Association of genetic variation in cystathionine-beta-synthase and arsenic metabolism

Variation in individual susceptibility to arsenic-induced disease may be partially explained by genetic differences in arsenic metabolism. Mounting epidemiological evidence and in vitro studies suggest that methylated arsenic metabolites, particularly monomethylarsonic (MMA3), are more acutely toxic than inorganic arsenic; thus, MMA3 may be the primary toxic arsenic species. To test the role of genetic variation in arsenic metabolism, polymorphisms in genes involved in one-carbon metabolism [methylenetetrahydrofolate reductase (MTHFR), methionine synthase (MTR), cystathionine-beta-synthase (CBS), thymidylate synthase (TYMS), dihydrofolate reductase (DHFR), serine hydroxymethyltransferase 1 (SHMT1)] and glutathione biosynthesis [glutathione-S-transferase omega 1 (GSTO1)] were examined in an arsenic-exposed population to determine their influence in urinary arsenic metabolite patterns. In 142 subjects in Cordoba Province, Argentina, variant genotypes for CBS rs234709 and rs4920037 SNPs compared with wild-type homozygotes were associated with 24% and 26% increases, respectively, in the mean proportion of arsenic excreted as monomethylarsonic acid (%MMA). This difference is within the range of differences in %MMA seen between people with arsenic-related disease and those without such disease in other studies. Small inverse associations with CBS rs234709 and rs4920037 variants were also found for the mean levels of the proportion of arsenic excreted as dimethylarsinous acid (%DMA). No other genetic associations were found. These findings are the first to suggest that CBS polymorphisms may influence arsenic metabolism in humans and susceptibility to arsenic-related disease.

Polymorphisms in one-carbon metabolism pathway genes, urinary arsenic profile, and urothelial carcinoma

BACKGROUND

Gene polymorphisms in the one-carbon metabolism pathway could contribute to arsenic methylation capability through plasma folate and homocysteine metabolism, thereby increasing the susceptibility to urothelial carcinoma (UC) risk.

OBJECTIVES

The goal of our study was to evaluate the roles of gene polymorphisms in the one-carbon metabolism pathway in the carcinogenesis of UC.

METHODS

A hospital-based case-controlled study was conducted. The urinary arsenic profile was examined using high-performance liquid chromatography and hydride generator-atomic absorption spectrometry. Folate levels were measured using a competitive immunoassay kit. Genotyping was conducted using polymerase chain reaction-restriction fragment length polymorphism technique.

RESULTS

Patients with UC had higher urinary total arsenic, inorganic arsenic percentage (InAs%) and monomethylarsenic acid percentage (MMA%), and lower dimethylarsenic acid percentage (DMA%), plasma folate and homocysteine levels than controls. The correlations between folate and DMA%, and folate and homocysteine, were significant according to Pearson's correlation coefficients. Subjects carrying the 5,10-methylenetetrahydrofolate reductase (MTHFR) CT or TT genotype had a lower DMA% and lower folate levels than those carrying the CC genotype. Participants with the methionine synthase (MS) AA genotype had higher homocysteine levels than those with the AG or GG genotype. However, neither MTHFR nor MS gene polymorphisms were associated with UC risk.

CONCLUSIONS

Environmental factors played a more important role in UC carcinogenesis than MTHFR or MS gene polymorphism.

Impact of smoking and chewing tobacco on arsenic-induced skin lesions

BACKGROUND

We recently reported that the main reason for the documented higher prevalence of arsenic-related skin lesions among men than among women is the result of less efficient arsenic metabolism.

OBJECTIVE

Because smoking has been associated with less efficient arsenic methylation, we aimed to elucidate interactions between tobacco use and arsenic metabolism for the risk of developing skin lesions.

METHODS

We used a population-based case-referent study that showed increased risk for skin lesions in relation to chronic arsenic exposure via drinking water in Bangladesh and randomly selected 526 of the referents (random sample of inhabitants > 4 years old; 47% male) and all 504 cases (54% male) with arsenic-related skin lesions to measure arsenic metabolites [methylarsonic acid (MA) and dimethylarsinic acid (DMA)] in urine using high-performance liquid chromatography (HPLC) and inductively coupled plasma mass spectrometry (ICPMS).

RESULTS

The odds ratio for skin lesions was almost three times higher in the highest tertile of urinary %MA than in the lowest tertile. Men who smoked cigarettes and bidis (locally produced cigarettes; 33% of referents, 58% of cases) had a significantly higher risk for skin lesions than did nonsmoking men; this association decreased slightly after accounting for arsenic metabolism. Only two women smoked, but women who chewed tobacco (21% of referents, 43% of cases) had a considerably higher risk of skin lesions than did women who did not use tobacco. The odds ratio (OR) for women who chewed tobacco and who had < or = 7.9%MA was 3.8 [95% confidence interval (CI), 1.4-10] compared with women in the same MA tertile who did not use tobacco. In the highest tertile of %MA or %inorganic arsenic (iAs), women who chewed tobacco had ORs of 7.3 and 7.5, respectively, compared with women in the lowest tertiles who did not use tobacco.

