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Alejandro-Vega S, Hardisson A, Rubio C, Gutiérrez ÁJ, Jaudenes-Marrero JR, Paz-Montelongo S. Soft Drinks as a Dietary Source of Fluoride Exposure. Biol Trace Elem Res 2024; 202:3816-3828. [PMID: 37922070 DOI: 10.1007/s12011-023-03937-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/24/2023] [Indexed: 11/05/2023]
Abstract
High fluoride exposures can lead to adverse effects such as dental and bone fluorosis, as well as endocrine and cognitive developmental problems. Water is the main dietary source of this ion, although significant concentrations have also been detected in other beverages widely consumed by the population such as soft drinks. A total of 200 soft drink samples (60 flavoured, 70 extracts, 60 fruit juice and 10 soft drinks) were analysed by fluoride ion selective potentiometry. A consumption of 330 mL was estimated for exposure assessment and subsequent F-risk assessment by soft drink consumption. The highest average concentration was found in extract soft drinks (2.45 ± 1.15 mg/L), followed by flavoured (1.71 ± 2.29 mg/L) and carbonated soft drinks (1.38 ± 0.40 mg/L), while the lowest was found in fruit juice soft drinks (1.09 ± 0.62 mg/L). The flavours with the highest concentration were tea-melon and tea-passion fruit with 3.66 ± 0.40 and 3.17 ± 0.56 mg/L respectively and the lowest was lemon flavour with 0.69 mg/L. The contribution of these beverages, considering the UL (Upper level) reference values set by EFSA (European Food Safety Authority) are between 3.28-41.78%, depending on age group and sex.
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Affiliation(s)
- Samuel Alejandro-Vega
- Area of Toxicology, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
- Grupo interuniversitario de Toxicología Ambiental y Seguridad de los Alimentos y Medicamentos, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
| | - Arturo Hardisson
- Area of Toxicology, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
- Grupo interuniversitario de Toxicología Ambiental y Seguridad de los Alimentos y Medicamentos, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
| | - Carmen Rubio
- Area of Toxicology, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
- Grupo interuniversitario de Toxicología Ambiental y Seguridad de los Alimentos y Medicamentos, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
| | - Ángel J Gutiérrez
- Area of Toxicology, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
- Grupo interuniversitario de Toxicología Ambiental y Seguridad de los Alimentos y Medicamentos, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
| | - Juan R Jaudenes-Marrero
- Area of Toxicology, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
- Grupo interuniversitario de Toxicología Ambiental y Seguridad de los Alimentos y Medicamentos, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain
| | - Soraya Paz-Montelongo
- Area of Toxicology, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain.
- Grupo interuniversitario de Toxicología Ambiental y Seguridad de los Alimentos y Medicamentos, Universidad de La Laguna, Canary Islands, 38071, La Laguna, Tenerife, Spain.
