administration of beta-glucan (50 mg/kg b.w.) daily for 21 days. Results showed that feed intake in the Pb + beta-glucan group was significantly increased in comparison with that of the Pb group (p < 0.001). We also found that liver malondialdehyde (MDA) level was increased significantly in the Pb group (p < 0.01), while glutathione (GSH) level (p < 0.05), glutathione peroxidase (GSH-Px) (p < 0.05), and catalase (CAT) (p < 0.01) activities were reduced when they were compared with control. Moreover, Pb administration increased expression of pro-apoptotic protein Bax, the ratio of Bax/Bcl-2, and decreased the expression of the antiapoptotic protein Bcl-2 (p < 0.01). Also, Pb was found to cause a significant decrease in sperm motility (p < 0.01) and sperm concentration (p < 0.05) but increase in sperm tails and total sperm anomalies (p < 0.05). These findings were partially preserved by the administration of beta-glucan. Taken together, these results indicated that beta-glucan has the potential to alleviate the Pb-induced toxicity.

Health repercussions of environmental exposure to lead: Methylation perspective

Lead (Pb) exposure has been a major public health concern for a long time now due to its permanent adverse effects on the human body. The process of lead toxicity has still not been fully understood, but recent advances in Omics technology have enabled researchers to evaluate lead-mediated alterations at the epigenome-wide level. DNA methylation is one of the widely studied and well-understood epigenetic modifications. Pb has demonstrated its ability to induce not just acute deleterious health consequences but also alters the epi-genome such that the disease manifestation happens much later in life as supported by Barkers Hypothesis of the developmental origin of health and diseases. Furthermore, these alterations are passed on to the next generation. Based on previous in-vivo, in-vitro, and human studies, this review provides an insight into the role of Pb in the development of several human disorders.

Genetic susceptibility of δ-ALAD associated with lead (Pb) intoxication: sources of exposure, preventive measures, and treatment interventions

Delta-aminolevulinic acid dehydratase (δ-ALAD) is involved in the synthesis of haem and exhibits a polymorphic nature. δ-ALAD polymorphism produces two alleles, namely δ-ALAD-1 and δ-ALAD-2, which in turn produce three different phenotypes, namely δ-ALAD1-1, δ-ALAD1-2, and δ-ALAD2-2. δ-ALAD gene is more susceptible to lead (Pb) toxicity than any other genes. Its genotype and phenotype frequencies change with respect to different geographical areas and extent of Pb exposure. The δ-ALAD-2 allele dominancy is linked with high concentration of lead in the body. It has also been thought that the δ-ALAD-2 allele can provoke Pb toxicity by producing a protein that binds more tightly with Pb than δ-ALAD-1 protein. However, few evidences suggest that δ-ALAD-2 may reduce harmful effects by increasing excretion of Pb from the body, thus producing its unavailability towards pathophysiologic alterations. However, the recent evidences have supported that the individuals who are heterozygote for the δ-ALAD-1 allele may be associated with a higher risk of long-term Pb toxicity. In this regard, the individuals who are exposed at occupational levels are among the most frequent study population. The main objective of our study was to explore the gene susceptibility associated with Pb poisoning. Moreover, this study also summarizes various sources of Pb exposure and thereafter outlined multiple strategies to minimize the Pb toxicity in order to save the exposed residential communities.

N,N'bis-(2-mercaptoethyl) isophthalamide (NBMI) exerts neuroprotection against lead-induced toxicity in U-87 MG cells

