Thallium toxicity in humans. Arh Hig Rada Toksikol. 2010;61:111-119. [PMID: 20338874 DOI: 10.2478/10004-1254-61-2010-1976]

Complexions therapy and severe intoxication by Thallium salts

The aim of this paper is to study the clinical features of severe intoxications with thallium salts and developing effective care schemes for the application of potassium hexacyanoferrate (II) and deferasirox for correction of detected disorders. A total of 39 patients diagnosed with severe thallium salt poisoning were examined in two groups. Group I comprised 20 patients with severe thallium salt poisoning, who were prescribed with potassium-iron hexacyanoferrate in a dose of 250 mg/kg/day per os, intravenous potassium infusions, furosemide intravenously in amount of 40 mg three times per, and hemodialysis until the thallium level in the blood dropped below 10 mg/L, lactulose 30 mL two times per day per os. Group II consisted of 19 people with severe thallium salt poisoning, which in addition to the above treatment, received Deferasirox in a dosage of 500 mg two times per day per os. The clinical picture of severe poisoning with thallium salts is characterized by lesions of the gastrointestinal tract, nervous system (central and peripheral), alopecia, heart rhythm disorders, and myocardial ischemia zones. Extension of standard therapy with potassium-iron by adding hexacyanoferrate deferasirox showed better effect on thallium elimination rate and improved functional state of liver and kidneys in patients with severe thallium salt poisoning.

Diagnosis and treatment of persons with acute thallium poisoning

•

This study presents a case of mass thallium poisoning including 44 persons.

•

For thallium poisoning, early diagnose is difficult and treatment approaches should be developed.

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Delayed alopecia and skin lesions are specific features of thallium poisoning.

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A combination of potassium-ferric hexacyanoferrate and intestinal lavage is effective against this poisoning.

Objective

This study aimed to describe organs and systems damages in persons after mass poisoning with thallium and show the results of treatment.

Methods

Forty-four persons (12 males and 32 females) with acute oral thallium poisoning were tested for thallium levels in blood and urine and examined by a toxicologist and a neurologist, and in some –cases, by a gynecologist, an ophthalmologist, and a psychiatrist. Persons were divided into the following three groups depending on the severity of the poisoning: I: This group consisted of 9 persons (blood thallium level 8.3–26.7 μg/L) and treatment applied in the hospital included intestinal lavage, antidote therapy with potassium-ferric hexacyanoferrate, sodium dimercaptopropanesulfonate; II: This group consisted of 21 persons (0.3-6.1 μg/L) who received a similar treatment at home; and III: This group consisted of 14 (normal) persons who did not receive any treatment.

Results

The most common combination of several symptoms such as alopecia (on day 17–23), muscle pain of different localization in the debut of the disease (>88.9 % of the persons), sudden unexplained general weakness (>76.2 % of the persons), peripheral paraparesis or tetraparesis (including no complaints), polyneuropathy (88.89 % in group I vs. 54.14 % in group II, p < 0.05), static and dynamic ataxia (33.3 % in group I vs. 19.4 % in group II, p < 0.05), vertigo (1/3 of the persons), postural tremor (1/3 of the persons), and cognitive and emotional disorders (2/3 of the persons). Ovarian dysfunction was observed in all women of group I but in 42.9 % of group II, p < 0.05. The treatment was successful. In group I, plasma and urine thallium level significantly decreased by 69.3 % and 84 %, respectively. Pain, movement and coordination disorders regressed first while tremor, sensory, cognitive and emotional disorders lasted longer. Polyneuropathies later became mononeuropathies. Tremor could increase despite a decreased thallium concentration.

Discussion

The Sklifosovsky Institute conducted the largest study in Russian Federation investigating disorders in persons with acute thallium poisoning confirmed by laboratory tests. The clinical symptoms were consistent with those reported in the literature. The applied treatment was successful and led to better results compared to our previous approaches of treating mass thallium poisoning.

Conclusions

This study shows a typical combination of thallium poisoning symptoms and allows us to recommend a complex therapy without the use of extracorporeal detoxification methods.

A comparative study of thallium(iii) and iodine(iii)-mediated ring contraction reactions for the synthesis of indane

Ring contraction reactions were carried out using HTIB and TTN to compare yields as well as the protection group tolerance.

Elemental Metabolomics for Prediction of Term Gestational Outcomes Utilising 18-Week Maternal Plasma and Urine Samples

A normal pregnancy is essential to establishing a healthy start to life. Complications during have been associated with adverse perinatal outcomes and lifelong health problems. The ability to identify risk factors associated with pregnancy complications early in gestation is vitally important for preventing negative foetal outcomes. Maternal nutrition has been long considered vital to a healthy pregnancy, with micronutrients and trace elements heavily implicated in maternofoetal metabolism. This study proposed the use of elemental metabolomics to study multiple elements at 18 weeks gestation from blood plasma and urine to construct models that could predict outcomes such as small for gestational age (SGA) (n = 10), low placental weight (n = 18), and preterm birth (n = 13) from control samples (n = 87). Samples collected from the Lyell McEwin Hospital in Adelaide, South Australia, were measured for 27 plasma elements and 37 urine elements by inductively coupled plasma mass spectrometry. Exploratory analysis indicated an average selenium concentration 20 μg/L lower than established reference ranges across all groups, low zinc in preterm (0.64 μg/L, reference range 0.66-1.10 μg/L), and higher iodine in preterm and SGA gestations (preterm 102 μg/L, SGA 111 μg/L, reference range 40-92 μg/L). Using random forest algorithms with receiver operating characteristic curves, low placental weight was predicted with 86.7% accuracy using plasma, 78.6% prediction for SGA with urine, and 73.5% determination of preterm pregnancies. This study indicates that elemental metabolomic modelling could provide a means of early detection of at-risk pregnancies allowing for more targeted monitoring of mothers, with potential for early intervention strategies to be developed.

Roe deer as a bioindicator: preliminary data on the impact of the geothermal power plants on the mineral profile in internal and bone tissues in Tuscany (Italy)

The European roe deer (Capreolus capreolus) is one of the most abundant ungulate species in Europe. Many studies have investigated its distribution, behavior, and ecology, but few have focused on its role as bioindicators for pollutants, particularly regarding antlers, which has been shown to indicate also deer physiology. The presence of geothermal power plants can induce accumulation of potentially polluting elements (such as Tl, S, and Pb). Thus, we collected roe deer samples from areas of Tuscany (Italy) where power plants are present. They were divided according to whether their home range included areas close or far from geothermal power plants. We analyzed the body measurements and the profile of the minerals in the liver and antlers tissues using the ICP-OES technique. Results showed that livers from roe deer close to power plant accumulated higher quantity of Bi, Co, Ni, Tl, and S compared to controls. Males culled close to geothermal power plants had significantly lower values for weight and chest circumference, and also, the antlers showed higher values for Li and Sr in the first sampling position. Thus, despite the small sample size in this preliminary study, antlers and livers of roe deer seem to be a bioindicator of industrial impact on the environment.