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2
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Zheng YH, Pan GJ, Quan Y, Zhang HY. Construction of microgravity biological knowledge graph and its applications in anti-osteoporosis drug prediction. LIFE SCIENCES IN SPACE RESEARCH 2024; 41:64-73. [PMID: 38670654 DOI: 10.1016/j.lssr.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/11/2023] [Accepted: 01/24/2024] [Indexed: 04/28/2024]
Abstract
Microgravity in the space environment can potentially have various negative effects on the human body, one of which is bone loss. Given the increasing frequency of human space activities, there is an urgent need to identify effective anti-osteoporosis drugs for the microgravity environment. Traditional microgravity experiments conducted in space suffer from limitations such as time-consuming procedures, high costs, and small sample sizes. In recent years, the in-silico drug discovery method has emerged as a promising strategy due to the advancements in bioinformatics and computer technology. In this study, we first collected a total of 184,915 literature articles related to microgravity and bone loss. We employed a combination of dependency path extraction and clustering techniques to extract data from the text. Afterwards, we conducted data cleaning and standardization to integrate data from several sources, including The Global Network of Biomedical Relationships (GNBR), Curated Drug-Drug Interactions Database (DDInter), Search Tool for Interacting Chemicals (STITCH), DrugBank, and Traditional Chinese Medicines Integrated Database (TCMID). Through this integration process, we constructed the Microgravity Biology Knowledge Graph (MBKG) consisting of 134,796 biological entities and 3,395,273 triplets. Subsequently, the TransE model was utilized to perform knowledge graph embedding. By calculating the distances between entities in the model space, the model successfully predicted potential drugs for treating osteoporosis and microgravity-induced bone loss. The results indicate that out of the top 10 ranked western medicines, 7 have been approved for the treatment of osteoporosis. Additionally, among the top 10 ranked traditional Chinese medicines, 5 have scientific literature supporting their effectiveness in treating bone loss. Among the top 20 predicted medicines for microgravity-induced bone loss, 15 have been studied in microgravity or simulated microgravity environments, while the remaining 5 are also applicable for treating osteoporosis. This research highlights the potential application of MBKG in the field of space drug discovery.
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Affiliation(s)
- Yu-Han Zheng
- Hubei Key Laboratory of Agricultural Bioinformatics, College of Informatics, Huazhong Agricultural University, Wuhan 430070, China
| | - Guan-Jing Pan
- Hubei Key Laboratory of Agricultural Bioinformatics, College of Informatics, Huazhong Agricultural University, Wuhan 430070, China
| | - Yuan Quan
- Hubei Key Laboratory of Agricultural Bioinformatics, College of Informatics, Huazhong Agricultural University, Wuhan 430070, China.
| | - Hong-Yu Zhang
- Hubei Key Laboratory of Agricultural Bioinformatics, College of Informatics, Huazhong Agricultural University, Wuhan 430070, China
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Park YA, Plehwe WE, Varatharajah K, Hale S, Christie M, Yates CJ. Skeletal fluorosis secondary to methoxyflurane use for chronic pain. JBMR Plus 2024; 8:ziae032. [PMID: 38577522 PMCID: PMC10994646 DOI: 10.1093/jbmrpl/ziae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/24/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
Skeletal fluorosis is rare and occurs secondary to chronic high amounts of fluoride consumption, manifesting as diffuse osteosclerosis, skeletal pain, connective tissue calcification, and increased fracture risk. Methoxyflurane is a volatile, fluorinated hydrocarbon-inhaled analgesic, and the maximum recommended dose is 15 mL (99.9 % w/w) per wk. A rodent study found increased skeletal fluoride after methoxyflurane exposure. However, skeletal fluorosis secondary to methoxyflurane use in humans has rarely been reported. We present the case of a 47-yr-old female with diffuse osteosclerosis secondary to fluorosis from methoxyflurane use for chronic pain, presenting with 3 yr of generalized bony pain and multiple fragility fractures. Lumbar spine BMD was elevated. CT and radiographs demonstrated new-onset marked diffuse osteosclerosis, with calcification of interosseous membranes and ligaments, and a bone scan demonstrated a grossly increased uptake throughout the skeleton. Biochemistry revealed an elevated alkaline phosphatase and bone turnover markers, mild secondary hyperparathyroidism with vitamin D deficiency, and mild renal impairment. Zoledronic acid, prescribed for presumed Paget's disease, severely exacerbated bony pain. Urinary fluoride was elevated (7.3 mg/L; reference range < 3.0 mg/L) and the patient revealed using methoxyflurane 9 mL per wk for 8 yr for chronic pain. A decalcified bone biopsy revealed haphazardly arranged cement lines and osteocytes lacunae and canaliculi, which was consistent with an osteosclerotic process. Focal subtle basophilic stippling around osteocyte lacunae was suggestive of fluorosis. Although fluorosis is not a histological diagnosis, the presence of compatible histology features was supportive of the diagnosis in this case with clinical-radiological-pathological correlation. Skeletal fluorosis should be considered as a cause of acquired diffuse osteosclerosis. Methoxyflurane should not be recommended for chronic pain. The risk of repeated low-dose exposure to fluoride from methoxyflurane use as analgesia may be greater than expected, and the maximum recommended dose for methoxyflurane may require re-evaluation to minimize skeletal complications. Abbreviated abstract Skeletal fluorosis is rare and occurs secondary to chronic high amounts of fluoride consumption, manifesting as diffuse osteosclerosis, skeletal pain, connective tissue calcification, and increased fracture risk. We present the case of a 47-yr-old female with skeletal fluorosis secondary to long-term methoxyflurane for chronic pain. The risk of repeated low-dose exposure to fluoride from methoxyflurane use for analgesia may be greater than expected, and the maximum recommended dose for methoxyflurane may require re-evaluation to minimize skeletal complications.