N,N'-bis(2-mercaptoethyl)isophthalamide (NBMI) is a novel lipophilic heavy metal chelator and thiol redox antioxidant. This study was designed to investigate the neuroprotective activity of NBMI in U-87 MG cells exposed to lead acetate (PbAc). Cells were pretreated with NBMI for 24 h prior to a 48 h exposure to PbAc. Cell death (55%, p < 0.0001) and reduction of intracellular GSH levels (0.70-fold, p < 0.005) induced by 250 µM Pb were successfully attenuated by NBMI pretreatment at concentrations as low as 10 µM. A similar pretreatment with the FDA-approved Pb chelator dimercaptosuccinic acid (DMSA) proved ineffective, indicating a superior PKPD profile for NBMI. Pretreatment with NBMI successfully counteracted Pb-induced neuroinflammation by reducing IL-1β (0.59-fold, p < 0.05) and GFAP expression levels. NBMI alone was also found to significantly increase ferroportin expression (1.97-fold, p < 0.05) thereby enhancing cellular ability to efflux heavy metals. While no response was observed on the apoptotic pathway, this study demonstrated for the first time that necrotic cell death induced by Pb in U-87 MG cells is successfully attenuated by NBMI. Collectively these data demonstrate NBMI to be a promising neuroprotective compound in the realm of Pb poisoning.

Environmental assessment of pediatric Lead exposure in Tehran; a prospective cross-sectional study

BACKGROUND

Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities.

METHODS

In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places.

RESULTS

Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft², 250 μg/ft². Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026).

CONCLUSION

Children's playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.

Prevalence of lead toxicity in adolescents in Kuwait

Background

Elevated blood lead level (EBLL) is a public health problem in both developing and industrialized countries. Being a petrochemical-based economy, lead (Pb) levels are expected to be high in Kuwait, but systematic data on population exposure are lacking. This study aimed at determining the prevalence of EBLL in adolescents in Kuwait.

Methods

Adolescents (N = 1385; age range 11–16 years) were cross-sectionally selected from public middle schools from all Governorates of Kuwait, utilizing multistage cluster random sampling. Pb in whole blood was analyzed by inductively coupled plasma mass spectrometry. Distribution of blood Pb levels (BLL) among Governorates and sexes were compared by non-parametric tests and the prevalence of EBLL (defined as BLL above the CDC reference level of ≥5 μg/dL) was estimated by χ² test. Binary logistic regression was used for assessing the association between EBLL and Governorate.

Results

Median (IQR) BLL was 5.1(3.6–7.1) μg/dL [4.9 (3.8–6.5) μg/dL in males and 5.4 (3.3–7.6) μg/dL in females; p = 0.001]. In the overall sample, 51% had BLL ≥5 μg/dL; 13% had ≥10 μg/dL and 3% > 20 μg/dL. Prevalence of EBLL was 47% in males and 56% in females (p < 0.001). EBLLs were clustered in Al-Asima, Al-Ahmadi (in both sexes); Al-Jahra (in males) and Mubarak Al-Kabeer (in females) Governorates.

Conclusions

EBLL is a significant public health problem in adolescents in Kuwait. Urgent public health intervention is required in areas with EBLL, and the sources of exposure need to be identified for prevention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11210-z.

Sublethal toxicity of PbI2 in perovskite solar cells to fish embryos (Danio rerio and Oryzias latipes): Deformity and growth inhibition

Pb-based perovskite in solar cells is a source of PbI₂. The objective of this study was to characterize the embryonic toxicity of PbI₂, a potentially leachable chemical and hazardous material, for two fish species (zebrafish and Japanese medaka). A series of measurements were performed to assess mortality, abnormalities (deformities and other pathological changes), hatchability, and growth inhibition. The results obtained showed that the toxicities observed were predominantly associated with Pb²⁺ and I^-. Therefore, given the potential ecotoxicity of PbI₂, precautions should be taken to prevent its release during the breakage and disposal of Pb-based perovskite solar cells.

