Lead neurotoxicity in children: basic mechanisms and clinical correlates

Perinatal exposure to lead induces morphological, ultrastructural and molecular alterations in the hippocampus

The aim of this paper is to examine if pre- and neonatal exposure to lead (Pb) may intensify or inhibit apoptosis or necroptosis in the developing rat brain. Pregnant experimental females received 0.1% lead acetate (PbAc) in drinking water from the first day of gestation until weaning of the offspring; the control group received distilled water. During the feeding of pups, mothers from the experimental group were still receiving PbAc. Pups were weaned at postnatal day 21 and the young rats of both groups then received only distilled water until postnatal day 28. This treatment protocol resulted in a concentration of Pb in rat offspring whole blood (Pb-B) below the threshold of 10 μg/dL, considered safe for humans.We studied Casp-3 activity and expression, AIF nuclear translocation, DNA fragmentation, as well as Bax, Bcl-2 mRNA and protein expression as well as BDNF concentration in selected structures of the rat brain: forebrain cortex (FC), cerebellum (C) and hippocampus (H). The microscopic examinations showed alterations in hippocampal neurons.Our data shows that pre- and neonatal exposure of rats to Pb, leading to Pb-B below 10 μg/dL, can decrease the number of hippocampus neurons, occurring concomitantly with ultrastructural alterations in this region. We observed no morphological or molecular features of severe apoptosis or necrosis (no active Casp-3 and AIF translocation to nucleus) in young brains, despite the reduced levels of BDNF. The potential protective factor against apoptosis was probably the decreased Bax/Bcl-2 ratio, which requires further investigation. Our findings contribute to further understanding of the mechanisms underlying Pb neurotoxicity and cognition impairment in a Pb-exposed developing brain.

Toxicity of lead: A review with recent updates

Lead poisoning has been recognized as a major public health risk, particularly in developing countries. Though various occupational and public health measures have been undertaken in order to control lead exposure, cases of lead poisoning are still reported. Exposure to lead produces various deleterious effects on the hematopoietic, renal, reproductive and central nervous system, mainly through increased oxidative stress. These alterations play a prominent role in disease manifestations. Modulation of cellular thiols for protection against reactive oxygen species (ROS) has been used as a therapeutic strategy against lead poisoning. N-acetylcysteine, α-lipoic acid, vitamin E, quercetin and a few herbal extracts show prophylaxis against the majority of lead mediated injury in both in vitro and in vivo studies. This review provides a comprehensive account of recent updates describing health effects of lead exposure, relevant biomarkers and mechanisms involved in lead toxicity. It also updates the readers about recent advances in chelation therapy and newer therapeutic strategies, like nanoencapsulation, to treat lead induced toxic manifestations.

Studying the effects of lead on DNA fragmentation and proapoptotic bax and antiapoptotic bcl-2 protein expression in PC12 cells

ABSTRACT The nervous system is one of the most important targets of lead poisoning. Despite decades of study, the exact mechanism of lead toxicity has not been fully elucidated. One of the suggested mechanisms of lead toxicity is induction of apoptosis, which has not been shown yet in some neuronal cells such as pheochromocytoma cells (PC12). Therefore, the present study sought to examine the effect of lead poisoning on apoptosis in PC12 cells as a suitable model of neuronal cell study. The present results showed that lead could induce toxicity in PC12 cells after 24 hours with as little as 1 muM in a concentration-dependent manner. In Western blot analysis, the ratio of Bax/Bcl-2 protein expression in cells incubated with 3, 30, and 90 muM lead acetate significantly increased compared to controls. Additionally, a DNA laddering pattern in lead-treated cells was shown, which could indicate nuclear fragmentation. It might be concluded that lead could cause PC12 cell death, in which apoptosis or programmed cell death plays an important role.

Flexibility of EF-hand motifs: structural and thermodynamic studies of Calcium Binding Protein-1 from Entamoeba histolytica with Pb2+, Ba2+, and Sr2+

BACKGROUND

EF-hand proteins can be activated by the binding of various heavy metals other than calcium, and such complexes can disturb the calcium-signaling pathway and cause toxicity and disease causing state. So far, no comprehensive study has been done to understand different heavy metals binding to calcium signaling proteins.

RESULTS

In this work, the flexibility of the EF-hand motifs are examined by crystallographic and thermodynamic studies of binding of Pb2+, Ba2+ and Sr2+ to Calcium Binding Protein-1 from Entamoeba histolytica (EhCaBP1). The structures of the EhCaBP1- heavy metal complexes are found to be overall similar, nevertheless specific differences in metal coordination, and small differences in the coordination distances between the metal and the ligands in the metal binding loop. The largest such distances occur for the Ba2+- EhCaBP1 complex, where two bariums are bound with partial occupancy at the EF2 motif. Thermodynamic studies confirm that EhCaBP1 has five binding sites for Ba2+ compared to four binding sites for the other metals. These structures and thermodynamic studies reveal that the EF-hand motifs can accommodate several heavy atoms with similar binding affinities. The binding of Ca2+ to the 1st, 2nd and 4th sites and the binding of Ba2+ to the 1st, 2nd, 4th and 5th sites are both enthalpically and entropically driven, whereas the binding of Sr2+ to the 1st, 2nd and 4th sites are simply enthalpy driven, interestingly in agreement with ITC data, Sr2+ do not coordinate with water in this structure. For all the metals, binding to the 3rd site is only entropy driven.

CONCLUSION

Energetically, Ca2+ is preferred in three sites, while in one site Ba2+ has better binding energy. The Sr2+-coordination in the EF hand motifs is similar to that of the native Ca2+ bound structure, except for the lack of water coordination. Sr2+ coordination seems to be a pre-formed in nature since all seven coordinating atoms are from the protein itself, which also correlates with entropy contributions in Sr2+ binding. These findings improve our understanding of metal association with calcium binding proteins and of metal induced conformational changes.