CONCLUSION

The increased risk of arsenic-related skin lesions in male smokers compared with nonsmokers appears to be partly explained by impaired arsenic methylation, while there seemed to be an excess risk due to interaction between chewing tobacco and arsenic metabolism in women.

Assessment of in vivo bioaccessibility of arsenic in dietary rice by a mass balance approach

A pilot dietary experiment was conducted over 10 days to evaluate whether a simple yet often underutilized approach of constructing mass balance of arsenic metabolites can be used to assess in vivo bioaccessibility of arsenic in cooked rice. Two volunteers were involved in this study. The quantity of drinking water, food and urine samples, together with arsenic concentration and speciation of these samples was monitored to construct a mass balance of arsenic intake and excretion. In the first five days, the two volunteers on a wheat diet had an average arsenic daily intake of 15.4+/-2.6microg and 9.6+/-0.7microg, respectively. In the next five days, these volunteers switched to a rice diet, increasing the average arsenic daily intake to 36.4+/-2.8microg and 34.1+/-7.7microg, respectively. Daily excretion of urinary arsenic, mostly as dimethylarsenic acid (DMA), doubled from 9.8+/-0.3microg to 21.0+/-3.0microg, and from 6.5+/-0.8microg to 11.6+/-4.5microg, respectively. The percentage of ingested arsenic excreted in urine remained constant at approximately 58% for one volunteer before and after the rice diet, and was approximately 69% for another. Mass balance established during a controlled dietary experiment over 10 days is shown to be a useful approach to evaluate in vivo bioaccessibility and metabolism of arsenic uptake from diet and is applicable to study with more subjects.

Distribution and metabolism of four different dimethylated arsenicals in hamsters

Arsenic toxicity and distribution are highly dependent on animal species and its chemical species. Recently, thioarsenical has been recognized in highly toxic arsenic metabolites, which was commonly found in human and animal urine. In the present study, we revealed the mechanism underlying the distribution and metabolism of non-thiolated and thiolated dimethylarsenic compounds such as dimethylarsinic acid (DMA(V)), dimethylarsinous acid (DMA(III)), dimethylmonothioarsinic acid (DMMTA(V)), and dimethyldithioarsinic acid (DMDTA(V)) after the administration of them into femoral vein of hamsters. DMA(V) and DMDTA(V) distributed in organs and body fluids were in their unmodified form, while DMA(III) and DMMTA(V) were bound to proteins and transformed to DMA(V) in organs. On the other hand, DMA(V) and DMDTA(V) were mostly excreted into urine as their intact form 1 h after post-injection, and more than 70% of the doses were recovered in urine as their intact form. By contrast, less than 8-14% of doses were recovered in urine as DMA(V), while more than 60% of doses were distributed in muscles and target organs (liver, kidney, and lung) of hamsters after the injection of DMMTA(V) and DMA(III). However, in red blood cells (RBCs), only a small amount of the arsenicals was distributed (less than 4% of the doses) after the injection of DMA(III) and DMMTA(V), suggesting that the DMA(III) and DMMTA(V) were hardly accumulated in hamster RBCs. Based on these observations, we suggest that although DMMTA(V) and DMDTA(V) are thioarsenicals, DMMTA(V) is taken up efficiently by organs, in a manner different from that of DMDTA(V). In addition, the distribution and metabolism of DMMTA(V) are like in manner similar to DMA(III) in hamsters, while DMDTA(V) is in a manner similar to DMA(V).

Effects of repeated seafood consumption on urinary excretion of arsenic species by volunteers

Arsenic (As) is a known human carcinogen and widely distributed in the environment. The main route of As exposure in the general population is through food and drinking water. Seafood harvested in Korea contains high-level organoarsenics such as arsenobetaine, arsenocholine, and arsenosugars, which are much less harmful than inorganic arsenics. However, for those who eat large amounts of seafood it is important to understand whether seafood consumption affects urinary levels of inorganic As metabolites such as arsenite, arsenate, monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA). In this study we investigated urinary As metabolites (inorganic As, MMA[V], DMA[V]) and some biological indexes such as AST, GSH, GPX, lipid peroxidation, and uric acid in volunteer study subjects (seven males and nine females). Total urinary As metabolites were analyzed by the hydride generation method, followed by arsenic speciation using HPLC with ICP-mass spectrometry. Study subjects refrained from eating seafood for 3 days prior to the first urine collection and then ingested seafood daily for 6 consecutive days. The first voided urine of the morning was collected from each subject the first day of the consecutive 6 days of seafood ingestion but prior to the first seafood meal. The first voided urine of the morning was also collected on days 1, 2, 3, 4, 5, 6, 7, 10, and 14 after seafood ingestion. The daily mean intake of total As was 6.98 mg, comprised of 4.71 mg of seaweed (67%), 1.74 mg of flat fish (25%), and 0.53 mg of conch (8%). We observed a substantial increase in total urinary As metabolites for subjects consuming seafood from day 1, which recovered to control level at day 10. The increase in total urinary As metabolites was attributed to the increase in DMA, which is a more harmful metabolite than organoarsenics. However, no significant changes in response biological indexes were observed. These results suggest that it is necessary to evaluate As metabolism when assessing the exposure to inorganic As and potential chronic health effects of seafood consumption in Korea.