High Blood Lead Levels: An Increased Risk for Development of Brain Hyperintensities among Type 2 Diabetes Mellitus Patients

The current study was aimed to ascertain the effect of blood lead level on brain tissues in patients with type 2 diabetes. A total of 300 human participants ages 27 to 60 years with type 2 diabetes (n = 150) and healthy individuals (n = 150) were included in this study. The serum samples were used for measuring HbA1c and fasting blood glucose. Blood lead level was measured using flame atomic absorption spectrophotometer. Magnetic resonance imaging sub-analysis was used to assess the brain hyperintensities. Brain hyperintensities were found in 55% of patients with diabetes and 6% of non-diabetic control group subjects. The deep white matter hyperintensities were observed in 45% of diabetic patients, while the subcortical hyperintensities were noted in 10% of cases. Entorhinal cortex changes (31%) and hippocampus changes (42%) were noted in diabetic patients with brain hyperintensities. Diabetic patients with brain hyperintensities showed higher blood lead levels, HbA1c, and fasting blood sugar (p < 0.0001) as compared with healthy volunteers. A higher correlation (R² = 0.8922) was found between deep white matter hyperintensities' size and blood lead levels. In nutshell, persistence of high blood lead level in diabetic patients may progress to brain hyperintensities which may consequently lead to cognitive, behavioral changes and Alzheimer's disease.

The Case For Cadmium and Lead Heavy Metal Screening

Exposure to cadmium and lead is widespread, and is related to environmental contamination, occupational sources, food, tobacco and other consumer products. Lower socioeconomic status increases the risk of heavy metal exposure and the diseases associated with cadmium and lead toxicity. Concurrent toxicity with both cadmium and lead is likely but has not often been assessed. There is now substantial evidence linking cadmium and lead to many diseases including hypertension, diabetes mellitus, obesity, cancer, coronary artery disease, chronic kidney disease (CKD) and lung disease. Both chronic renal failure and ischemic heart disease patients have been treated separately in recent studies with calcium disodium ethylenediaminetetraacetic acid (Ca EDTA) chelation therapy. In patients with CKD, serum creatinine 1.5-4.0 mg/dL, and increased body lead burden, weekly low dose chelation with Ca EDTA slowed the rate of decline in renal function in diabetics and non-diabetics. In patients with a history of myocardial infarction, the Trial to Assess Chelation Therapy (TACT) study showed that Ca EDTA chelation decreased the likelihood of cardiovascular events, particularly in diabetics. Ca EDTA chelation administered carefully at lower dosage (<50 mg/kg per week) is generally safe. In the past, acute renal failure associated with much higher dosage was reported. We suggest that the preponderance of the evidence favors a more activist approach towards diagnosis and possible intervention in heavy metal toxicity.

Methyl jasmonate ameliorates lead toxicity in Oryza sativa by modulating chlorophyll metabolism, antioxidative capacity and metal translocation

Lead (Pb) not only negatively alters plant growth and yield but may also have potentially toxic risks to human health. Nevertheless, the interaction between rice (Oryza sativa L.) plants and the molecular cell dynamics induced by lead-methyl jasmonate (MJ) remains unknown. Here, plants were hydroponically exposed to Pb (150 and 300 µM) alone or in combination with 0.5 and 1 µM MJ. The application of MJ modulated the expression of the HMAs, PCS1, PCS2 and ABCC1 genes, thereby immobilizing the Pb in the roots and lessening its translocation to the aerial parts of the rice plant. The supplementation of MJ improved the growth and yield of Pb-stressed rice by adjusting the proline and chlorophyll metabolism, increasing the phytochelatins (PCs) accumulation and diminishing the accumulation of Pb in the shoots. the application of MJ alleviated the oxidative stress of rice plants exposed to Pb toxicity by enhancing the activity of antioxidant enzymes and enzymes of the glyoxalase system (glyoxalase I and II) and decreasing the endogenous levels of malondialdehyde (MDA), hydrogen peroxide (H2O2) and methylglyoxal (MG). Therefore, the results of the present study could provide a molecular insight and cellular interplay scheme for the development of a promising strategy in Pb-contaminated areas to produce healthy food.