Low-level environmental exposure to lead and renal adverse effects: a cross-sectional study in the population of children bordering the Mbeubeuss landfill near Dakar, Senegal

This study deals with the health effects within a child population, neighbouring a landfill. After detecting metals in soil and air samples collected in the surroundings of the landfill and in a control site, we have studied: (i) levels of lead (Pb) and exposure biomarkers in blood and urine, (ii) oxidative stress biomarkers and (iii) renal injury by applying a set of early effect biomarkers. Levels of Pb were higher in the exposed site (i.e. 1129 mg/kg and 640 ng/m(3) in soil and air samples, respectively) versus those in the control site (i.e. 14.3 mg/kg and 9.3 ng/m(3) in soil and air samples, respectively). Pb impregnation and levels of delta-aminolevulinic acid in urine were influenced by the living site that shows the prevailingly alarming situation in the Mbeubeuss landfill. Malondialdehyde changes indicated Pb-induced excessive production of reactive oxygen species. Lactate dehydrogenase activities and proteinuria were found to be higher in the children living in the exposed site. These evidences may reveal the usefulness of these two effect biomarkers to monitor the kidney injury entailed by relatively low-environmental exposure to Pb. Overall, these results show that the Mbeubeuss landfill constitutes a real source of environmental and health risk, be it living or working on site, of the surrounding population, predominantly for children.

Lead exposure in Nunavik: from research to action

Background

In 1999, the Government of Canada regulated the use of lead shot for hunting. Concurrently, the Nunavik Regional Board of Health and Social Services (NRBHSS) was informed of the results of an isotope study that pointed to lead ammunition as a likely source of lead exposure in Nunavik. Rapidly thereafter, a coalition for the banning of lead shot was implemented by the NRBHSS as well as by regional/local partners and by Inuit hunters in order to disseminate this information to the public.

Objectives

The purpose of this article is to describe the intervention conducted in the winter of 1999 by the NRBHSS and to assess the combined impact of national legislation and an awareness campaign on blood lead levels in Nunavik.

Study design

Impact assessment of the intervention for the banning of lead shot conducted in 1999 in Nunavik using blood lead levels data before and after the intervention.

Methods

Data on blood lead levels in Nunavik describing foetal exposure as well as during childhood and in adults published between 1992 and 2009 were compiled. Blood lead levels in Nunavik prior to and after the interventions were compared. To assess the current situation, the most recent blood lead levels were compared with those from surveys conducted during the same period in North America.

Results

Analysis of blood samples collected from umbilical cord and from adults show that blood lead levels in Nunavik significantly declined between 1992 and 2004. Nevertheless, lead exposure in Nunavik still remains higher in comparison to that observed in other North American surveys.

Conclusions

The current situation regarding lead exposure in Nunavik has significantly improved as a result of the implemented intervention. However, according to recent data, a gap still subsists relative to other North American populations.

Predictors of virtual radial arm maze performance in adolescent Italian children

BACKGROUND

Comparisons between animal and human neurotoxicology studies are a foundation of risk assessment, but are hindered by differences in measured behaviors. The radial arm maze (RAM), a rodent visuospatial learning and memory task, has a computerized version for use in children, which may help improve comparisons between animal and human studies.

OBJECTIVE

To describe the characteristics and correlates of the virtual radial arm maze (VRAM) in 255 children age 10-15 years from Italy.

METHODS

We administered the VRAM using a laptop computer and measured children's performance using the latency, distance, and working/reference memory errors during eight trials. Using generalized linear mixed models, we described VRAM performance in relation to demographic factors, child activities, and several standard neuropsychologic tests (Italian translations), including the Conners Parent Rating Scales-Short Version (CPRS), California Verbal Learning Test (CVLT), Wechsler Intelligence Scales for Children, finger tapping speed, reaction time, and motor skills.

RESULTS

Children's VRAM performance tended to improve between trials 1 and 6 and then plateaued between trials 6 and 8. Males finished the task 14 s faster (95% confidence interval [CI]: -20, -9) than females. Children who played 2+h of video games per day finished 16 s faster (CI: -26, -6) and with 34% (CI: 5, 54%) fewer working memory errors than children who reported not playing video games. Higher IQ and better CVLT scores were associated with better VRAM performance. Higher cognitive/inattention CPRS scores were associated with more working (11%; CI: 1, 22) and reference memory errors (7%; CI: 1, 12).

CONCLUSIONS

Consistent with animal studies, VRAM performance improved over the course of test trials and males performed better than females. Better VRAM performance was related to higher IQ, fewer inattentive behaviors, and better verbal memory. The VRAM may help to improve the integration and comparison between animal and epidemiological studies of environmental neurotoxicants.

Assessing windows of susceptibility to lead-induced cognitive deficits in Mexican children

BACKGROUND

The identification of susceptible periods to Pb-induced decrements in childhood cognitive abilities remains elusive.

OBJECTIVE

To draw inferences about windows of susceptibility using the pattern of associations between serial childhood blood lead (BPb) concentrations and children's cognitive abilities at 4 years of age among 1035 mother-child pairs enrolled in 4 prospective birth cohorts from Mexico City.

METHODS

Multiple longitudinally collected BPb measurements were obtained from children (1, 2, 3, and 4 years) between 1994 and 2007. Child cognitive abilities were assessed at 4 years using the general cognitive index (GCI) of the McCarthy Scales of Children's Abilities. We used multivariable linear regression to estimate the change in cognitive abilities at 4 years of age with a 10 μg/dL increase in childhood BPb concentrations adjusting for maternal IQ, education, marital status, child sex, breastfeeding duration, and cohort.

RESULTS

In separate models for each BPb measurement, 2 year BPb concentrations were most strongly associated with reduced GCI scores at 4 years after adjusting for confounders (β: -3.8; 95% confidence interval CI: -6.3, -1.4). Mutual adjustment for other BPb concentrations in a single model resulted in larger, but less precise estimate between 2 year BPb concentrations and GCI scores at 4 years of age (β: -7.1; 95% CI: -12, -2.0). The association between 2 year BPb and GCI was not heterogeneous (p=0.89), but some BPb and GCI associations varied in magnitude and direction across the cohorts. Additional adjustment for child hemoglobin, birth weight, gestational age, gestational BPb concentrations, or test examiner did not change the pattern of associations.

CONCLUSIONS

Higher BPb concentrations at 2 years of age were most predictive of decreased cognitive abilities among these Mexico City children; however, the observed pattern may be due to exposure, outcome, or cohort related factors. These results may help developing countries more efficiently implement childhood Pb prevention strategies.