The Effect of Dietary Humic Preparations on the Content of Essential and Non-Essential Chemical Elements in Hen Eggs

This study was conducted to determine the effect of dietary supplementation with two humic preparations, Humokarbowit (HKW) and Humobentofet (HBF), on the mineral content of the albumen and egg yolk of Lohmann Brown hens. The content of macroelements (Ca, K, Mg, Na, P, S), microelements (Al, Ba, Cu, Fe, I, Mn, Si, Sr, Zn) and trace elements (Ag, As, Be, Bi, Cd, Co, Cr, Ga, Hg, Li, Mo, Ni, Pb, Rb, Sb, Se, Sn, Ti, Tl, V, W, Y and Zr) in the feed mixture (FM), albumen and yolk were presented. The material was collected from laying hens kept in a cage system in two groups, control (C) and enriched (E), with standard feed and feed enriched with humic preparations, respectively. The enriched feed mixture was characterised by a significantly higher Ag, Ba, Be, Bi, Co, Fe, Ga, Hg, K, Mg, Ni, S, Sb, Si, Zn and Zr content compared to the standard, basal mixture. Only some of these elements were found in significantly increased levels in albumen (Bi, Co, Ni, S) and yolk (Bi, Fe, K, Sb). Another noteworthy finding was a significantly lower concentration of Na in the content of eggs from the E-Group, which corresponds to the content of this important macronutrient in the feed. In addition, a significant increase in the concentration of elements such as Al, I, Li, Sr, Ti, Tl, Y, W was noted with a reduction in Cd, Cr, Hg, Mn, Rb, Sn in Group-E, which indicates a complicated egg formation processes, including biotransfer-essential and non-essential chemical elements.

Thallium(I) Oxidation by Permanganate and Chlorine: Kinetics and Manganese Dioxide Catalysis

The oxidation of the toxic heavy metal thallium(I) (Tl(I)) is an efficient way to enhance Tl removal from water and wastewater. However, few studies have focused on the kinetics of Tl(I) oxidation in water, especially at environmentally relevant pH values. Therefore, the kinetics and mechanisms of Tl(I) oxidation by the common agents KMnO₄ and HOCl under environmentally relevant pH condition were explored in the present study. The results indicated that the pH-dependent oxidation of Tl(I) by KMnO₄ exhibited second-order kinetics under alkaline conditions (pH 8-10) with the main active species being TlOH, while the reaction could be characterized by autocatalysis at pH 4-6, and Mn(III) might also play an essential role in the MnO₂ catalysis. Furthermore, a two-electron transfer mechanism under alkaline conditions was preliminarily proposed by using linear free energy relationships and X-ray photoelectron spectroscopy (XPS) analysis. Distinctively, the reaction rate of Tl(I) oxidation by HOCl decreased with increasing pH, and protonated chlorine might be the main active species. Moreover, the Tl(I)-HOCl reaction could be regarded as first order with respect to Tl(I), but the order with respect to HOCl was variable. Significant catalysis by MnO₂ could also be observed in the oxidation of Tl(I) by HOCl, mainly due to the vacancies on MnO₂ as active sites for sorbing Tl. This study elucidates the oxidation characteristics of thallium and establishes a theoretical foundation for the oxidation processes in thallium removal.

Repeated measures of prenatal thallium exposure and placental inflammatory cytokine mRNA expression: The Ma'anshan birth cohort (MABC) study

Thallium (Tl), a ubiquitous environmental toxicant, can cross the placental barrier during pregnancy. However, the effects of prenatal Tl exposure on placental function are currently unclear. Based on the Ma'anshan Birth Cohort study, we examined whether long-term prenatal Tl exposure was associated with placental inflammation. Tl concentrations were quantified in serum samples (n = 7050) from 2515 pregnancy during each trimester, placental inflammatory cytokine mRNA expression was assessed in 2519 placenta tissues. Geometric mean values of serum Tl concentrations were 63.57, 63.63 and 48.71 ng/L for the first, second and third trimesters, respectively. After adjustment for potential confounders, serum Tl concentration was positively associated with CD68 (β: 0.30; 95% CI: 0.05, 0.56) in the first trimester and TNF-α (β: 0.12; 95% CI: 0.01, 0.23), IL-6 (β: 0.15; 95% CI: 0.05, 0.25) and CD68 (β: 0.25; 95% CI: 0.10, 0.39) in the third trimester, however was negatively associated with IL-4 (β: -0.21; 95% CI: -0.41, -0.01) and CD206 (β: -0.23; 95% CI: -0.45, -0.02) in the first trimester. Repeated measures analysis showed that TNF-α, IL-6 and CD68 increased by 0.11 (95% CI: 0.01, 0.21), 0.12 (0.15, 95% CI: 0.05, 0.25), 0.22 (95% CI: 0.10, 0.39), respectively, with each 1ln-transformed Tl increase in total samples. Gender-specific analyses revealed that these associations were largely driven by male offspring. In addition, immunohistochemistry revealed that nuclear NF-κB p65 expression increased in placenta tissue. The results of this prospective cohort study provide longitudinal evidence that prenatal Tl exposure induces a placental inflammatory response in the Chinese population.

Determination of thallium in urine, blood, and hair in illicit opioid users in Iran

CONTEXT

Heavy metals, including thallium and lead, are introduced to illicit drug users' body as a result of using drugs such as cocaine and heroin.

OBJECTIVE

This study aimed to determine urine, blood, and hair thallium (Tl) concentrations in illicit opioid users along with the relevant clinical signs and symptoms consistent with thallotoxicosis and to compare them with the corresponding variables in the control non-opioid user group.

MATERIALS AND METHODS

This case-control study was conducted on 50 illicit opioid users who had abused opioids continuously for more than a year, referred to Amirie Drug Abuse Treatment Clinic in Kashan, Iran. The control group included 50 non-opioid users. Thallium concentrations in urine, blood, and hair were assessed in both groups (n = 100) using electrothermal (graphite furnace) atomic absorption spectrometry (ET AAS, GF AAS).

RESULTS

In the studied group, the median (interquartile range) concentrations of thallium in urine, blood, and hair were 54.8 ± 79.9 μg/L, 14.5 ± 11.1 μg/L, and 5.4 ± 3.7 µg/g, respectively; these values were 4.8 ± 5.2 μg/L, 2.5 ± 2.4 μg/L, and 1.4 ± 1.1 µg/g, respectively, in the control group. There were significant differences in urine, blood, and hair thallium concentrations between the study group and the control group (p < 0.001). There were significant correlations between duration of illicit opioid use and urine thallium concentrations (r = 0.394, p = 0.005) and hair thallium concentrations (r = 0.293, p = 0.039), but not with blood thallium concentrations (r = 0.246, p = 0.085). Urine and blood thallium concentrations of illicit opioid users with clinical signs and symptoms consistent with thallotoxicosis of weakness (p = 0.01), depression (p = 0.03), and headache (p = 0.03) were higher than users without these problems.

DISCUSSION AND CONCLUSION

The results of the study showed that thallium concentrations in urine, blood, and hair in illicit opioid users were significantly higher than the comparable concentrations in the control group. This can be due to the use of illicit opioids adulterated with thallium. Also, this study showed long-term illicit opioid use may lead to thallium exposure. In addition, cigarette smoking was associated with increased thallium exposure.

The continuous physiological changes of zebrafish (Danio rerio) based on metabolism under controlled thallium stress

In this research, the continuous physiological changes of zebrafish (Danio rerio) in 0.1 μg/L thallium (Tl) in 15 days were investigated. The results showed that Tl(I) stress had a significant positive linear correlation with zebrafish ammonia nitrogen excretion (ANE) (p < 0.001), and the mean value of ANE in Tl(I) treatment (435 ± 227 mg/kg/h) was approximately 2 times higher than in the control group (239 ± 168 mg/kg/h), which suggested that ANE was suitable for Tl(I) stress assessment. A substantial difference based on oxygen consumption rate (OCR) between the control group (587 ± 112 mg/kg/h) and Tl(I) treatment (260 ± 88 mg/kg/h) with a high significance p < 0.001 could be observed, and the results indicated that Tl(I) played a negative role in OCR of zebrafish. The characteristics of both ANE and OCR changes under slight Tl(I) stress could be reflected by the ammonia quotient (AQ). It was noteworthy that AQ increased rapidly in first 6 h from 0.66 to 4.50, which was 3 times higher than 1.2, indicating rapid increase in both anaerobic energy utilization and protein metabolism in 0.1 μg/L Tl(I) exposure. It is concluded that the physiological changes of zebrafish based on metabolism can be regarded as a sensitive biological indicator of Tl(I) pollution, which could work as a substitute of potassium that disrupts the normal biological metabolism in the process of transport.