Changes in urinary arsenic methylation profiles in a 15-year interval after cessation of arsenic ingestion in southwest Taiwan

BACKGROUND

Inorganic arsenic (iAs) is carcinogenic to humans. Methylated metabolites of arsenic (As) found in the urine could serve as potential tools for screening and early detection of cancer in populations exposed to As. Relatively little information is available regarding changes in As methylation profiles after cessation of As exposure.

OBJECTIVE

We examined the changes in urinary arsenic (uAs) species profiles over 15 years in a cancer-free population that has ceased heavy and prolonged ingestion of As.

METHODS

In 1989, a cohort study was carried out with 1,081 adults who resided in three villages in southwestern Taiwan where arseniasis was hyperendemic. After 15 years of follow-up, a subgroup of 205 cancer-free participants had completed all interviews and had uAs methylation data available. We used this group in our statistical analysis. Arsenic species were measured by high-performance liquid chromatography-hydride generation-atomic absorption spectrometry.

RESULTS

We compared the initial analyses from 1989 with those performed 15 years later and found that the average differences for the proportion of urinary iAs, monomethylarsonic acid (MMA(V)), and dimethylarsinic acid (DMA(V)) were -4.90%, -6.80%, and 11.69%, respectively. The elderly and those residents with longer periods of consuming high-As artesian well water exhibited greater changes (decreases) in %MMA(V).

CONCLUSION

The As methylation profiles indicate increased efficiency in As metabolism in residents after cessation of long-term exposure to high-level As. Moreover, the decreased %MMA(V) was more pronounced in the elderly cancer-free subcohort subjects.

Influence of cobalamin on arsenic metabolism in Bangladesh

BACKGROUND

Arsenic is a carcinogen to which 35 million people in Bangladesh are chronically exposed. The enzymatic transfer of methyl groups to inorganic As (iAs) generates monomethylarsonic (MMA) and dimethylarsinic acids (DMA) and facilitates urinary As (uAs) elimination. This process is dependent on one-carbon metabolism, a pathway in which folate and cobalamin have essential roles in the recruitment and transfer of methyl groups. Although DMA(V) is the least toxic metabolite, increasing evidence suggests that MMA(III) may be the most cytotoxic and genotoxic As intermediary metabolite.

OBJECTIVE

We examined the associations between plasma cobalamin and uAs metabolites.

METHODS

We conducted a cross-sectional study of 778 Bangladeshi adults in which we over-sampled cobalamin-deficient participants. Participants provided blood samples for the measurement of plasma cobalamin and urine specimens for As measurements.

RESULTS

Cobalamin was inversely associated with the proportion of total uAs excreted as iAs (%iAs) [unstandardized regression coefficient (b) = -0.10; 95% confidence interval (CI), -0.17 to -0.02; p = 0.01] and positively associated with %MMA (b = 0.12; 95% CI, 0.05 to 0.20; p = 0.001). Both of these associations were stronger among folate-sufficient participants (%iAs: b = -0.17; 95% CI, -0.30 to -0.03; p = 0.02. %MMA: b = 0.20; 95% CI, 0.11 to 0.30; p < 0.0001), and the differences by folate status were statistically significant.

CONCLUSIONS

In this group of Bangladeshi adults, cobalamin appeared to facilitate the first As methylation step among folate-sufficient individuals. Given the toxicity of MMA(III), our findings suggest that in contrast to folate, cobalamin may not favorably influence As metabolism.

Urinary arsenic methylation capability and carotid atherosclerosis risk in subjects living in arsenicosis-hyperendemic areas in southwestern Taiwan