Novel approach for generation of low calcium reagents for investigations of heavy metal effects on calcium signaling

INTRODUCTION

Lead exposure can cause learning disabilities, memory loss and severe damage to the nervous system. However, the exact mechanism by which lead causes learning disabilities is not fully understood. The effects of lead on calcium-regulated signaling pathways are difficult to study biochemically; with the traditional method of controlling the free calcium concentration with EGTA, the exact concentrations of free lead and calcium ions in solution are interdependent and prone to error because EGTA also buffers lead.

METHODS AND RESULTS

In our approach, we first reduced the free calcium concentration in the solution using calcium-binding resins before adding lead to buffers. The solution was sequentially treated with Chelex-100 ion exchange resin, followed by immobilized BAPTA resin. The final concentration of free calcium in the solution was measured with Fluo-3 indicator. Our protocol successfully produced buffers with free calcium levels below 15 nM, which is substantially below threshold for activation of calcium-dependent enzymes in signaling pathways (which is typically a few hundred nanomolar calcium, when determined in vitro).

CONCLUSION

This method provides an improved approach to study the effect of heavy metals on calcium-stimulated signaling pathways.

Outbreak of fatal childhood lead poisoning related to artisanal gold mining in northwestern Nigeria, 2010

BACKGROUND

In May 2010, a team of national and international organizations was assembled to investigate children's deaths due to lead poisoning in villages in northwestern Nigeria.

OBJECTIVES

Our goal was to determine the cause of the childhood lead poisoning outbreak, investigate risk factors for child mortality, and identify children < 5 years of age in need of emergency chelation therapy for lead poisoning.

METHODS

We administered a cross-sectional, door-to-door questionnaire in two affected villages, collected blood from children 2-59 months of age, and obtained soil samples from family compounds. Descriptive and bivariate analyses were performed with survey, blood lead, and environmental data. Multivariate logistic regression techniques were used to determine risk factors for childhood mortality.

RESULTS

We surveyed 119 family compounds. Of 463 children < 5 years of age, 118 (25%) had died in the previous year. We tested 59% (204/345) of children < 5 years of age, and all were lead poisoned (≥ 10 µg/dL); 97% (198/204) of children had blood lead levels (BLLs) ≥ 45 µg/dL, the threshold for initiating chelation therapy. Gold ore was processed inside two-thirds of the family compounds surveyed. In multivariate modeling, significant risk factors for death in the previous year from suspected lead poisoning included the age of the child, the mother's work at ore-processing activities, community well as primary water source, and the soil lead concentration in the compound.

CONCLUSION

The high levels of environmental contamination, percentage of children < 5 years of age with elevated BLLs (97%, > 45 µg/dL), and incidence of convulsions among children before death (82%) suggest that most of the recent childhood deaths in the two surveyed villages were caused by acute lead poisoning from gold ore-processing activities. Control measures included environmental remediation, chelation therapy, public health education, and control of mining activities.

Determinants of lead exposure in children on the outskirts of Salvador, Brazil

Lead (Pb) is a toxic heavy metal that is widely distributed throughout the environment. Pb is an important neurotoxic metal and children are more susceptible to its effect due to their higher absorption rate and greater susceptibility of the developing nervous system. In this work, we evaluated the lead exposure levels in children living near a metallurgical plant and identified risk factors associated with its internal dose. All children, aged 1-10 years and 11 months, living near a metallurgical plant in the great Salvador area, Brazil were evaluated in this cross-sectional study and compared with children from a non exposed area. Occipital hair and blood were used to assess exposure. Air lead levels in the respirable fraction (PM(2.5)) were also measured in both areas. Blood lead levels (BLL), hair lead levels (PbH) and air lead were determined by graphite furnace atomic absorption spectrometry. Spearman correlations analysis was used to evaluate correlations between BLL, PbH and descriptors. Significant risk factors were modeled using multivariate linear regression analysis. Air lead levels were approximately ten-folds lower than EPA reference concentration (0.15 μg/m(3)). Median BLL and PbH were 1.65 ± 1.45 μg/dL and 1.26 ± 3.70 μg/g, respectively, in exposed children. In the referents, medians were BLL 1.20 ± 1.20 μg/dL; PbH 2.09 ± 2.06 μg/g. No significant difference was observed in biomarkers levels between boys and girls. It was observed a positive weak correlation (Spearman rho = 0.197, p = 0.033) between BLL and PbH. Our data show that children's lead body burden measured as BLL or PbH are low when compared with the recommended reference values. Despite that, we were able to identify four risk factors associated with increased biological lead levels: age, living near industrial site, environmental tobacco smoking and, above all, domestic waste burning. In order to prevent such avoidable exposure, environmental education and proper waste management should be implemented, especially in developing countries.

Perinatal lead exposure alters postnatal cholinergic and aminergic system in rat brain: reversal effect of calcium co-administration

Our earlier studies indicated the role of neurotransmitter systems in lead (Pb) induced behavioral perturbations. In this study, we examined the alterations in synaptosomal acetylcholine (ACh), epinephrine, dopamine, acetylcholinesterase (AChE), and mitochondrial monoamine oxidase (MAO) in the cerebellum and hippocampus of perinatally Pb-exposed rats. Rats (Wistar) were exposed to 0.2% Pb (Pb acetate in drinking water of mother) from gestational day 6 and the pups were exposed lactationally (through mother's milk) to Pb till weaning (postnatal day 21). Studies conducted on different postnatal days (PND 21, 28, 35 and 60) showed significant decreases in synaptosomal AChE and mitochondrial MAO activities, and increases in the levels of ACh, dopamine and epinephrine in the cerebellum and hippocampus of Pb-exposed rats. These alterations were greater at PND 35 and more pronounced in the cholinergic system (ACh and AChE) of hippocampus and the aminergic system (epinephrine, dopamine and MAO) of cerebellum. The total locomotor activity and exploratory behavior were also decreased significantly in Pb-exposed animals corresponding to the alterations observed in cholinergic and aminergic systems. Calcium administration together with Pb, however significantly reversed the Pb-induced alterations in transmitters and enzymes, as well as exploratory and motor behavior suggesting protective effect of calcium in Pb-exposed animals.