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Affiliation(s)
- Yeung-Ae Park
- Department of Diabetes & Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria 3052, Australia
| | | | - Kapilan Varatharajah
- Department of Radiology, Royal Melbourne Hospital, Melbourne, Victoria 3052, Australia
| | - Sophie Hale
- Department of Pathology, Royal Melbourne Hospital, Melbourne, Victoria 3052, Australia
| | - Michael Christie
- Department of Pathology, Royal Melbourne Hospital, Melbourne, Victoria 3052, Australia
| | - Christopher J Yates
- Department of Diabetes & Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria 3052, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville 3052, Australia
- Department of Diabetes & Endocrinology, Western Health, Melbourne, Victoria 3021, Australia
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4
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Berger MM, Shenkin A, Dizdar OS, Amrein K, Augsburger M, Biesalski HK, Bischoff SC, Casaer MP, Gundogan K, Lepp HL, de Man AME, Muscogiuri G, Pietka M, Pironi L, Rezzi S, Schweinlin A, Cuerda C. ESPEN practical short micronutrient guideline. Clin Nutr 2024; 43:825-857. [PMID: 38350290 DOI: 10.1016/j.clnu.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/27/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. The importance of MNs in common pathologies is recognized by recent research, with deficiencies significantly impacting the outcome. OBJECTIVE This short version of the guideline aims to provide practical recommendations for clinical practice. METHODS An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL for the initial guideline. The search focused on physiological data, historical evidence (for papers published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations. RESULTS The limited number of interventional trials prevented meta-analysis and led to a low level of evidence for most recommendations. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90 % of votes. Altogether the guideline proposes 3 general recommendations and specific recommendations for the 26 MNs. Monitoring and management strategies are proposed. CONCLUSION This short version of the MN guideline should facilitate handling of the MNs in at-risk diseases, whilst offering practical advice on MN provision and monitoring during nutritional support.
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Affiliation(s)
- Mette M Berger
- Faculty of Biology & Medicine, Lausanne University, Lausanne, Switzerland.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Oguzhan Sıtkı Dizdar
- Department of Internal Medicine and Clinical Nutrition Unit, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
| | - Karin Amrein
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Austria.
| | - Marc Augsburger
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Geneva University Hospital and University of Geneva, Lausanne-Geneva, Switzerland.
| | | | - Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Michael P Casaer
- KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium.
| | - Kursat Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey.
| | | | - Angélique M E de Man
- Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università di Napoli (Federico II), Naples, Italy; United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy.
| | - Magdalena Pietka
- Pharmacy Department, Stanley Dudrick's Memorial Hospital, Skawina, Poland.
| | - Loris Pironi
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Centre for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy.
| | - Serge Rezzi
- Swiss Nutrition and Health Foundation, Epalinges, Switzerland.