Thallium toxicity due to audultered infusion with thallium sulfate in eight members belonging to the same family nucleus: Autopsy findings and ICP-MS analysis (inductively coupled plasma mass spectrometry) in a triple homicide

The banning of the heavy metal thallium (Tl) in many Countries, because of its toxicity, led to a remarkable reduction of the number of cases of poisoning both accidental and homicidal forcing us to better study the pharmacokinetics of this poison using new technologies. The Authors, in this work, are reporting the case of a collective thallium toxicosis caused by voluntary adulteration of an infusion with thallium sulfate, occurred in 8 members of the same familial nucleus; the administration of Prussian Blu resulted to be ineffective for 3 of these members that died at a later time. The most peculiar aspects of this rare manner of poisoning are discussed; the analytical procedures used, Inductively Coupled Plasma Mass Spectrometry (ICP-MS) in particular, resulted to be fundamental in the forensic diagnosis process of acute poisoning cause by thallium.

Prenatal exposure to thallium is associated with decreased mitochondrial DNA copy number in newborns: Evidence from a birth cohort study

BACKGROUND

Prenatal exposure to thallium is related to adverse birth outcomes. However, little is known about the effects of prenatal exposure to thallium on the mitochondrial DNA copy number (mtDNAcn) in newborns; such knowledge might reveal a potential mechanism linking maternal thallium exposure and adverse birth outcomes.

OBJECTIVE

To investigate the trimester-specific associations of maternal thallium exposure with cord blood leukocyte mtDNAcn.

METHODS

A total of 746 pregnant women with trimester-specific urinary samples and cord blood samples were recruited from Wuhan Children Hospital between November 2013 and March 2015 in Wuhan City, China. The concentration of thallium in maternal urine was quantified using inductively coupled plasma mass spectrometry (ICP-MS). Cord blood leukocyte mtDNAcn was measured by real-time quantitative polymerase chain reaction (qPCR). Trimester-specific associations of specific gravity (SG)-adjusted urinary thallium concentrations with mtDNAcn were estimated using a multiple informant model.

RESULTS

The geometric mean value of maternal urinary thallium was 0.34 μg/L, 0.36 μg/L, and 0.34 μg/L for the first, second, and third trimesters, respectively. Prenatal exposure to thallium during the first trimester, rather than during the second or the third trimester, was identified as negatively related to mtDNAcn. The multiple informant model showed a 10.4% lower level of mtDNAcn with each doubling increase of thallium levels (95% CI, -16.4%, -3.9%; P = 0.002). The observed associations were stronger among female newborns and among newborns born to older mothers.

CONCLUSIONS

The present study revealed a significant negative association between maternal thallium exposure during early pregnancy and cord blood leukocyte mtDNAcn in Chinese newborns, pointing to the important role of mitochondria as a target of thallium toxicity in early pregnancy.

Clinical characteristics and treatment of thallium poisoning in patients with delayed admission in China

Thallium is highly toxic and its effects are cumulative. The clinical symptoms of thallium poisoning are non-specific, thereby delaying admission and treatment. This study aimed to summarize the clinical features and treatment experience of patients with delayed admission who experience thallium poisoning.We conducted a retrospective descriptive analysis of patients in our hospital from 2008 to 2018 who had thallium poisoning and experienced a delay in hospital admission. The time from symptom onset to admission was assessed. The patients were divided into 3 groups and descriptive analyses of their clinical characteristics, including basic patient information, symptoms, laboratory test results, examination findings, treatment methods, outcomes, and follow-up information, were conducted.A total of 34 patients with thallium poisoning were included: 8 were admitted to the hospital early or with mild delay, 9 had a moderate delay, and 17 had a severely delayed admission. The time from illness onset to admission was 13 (interquartile range, 7.5-26) days. Some patients with delayed admission had significant symptoms associated with central nervous system damage, and changes in magnetic resonance images and electroencephalograms were also noted. After admission, all patients received Prussian blue treatment, and some patients with relatively high blood concentration received blood purification treatments. Following treatment, the blood and urine thallium concentrations of all patients decreased significantly, and their symptoms were alleviated.Our results show that delayed patient admission in cases of thallium poisoning is associated with greater risk of central nervous system damage. Use of Prussian blue combined with blood purification treatments might improve patients' conditions.

Survey of trace elements in bottled natural mineral waters using ICP-MS

This study monitors the elemental composition of different brands of bottled natural mineral waters marketed in Turkey and discusses compositional parameters. Natural mineral water samples were analyzed for cesium (Cs), rubidium (Rb), thallium (Tl), cobalt (Co), arsenic (As), chromium (Cr), lead (Pb), gallium (Ga), vanadium (V), silver (Ag), cadmium (Cd), uranium (U), thorium (Th), and molybdenum (Mo) by inductively coupled plasma mass spectrometry (ICP-MS). Method trueness was confirmed by using 1640A natural water certified reference materials purchased from Laboratory of the Government Chemist (LGC). The linearity, limit of detection, limit of quantification, repeatability, and recovery (%) were assessed. Method validation data and results obtained from the certified reference material suggested that the method could be applied to determine elemental contaminants of the samples. Cd, Tl, Ag, and Th could not be determined (< LOD) in the samples. Pb, Cs, Co, Rb, Ga, V, U, As, Cr, and Mo were determined in samples. The results were compared with elemental standards for natural mineral waters set according to the World Health Organization and United States Environmental Protection Agency, and the concentrations of all metals did not exceed these values.

Thallium(I) treatment induces nucleolar stress to stop protein synthesis and cell growth

Thallium is considered as an emergent contaminant owing to its potential use in the superconductor alloys. The monovalent thallium, Tl(I), is highly toxic to the animals as it can affect numerous metabolic processes. Here we observed that Tl(I) decreased protein synthesis and phosphorylated eukaryotic initiation factor 2α. Although Tl(I) has been shown to interact with the sulfhydryl groups of proteins and cause the accumulation of reactive oxygen species, it did not activate endoplasmic reticulum stress. Notably, the level of 60S ribosomal subunit showed significant under-accumulation after the Tl(I) treatment. Given that Tl(I) shares similarities with potassium in terms of the ionic charge and atomic radius, we proposed that Tl(I) occupies certain K+-binding sites and inactivates the ribosomal function. However, we observed neither activation of ribophagy nor acceleration of the proteasomal degradation of 60S subunits. On the contrary, the ribosome synthesis pathway was severely blocked, i.e., the impairment of rRNA processing, deformed nucleoli, and accumulation of 60S subunits in the nucleus were observed. Although p53 remained inactivated, the decreased c-Myc and increased p21 levels indicated the activation of nucleolar stress. Therefore, we proposed that Tl(I) interfered the ribosome synthesis, thus resulting in cell growth inhibition and lethality.

Response of microbial communities and interactions to thallium in contaminated sediments near a pyrite mining area

Thallium (Tl) is a well-recognized hazardous heavy metal with very high toxicity. It is usually concentrated in sulfide minerals, such as pyrite (FeS₂), sphalerite (ZnS), chalcopyrite (CuS) and galena (PbS). Here, this study was carried out to investigate the indigenous microbial communities via 16S rRNA gene sequence analysis in typical surface sediments with various levels of Tl pollution (1.8-16.1 mg/kg) due to acid mine drainage from an active Tl-containing pyrite mining site in South China. It was found with more than 50 phyla from the domain Bacteria and 1 phyla from the domain Archaea. Sequences assigned to the genera Ferroplasma, Leptospirillum, Ferrovum, Metallibacterium, Acidithiobacillus, and Sulfuriferula manifested high relative abundances in all sequencing libraries from the relatively high Tl contamination. Canonical correspondence analysis further uncovered that the overall microbial community in this area was dominantly structured by the geochemical fractionation of Tl and geochemical parameters such as pH and Eh. Spearman's rank correlation analysis indicated a strong positive correlation between acidophilic Fe-metabolizing species and Tl_total, Tl_oxi, and Tl_res. The findings clarify potential roles of such phylotypes in the biogeochemical cycling of Tl, which may facilitate the development of in-situ bioremediation technology for Tl-contaminated sediments.