Long-term exposure to inorganic arsenic from artesian drinking well water is associated with carotid atherosclerosis in the Blackfoot Disease (BFD)-hyperendemic area in Taiwan. The current study examined the arsenic methylation capacity and its risk on carotid atherosclerosis. A total of 304 adults (158 men and 146 women) residing in the BFD-hyperendemic area were included. The extent of carotid atherosclerosis was assessed by duplex ultrasonography. Chronic arsenic exposure was estimated by an index of cumulative arsenic exposure (CAE) and the duration of artesian well water consumption. Urinary levels of inorganic arsenite [As(III)], arsenate [As(V)], monomethylarsonic acid [MMA(V)] and dimethylarsinic acid [DMA(V)] were determined by high performance liquid chromatography linked on-line to a hydride generator and atomic absorption spectrometry (HPLC-HG-AAS). The percentage of arsenic species, primary methylation index [PMI=MMA(V)/(As(III)+As(V)] and secondary methylation index [SMI=DMA(V)/MMA(V)] were calculated and employed as indicators of arsenic methylation capacity. Results showed that women and younger subjects had a more efficient arsenic methylation capacity than did men and the elderly. Carotid atherosclerosis cases had a significantly greater percentage of MMA(V) [%MMA(V)] and a lower percentage of DMA [%DMA (V)] compared to controls. Subjects in the highest two tertiles of PMI with a median of CAE >0 mg/L-year had an odds ratio (OR) and a 95% confidence interval (CI) of carotid atherosclerosis of 2.61 and 0.98-6.90 compared to those in the highest two tertiles of PMI with a CAE=0 mg/L-year. We conclude that individuals with greater exposure to arsenic and lower capacity to methylate inorganic arsenic may be at a higher risk to carotid atherosclerosis.

Environmental Arsenic Exposure and Urinary 8-OHdG in Arizona and Sonora

Although at high levels arsenic exposure is associated with increased cancer incidence, information on the health effects of lower exposure levels is limited. The objective of this study was to determine whether arsenic at concentrations below 40 microg/L in drinking water is associated with increased urinary 8-hydroxydeoxyguanosine (8-OHdG), a biomarker of DNA oxidative damage and repair. Urine samples were collected from 73 nonsmoking adults residing in two communities in Arizona (mean tap water arsenic (microg/L) 4.0 +/- 2.3 and 20.3 +/- 3.7), and 51 subjects in four communities in Sonora, Mexico (mean tap water arsenic (microg/L) ranging from 4.8 +/- 0.1 to 33.3 +/- 0.6). Although urinary arsenic concentration increased with higher exposure in tap water, urinary 8-OHdG concentration did not differ by community within Arizona or Sonora, and was not associated with urinary arsenic concentration. At the exposure levels evaluated in this study, drinking water arsenic was not associated with increased DNA oxidation as measured by urinary 8-OHdG.

Evaluation of micronucleus frequencies in blood lymphocytes from smelting plant workers exposed to arsenic

Arsenic is a world health problem due to the seriousness of its effects, mainly related with the increase of cancer. In Chile, the geological characteristics of the northern region, associated with the development of the copper mining and smelting activities, have contributed to increase the environmental levels of arsenic. This study has been conducted to investigate the relationship between arsenic occupational exposure and genotoxic effects in smelting plant workers. To determine the genotoxic risk related to the increase of cancer among the chronically exposed population, the frequency of micronuclei in blood (BNMN) has been evaluated. The study was carried out in a total of 207 men, divided into three groups: an exposed group of 105 individuals working in a smelting plant, an internal reference group with 52 employees at the same mine but in the administrative area, and an external reference group of 50 workers from another copper mine where no significant levels of arsenic were detected. As expected, differences between arsenic levels in urine have been detected between groups, with the exposed group being the one with a higher level of total arsenic in urine, followed by the internal reference group. Despite that, no significant differences in micronuclei frequencies in lymphocytes were detected among these groups.

Impact of arsenic in foodstuffs on the people living in the arsenic-affected areas of West Bengal, India

Although the accumulation of arsenic (As) in human blood is linked with some diseases and with occupational exposure, there are few reports on speciation of As in blood. On the basis of our earlier article, elevated level of arsenicals in human urine and blood were found in the ex-exposed population via As-containing drinking water. The aim of the present study was to get an insight on impact of As in foodstuffs on the people living in the As-affected areas. Moreover, speciation of arsenicals in urine, and water-samples found in arsenobetaine (AsB). Since sampling population (n=25) was not taking any seafood, As in foodstuffs was thought to be the prime source for this discrepancy. So, speciation of methanol extract of freeze-dried red blood cells (RBCs) and foodstuffs, and trichloro acetic acid (TCA) treated plasma by high performance liquid chromatography-inductively coupled argon plasma mass spectrometer (HPLC-ICP MS) collected from the study population (n=33) was carried out to support our hypothesis. Results showed that urine contained AsB (1.7%), arsenite (iAs(III)) (14.3), arsenate (iAs(V)) (4.9), monomethylarsonous acid (MMA(III)) (0.64), monomethylarsonic acid (MMA(V)) (13.6), dimethylarsinous acid (DMA(III)) (7.7), and dimethylarsinic acid (DMA(V)) (65.4). Blood contained 21.3 microg L(- 1) (mean) As and of which 27.3% was in plasma and 72.7% in RBCs. RBCs contained AsB (21.6%) and DMA(V) (78.4) and blood plasma contained AsB (12.4%), iAs(III) (25.9), MMA(V) (30.3), and DMA(V) (31.4). Furthermore, speciation of As in foodstuffs showed that most of them contained AsB (3.54-25.81 microg kg(- 1)) (25.81-312.44 microg kg(- 1)) along with iAs(III) (9.62-194.93), iAs(V) (17.63-78.33), MMA(V) (9.47-73.22) and DMA(V) (13.43-101.15) that supported the presence of AsB and elevated As in urine and blood samples of the present study group. Inorganic As (iAs) predominates in rice (67.17-86.62%) and in spices (40-90.35%), respectively over organic As. So, As in the food chain is a real threat to human health.