Childhood and adult socioeconomic position, cumulative lead levels, and pessimism in later life: the VA Normative Aging Study

Pessimism, a general tendency toward negative expectancies, is a risk factor for depression and also heart disease, stroke, and reduced cancer survival. There is evidence that individuals with higher lead exposure have poorer health. However, low socioeconomic status (SES) is linked with higher lead levels and greater pessimism, and it is unclear whether lead influences psychological functioning independently of other social factors. The authors considered interrelations among childhood and adult SES, lead levels, and psychological functioning in data collected on 412 Boston area men between 1991 and 2002 in a subgroup of the VA Normative Aging Study. Pessimism was measured by using the Life Orientation Test. Cumulative (tibia) lead was measured by x-ray fluorescence. Structural equation modeling was used to quantify the relations as mediated by childhood and adult SES, controlling for age, health behaviors, and health status. An interquartile range increase in lead quartile was associated with a 0.37 increase in pessimism score (P < 0.05). Low childhood and adult SES were related to higher tibia lead levels, and both were also independently associated with higher pessimism. Lead maintained an independent association with pessimism even after childhood and adult SES were considered. Results demonstrate an interrelated role of lead burden and SES over the life course in relation to psychological functioning in older age.

Differential effect of postnatal lead exposure on gene expression in the hippocampus and frontal cortex

Although developmental lead exposure is known to have detrimental effects on a variety of cognitive functions that depend on the integrity of the hippocampus and frontal cortex, little is known about how low levels of lead exposure affect expression of key families of genes in these structures. The present study examined the effects of exposure to environmentally relevant levels of lead during the sensitive early post-weaning period in the rat on the expression profiles of a select number of neurobiologically relevant genes (i.e., genes for neurotrophic factors, NMDA receptors, metabotropic glutamate receptors, synaptic function/plasticity, cell signaling, and transcription/regulation) in the rat hippocampus and frontal cortex. Exposure to lead (180 and 375-ppm lead acetate in food for 30 days) significantly increased blood lead levels (5.8 to 10.3 μg/dl) and significantly affected expression of many of the genes examined. In many instances, lead exposure had different effects on the same gene depending on the brain region in which the expression of that gene was examined. Gene expression in the frontal cortex was often more sensitive to modification than gene expression in the hippocampus. These results suggest that even past infancy, exposures to low levels of lead can have significant effects on gene expression in the frontal cortex and the hippocampus with the potential to exert long-term effects on behavior and cognition.

Influence of industrial environments on the development of respiratory systems and morphofunctional features in preadolescent boys

The present study examines the differences between levels of selected structural and functional features of boys 11–13 years in age from regions with varying levels of air pollution, including an industrial and rural region. The sample consisted of 213 boys from the industrial region and 98 from the rural region. Somatic, respiratory parameters and motor abilities were evaluated in both groups. The analysis of respiratory parameters revealed significantly better development of respiratory systems in boys from the rural region. Additionally, motor abilities were also better developed in boys from the rural region.

Blood lead levels during different trimesters of pregnancy and the possible influencing factors in Chengdu, China

Lead is a toxic element. It can damage multiple human organs and systems. In present study, we detected the blood lead levels (BLLs) during the whole pregnancy period and 6-12th weeks after delivery and analyzed their influencing factors by healthy pregnant women. We recruited 128 healthy pregnant women absent of pregnancy or obstetric complications or abnormal pregnancy outcomes as the gravida group. The control group consisted of 120 healthy non-pregnant women. The lead concentrations of all the three pregnancy trimesters and postpartum were: 5.95 ± 2.27, 5.51 ± 1.93, 5.57 ± 1.85, and 6.88 ± 1.90 μg/dl; and the mean lead concentration of control group was 6.87 ± 2.29 μg/dl. We found that the BLLs of the gravida group were lower than that of control group during all three trimesters and occupations, supplement nutrition elements, and time of house painted could affect blood lead levels of pregnant women. Lead-related occupations, using cosmetics, and living in a house painted <1 year are risk factors of high BLLs among pregnant women, while calcium, iron, zinc, and milk supplements are protective factors. These may help people especially pregnant women to reduce lead exposure via supplement of calcium, iron, zinc, and milk or avoiding contacting above risk factors.

Proliferation potential of human amniotic fluid stem cells differently responds to mercury and lead exposure

There are considerable gaps in our knowledge on cell biological effects induced by the heavy metals mercury (Hg) and lead (Pb). In the present study we aimed to explore the effects of these toxicants on proliferation and cell size of primary human amniotic fluid stem (AFS) cells. Monoclonal human AFS cells were incubated with three dosages of Hg and Pb (single and combined treatment; ranging from physiological to cytotoxic concentrations) and the intracellular Hg and Pb concentrations were analyzed, respectively. At different days of incubation the effects of Hg and Pb on proliferation, cell size, apoptosis, and expression of cyclins and the cyclin-dependent kinase inhibitor p27 were investigated. Whereas we found Hg to trigger pronounced effects on proliferation of human AFS cells already at low concentrations, anti-proliferative effects of Pb could only be detected at high concentrations. Exposure to high dose of Hg induced pronounced downregulation of cyclin A confirming the anti-proliferative effects observed for Hg. Co-exposure to Hg and Pb did not cause additive effects on proliferation and size of AFS cells, and on cyclin A expression. Our here presented data provide evidence that the different toxicological effects of Pb and Hg on primary human stem cells are due to different intracellular accumulation levels of these two toxicants. These findings allow new insights into the functional consequences of Pb and Hg for mammalian stem cells and into the cell biological behavior of AFS cells in response to toxicants.

Human biomonitoring for metals in Italian urban adolescents: data from Latium Region

As a part of the activities of the first Italian human biomonitoring survey (PROBE - PROgramme for Biomonitoring general population Exposure), a reference population of adolescents, aged 13-15 years, was examined for their exposure to metals. The study included 252 adolescents living in urban areas, representative of Latium Region (Italy) and blood specimens were analyzed for metals (As, Be, Cd, Co, Cr, Hg, Ir, Mn, Mo, Ni, Pb, Pd, Pt, Rh, Sb, Sn, Tl, U, V and W) by sector field inductively coupled plasma mass spectrometry. The results obtained will improve the knowledge about the body burden in adolescents and are tentative reference values for Italian young people as a basis for risk evaluation deriving from urban/environmental exposure to metals.