The mobility of thallium in sediments and source apportionment by lead isotopes

Thallium (Tl) is a very toxic heavy metal. As a part of ongoing investigations, the mobility, sources and fate of Tl were investigated for sediments from a watershed in the northern part of the Pearl River, South China, whose catchment has been seriously impacted by large-scale PbZn smelting activities onshore. A wide dispersion of severe Tl contamination was observed throughout the depth profiles. A modified IRMM (Institute for Reference Materials and Measurements, Europe) sequential extraction procedure of a selected depth profile uncovered an exceptionally high enrichment of Tl in geochemically-mobile fractions (i.e., weak-acid-exchangeable, reducible and oxidizable fractions), on average 5.94 ± 2.19 mg/kg (74.6% ± 5.1% of the total Tl content) not only in the surface sediments but also in deep sediments. The proximal quantitative source apportionment using Pb isotopic fingerprinting technique indicated that a majority (80%-90%) of Tl contamination along the depth profiles is anthropogenically derived from the PbZn smelting wastes. The results highlight the pivotal role of smelting activities in discharging huge amounts of geochemically-mobile Tl to the sediments down to approximately 1 m in length, which is quantitatively evidenced by Pb isotopic tracing technique. Lead isotopes combined with distribution of Tl and Pb contents identified a potential marker for a point source from the PbZn smelter in the river catchment, which also provides a theoretical framework for source apportionment of metal contamination in a larger river/marine system and in other sulfide mining/smelting areas likewise.

Successful treatment of a patient with severe thallium poisoning in a coma using Prussian blue and plasma exchange: A case report

RATIONALE

This is the first reported severe thallium poisoning patient successfully treated with Prussian blue (PB) and plasma exchange (PE).

PATIENT CONCERNS

A 42-year-old woman in a coma owing to severe thallium poisoning was admitted to our department after day 44 of poisoning. At admission, blood and urine thallium concentrations were 380.0 and 2580.0 ng/mL, respectively.

DIAGNOSIS

The patient was diagnosed with toxic encephalopathy induced by thallium poisoning; in addition, she was also diagnosed with bilateral pneumonia, respiratory failure, moderate anemia, hypoproteinemia, and electrolyte imbalance based on her chest X-ray, blood gas analysis, Hb level, albumin levels, and serum electrolyte results.

INTERVENTIONS

The patient was intubated and treated with PB (6600 mg/d, 15 days in total) combined with PE (once daily, 5 days in total) as well as other symptomatic supportive care measures.

OUTCOMES

After treatments, her blood and urinary thallium concentrations gradually decreased and on the 13th day after admission, the blood thallium concentration decreased to 0 ng/mL. The oxygenation index gradually improved, meantime, the patient gradually regained consciousness, and on the 50th day of admission, the patient's consciousness reverted to a clear-headed state. The patient recovered mostly after 37 months of follow-up.

LESSONS

Through this case, we learned that the gradual reduction in blood and urine thallium concentration and the patient's improved condition is correlated with PB and PE treatment. For patients with severe thallium poisoning, this treatment method might be effective; but the exact curative effect is unconfirmed, requiring further research to verify.

Prenatal thallium exposure and poor growth in early childhood: A prospective birth cohort study

BACKGROUND

Thallium (Tl) exposure remains a public health problem with potential impacts on humans. Studies have suggested that prenatal exposure to thallium may be associated with fetal growth, but no studies are known have explored its association with early childhood anthropometry.

OBJECTIVE

To investigate the effects of prenatal Tl exposures on early child growth and development aged 0-2 years in a prospective birth cohort study.

METHODS

3080 pregnant women and their children participated in the study, which were recruited from a birth cohort in China. Serum samples collected in the first and second trimester of pregnant subjects and umbilical cord blood of infants were analyzed for Tl exposure assessment. Infant length or standing height and weight were obtained from medical records and 2 years planned visits. We used length/height and weight to calculate z-scores for weight-for-age (WAZ), height-for-age (HAZ), weight-for-height (WHZ), and body mass index-for-age (zBMI) based on World Health Organization standards. Linear mixed model was used to investigate the association between serum concentrations of Tl and the children's anthropometric characteristics (WAZ, HAZ, WHZ, and zBMI), and stratification analysis by sex was also examined.

RESULTS

The median (P₂₅-P₇₅) of Tl levels in the first trimester, second trimester and umbilical cord serum were 61.7 (50.7-77.0), 60.1 (50.9-74.8) and 38.4 (33.6-43.9) ng/L, respectively. Paired Mann-Whitney tests found Tl concentrations in umbilical cord serum were significantly less than that in maternal serum during the first and second trimesters (all p < 0.01). Using adjusted linear mixed model, no significant relationships were observed between maternal Tl exposure and child growth parameters. However, the umbilical cord serum Tl levels may contributed to decreased WAZ (β = -0.382, 95% confidence interval (CI): -0.670, -0.095) and HAZ (β = -0.427, 95% CI: -0.702, -0.152). When stratified by sex, the umbilical cord serum Tl levels were negatively related to WAZ (β = -0.450, 95% CI: -0.853, -0.048) and HAZ (β = -0.775, 95% CI: -1.160, -0.391) for girls. Among boys, overall Tl exposures were not significantly associated with early children anthropometric outcomes.

CONCLUSIONS

In the present study, our results suggested that prenatal Tl exposures may have a sex specific effect on child anthropometric measurements in the first 2 years of life. Umbilical cord serum Tl levels tended to be reduced child's stature and weight in young girls.

Raising the Bar On-Bead: Efficient On-Resin Synthesis of α-Conotoxin LvIA

α4/7-Conotoxin LvIA is an isoform-selective inhibitor of the α3β2 nicotinic acetylcholine receptor. An efficient strategy for the synthesis of this toxin is critical to advancing its utility as a probe for receptor function and as a potential pharmaceutical lead target. On-resin methods for peptide synthesis offer potential synthetic advantages; however, strategies for on-resin formation of multiple disulfides have historically been low-yielding. Here, we harness the reactivity of the Allocam protecting group and employ 3-amino acid spacer strategy to synthesize α4/7-conotoxin LvIA via three different on-resin strategies, each of which results in an isolated yield higher than prior fully on-resin approaches.

Chemical Analysis of Weight Loss Herbal Supplement Safe Lean™ Associated With Acute Liver Injury - A Concern for Spurious Drug, Misbranding and Adulteration

Liver injury due to herbal and dietary supplements are well described in literature and its incidence has been on the rise in the past decade. Labelling an herbal product as non-medicinal and as a supplement precludes protocols needed for testing, trials and marketing criteria. This has led to rampant use of clinically unproven multi-herb-based drugs use for a myriad of lifestyle diseases. In this report, we discuss a new dietary weight loss supplement, Safe Lean™ that was found to be the cause of liver injury in a young obese woman, that resolved after discontinuation, and discuss current literature on component, toxicology and chemical analysis of the offending drug.