Thio-dimethylarsinate is a common metabolite in urine samples from arsenic-exposed women in Bangladesh

Over the last 6 years, much work on arsenic species in urine samples has been directed toward the determination of the reduced dimethylated arsenic species, DMA(III), because of its high toxicity and perceived key role in the metabolism of inorganic arsenic. Recent work, however, has suggested that DMA(III) may at times have been misidentified because its chromatographic properties can be similar to those of thio-dimethylarsinate (thio-DMA). We analyzed by HPLC-ICPMS (inductively coupled plasma mass spectrometry) urine samples from 75 arsenic-exposed women from Bangladesh with total arsenic concentrations ranging from 8 to 1034 microg As/L and found that thio-DMA was present in 44% of the samples at concentrations ranging mostly from trace amounts to 24 microg As/L (one sample contained 123 microg As/L). Cytotoxicity testing with HepG2 cells derived from human hepatocarcinoma indicated that thio-DMA was about 10-fold more cytotoxic than dimethylarsinate (DMA). The widespread occurrence of thio-DMA in urine from these arsenic-exposed women suggests that this arsenical may also be present in other urine samples and has so far escaped detection. The work highlights the need for analytical methods providing specific determinations of arsenic compounds in future studies on arsenic metabolism and toxicology.

Tissue distribution and urinary excretion of dimethylated arsenic and its metabolites in dimethylarsinic acid- or arsenate-treated rats

Adult female Fisher 344 rats received drinking water containing 0, 4, 40, 100, or 200 parts per million of dimethylarsinic acid or 100 parts per million of arsenate for 14 days. Urine was collected during the last 24 h of exposure. Tissues were then taken for analysis of dimethylated and trimethylated arsenicals; urines were analyzed for these arsenicals and their thiolated derivatives. In dimethylarsinic acid-treated rats, highest concentrations of dimethylated arsenic were found in blood. In lung, liver, and kidney, concentrations of dimethylated arsenic exceeded those of trimethylated species; in urinary bladder and urine, trimethylated arsenic predominated. Dimethylthioarsinic acid and trimethylarsine sulfide were present in urine of dimethylarsinic acid-treated rats. Concentrations of dimethylated arsenicals were similar in most tissues of dimethylarsinic acid- and arsenate-treated rats, including urinary bladder which is the target for dimethylarsinic acid-induced carcinogenesis in the rat. Mean concentration of dimethylated arsenic was significantly higher (P<0.05) in urine of dimethylarsinic acid-treated rats than in arsenate-treated rats, suggesting a difference between treatment groups in the flux of dimethylated arsenic through urinary bladder. Concentrations of trimethylated arsenic concentrations were consistently higher in dimethylarsinic acid-treated rats than in arsenate-treated rats; these differences were significant (P<0.05) in liver, urinary bladder, and urine. Concentrations of dimethylthioarsinic acid and trimethylarsine sulfide were higher in urine from dimethylarsinic acid-treated rats than from arsenate-treated rats. Dimethylarsinic acid is extensively metabolized in the rat, yielding significant concentrations of trimethylated species and of thiolated derivatives. One or more of these metabolites could be the species causing alterations of cellular function that lead to tumors in the urinary bladder.

Arsenic Metabolism, Genetic Susceptibility, and Risk of Premalignant Skin Lesions in Bangladesh

We conducted a case-control study to investigate interindividual variability in susceptibility to health effects of inorganic arsenic due to arsenic metabolism efficiency, genetic factors, and their interaction. A total of 594 cases of arsenic-induced skin lesions and 1,041 controls was selected from baseline participants in a large prospective cohort study in Bangladesh. Adjusted odds ratios (OR) for skin lesions were estimated in relation to the polymorphisms in the glutathione S-transferase omega1 and methylenetetrahydrofolate reductase genes, the percentage of monomethylarsonous acid (%MMA) and dimethylarsinic acid (%DMA) in urine, and the ratios of MMA to inorganic arsenic and DMA to MMA. Water arsenic concentration was positively associated with %MMA and inversely associated with %DMA. The dose-response relationship of risk of skin lesion with %MMA was more apparent than those with other methylation indices; the ORs for skin lesions in relation to increasing %MMA quartiles were 1.00 (reference), 1.33 [95% confidence interval (95% CI), 0.92-1.93], 1.68 (95% CI, 1.17-2.42), and 1.57 (95% CI, 1.10-2.26; P for trend = 0.01). The ORs for skin lesions in relation to the methylenetetrahydrofolate reductase 677TT/1298AA and 677CT/1298AA diplotypes (compared with 677CC/1298CC diplotype) were 1.66 (95% CI, 1.00-2.77) and 1.77 (95% CI, 0.61-5.14), respectively. The OR for skin lesions in relation to the glutathione S-transferase omega1 diplotype containing all at-risk alleles was 3.91 (95% CI, 1.03-14.79). Analysis of joint effects of genotypes/diplotypes with water arsenic concentration and urinary %MMA suggests additivity of these factors. The findings suggest that arsenic metabolism, particularly the conversion of MMA to DMA, may be saturable and that differences in urinary arsenic metabolites, genetic factors related to arsenic metabolism, and their joint distributions modulate arsenic toxicity.