| | - Anna Schweinlin
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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5
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Zhang M, Xu H, Lou Q, Yin F, Guo N, Wu L, Huang W, Ji Y, Yang L, Li Q, Wang S, Guan Z, Yang Y, Gao Y. LDL receptor-related protein 5 rs648438 polymorphism is associated with the risk of skeletal fluorosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:687-696. [PMID: 36617395 DOI: 10.1080/09603123.2022.2163989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
To investigate the potential association between LRP5 rs648438 polymorphism and the risk of skeletal fluorosis (SF) was evaluated in a cross-sectional case-control study conducted in Shanxi, China, in 2019. A total of 973 individuals were enrolled in this study, in which cases and controls were 346 and 627, respectively. SF was diagnosed according to the standard WS/192-2008 (China). The LRP5 rs648438 was detected by the multiple PCR and sequencing. LRP5 rs648438 was found to follow a dominant genetic model using a web-based SNP-STATS software. Logistic regression analysis found that the TC/CC genotype of LRP5 rs648438 might be a protective factor for SF. When stratified by gender, this protective effect of TC/CC genotype in rs648438 was pronounced in males. There was an interaction between gender and rs648438 on risk of SF. Our study suggested that TC/CC genotype of rs648438 might be a protective factor for water-drinking-type skeletal fluorosis, especially in male participants.
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Affiliation(s)
- Meichen Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Haili Xu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qun Lou
- Xiamen Center for Disease Control and Prevention, Xiamen, Fujian, China
| | - Fanshuo Yin
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ning Guo
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Liaowei Wu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Wei Huang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yi Ji
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Liu Yang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qiao Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Sa Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhizhong Guan
- Department of Pathology and Key Lab of Endemic and Ethnic Diseases, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, China
| | - Yanmei Yang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanhui Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, Heilongjiang, China
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Gerges MM, Ngo VT, Tu J, Colletti PM, Wassef H. Skeletal Fluorosis. Clin Nucl Med 2023; 48:1127-1130. [PMID: 37883215 DOI: 10.1097/rlu.0000000000004911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
ABSTRACT A 27-year-old man with polysubstance abuse including methamphetamine, fentanyl, and 1.5 years of electronics compressed gas duster inhalation presented following an assault. Radiologic imaging performed for suspected fractures revealed periosteal reaction, cortical thickening with increased bone density, and ligament and tendon ossification, which were not present on imaging obtained 3 years before presentation. A bone scan was subsequently performed revealing a metabolic superscan with cortical irregularity. Further investigation revealed skeletal fluorosis from electronics compressed gas duster inhalation. Skeletal fluorosis may be considered when these osseous findings are encountered.
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Affiliation(s)
- Maria M Gerges
- From the FAU Schmidt College of Medicine, Boca Raton, FL
| | | | - Jonathan Tu
- University of Southern California, Keck School of Medicine, Los Angeles, CA
| | - Patrick M Colletti
- University of Southern California, Keck School of Medicine, Los Angeles, CA
| | - Heidi Wassef
- University of Southern California, Keck School of Medicine, Los Angeles, CA
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7
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Meng X, Wang J, Liu Y, Li M, Guan Z, Sowanoua A, Yang D, Pei J, Gao Y. Relatively low fluoride in drinking water increases risk of knee osteoarthritis (KOA): a population-based cross-sectional study in China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:8735-8747. [PMID: 37715839 DOI: 10.1007/s10653-023-01742-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/21/2023] [Indexed: 09/18/2023]
Abstract
Previous studies indicate that fluoride in drinking water has a toxic effect on cartilage and skeleton, which triggers osteoarthritis (OA) of which the most frequent is knee OA (KOA). A cross-sectional study was conducted to assess the association between fluoride exposure and KOA among 1128 subjects. Water fluoride (WF) and urinary fluoride (UF) were chosen as external exposure (internal exposure) of fluoride. Logistic regression analysis showed that an increased fluoride exposure was a risk factor for KOA (WF: OR = 1.318, 95% CI 1.162-1.495, p < 0.001; UF: OR = 1.210, 95% CI 1.119-1.310, p < 0.001). After adjusting for covariates, the risk of KOA in the 4th quartile (Q) of WF was twice that of the 1st Q (OR = 2.079, 95% CI 1.448-2.986, p < 0.001). The risks of KOA in the 2nd Q, 3rd Q and 4th Q of UF were 1.6, 1.5, and 2.9 times higher than in the 1stQ (OR = 1.597, 95% CI 1.066-2.393, p = 0.023; OR = 1.560, 95% CI 1.043-2.333, p = 0.030; OR = 2.897, 95% CI 1.957-4.288, p < 0.001). The population aged < 60 exposed to the 4th Q of WF (or UF) had a higher risk than the population exposed to the 1st Q of WF (or UF) (ORWF = 1.958, 95% CI 1.249-3.070, p = 0.003; ORUF = 2.923, 95% CI 1.814-4.711, p < 0.001). With increasing UF by Q, the male had a risk of KOA. In conclusion, excessive fluoride dose in drinking water could increase the risk of KOA. Especially, the population with aged < 60, male and obesity more likely to having KOA when they exposed to same higher fluoride.