Indoor metallic pollution related to mining activity in the Bolivian Altiplano

The environmental pollution associated with mining and metallurgical activities reaches its greatest extent in several Andean cities and villages. Many locations in this area have accumulated through centuries a large amount of mining wastes, often disregarding the magnitude of this situation. However, in these naturally mineralized regions, there is little information available stating the exact role of mining and metallurgical industries in urban pollution. In this study, we demonstrated that the various metallic elements present in indoor dust (As, Cd, Cu, Pb, Sb, Sn, Zn) had a common origin and this contamination was increased by the proximity to the mines. Lead dust concentration was found at concerning levels for public health. In addition, wrong behaviors such as carrying mining workwear home contributed to this indoor dust pollution. Consequently, the constant exposure of the population could represent a potential health hazard for vulnerable groups, especially children.

Peripheral blood signatures of lead exposure

BACKGROUND

Current evidence indicates that even low-level lead (Pb) exposure can have detrimental effects, especially in children. We tested the hypothesis that Pb exposure alters gene expression patterns in peripheral blood cells and that these changes reflect dose-specific alterations in the activity of particular pathways.

METHODOLOGY/PRINCIPAL FINDING

Using Affymetrix Mouse Genome 430 2.0 arrays, we examined gene expression changes in the peripheral blood of female Balb/c mice following exposure to per os lead acetate trihydrate or plain drinking water for two weeks and after a two-week recovery period. Data sets were RMA-normalized and dose-specific signatures were generated using established methods of supervised classification and binary regression. Pathway activity was analyzed using the ScoreSignatures module from GenePattern.

CONCLUSIONS/SIGNIFICANCE

The low-level Pb signature was 93% sensitive and 100% specific in classifying samples a leave-one-out crossvalidation. The high-level Pb signature demonstrated 100% sensitivity and specificity in the leave-one-out crossvalidation. These two signatures exhibited dose-specificity in their ability to predict Pb exposure and had little overlap in terms of constituent genes. The signatures also seemed to reflect current levels of Pb exposure rather than past exposure. Finally, the two doses showed differential activation of cellular pathways. Low-level Pb exposure increased activity of the interferon-gamma pathway, whereas high-level Pb exposure increased activity of the E2F1 pathway.

Heavy metal chelation in neurotoxic exposures

Metals such as iron and copper are critical to living organisms, whereas other metals such as lead and arsenic have no known biologic role. Any metals in large amounts may cause toxicity. Many metals cause pervasive systemic effects involving the nervous system, which can be subtle in some cases. Although challenging, the diagnosis and treatment of metal poisoning can be made based on history, physical examination, and the proper use of metal testing. This article focuses on the use, and misuse, of chelation in the diagnosis and management of metal intoxication.

Prospective cohort study of lead exposure and electrocardiographic conduction disturbances in the Department of Veterans Affairs Normative Aging Study

BACKGROUND

No studies have examined the association between cumulative low-level lead exposure and the prospective development of electrocardiographic conduction abnormalities, which may mediate the association between lead and several cardiovascular end points.

OBJECTIVE

We prospectively examined the association between lead exposure and the development of electrocardiographic conduction abnormalities.

METHODS

We assessed blood lead, bone lead--a biomarker of cumulative lead exposure--measured with K-shell X-ray fluorescence, and electrocardiographic end points among 600 men in the Normative Aging Study who were free of electrocardiographic abnormalities at the time of the baseline ECG. Of these men, we had follow-up data from a second electrocardiogram for 496 men 8.1 (SD = 3.1) years later, on average. We used repeated measures linear regression to analyze change in electrocardiographic conduction timing and logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for developing specific conduction disturbances and adjusted for potential confounders.

RESULTS

Mean (± SD) blood (5.8 ± 3.6), patella bone (30.3 ± 17.7), and tibia bone (21.6 ± 12.0) lead concentrations were similar to those found in samples from the general U.S. population and much lower than those reported in occupationally exposed groups. Compared with those in the lowest tertile of tibia lead, those in the highest had a 7.94-ms (95% CI, 1.42-14.45) increase in heart rate-corrected QT (QTc) interval and a 5.94-ms increase in heart rate-corrected QRS (95% CI, 1.66-10.22) duration > 8 years. Those in the highest tertile of tibia lead also had increased odds of QT prolongation (QTc ≥ 440 msec; OR = 2.53; 95% CI, 1.22-5.25) and JT prolongation (heart rate-corrected JT > 360 msec; OR = 2.53; 95% CI, 0.93-6.91). Results were weaker for patella lead. No associations were identified with blood lead.

CONCLUSIONS

This study suggests that low-level cumulative exposure to lead is associated with worse future cardiac conductivity in the ventricular myocardium, as reflected in QT interval characteristics.

In vitro Pb exposure disturbs the balance between Aβ production and elimination: the role of AβPP and neprilysin

Metabolism of β-amyloid peptide (Aβ) is closely associated with the pathology and etiology of Alzheimer's disease (AD). Our previous studies on aging primates and rodents have revealed that early life lead exposure increases the expression of the β-amyloid precursor protein (AβPP), elevates Aβ levels, and promotes neurodegeneration in old age. These effects were attributed to de novo synthetic pathways; however, the impact on Aβ degradation was not explored. Neprilysin (NEP), a rate-limiting catabolic peptidase is involved in Aβ metabolism in vivo. In the present study we sought to investigate whether accumulation of Aβ induced by Pb exposure is partially due to its ability to subdue NEP expression and consequently NEP activity. SH-SY5Y cells were exposed to Pb concentrations of 0, 5, 10, 20, and 50 μM for 48 h and AβPP, NEP protein and mRNA levels were measured. Additionally, NEP enzymatic activity and Aβ levels were also assessed. Western blot and RT-PCR analysis indicated significant increases in the protein and mRNA expression of AβPP, which appeared to be concentration and time-dependent, while the protein and mRNA expression of NEP as well as NEP activity declined. These actions of Pb were specific and were not observed when substituted by another metal. These results suggest that Pb causes both the overexpression of AβPP and repression of NEP resulting in the buildup of Aβ.