Consumption of folate-related nutrients and metabolism of arsenic in Bangladesh

BACKGROUND

Inorganic arsenic (InAs) is metabolized to monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), and this methylation facilitates urinary arsenic excretion. Previous studies suggest that persons with more complete methylation, characterized as greater proportions of DMA and lesser proportions of MMA and InAs in urine, have a lower risk of adverse arsenic-related health outcomes.

OBJECTIVE

The purpose of this study was to examine whether the capacity to methylate arsenic differs by nutrient intake.

DESIGN

Participants were 1016 Bangladeshi adults exposed to arsenic in drinking water. Nutrient intake was assessed with a validated food-frequency questionnaire. Multivariate regression analyses were used to examine associations of nutrients with urinary arsenic metabolite profiles.

RESULTS

In multivariate analyses, higher intakes of cysteine, methionine, calcium, protein, and vitamin B-12 were associated with lower percentages of InAs and higher ratios of MMA to InAs in urine. Higher intakes of niacin (beta=0.22, P=0.02) and choline (beta=0.10, P=0.02) were associated with higher DMA-to-MMA ratios, after adjustment for age, sex, smoking, total urinary arsenic, and total energy intake.

CONCLUSIONS

Findings from the current study show the influence of multiple nutrients on arsenic methylation. In particular, this study highlights the potential importance of dietary intakes of cysteine, methionine, niacin, vitamin B-12, and choline on health effects of arsenic by modulating its metabolism.

Arsenic methylation, GSTT1, GSTM1, GSTP1 polymorphisms, and skin lesions

OBJECTIVE

We investigated whether primary and secondary arsenic methylation ratios were associated with skin lesions and whether GSTT1, GSTP1, and GSTM1 polymorphisms modify these relationships.

METHODS

A case-control study of 600 cases and 600 controls that were frequency matched on age and sex was conducted in Pabna, Bangladesh, in 2001-2002. Individual well water, urine, and blood samples were collected. Water arsenic concentration was determined using inductively coupled plasma mass spectrometry (ICP-MS). Urinary arsenic speciation was determined using high performance liquid chromatography hydride with generator atomic absorption spectrometry and ICP-MS. Genotyping was conducted using multiplex polymerase chain reaction and TaqMan.

RESULTS

A 10-fold increase in primary methylation ratio [monomethylarsonic acid (MMA)/(arsenite + arsenate] was associated with a 1.50-fold increased risk of skin lesions (multivariate odds ratio = 1.50; 95% confidence interval, 1.00-2.26). We observed significant interaction on the multiplicative scale between GSTT1 wildtype and secondary methylation ratio [dimethylarsinic acid/MMA; likelihood ratio test (LRT), p = 0.01]. No significant interactions were observed for GSTM1 or GSTP1 or for primary methylation ratios.

CONCLUSION

Our findings suggest that increasing primary methylation ratios are associated with an increase in risk of arsenic-related skin lesions. The interaction between GSTT1 wildtype and secondary methylation ratio modifies risk of skin lesions among arsenic-exposed individuals.

Evaluation of the three most commonly used analytical methods for determination of inorganic arsenic and its metabolites in urine

This work compares the three most common analytical methods for determination of inorganic arsenic and its metabolites in urine: high performance liquid chromatography coupled to either inductively coupled plasma mass spectrometry or atomic fluorescence spectrometry via hydride generation (high performance liquid chromatography-hydride generation-inductively coupled plasma mass spectrometry (HPLC-HG-ICPMS) and HPLC-HG-atomic fluorescence spectrometry (AFS), respectively) and atomic absorption spectrometry coupled to HG (HG-atomic absorption spectrometry (AAS)). This was done with the focus to find alternatives to ICPMS, the investment and running costs of which are rather high. Between-laboratory comparison of HPLC-HG-ICPMS and HPLC-HG-AFS showed good agreement for inorganic arsenic, methylarsonate (MA) and dimethylarsinate (DMA) (R(2)=0.91, R(2)=0.92 and R(2)=0.90, respectively, N=86). Within-laboratory comparisons of HPLC-HG-AFS, HPLC-HG-ICPMS and HG-AAS showed good agreement for all arsenic species and the sum of inorganic arsenic and its metabolites in urine (HPLC-HG-ICPMS versus HPLC-HG-AFS: R(2)=0.95; HG-AAS versus HPLC-HG-AFS: R(2)=0.95 and HPLC-HG-ICPMS versus HG-AAS: R(2)=0.97; N=89). HPLC-HG-AFS was found to be a simple, but high quality alternative to HPLC-HG-ICPMS for the speciation and quantification of inorganic arsenic and its metabolites in urine at arsenic concentrations above 10microgL(-1). Because of its considerably lower costs compared to HPLC-HG-ICPMS, it may be a good alternative in laboratories where the high cost of ICPMS is not justified in relation to the intended use of the instrument.