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Affiliation(s)
- Xinyue Meng
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Jian Wang
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Yang Liu
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Mang Li
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Zhizhong Guan
- Department of Pathology and Key Lab of Endemic and Ethnic Diseases, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Alphonse Sowanoua
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Dan Yang
- Chongqing Blood Center, Jiulongpo, 400015, Chongqing, China.
- , Chongqing, China.
| | - Junrui Pei
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China.
| | - Yanhui Gao
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China.
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8
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de Carvalho Machado C, Dinis-Oliveira RJ. Clinical and Forensic Signs Resulting from Exposure to Heavy Metals and Other Chemical Elements of the Periodic Table. J Clin Med 2023; 12:jcm12072591. [PMID: 37048674 PMCID: PMC10095087 DOI: 10.3390/jcm12072591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/19/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
Several heavy metals and other chemical elements are natural components of the Earth’s crust and their properties and toxicity have been recognized for thousands of years. Moreover, their use in industries presents a major source of environmental and occupational pollution. Therefore, this ubiquity in daily life may result in several potential exposures coming from natural sources (e.g., through food and water contamination), industrial processes, and commercial products, among others. The toxicity of most chemical elements of the periodic table accrues from their highly reactive nature, resulting in the formation of complexes with intracellular compounds that impair cellular pathways, leading to dysfunction, necrosis, and apoptosis. Nervous, gastrointestinal, hematopoietic, renal, and dermatological systems are the main targets. This manuscript aims to collect the clinical and forensic signs related to poisoning from heavy metals, such as thallium, lead, copper, mercury, iron, cadmium, and bismuth, as well as other chemical elements such as arsenic, selenium, and fluorine. Furthermore, their main sources of occupational and environmental exposure are highlighted in this review. The importance of rapid recognition is related to the fact that, through a high degree of suspicion, the clinician could rapidly initiate treatment even before the toxicological results are available, which can make a huge difference in these patients’ outcomes.
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Affiliation(s)
- Carolina de Carvalho Machado
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Correspondence: (C.d.C.M.); or (R.J.D.-O.); Tel.: +351-224-157-216 (R.J.D.-O.)
| | - Ricardo Jorge Dinis-Oliveira
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- TOXRUN—Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
- UCIBIO-REQUIMTE-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- MTG Research and Development Lab, 4200-604 Porto, Portugal
- Correspondence: (C.d.C.M.); or (R.J.D.-O.); Tel.: +351-224-157-216 (R.J.D.-O.)