The influence of environmental exposure on lead concentrations in scalp hair of children in Pakistan

In the present study the environmental and occupational exposure of Pb has been assessed by analyzing the scalp hair (SH) of children (both genders), residing in the vicinity of industrial area of Hyderabad, Pakistan. A total of 339 children attending primary schools situated in the industrial area, age ranged 5-10 years, while for comparative purpose children of the same age group from schools located in an area devoid of industries, were selected. The scalp hair was oxidized by acid mixture in a microwave oven prior to determination of Pb by graphite furnace atomic absorption spectrometry. The concentration profile of Pb in SH of children showed that the level changed significantly (44-64%) with changes of living habits or environmental exposure. The influence of age, sex, and family occupation on the children's hair Pb concentration was also evaluated. Significant differences in SH-Pb levels were observed between the exposed (EXC) and non-exposed (NEC) children (p<0.01). The concentration of Pb in boys of exposed (EX) and non-exposed (NEX) area was more than in girls of the corresponding localities. The boys and girls of NEX and EX areas have SH-Pb in the range of 3.97-5.4 and 6.06-13.7 μg g(-1) and 3.41-7.4 and 5.56-11.5 μg g(-1), respectively. The Pb levels increased with age in both study groups.

Environmental ecological modeling of human blood lead levels in East Asia

Environmental ecological modeling (EEM), which unifies models simulating transport of chemicals and exposure of humans to chemicals, was used to simulate long-term trends of female adult human blood lead levels (BLLs) and historical exposure to the atmospheric lead in four East Asian countries: Japan, Korea, China, and Vietnam. Anthropogenic lead emissions to the atmosphere in Vietnam were estimated from energy statistics to be 1931 t yr(-1). Calculated BLLs generally agreed with those observed in samples collected in these countries as the error factors were less than 2. The model results revealed that BLLs decreased significantly in Tokyo (by 58%) and Seoul (by 45%) in recent decades and confirmed the effects of efforts to reduce environmental lead in Japan and Korea. The model results also revealed that BLLs in Beijing did not decrease in this decade as much as in Tokyo and Seoul, despite the phasing out of leaded gasoline, and that the contribution from the atmospheric component was increasing (43% in 2009). Finally, we applied EEM to simulate BLLs of children in Hanoi. The probability of children having BLLs greater than 50 μg L(-1) was 7.5%, which was greater than those observed in developed countries.

Regular breakfast and blood lead levels among preschool children

BACKGROUND

Previous studies have shown that fasting increases lead absorption in the gastrointestinal tract of adults. Regular meals/snacks are recommended as a nutritional intervention for lead poisoning in children, but epidemiological evidence of links between fasting and blood lead levels (B-Pb) is rare. The purpose of this study was to examine the association between eating a regular breakfast and B-Pb among children using data from the China Jintan Child Cohort Study.

METHODS

Parents completed a questionnaire regarding children's breakfast-eating habit (regular or not), demographics, and food frequency. Whole blood samples were collected from 1,344 children for the measurements of B-Pb and micronutrients (iron, copper, zinc, calcium, and magnesium). B-Pb and other measures were compared between children with and without regular breakfast. Linear regression modeling was used to evaluate the association between regular breakfast and log-transformed B-Pb. The association between regular breakfast and risk of lead poisoning (B-Pb≥10 μg/dL) was examined using logistic regression modeling.

RESULTS

Median B-Pb among children who ate breakfast regularly and those who did not eat breakfast regularly were 6.1 μg/dL and 7.2 μg/dL, respectively. Eating breakfast was also associated with greater zinc blood levels. Adjusting for other relevant factors, the linear regression model revealed that eating breakfast regularly was significantly associated with lower B-Pb (beta = -0.10 units of log-transformed B-Pb compared with children who did not eat breakfast regularly, p = 0.02).

CONCLUSION

The present study provides some initial human data supporting the notion that eating a regular breakfast might reduce B-Pb in young children. To our knowledge, this is the first human study exploring the association between breakfast frequency and B-Pb in young children.

Quantitative analysis of toxic metals lead and cadmium in water jet by laser-induced breakdown spectroscopy

Laser-induced breakdown spectroscopy (LIBS) has been applied to the analysis of toxic metals Pb and Cd in Pb(NO3)2 and Cd(NO3)2.4H2O aqueous solutions, respectively. The plasma is generated by focusing a nanosecond Nd:YAG (λ=1064 nm) laser on the surface of liquid in the homemade liquid jet configuration. With an assumption of local thermodynamic equilibrium (LTE), calibration curves of Pb and Cd were obtained at different delay times between 1 to 5 μs. The temporal behavior of limit of detections (LOD) was investigated and it is shown that the minimum LODs for Pb and Cd are 4 and 68 parts in 10(6) (ppm), respectively. In order to demonstrate the correctness of the LTE assumption, plasma parameters including plasma temperature and electron density are evaluated, and it is shown that the LTE condition is satisfied at all delay times.

Proton magnetic resonance spectroscopy in adults with childhood lead exposure

BACKGROUND

Childhood lead exposure adversely affects neurodevelopment. However, few studies have examined changes in human brain metabolism that may underlie known adverse cognitive and behavioral outcomes.

OBJECTIVE

We examined the association between mean childhood blood lead levels and in vivo brain metabolite concentrations as adults, determined by proton magnetic resonance spectroscopy (MRS) in a birth cohort with documented low-to-moderate lead exposure.

METHODS

Adult participants from the Cincinnati Lead Study [n = 159; mean age (± SD), 20.8 ± 0.9 years] completed a quantitative, short-echo proton MRS protocol evaluating seven regions to determine brain concentrations of N-acetyl aspartate (NAA), creatine and phosphocreatine (Cr), cholines (Cho), myo-inositol, and a composite of glutamate and glutamine (GLX). Correlation and multiple linear regression analyses were conducted.

RESULTS

Mean childhood blood lead levels were associated with regionally specific brain metabolite concentrations adjusted for age at imaging and Full-Scale intelligence quotient. Adjusted analyses estimated for a unit (micrograms per deciliter) increase in mean childhood blood lead concentrations, a decrease of NAA and Cr concentration levels in the basal ganglia, a decrease of NAA and a decrease of Cho concentration levels in the cerebellar hemisphere, a decrease of GLX concentration levels in vermis, a decrease of Cho and a decrease of GLX concentration levels in parietal white matter, and a decrease of Cho concentration levels in frontal white matter.