Details of a thallium poisoning case revealed by single hair analysis using laser ablation inductively coupled plasma mass spectrometry

Heavy metals pose significant morbidity and mortality threats to humans in connection with both acute and chronic exposure. The often-delayed manifestations of some toxic effects and the wide-spectrum of symptoms caused by heavy metal poisoning may perplex the clinical diagnosis and, when involved in crimes, complicate the forensic investigation. To investigate the original intoxication process of a thallium poisoning case, which occurred in China more than two decades ago, laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) was used to analyze several hairs of the victim from before, during and after the poisoning period. Ablation line scans of the entire length of a ∼7cm hair revealed ∼4months of repeated exposure to thallium with increased doses and frequency toward the end, while scan of a ∼0.7cm hair revealed ∼2weeks of constant ingestions of large doses of thallium accompanied by elevated amount of lead. The endogenous origin of thallium was confirmed by the preservation of the same longitudinal distribution profile in the inner part of hair, but the source of lead could not be unambiguously determined due to the intrinsic limitation of hair analysis to distinguish ingested lead from exogenous contaminants. The overall thallium distribution profiles in the analyzed hairs suggested both chronic and acute thallium exposures that correlated well with the sequential presentation of a plethora of symptoms experienced by the victim. Aligning the time-resolved thallium peaks with symptoms also provided clues on possible routes of exposure at different poisoning stages. This work demonstrated the capability of using single hair LA-ICP-MS analysis to reconstitute a prolonged and complicated heavy metal poisoning case, and highlighted the necessity of assessing multiple elements in the medico-legal investigation of suspicious heavy metal poisonings.

Lead-Free Halide Double Perovskites: A Review of the Structural, Optical, and Stability Properties as Well as Their Viability to Replace Lead Halide Perovskites

Perovskite solar cells employ lead halide perovskite materials as light absorbers. These perovskite materials have shown exceptional optoelectronic properties, making perovskite solar cells a fast-growing solar technology. Perovskite solar cells have achieved a record efficiency of over 20%, which has superseded the efficiency of Gräztel dye-sensitized solar cell (DSSC) technology. Even with their exceptional optical and electric properties, lead halide perovskites suffer from poor stability. They degrade when exposed to moisture, heat, and UV radiation, which has hindered their commercialization. Moreover, halide perovskite materials consist of lead, which is toxic. Thus, exposure to these materials leads to detrimental effects on human health. Halide double perovskites with A2B′B″X6 (A = Cs, MA; B′ = Bi, Sb; B″ = Cu, Ag, and X = Cl, Br, I) have been investigated as potential replacements of lead halide perovskites. This work focuses on providing a detailed review of the structural, optical, and stability properties of these proposed perovskites as well as their viability to replace lead halide perovskites. The triumphs and challenges of the proposed lead-free A2B′B″X6 double perovskites are discussed here in detail.

Study on the relationship between age and the concentrations of heavy metal elements in human bone

Background

Excessive amounts of heavy metals such as cadmium, chromium, cobalt, lead, thallium, and manganese are extremely harmful to the human body. These elements can accumulate in bone and impact bone metabolism. In this study, we investigated the relationship between age and the concentrations of these elements in human bone and blood.

Methods

Bone and blood samples were obtained from both older and younger patients. The concentrations of the elements under investigation were measured by inductively coupled plasma mass spectrometry (ICP-MS), and the specific concentrations in the bone and blood were then calculated.

Results

The results showed that with increasing age, the concentrations of chromium, cobalt, and thallium in bone decreased significantly, while the concentration of cadmium in bone markedly increased. However, there was no clear correlation between age and the concentrations of these heavy metals in blood. Notably, there was a close correlation between the concentration of cobalt in bone and the presence of osteopenia.

Conclusions

Senescence of the human body is accompanied by the shifting of cobalt, chromium, and thallium from the bone to the outer- bone. However, the concentration of cadmium in bone increases with age. These changes are very likely to be related to the equilibrium of bone metabolism in senescent individuals. In addition, only cobalt was shown to be significantly related to osteopenia.

Fractionation and mobility of thallium in areas impacted by mining-metallurgical activities: Identification of a water-soluble Tl(I) fraction

Mining and metallurgy generate residues that may contain thallium (Tl), a highly toxic metal, for which it is currently not feasible to determine its geochemical speciation through X-ray absorption spectroscopy due to a combination of very low contents and the interference of accompanying high arsenic contents. Therefore, fractionation studies in residues and soils are required to analyze the mobility and bioavailability of this metal, which in turn provide information to infer its speciation. For this purpose, in this work a modification of the BCR procedure was applied to residues and contaminated soils from three mining zones of Mexico and two mining zones of Spain, spanning samples with acidic to alkaline pH values. The Tl extraction procedure consisted of the following fractions: (1) water-extractable, (2) easily exchangeable and associated to carbonates, associated to (3) poorly-crystalline and (4) crystalline Fe and Mn oxyhydroxides, and (5) associated to organic matter and sulfides; and finally a residual fraction as associated to refractory primary and other secondary minerals. The extracted contents were analyzed by Inductively-Coupled Plasma with Mass Spectrometry. Surprisingly, water-soluble, in Tl(I) oxidation state, was detected in most areas, regardless of the pH, a fact that has not been reported before in these environments, and alerts to potential health risks not previously identified. Most of the samples from a metallurgy area showed high levels of Tl in non-residual fractions and a strong correlation was obtained between extracted Mn and Tl in the third fraction, suggesting its association to poorly crystalline manganese oxides. In the majority of samples from purely mining environments, most of the Tl was found in the residual fraction, most probably bound to alumino-silicate minerals. The remaining Tl fractions were extracted mainly associated to the reducible mineral fractions, and in one case also in the oxidizable fraction (presumably associated to sulfides). Capsule: Soluble Tl(I) was found in all soil samples contaminated with either mining or metallurgical wastes. Additionally, in those affected by metallurgical wastes a very strong Tl-Mn correlation was found.

Influence of environmental and anthropogenic parameters on thallium oxidation state in natural waters

The abandoned mining area of Valdicastello Carducci (Tuscany, Italy) is characterized by the massive presence of thallium in the acid mine drainages and in the valley stream crossing the region. We previously found that Tl(III), generally considered the less stable oxidation state of thallium, is present both in the stream and in tap water distributed in the area, whereas acid mine drainages only contain Tl(I). These findings posed some concern related to the reactivity and dispersion of this toxic element in the environment. Since the valence state of thallium determines its toxicity, distribution and mobility, the study of thallium redox speciation appears crucial to understand its environmental behaviour. In this work, water samples collected from the mine drainages and the contaminated stream were adopted as model to study the distribution of aqueous Tl(I)/Tl(III) as a function of light exposure and solution properties and composition. The influence of three light sources and organic acids was evaluated. Thallium speciation was also assessed in tap water after treatment with common oxidizing agents, and in the rust crust collected from the public waterworks.

A High-Throughput Screening Assay for NKCC1 Cotransporter Using Nonradioactive Rubidium Flux Technology

A high-throughput screening (HTS) assay was developed for cotransporter, NKCC1, which is a potential target for the treatment of diverse disorders. This nonradioactive rubidium flux assay coupled with ion channel reader series provides a working screen for this target expressed in human embryonic kidney (HEK) cell line. An eightfold window of detection was achieved with the optimized assay. This new functional assay offered a robust working model for NKCC1 in determining reliable and concordant rank orders of the test compounds supporting its sensitivity and specificity. The robustness of manual assay indicated by Z' of 0.9 qualified its amenability to automation. The Z' of 0.7 was displayed by automated assay employed in high-throughput screening of compound libraries against this target. Being electrically neutral, the NKCC1 screening is difficult to achieve by both manual and automated electrophysiological techniques. These techniques, although considered gold standard, suffer from their inherent problems of being too slow to be in high-throughput format and with high running costs. In addition to being a functional assay for NKCC1, it is nontoxic as compared with thallium flux assay, which is prone to generate high number of false-positive/false-negative rates because of its innate fluorescence issues.

Association of co-exposure to heavy metals with renal function in a hypertensive population

BACKGROUND

Chronic kidney disease (CKD) is an increasing health problem worldwide. Recent studies have suggested the potential associations between exposure to metals and CKD events, particularly in participants with hypertension. However, relevant studies are limited.