Effect of fasting on the pattern of urinary arsenic excretion

Millions of people in some of the poorest regions of the world are exposed to high levels of arsenic through drinking contaminated water. It has been reported that development of cancer caused by arsenic exposure in such populations is dependent on dietary and nutritional factors which can modulate arsenic metabolism. Many people in arsenic exposed regions of Bangladesh and India practice fasting for at least one month every year when they refrain from consumption of food and fluid during daylight hours. How such practices may modulate arsenic metabolism has not been previously investigated. This study investigated this issue by determining total arsenic and its species in urine samples from a group of 29 unexposed volunteers at the beginning of the fasting and at the end of approximately 12 h of fasting period. Inductively coupled plasma mass spectrometry (ICP-MS) and high performance liquid chromatography (HPLC) coupled with ICP-MS was used to measure the total arsenic and arsenic speciation in the urine samples, respectively. The mean total levels of arsenic at the beginning of fasting (18.3 microg g(-1) creatinine) and at the end of approximately 12 h of fasting (17.7 microg g(-1) creatinine) did not differ significantly (p > 0.05). However, the percentages of urinary arsenic as the methylated arsenic species methylarsonate (MA) were found to be significantly different (p < 0.05) and this species was observed more frequently at the end of fasting, although its overall concentration was similar. There were no significant differences (p > 0.05) in both the concentrations and percentages of other urinary arsenic species detected, namely arsenobetaine (AB) and dimethylarsinate (DMA). Arsenite (As(III)) and arsenate (As(V)) were also analyzed, but were not detected. We conclude that fasting for a period of 12 h results in a significant increase in the percentage of urinary arsenic as MA, and its frequency of detection in the volunteers at the end of the fasting period is almost nine fold higher. This suggests that metabolism of arsenic is altered by fasting.

Metabolic profile in workers occupationally exposed to arsenic: role of GST polymorphisms

Arsenic is a well-known human carcinogen with a ubiquitous distribution in the natural environment. Chronic exposure to inorganic arsenic involves a biotransformation process that leds to the main excretion of organic methylated metabolites, such as monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), as well as the parental inorganic species. Interindividual variation in arsenic metabolism has been extensively reported, and polymorphisms in genes involved in such process could be related to changes in the arsenic excretion profile and the response to chronic exposures. Our analysis of the metabolic profiles in three groups of workers exposed to different arsenic exposure levels showed high amounts of inorganic arsenic and MMA in the most-exposed workers versus the least-exposed workers, in whom high amounts of DMA were observed. With respect to the role of different genetic polymorphisms in the glutathione S-transferase (GST) genes in the modulation of the urinary profiles, for the overall population only a tendency was just observed between GSTM1 null and MMA excretion as well as between GSTP1 val/val and DMA excretion.

Effect of plasma homocysteine level and urinary monomethylarsonic acid on the risk of arsenic-associated carotid atherosclerosis

Arsenic-contaminated well water has been shown to increase the risk of atherosclerosis. Because of involving S-adenosylmethionine, homocysteine may modify the risk by interfering with the biomethylation of ingested arsenic. In this study, we assessed the effect of plasma homocysteine level and urinary monomethylarsonic acid (MMA(V)) on the risk of atherosclerosis associated with arsenic. In total, 163 patients with carotid atherosclerosis and 163 controls were studied. Lifetime cumulative arsenic exposure from well water for study subjects was measured as index of arsenic exposure. Homocysteine level was determined by high-performance liquid chromatography (HPLC). Proportion of MMA(V) (MMA%) was calculated by dividing with total arsenic species in urine, including arsenite, arsenate, MMA(V), and dimethylarsinic acid (DMA(V)). Results of multiple linear regression analysis show a positive correlation of plasma homocysteine levels to the cumulative arsenic exposure after controlling for atherosclerosis status and nutritional factors (P < 0.05). This correlation, however, did not change substantially the effect of arsenic exposure on the risk of atherosclerosis as analyzed in a subsequent logistic regression model. Logistic regression analyses also show that elevated plasma homocysteine levels did not confer an independent risk for developing atherosclerosis in the study population. However, the risk of having atherosclerosis was increased to 5.4-fold (95% CI, 2.0-15.0) for the study subjects with high MMA% (> or =16.5%) and high homocysteine levels (> or =12.7 micromol/l) as compared to those with low MMA% (<9.9%) and low homocysteine levels (<12.7 micromol/l). Elevated homocysteinemia may exacerbate the formation of atherosclerosis related to arsenic exposure in individuals with high levels of MMA% in urine.