Adaptive epigenetic response of glutathione (GSH)-related genes against lead (Pb)-induced toxicity, in individuals chronically exposed to the metal

It is well known that one of the most outstanding adverse effects related to lead (Pb) exposure is oxidative stress; moreover, recent findings suggest that disturbances of the redox status of cells are associated with epigenetic responses, and metabolism of glutathione (GSH) plays an important role in this process. This study aimed to assess Pb exposure on % methylation of GSH-related genes' promoter regions (%CH₃-CpG) and their influence on biomarkers of oxidative stress, in workers exposed to the metal. One hundred nine male workers participated in the study; ICP-MS determined blood lead levels (BLL); biochemical parameters related to redox status, named GSH, glutathione peroxidase (GPX) and glutathione-S-transferase (GST) were quantified by UV/Vis spectrophotometry. Determination of %CH₃-CpG of genes GCLC, GPX1, GSR, and GSTP1 were done by pyrosequencing. Inverse associations were seen between BLL and %CH₃-CpG-GCLC, and %CH₃-CpG-GSTP1. Moreover, metal exposure did not impact GSH, GPX, and GST; however, negative associations were observed between %CH₃-CpG-GPX1 and %CH₃-CpG-GSTP1, and the activities of GPX and GST, respectively. Taken together, our results give further evidence about adaptive epigenetic response to avoid oxidative damage induced by Pb exposure, allowing a better understanding of the molecular mechanisms related to the metal toxicity.

Transcriptome Analysis of the Hepatopancreas in the Litopenaeus vannamei Responding to the Lead Stress

Lead (Pb) is one of the most hazardous pollutants and toxic heavy metal in marine environment. The molecular mechanisms of Pb toxicity in aquatic organism are not well understood. In this study, hepatopancreas transcriptome of Litopenaeus vannamei (L. vannamei) was characterized by a comparison between control and Pb exposure samples using RNA-Seq approach. Hepatopancreas morphology of L. vannamei was also assessed. The result reveals that compared with the control group, an increase in the number of B cells was observed following Pb exposure in L. vannamei. Transcriptome data showed that a total of 1593 genes were recognized to be differentially expressed including 1278 up-regulated and 315 down-regulated genes. These genes were mainly associated with energy metabolism, cell apoptosis, exogenous microbial infection, cell junction, and cell adhesion. Fifteen ribosomal protein genes (RPS3, RPS13, RPSA, RPL11, RPS2, RPL8, RPS23, RPL3, RPL5, RPS6, RPS4X, RPS18, RPL19, RPL9, RPL6) were identified as the common hubs of protein-protein interaction (PPI) networks, as well as part of modules of the PPI network. Besides ribosomal protein, we identified differential expression genes (DEGs) including GAPDH, EEF1A1, HSPA8, UBC, and EEF1G as the common hubs of PPI networks. These findings may have important implications for understanding the adverse biological effects of Pb and its toxic mechanisms, as yet not clearly defined, and provide potential biomarkers of Pb exposure in hepatopancreas of L. vannamei, which might be useful for monitoring aquatic environments and assessing the health of the marine ecosystem.

Binding Capacities and Antioxidant Activities of Lactobacillus plantarum and Pichia kudriavzevii Against Cadmium and Lead Toxicities

The cadmium and lead binding capacities and antioxidant activities of Lactobacillus plantarum and Pichia kudriavzevii were evaluated in vitro and in vivo. Lactic acid bacteria and yeasts obtained from fermenting cassava mash and maize slurry were screened for tolerance to cadmium and lead at 500-1050 mg ml^-1 screened for probiotic potentials and antioxidant activities such as 2,2-diphenyl-1-picrylhydrazyl and ferric reducing antioxidant properties. The in vivo studies were carried out in male Wistar rats. The strains identified as Lactobacillus plantarum ML05 and Pichia kudriavzevii FY05 demonstrated the best probiotic potentials and antioxidant activities. Alterations in antioxidant capacities were positive in the treatment groups. The histopathology displayed positive changes in the renal tubules and glomeruli, hypertrophy, with normal capsular spaces without inflammation in the kidney, while the liver sinusoids appear normal in the rats administered with L. plantarum ML05 and P. kudriavzevii FY05 while the infected and not treated showed cell necrosis induced by toxicities. Our results provided new evidence that Lactobacillus plantarum and Pichia kudriavzevii have different biological actions on the heavy metals binding capacities and antioxidant activities in experimental animals. This study suggests that these microorganisms can be considered dietary therapeutics against cadmium and lead toxicities.