OBJECTIVES

We aimed to explore the associations of metal exposure with renal function in participants with essential hypertension.

METHODS

Nine hundred and thirty-four participants with essential hypertension were recruited at the Department of Cardiology, Union Hospital, Wuhan, China. We measured the levels of chromium, cadmium, thallium and uranium in urine and calculated the estimated glomerular filtration rate (eGFR) for renal function. Multivariable linear regression models adjusted for potential confounders were applied.

RESULTS

After adjusting for potential confounders and other metals, doubling of urinary chromium or uranium levels decreased eGFR by 2.90 (95% confidence interval, 2.04 to 3.76) and 1.87 (0.58 to 3.15) mL/min per 1.73m², respectively. Co-exposure to chromium and uranium was found to greatly decrease eGFR, particularly in women. Compared with those in the low exposure group, women with high exposure to chromium and uranium had a 11.36 (3.66 to 19.07) mL/min per 1.73m² adjusted decline in eGFR. Higher urinary thallium levels were positively related to elevated eGFR in men. The adjusted increase in eGFR with doubling of thallium levels was 3.12 (1.14 to 5.10) mL/min per 1.73m². Sex-difference in the associations of exposure to heavy metals with eGFR was also suggested.

CONCLUSIONS

Our findings suggest that environmental exposure to chromium and uranium might contribute to a decline in eGFR in individuals with hypertension. The associations of exposure to heavy metals with eGFR might be sex-different. Further studies are warranted to confirm our findings and clarify the underlying mechanisms.

Ratiometric Phosphorescent Probe for Thallium in Serum, Water, and Soil Samples Based on Long-Lived, Spectrally Resolved, Mn-Doped ZnSe Quantum Dots and Carbon Dots

Thallium (Tl) is an extremely toxic heavy metal and exists in very low concentrations in the environment, but its sensing is largely underexplored as compared to its neighboring elements in the periodic table (especially mercury and lead). In this work, we developed a ratiometric phosphorescent nanoprobe for thallium detection based on Mn-doped ZnSe quantum dots (QDs) and water-soluble carbon dots (C-dots). Upon excitation with 360 nm, Mn-doped ZnSe QDs and C-dots can emit long-lived and spectrally resolved phosphorescence at 580 and 440 nm, respectively. In the presence of thallium, the phosphorescence emission from Mn-doped ZnSe QDs could be selectively quenched, while that from C-dots retained unchanged. Therefore, a ratiometric phosphorescent probe was thus developed, which can eliminate the potential influence from both background fluorescence and other analyte-independent external environment factors. Several other heavy metal ions caused interferences to thallium detection but could be efficiently masked with EDTA. The proposed method offered a detection limit of 1 μg/L, which is among the most sensitive probes ever reported. Successful application of this method for thallium detection in biological serum as well as in environmental water and soil samples was demonstrated.

Fractional distribution of thallium in paddy soil and its bioavailability to rice

To investigate the bioavailability of thallium (Tl) in soil and rice in a Tl-contaminated area in Guangdong, China, the topsoil and rice samples were collected from 24 sampling sites and analyzed. Moreover, a modified sequential extraction procedure was applied to determine the different Tl fractions in the soil. The mean pH value of the soil samples was 4.50. The total Tl concentration in the paddy soil was about 4-8 times higher than the Canadian guideline value (1mgkg^-1) for agricultural land uses. The mean ecological risk index of Tl was determined to be 483, indicating that potential hazard of the paddy soil was serious. The mean content of Tl in rice was 1.42mgkg^-1, which exceeded the German maximum permissible level (0.5mgkg^-1) of Tl in foods and feedstuffs by a factor of nearly 3. The hazard quotient value via rice intake was 57.6, indicating a high potential health risk to the local residents. The distribution of various Tl fractions followed the order of easily reducible fraction (40.3%) > acid exchangeable fraction (30.5%) > residual fraction (23.8%) > oxidizable fraction (5.4%). Correlation analyses showed that the easily reducible fraction correlates positively with the soil Fe and Mn contents, whereas the acid exchangeable fraction is significantly correlated with the S content. The soil pH was negatively correlated with the Tl content in both soil and rice. The Tl content in rice was more strongly correlated with the exchangeable fraction than the total Tl content in the soil. Overall, the bioavailability of Tl in more acidic soil is higher, and is strongly dependent on the speciation of Tl, especially the content of acid exchangeable fraction.

The efficient removal of thallium from sintering flue gas desulfurization wastewater in ferrous metallurgy using emulsion liquid membrane

The removal of thallium ions in flue gas desulfurization wastewater from ferrous metallurgic industry was studied by emulsion liquid membrane (ELM) method using 2-ethylhexyl phosphoric acid-2-ethylhexyl ester (P507) as carrier, aviation kerosene (AK) as organic solvent, polyisobutylene succinimide (T154) as surfactant, polyisobutylene (PIB) as additive, and sulfuric acid as internal reagent. Some important influence parameters such as concentrations of carrier, surfactant and stripping agent, agitation speed, extraction time, volume ratios of feed solution to emulsion phase and internal phase to membrane phase, and their effects on the removal efficiency of Tl in the ELM process were investigated and optimized. Under the optimum operating conditions of 2% of carrier, 5% of surfactant, 0.5 M of stripping agent, 350 rpm of agitation speed, 12.5:1 of volume ratio of feed solution to emulsion phase, and 3:1 volume ratio of membrane to internal phase, the maximum extraction efficiency of thallium reached 99.76% within 15-min reaction time. The ICP-MS analysis indicated that the thallium concentration in treated wastewater was below 5 μg/L and could meet the emission standard demand for industrial wastewater enacted by the local government of Hunan province of China. Meanwhile, the extraction of impurity ions calcium and magnesium in the ELM system was investigated. The result showed that an acidic environment would be in favor of the removal of Tl from calcium and magnesium contained in wastewater. Graphical abstract ᅟ.

Highly efficient removal of trace thallium from contaminated source waters with ferrate: Role of in situ formed ferric nanoparticle

Thallium (Tl) is highly toxic to mammals and relevant pollution cases are increasing world-widely. Convenient and efficient method for the removal of trace Tl from contaminated source water is imperative. Here, the removal of trace Tl by K₂FeO₄ [Fe(VI)] was investigated for the first time, with the exploration of reaction mechanisms. Six different types of water treatment agents (powdered activated carbon, Al₂(SO₄)₃, FeCl₃, δ-MnO₂, MnO₂ nano-particles, and K₂FeO₄) were used for the removal of Tl in spiked river water, and K₂FeO₄ showed excellent removal performance. Over 92% of Tl (1 μg/L) was removed within 5 min by applying 2.5 mg/L of K₂FeO₄ (pH 7.0, 20 °C). XPS analysis revealed that in the reaction of Tl(I) with K₂FeO₄, Tl(I) was oxidized to Tl(III), and removed by the K₂FeO₄ reduced ferric particles. The removal of Tl by in situ formed and ex situ formed ferric particle was examined respectively, and the results revealed that the removal of trace Tl could be attributed to the combination of adsorption and coprecipitation processes. The hydrodynamic size of the reduced particle from K₂FeO₄ ranged from 10 nm to 100 nm, and its surface was negatively charged under neutral pH condition. These factors were conducive for the efficient removal of Tl by K₂FeO₄. The effects of solution pH, coexisting ions (Na⁺, Ca²⁺, and HCO₃^-), humic acid, solution temperature, and reductive environment on the removal and desorption of Tl were investigated, and the elimination of Tl in polluted river water and reservoir water was performed. These results suggest that K₂FeO₄ could be an efficient and convenient agent on trace Tl removal.