CONCLUSIONS

Gray-matter NAA reductions associated with increasing childhood blood lead levels suggest that sustained childhood lead exposure produces an irreversible pattern of neuronal dysfunction, whereas associated white-matter choline declines indicate a permanent alteration to myelin architecture.

Effect of age-dependent exposure to lead on hepatotoxicity and nephrotoxicity in male rats

Lead is known to induce a broad range of physiological, biochemical, and behavioral dysfunctions in laboratory animals and humans. This includes age-specific variations in absorption, retention, and tissue distribution of lead. This study was carried out to investigate the effects of chronic exposure to lead (50 mg/L) on liver and kidneys of two different age groups of male rats treated with lead from delivery until puberty period (40 days) and postpuberty period (65 days). For this purpose, the concentrations of thiobarbituric acid reactive substance (TBARS), total thiol groups (SH), and superoxide dismutase (SOD) activity were measured in the liver and kidney of rats. Renal function was analyzed by determining creatinine, acid uric, and urea. Plasma activities of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and albumin were determined spectrophotometrically to evaluate hepatic function. These markers of damage were determined to assess the level of toxicity in these animals. Our results clearly show that the administration of lead produces oxidative damage in liver and kidney, as strongly suggested by the significant increase in TBARS, decrease in total SH, and the alteration of SOD activity. In young lead-exposed animals, lead-induced perturbations on the synthetic function of the liver and the kidney were more pronounced. However, nephropathy is evident for adult lead-exposed animals. It is concluded that lead induces severe hepatic and renal toxicity, which depends on the age of the animals and the target organ.

Toxicity biomarkers among US children compared to a similar cohort in France: a blinded study measuring urinary porphyrins

The purpose of this blinded study was to evaluate potential environmental toxicity in a cohort of neurotypical children (n = 28) living in a suburban area of north-central Texas in the United States (US) with a comparable age- and gender-matched cohort of neurotypical children (n = 28) living in a suburban area of southeastern France using urinary porphyrin testing: uroporphyrin (uP), heptacarboxyporphyrin (7cxP), hexacarboxyporphyrin (6cxP), pentacarboxyporphyrin (5cxP), precoproporphyrin (prcP), and coproporphyrin (cP). Results showed significantly elevated 6cxP, prcP (an atypical, mercury-specific porphyrin), and cP levels, and increasing trends in 5cxP levels, among neurotypical children in the USA compared to children in France. Data suggest that in US neurotypical children, there is a significantly increased body-burden of mercury (Hg) compared to the body-burden of Hg in the matched neurotypical children in France. The presence of lead contributing to the higher levels of cP also needs to be considered. Further, other factors including genetics can not be completely ruled out.

Investigating the effect of lead acetate on rat bone marrow-derived mesenchymal stem cells toxicity: role of apoptosis

Lead exposure continues to be a significant public health problem. Osteoporosis, inhibition of fracture healing, and cartilage functional impairment have been reported from lead exposure. Mesenchymal stem cells (MSCs) are a bone marrow population of cells with the ability to differentiate into various cell types, particularly osteocytes and chondrocytes. Despite intensive investigation on the effect of lead poisoning on various cell types, there is very little if any report on the effect of lead on MSCs. The aim of this study, therefore, was to investigate the effect of lead acetate on rat bone marrow derived MSCs toxicity and its mechanism by examining the role of pro- and anti-apoptotic proteins in this process. It was revealed that lead acetate could induce cell death in a dose-dependent manner using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl tetrazolium (MTT) assay. Compared to controls, the significant over-expression of pro-apoptotic proteins, including Bax, caspases-9, -3, and p53, with no significant change in anti-apoptotic Bcl(2) protein were obtained in lead-treated cells using western blotting analysis. There was a significant increase in DNA fragmentation in treated MSCs compared to controls using flow-cytometry. Finally, it might be concluded that lead acetate could induce cell toxicity and apoptosis in MSCs, causing instability in mitochondria and in turn activation of the intrinsic pathway including over-expression of Bax, caspase 9 and caspase 3, leading to DNA damage and activation of P53.

Comparative value of phosphate sources on the immobilization of lead, and leaching of lead and phosphorus in lead contaminated soils

The mobility and bioavailability of lead (Pb) in soils can be mitigated by its immobilization using both soluble and insoluble phosphate (P) compounds. The effectiveness of insoluble P sources on Pb immobilization depends on their rate of dissolution which can be enhanced by phosphate solubilizing bacteria (PSB). In this study, the effect of soluble (potassium dihydrogen phosphate) and insoluble (rock phosphate in the presence and absence of PSB) P compounds on the immobilization of Pb, and leaching of Pb and P was examined using both naturally contaminated (SR soil: NH₄NO₃ extractable Pb: 28.7 mg/kg, pH: 5.88, organic matter: 0.7%) and Pb spiked (AH soil: NH(4)NO(3) extractable Pb: 42.7 mg/kg, pH: 5.23, organic matter: 10.9%) soils. Phosphate compounds were added at the rate of 200 mg P/kg and 800 mg P/kg for SR and AH soils, respectively. Soluble P treatment immobilized 80% and 57% of Pb in SR and AH soils, respectively. Insoluble rock phosphate immobilized 40% and 9% of Pb without PSB, and 60% and 17% with PSB in SR and AH soils, respectively. Lead leaching was the lowest when soils were amended with rock phosphate in the presence of PSB, which reduced Pb leaching by 36% for SR soil and 18% for AH soil compared to the control. The leaching of Pb increased when the soils were amended with soluble P because soluble P treatment increased dissolved organic carbon (DOC) concentration of soil, thereby increasing Pb mobility. Soluble P treatment significantly increased P leaching and 9% of total added P was leached from low P retaining AH soil. The optimum level of P amendment is a critical issue when soluble P is used as a Pb immobilizing agent because of eutrophication resulting from excessive P leaching to surface and ground water. While the soluble P compound was effective in the immobilization of Pb, it resulted in P leaching which increased with increasing levels of P addition. However, rock phosphate amendment with PSB achieved the immobilization of Pb with a minimum effect on both Pb and P leaching.