Ellagic acid plays an important role in enhancing productive performance and alleviating oxidative stress, apoptosis in laying quail exposed to lead toxicity

Lead (Pb) is one of the most toxic heavy metal environmental pollutants due to its widespread use of the industry and it is a harmful substance for human and animal health. This study was conducted to investigate the potential protective effects of ellagic acid (EA) on performance, egg quality, antioxidant parameters, and apoptotic pathway proteins in laying quails exposed to Pb toxicity. A total of 168 (15-week old) laying quails (Coturnix coturnix Japonica) were divided into 6 experimental groups (with similar initial average body weight). Birds were fed 1 of 6 diets for 8 weeks: 1 - Control (basal diet), 2 - Pb (basal diet + 100 mg/kg Pb), 3 - EA-300 (basal diet + 300 mg/kg EA), 4 - EA-500 (basal diet + 500 mg/kg EA), 5 - Pb + EA-300 (basal diet + 100 mg/kg Pb + 300 mg/kg EA), 6 - Pb + EA-500 (basal diet + 100 mg/kg Pb + 500 mg/kg EA). The results showed that adding 100 mg/kg of Pb to basal diet was adversely affected the performance parameters and, feed intake and egg production were significantly decreased by Pb supplementation (P < 0.01). However, the EA supplementation to Pb groups improved the performance parameters. Compared with the Pb alone group, in Pb + EA-500 group increased egg production by 8.4%. There were no significant differences in the Haugh unit, albumen index, and yolk index among groups (P > 0.05). Liver and kidney tissues of Pb group malondialdehyde (MDA) level increased (P < 0.001) and, GSH, GSH-Px, and CAT values decreased (P < 0.001) but, EA supplementation alleviated this condition (P < 0.001). The protein levels of caspase-3 and -9 were significantly increased in the Pb group compared to the control group, whereas EA supplementation alleviated the Pb-induced apoptosis by decreasing caspase-3 and -9 levels in the liver tissue (p < 0.001). In laying quails exposed to Pb toxicity, EA supplementation improves the performance parameters, enhances the antioxidant defense system, and suppresses apoptosis via regulates the expression of caspase-3 and -9. Thus, it was concluded that EA (especially 500 mg/kg) can ameliorate the toxic effects of Pb exposure in quails.

Lead Toxicity in Children: An Unremitting Public Health Problem

BACKGROUND

Lead is a pervasive environmental contaminant. Lead accumulates in the body, impairing a molecular level various cellular processes. Lead exposure during childhood causes adverse and permanent neurodevelopmental consequences, sometimes even with "low" blood lead levels. Symptoms are frequently silent, making lead exposure an often unrecognized and underestimated threat for pervasive neurocognitive disorders.

METHODS

We identified articles focusing on childhood exposure to lead and neurodevelopment via a search of the electronic database PubMed (National Library of Medicine), including journal articles published from 2007 to 2019. These articles were used to evaluate the effect of environmental lead exposure and analyze whether control efforts over the past decades have altered the prevalence of exposed children.

CONCLUSIONS

Children are still being exposed to lead despite evidence of the adverse impact of exposure, even for children with blood lead levels below the currently recognized threshold for intervention. Legislative and educational efforts have reduced lead exposure but are not being followed universally. Primary prevention and identification of high-risk populations are the best cost-benefit interventions to fight this public health problem.

Common Hematologic, Nutritional, Asthma/Allergic Conditions and Lead Screening/Management

This article describes hematologic, nutritional, allergic/asthmatic conditions, lead screening, and management of these among immigrants and refugees. Some of these conditions present more frequently or differently in the newcomer population. Early identification and treatment are key to improving health outcomes. Screening and treatment suggested in this article are based on current guidelines and are intended for primary care providers who are caring for refugee and immigrant patients, especially within a medical home. Special considerations include level of education, instruction, demonstration, and cultural humility.