Qualitative thallium urinary assays are almost as valuable as quantitative tests: implication for outpatient settings in low and middle income countries

BACKGROUND

Thallium (Tl), lead and steroid exposures were reported as a result of street drug consumption such as heroin and cocaine.

OBJECTIVE

This study aimed to compare the values of qualitative and quantitative assays for detecting Tl as an adulterant in opioid-like compound drug users.

METHODS

This case-control study was conducted throughout a specified time bracket ranging from May 2015 to November 2015 in Imam Reza Hospital, Mashhad, Iran. In general, urine thallium samples for 100 opioid overdosed subjects with a history of chronic opioid use and 50 non-drug users were studied. Qualitative 24 hours-urinary-thallium-level (QL) and quantitative 24 hours-urinary-thallium-level (QT) were conducted in both groups. Independent-samples t-test and Spearman's Coefficient were applied for analytical purposes. SPSS software 16 was used to conduct statistical analyses with P values less than 0.05 regarded as significant.

RESULTS

A total of 150 cases were studied. Raw opium users accounted for 66% of the cases followed by mixed (28%) and heroin users (6%). Mean (SD) QT level for QL was 26.8 (1) μg/L, while it was 2.3 μg/L (0.4 μg/L) for negative QL, which was far below QL positive cases (p=0.002). The qualitative test showed more accuracy at higher quantitative levels. In all cases, qualitative test was fully sensitive (100%), highly specific (89%) with a positive likelihood ratio (PLR) of 9.1 and a negative likelihood ratio (NLR) of 0.

CONCLUSION

These results suggest that qualitative assays could be used with confidence in assessing Tl exposure in drug users. Physicians may easily and confidently use Tl qualitative tests in rehabilitation centers, where toxicology laboratories may not be available.

Risk assessment and vertical distribution of thallium in paddy soils and uptake in rice plants irrigated with acid mine drainage

The objective of this paper is to assess the influence of irritating paddy fields with acid mine drainage containing thallium (Tl) to rice plant-soil system and potential health risks for local residents. Vertical distribution of Tl, pH, organic matter (OM), and cation exchange capacity (CEC) in 24 paddy soil profiles around Yunfu pyrite mine area was investigated. Rice plant samples were collected from the corresponding soil sampling site. The results showed that Tl concentrations in paddy soils at 0-60 cm depth range from 3.07 to 9.42 mg kg^-1, with a mean of 5.74 mg kg^-1, which were significantly higher than the background value of soil in China (0.58 mg kg^-1). On the whole, Tl contents in paddy soil profiles increased quickly with soil depth from 0 to 30 cm and decreased slowly with soil depth from 30 to 60 cm. The soil Tl content was significant negatively correlated with soil pH. The mean content of Tl in the root, stem, leaf, and rice was 4.36, 1.83, 2.74, and 1.42 mg kg^-1, respectively, which exceeded the proposed permissible limits for foods and feedstuffs in Germany. The Tl content in various tissues of the rice plants followed the order root > leaf > stem (rice), which suggested that most Tl taken up by rice plants retained in the root, and a little migrated to the leaf, stem, and rice. Correlation analysis showed that Tl content in root was significant positively correlated with Tl content in leaf and rice. The ranges of hazard quotient (HQ) values were 4.08∼24.50 and 3.84∼22.38 for males and females, respectively. Males have higher health risk than females in the same age group. In childhood age groups (2 to <21 years) and adult age groups (21 to <70 years), the highest health risk level was observed in the 11 to 16 age group and 21 to 50 age group, respectively. The findings indicated that regular irrigation with Tl-bearing acid mine drainage led to considerable contamination of Tl in paddy soil and rice plant. Local government should take various measures to treat Tl contamination, especially the tailings.

Presence of thallium in the environment: sources of contaminations, distribution and monitoring methods

Thallium is released into the biosphere from both natural and anthropogenic sources. It is generally present in the environment at low levels; however, human activity has greatly increased its content. Atmospheric emission and deposition from industrial sources have resulted in increased concentrations of thallium in the vicinity of mineral smelters and coal-burning facilities. Increased levels of thallium are found in vegetables, fruit and farm animals. Thallium is toxic even at very low concentrations and tends to accumulate in the environment once it enters the food chain. Thallium and thallium-based compounds exhibit higher water solubility compared to other heavy metals. They are therefore also more mobile (e.g. in soil), generally more bioavailable and tend to bioaccumulate in living organisms. The main aim of this review was to summarize the recent data regarding the actual level of thallium content in environmental niches and to elucidate the most significant sources of thallium in the environment. The review also includes an overview of analytical methods, which are commonly applied for determination of thallium in fly ash originating from industrial combustion of coal, in surface and underground waters, in soils and sediments (including soil derived from different parent materials), in plant and animal tissues as well as in human organisms.

Epidermal growth factor prevents thallium(I)- and thallium(III)-mediated rat pheochromocytoma (PC12) cell apoptosis

We have reported recently that the proliferation of PC12 cells exposed to micromolar concentrations of Tl(I) or Tl(III) has different outcomes, depending on the absence (EGF^- cells) or the presence (EGF⁺ cells) of epidermal growth factor (EGF) added to the media. In the current work, we investigated whether EGF supplementation could also modulate the extent of Tl(I)- or Tl(III)-induced cell apoptosis. Tl(I) and Tl(III) (25-100 μM) decreased cell viability in EGF^- but not in EGF⁺ cells. In EGF^- cells, Tl(I) decreased mitochondrial potential, enhanced H₂O₂ generation, and activated mitochondrial-dependent apoptosis. In addition, Tl(III) increased nitric oxide production and caused a misbalance between the anti- and pro-apoptotic members of Bcl-2 family. Tl(I) increased ERK1/2, JNK, p38, and p53 phosphorylation in EGF^- cells. In these cells, Tl(III) did not affect ERK1/2 and JNK phosphorylation but increased p53 phosphorylation that was related to the promotion of cell senescence. In addition, this cation significantly activated p38 in both EGF^- and EGF⁺ cells. The specific inhibition of ERK1/2, JNK, p38, or p53 abolished Tl(I)-mediated EGF^- cell apoptosis. Only when p38 activity was inhibited, Tl(III)-mediated apoptosis was prevented in EGF^- and EGF⁺ cells. Together, current results indicate that EGF partially prevents the noxious effects of Tl by preventing the sustained activation of MAPKs signaling cascade that lead cells to apoptosis and point to p38 as a key mediator of Tl(III)-induced PC12 cell apoptosis.

Metals and Neurodegeneration

Metals play important roles in the human body, maintaining cell structure and regulating gene expression, neurotransmission, and antioxidant response, to name a few. However, excessive metal accumulation in the nervous system may be toxic, inducing oxidative stress, disrupting mitochondrial function, and impairing the activity of numerous enzymes. Damage caused by metal accumulation may result in permanent injuries, including severe neurological disorders. Epidemiological and clinical studies have shown a strong correlation between aberrant metal exposure and a number of neurological diseases, including Alzheimer’s disease, amyotrophic lateral sclerosis, autism spectrum disorders, Guillain–Barré disease, Gulf War syndrome, Huntington’s disease, multiple sclerosis, Parkinson’s disease, and Wilson’s disease. Here, we briefly survey the literature relating to the role of metals in neurodegeneration.

Sodium and Potassium Interactions with Nucleic Acids

Metal ions are essential cofactors for the structure and functions of nucleic acids. Yet, the early discovery in the 70s of the crucial role of Mg(2+) in stabilizing tRNA structures has occulted for a long time the importance of monovalent cations. Renewed interest in these ions was brought in the late 90s by the discovery of specific potassium metal ions in the core of a group I intron. Their importance in nucleic acid folding and catalytic activity is now well established. However, detection of K(+) and Na(+) ions is notoriously problematic and the question about their specificity is recurrent. Here we review the different methods that can be used to detect K(+) and Na(+) ions in nucleic acid structures such as X-ray crystallography, nuclear magnetic resonance or molecular dynamics simulations. We also discuss specific versus non-specific binding to different structures through various examples.