Effects of arsenic exposure among semiconductor workers: a cautionary note on urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine

Arsenic is a notorious environmental toxicant and was found to cause oxidative stress in cultured cells and animals. However, little work has been done in human studies, especially for the population occupationally exposed to arsenic. In order to investigate the effect of occupational exposure to arsenic in oxidative stress, we measured urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) from 90 semiconductor workers including 50 exposed and 40 nonexposed subjects. A highly sensitive and specific isotope dilution LC-MS/MS method was used for quantification of 8-oxodGuo. The levels of inorganic arsenic (iAs3+, iAs5+), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) in urine were determined by high-performance liquid chromatography-flow injection atomic absorption spectrometry (HPLC-FIAAS). Results showed that the mean urinary concentrations of total arsenic and 8-oxodGuo were significantly higher for exposed workers compared with the nonexposed workers. In addition, elevated urinary 8-oxodGuo concentrations of exposed workers were correlated with urinary levels of MMA (r = 0.44, P < 0.005) and the extent of primary methylation (the ratio of MMA to inorganic arsenic) (r = 0.40, P < 0.005). These findings suggested that occupational exposure to arsenic could result in the induction of oxidative stress. The presence and/or formation of MMA could play an important role in arsenic-involved injuries.

Distribution of urinary selenium and arsenic among pregnant women exposed to arsenic in drinking water

Inorganic arsenic (In-As) is a well-known toxicant and carcinogen found naturally in surface and groundwater around the world. Exposure can cause skin lesions, adverse reproductive outcomes, and cancer. There are two main pathways of arsenic (As) metabolism in humans: the reduction reactions, and the oxidative methylation reactions, where methyl groups are attached to As compounds to form monomethylarsenate (MMA) and dimethylarsenate (DMA). MMA, DMA, and In-As are excreted in urine. Urinary levels of another metalloid, selenium (Se), have recently been shown to be associated with increased As excretion and altered metabolite distribution. This study investigates this association, using data collected in a larger prospective study of arsenic and reproductive effects in Chile. This analysis included 93 pregnant women from Antofagasta. Data on demographic, behavioral, and other characteristics were obtained via interviews conducted by trained midwives, and spot urine samples were analyzed for As and Se concentration using inductively coupled plasma-mass spectrometry (ICP-MS). Urinary Se levels were found to be correlated with urinary As levels in bivariate analysis (r = 0.68, P < 0.01). Multiple linear regression analyses revealed that higher urinary Se levels were associated with increased urinary As excretion, increased %DMA, and decreased %In-As. The results of this study suggest that in populations exposed to arsenic, Se intake may be correlated with urinary As excretion, and may alter As methylation.

Folate, homocysteine, and arsenic metabolism in arsenic-exposed individuals in Bangladesh

Chronic exposure to arsenic is occurring throughout South and East Asia due to groundwater contamination of well water. Variability in susceptibility to arsenic toxicity may be related to nutritional status. Arsenic is methylated to monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) via one-carbon metabolism, a biochemical pathway that is dependent on folate. The majority of one-carbon metabolism methylation reactions are devoted to biosynthesis of creatine, the precursor of creatinine. Our objectives of this cross-sectional study were to characterize the relationships among folate, cobalamin, homocysteine, and arsenic metabolism in Bangladeshi adults. Water arsenic, urinary arsenic, urinary creatinine, plasma folate, cobalamin, and homocysteine were assessed in 1,650 adults; urinary arsenic metabolites were analyzed for a subset of 300 individuals. The percentage of DMA in urine was positively associated with plasma folate (r = 0.14, p = 0.02) and negatively associated with total homocysteine (tHcys; r = -0.14, p = 0.01). Conversely, percent MMA was negatively associated with folate (r = -0.12, p = 0.04) and positively associated with tHcys (r = 0.21, p = 0.0002); percent inorganic arsenic (InAs) was negatively associated with folate (r = -0.12, p = 0.03). Urinary creatinine was positively correlated with percent DMA (r = 0.40 for males, p < 0.0001; 0.25 for females, p = 0.001), and with percent InAs (r = -0.45 for males, p < 0.0001; -0.20 for females, p = 0.01). Collectively, these data suggest that folate, tHcys, and other factors involved in one-carbon metabolism influence arsenic methylation. This may be particularly relevant in Bangladesh, where the prevalence of hyperhomocysteinemia is extremely high.