Environmental lead exposure and otoacoustic emissions in Andean children

Studies relating sensory hearing impairment to lead (Pb) exposure in children have presented inconsistent results. The objective of this study was to measure distortion product otoacoustic emissions (DPOAE), sounds emanating from the outer hair cells of the inner ear, in Pb-exposed children to determine the effects of Pb poisoning on the inner ear. DPOAE were recorded for 9 f(2) frequencies from 1187 to 7625 Hz on 102 ears of 53 Pb-exposed children (aged 6-16 yr) residing in Pb-contaminated environments in the Andes Mountains of Ecuador where Pb glazing of ceramics is the primary livelihood. Blood lead (PbB) levels ranged from 4.2 to 94.3 μg/dl (mean: 37.7; SD: 25.7; median: 36.4). The median PbB level was markedly higher than the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) 10-μg/dl action level. Spearman rho correlation analyses of the relation between PbB level and DPOAE amplitude and between PbB level and DPOAE signal-to-noise ratio revealed no significant associations at any of the f(2) frequencies tested. In addition, no significant correlation (Spearman rho) between PbB level and hearing sensitivity for 6 pure-tone test frequencies from 1000 to 8000 Hz was found. Although the study group was found to have abnormally elevated PbB levels, in contrast to some earlier reports, the results of the current study showed no consistent Pb-induced sensory effects on the cochlea of Pb-intoxicated children.

Low-level lead exposure attenuates the expression of three major isoforms of neural cell adhesion molecule

Toxic lead (Pb) exposure poses serious risks to human health, especially to children at developmental stages, even at low exposure levels. Neural cell adhesion molecule (NCAM) is considered to be a potential early target in the neurotoxicity of Pb due to its role in cell adhesion, neuronal migration, synaptic plasticity, and learning and memory. However, the effect of low-level Pb exposure on the specific expression of NCAM isoforms has not been reported. In the present study, we found that Pb could concentration-dependently (1-100 nM) inhibit the expression of three major NCAM isoforms (NCAM-180, -140, and -120) in primary cultured hippocampal neurons. Furthermore, it was verified that levels of all three major isoforms of NCAM were reduced by Pb exposure in human embryonic kidney (HEK)-293 cells transiently transfected with NCAM-120, -140, or -180 isoform cDNA constructs. In addition, low-level Pb exposure delayed the neurite outgrowth and reduced the survival rate of cultured hippocampal neurons at different time-points. Together, our results demonstrate that developmental low-level Pb exposure can attenuate the expression of all three major NCAM isoforms, which may contribute to the observed Pb-mediated neurotoxicity.

Lead exposure in female workers who are pregnant or of childbearing age

In adults, high-level lead exposure often occurs in the lead-related industries. Acute lead poisoning has become rare, but chronic exposure to low-level lead remains a public health issue. With recent advances in our understanding of lead toxicity at low-levels, researchers have shifted their focus to studying lead at concentrations below those currently recommended as 'acceptable' in worker protection. As gender plays an important role in the storage, biokinetics, and toxicity of lead, it seems inappropriate to extrapolate findings of lead exposure in men to women. Women's bones release lead more slowly to the bloodstream, so blood levels remain increased for a long time after cessation of high exposure, reflecting the endogenous source of the lead. Particularly in pregnant women, bone lead release could influence health in pregnancy and be extremely harmful to the rapidly growing and developing fetus. Accordingly, female workers of childbearing age should avoid excessive lead exposure. However, because studies of pregnant workers encounter many difficulties and inconveniences, sufficient research has not been conducted in this area. As an alternative, a group of non-occupationally exposed women, matched as well as possible for anthropometric and reproductive variables and with almost the same levels of blood lead, could be recruited for survey.

Association between blood lead levels (<5 μg/dL) and inattention-hyperactivity and neurocognitive profiles in school-aged Korean children

OBJECTIVES

The association between low blood lead levels (<5 μg/dL) and the inattention-hyperactivity symptoms and neurocognitive profiles of school-aged Korean children was investigated.

METHODS

We measured blood lead levels in 256 Korean children aged 8-10 years. Teachers completed the Attention-Deficit Hyperactivity Disorder Rating Scale (T-ARS)-IV to assess inattentive and hyperactive symptoms. Parents completed the Korean version of the Learning Disability Evaluation Scale (K-LDES). Children performed neurocognitive tests [The Continuous Performance Test (CPT), the Children's Color Trails Test, and the Stroop Color and Word Test (SCWT)].

RESULTS

A linear regression analysis indicated that the blood lead concentrations were associated with the inattention scores [B=4.8, S.E.=1.6, 95% confidence interval (CI): 1.5-8.0], the hyperactivity subscores (3.1, 1.4, 0.3-5.9), and the total score (7.9, 2.9, 2.1-13.6) on the T-ARS; the number of omission errors on the CPT (20.6, 7.1, 6.5-34.6); the listening (-1.4, 0.7, -2.8 to -0.1), reading (-2.1, 0.7, -3.4 to -0.7), writing (-2.0, 0.7, -3.4 to -0.6), spelling (-2.2, 0.7, -3.7 to -0.7), and calculating (-1.8, 0.7, -3.1 to -0.4) scores on the K-LDES; and the color-word score on the SCWT (-6.7, 3.4, -13.3 to -0.1). A logistic regression analysis indicated that the probability of inattentive and hyperactive symptoms was increased with higher blood lead levels in boys with an odds ratio of 2.768 [B=1.018, S.E.=0.487, p=0.036, 95% CI: 1.066-7.187].

CONCLUSION

This study suggests that even low blood lead levels (<5 μg/dL) are associated with inattentive and hyperactivity symptoms and learning difficulties in school-aged children.

Iron, Lead, and Children's Behavior and Cognition

Iron deficiency (ID) is the most common micronutrient deficiency in the world, with consequences of ID and ID anemia (IDA) in young children including behavioral and cognitive deficits. In turn, lead exposure is one of the most common environmental toxicants affecting children. Elevated blood lead levels (BLLs) in young children are also associated with behavioral and cognitive deficits. The metabolic and physiological connections between iron and lead, including a common route of entry into the body and similar neural targets, suggest a considerable overlap in their effects on functional outcomes. Very few studies have examined the existence of increased susceptibility to lead neurotoxicity in children with ID, but there is evidence that ID and BLL are independently associated with cognition and behavior. Children's susceptibility to both ID and elevated BLLs will likely depend on the timing and severity of both exposures, something that should be investigated systematically.