Thallium exists in opioid poisoned patients

Background

Thallium (Tl) is a toxic heavy metal that exists in nature. Tl poisoning (thallotoxicosis) may occur in opioid addicts. This study was designed to evaluate the frequency and level of urinary Tl in opioid abusers. In addition, clinical findings were evaluated.

Methods

A total of 150 subjects were examined. Cases with a history of at least 3 years of abuse were admitted in the Imam Reza Hospital as the case group; 50 non-opioid abusers from the target population were included as the control group. Twenty-four hour urinary qualitative and quantitative Tl analyses were performed on both groups.

Results

Out of the 150 subjects, 128 (85 %) were negative for qualitative urinary Tl, followed by 5 % (trace), 7 % (1+), 2 % (2+), and 1 % (3+). Mean (standard error (SE), Min–Max) quantitative urinary Tl level was 14 μg/L (3.5 μg/L, 0–346 μg/L). Mean urinary Tl level in the case group was 21 μg/L (5 μg/L, 0–346 μg/L) and that in the controls was 1 μg/L (0.14 μg/L, 0–26 μg/L), which were significantly different (P = 0.001). The most frequent clinical findings were ataxia (86 %), sweating (81 %), and constipation (54 %). In all cases (n = 150), the mean (SE) value for cases with positive qualitative urinary Tl was 26.8 μg/L (0.9 μg/L) and that in the negative cases was 2.3 μg/L (0.2 μg/L), which were significantly different (P = 0.002).

Conclusions

This study showed that long-term opioid abuse may lead to Tl exposure. In opioid abusers with the clinical manifestation of thallotoxicosis, urinary Tl should be determined.

Toxicity of thallium on isolated rat liver mitochondria: the role of oxidative stress and MPT pore opening

Thallium(I) is a highly toxic heavy metal; however, up to now, its mechanisms are poorly understood. The authors' previous studies showed that this compound could induce reactive oxygen species (ROS) formation, reduced glutathione (GSH) oxidation, membrane lipid peroxidation, and mitochondrial membrane potential (MMP) collapse in isolated rat hepatocyte. Because the liver is the storage site of thallium, it seems that the liver mitochondria are one of the important targets for hepatotoxicity. In this investigation, the effects of thallium on mitochondria were studied to investigate its mechanisms of toxicity. Mitochondria were isolated from rat liver and incubated with different concentrations of thallium (25-200 µM). Thallium(I)-treated mitochondria showed a marked elevation in oxidative stress parameters accompanied by MMP collapse when compared with the control group. These results showed that different concentrations of thallium (25-200 µM) induced a significant (P < 0.05) increase in mitochondrial ROS formation, ATP depletion, GSH oxidation, mitochondrial outer membrane rupture, mitochondrial swelling, MMP collapse, and cytochrome c release. In general, these data strongly supported that the thallium(I)-induced liver toxicity is a result of the disruptive effect of this metal on the mitochondrial respiratory complexes (I, II, and IV), which are the obvious causes of metal-induced ROS formation and ATP depletion. The latter two events, in turn, trigger cell death signaling via opening of mitochondrial permeability transition pore and cytochrome c expulsion.

Tl(I) and Tl(III) alter the expression of EGF-dependent signals and cyclins required for pheochromocytoma (PC12) cell-cycle resumption and progression

The effects of thallium [Tl(I) and Tl(III)] on the PC12 cell cycle were evaluated without (EGF(-)) or with (EGF(+)) media supplementation with epidermal growth factor (EGF). The following markers of cell-cycle phases were analyzed: cyclin D1 (G1 ); E2F-1, cyclin E and cytosolic p21 (G1 →S transition); nuclear PCNA and cyclin A (S); and cyclin B1 (G2). The amount of cells in each phase and the activation of the signaling cascade triggered by EGF were also analyzed. Tl(I) and Tl(III) (5-100 μM) caused dissimilar effects on PC12 cell proliferation. In EGF(-) cells, Tl(I) increased the expression of G1 →S transition markers and nuclear PCNA, without affecting cyclin A or cyclin B1. In addition to those, cyclin B1 was also increased in EGF(+) cells. In EGF(-) cells, Tl(III) increased the expression of cyclin D1, all the G1→S and S phase markers and cyclin B1. In EGF(+) cells, Tl(III) increased cyclin D1 expression and decreased all the markers of G1 →S transition and the S phase. Even when these cations did not induce the activation of EGF receptor (EGFR) in EGF(-) cells, they promoted the phosphorylation of ERK1/2 and Akt. In the presence of EGF, the cations anticipated EGFR phosphorylation without affecting the kinetics of EGF-dependent ERK1/2 and Akt phosphorylation. Altogether, results indicate that Tl(I) promoted cell proliferation in both EGF(-) and EGF(+) cells. In contrast, Tl(III) promoted the proliferation of EGF(-) cells but delayed it in EGF(+) cells, which may be related to the toxic effects of this cation in PC12 cells.

Human fatality due to thallium poisoning: autopsy, microscopy, and mass spectrometry assays

Thallium has been responsible for many intoxications since its discovery; however, toxicological profiles for thallium in human fatalities have not been updated recently. Autopsy, microscopic investigations, and toxicological analyses were performed on a married couple who died from thallium sulfate intended homicidal poisoning. The distribution of thallium was established by inductively coupled plasma mass spectrometry with hair samples showing the highest thallium concentration. Electron microscopy revealed a dystrophic condition of hair with disorganized cuticle and atrophy of the hair bulb. Thallium interacts with cells at different levels, with prominent ultrastructural injuries in the mitochondria and endoplasmic reticulum, and high concentration of electron dense granules observed in the cytoplasm and mitochondria of several organs. Alopecia, toxic encephalopathy, and peripheral neuropathy were diagnosed in the victims and suggested to be crucial implications for thallium poisoning. The analytical procedures used in this case are of considerable forensic importance in the diagnosis of thallium poisoning.

Trace metals in blood and urine of newborn/mother pairs, adolescents and adults of the Flemish population (2007-2011)

The Flemish Centre for Environment and Health started with human biomonitoring in 2002 (FLEHS I: 2002-2006). The main goal of the second human biomonitoring cycle (FLEHS II: 2007-2011), was to determine mean values for a large number of pollutants in a representative sample of the general Flemish population. Values for Cd and Pb were updated, and a group of previously undetermined metals and metalloids (As, Mn, Cu and Tl) were included in some of the age groups. In this human biomonitoring program, three different age groups of the general Flemish population were monitored: 255 newborns and their mothers, 210 adolescents aged 14-15, and 204 adults between 20 and 40 years old. Trace elements were determined in cord blood and maternal blood of the mothers, in blood and urine of adolescents and in urine of adults. Determinants of life-style and personal factors were taken into account. The levels of trace elements in cord blood and maternal blood were for most elements at the lower end of the range found in literature. For Pb, As and Tl, a strong correlation (respectively r=0.43, 0.55 and 0.33; p<0.05) was found between levels in cord blood (respectively 8.6, 0.54 and 0.017 μg/L) and maternal blood (11.1, 0.64 and 0.028 μg/L), indicating that they are transported via the placenta from mother to fetus. The levels found in the adolescents and adults were compared with results from international biomonitoring studies, and were found to be in the same ranges. With the exception of Pb, all trace elements increased with increasing age group population. Finally, the results also showed that the levels of Cd and Pb in blood for this campaign (e.g. for Pb 8.6 and 14.8 μg/L in neonates and adolescents respectively) were lower compared to the first campaign (e.g. for Pb 14.7 and 21.7 μg/L in neonates and adolescents respectively), indicating a decrease over time. However, differences in sampling strategies might partially explain this observed trend.