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9
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Wen C, Zhang Q, Xie F, Jiang J. Brick tea consumption and its relationship with fluorosis in Tibetan areas. Front Nutr 2022; 9:1030344. [PMID: 36583212 PMCID: PMC9792988 DOI: 10.3389/fnut.2022.1030344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Brick tea-type fluorosis (BTF) due to a high intake of brick tea is possible in Tibetan populations, and dental fluorosis (DF) and skeletal fluorosis (SF) are its primary manifestations. To determine the prevalence of DF and SF and their relationships with brick tea intake in Tibetan populations, a literature review was conducted for studies published between 1994 and 2021. The available evidence revealed that brick tea may be produced from older stems and leaves of the tea plant and that the fluoride content of brick tea exceeds the national standard. The harsh environment of the plateau has led to limited food sources for the local Tibetan people who form the habit of drinking tea leaves as a satiation solution to digest greasy food and replenish vitamins, and regular consumption of brick tea leads to excessive exposure of Tibetan residents to fluoride. Studies in Tibet showed that the prevalence of DF in children was 14.06-75.93% in different districts, and the overall pooled prevalence of DF was 26.08%. The prevalence of SF in adults was 19.90-74.77% in different Tibetan districts, and the overall pooled prevalence of SF was 33.84%. The analysis of risk factors showed that the prevalence of BTF may be related to high-altitude and different working and living conditions, and BTF in children may be associated with fluoride intake during mothers' pregnancy and lactation. With the development of bioinformatics research, gene polymorphisms were suspected to be related to susceptibility to fluorosis in Tibetan populations. The study of BTF in Tibetan people needs to be further investigated and standardized, and additional studies evaluating the pathogenesis and preventive measures of BTF are warranted.
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Affiliation(s)
- Cai Wen
- Department of Oral Implantology, Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China,Department of VIP Dental Service, Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China,Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China,*Correspondence: Cai Wen, ; orcid.org/0000-0002-3400-5382
| | - Qing Zhang
- Department of Nosocomial Infection Control, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Fei Xie
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China,School of Stomatology, Southwest Medical University, Luzhou, Sichuan, China
| | - Jixin Jiang
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China,School of Stomatology, Southwest Medical University, Luzhou, Sichuan, China
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10
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Zhao S, Guo J, Xue H, Meng J, Xie D, Liu X, Yu Q, Zhong H, Jiang P. Systematic impacts of fluoride exposure on the metabolomics of rats. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 242:113888. [PMID: 35872488 DOI: 10.1016/j.ecoenv.2022.113888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/09/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
Fluoride is widely present in the environment. Excessive fluoride exposure leads to fluorosis, which has become a global public health problem and will cause damage to various organs and tissues. Only a few studies focus on serum metabolomics, and there is still a lack of systematic metabolomics associated with fluorosis within the main organs. Therefore, in the current study, a non-targeted metabolomics method using gas chromatography-mass spectrometry (GC-MS) was used to research the effects of fluoride exposure on metabolites in different organs, to uncover potential biomarkers and study whether the affected metabolic pathways are related to the mechanism of fluorosis. Male Sprague-Dawley rats were randomly divided into two groups: a control group and a fluoride exposure group. GC-MS technology was used to identify metabolites. Multivariate statistical analysis identified 16, 24, 20, 20, 24, 13, 7, and 13 differential metabolites in the serum, liver, kidney, heart, hippocampus, cortex, kidney fat, and brown fat, respectively, in the two groups of rats. Fifteen metabolic pathways were affected, involving toxic mechanisms such as oxidative stress, mitochondrial damage, inflammation, and fatty acid, amino acid and energy metabolism disorders. This study provides a new perspective on the understanding of the mechanism of toxicity associated with sodium fluoride, contributing to the prevention and treatment of fluorosis.
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Affiliation(s)
- Shiyuan Zhao
- Translational pharmaceutical laboratory of Jining First People's Hospital, Jining Medical University, Jining 272000, China.
| | - Jinxiu Guo
- Translational pharmaceutical laboratory of Jining First People's Hospital, Jining Medical University, Jining 272000, China.
| | - Hongjia Xue
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo 315100, China.
| | - Junjun Meng
- Translational pharmaceutical laboratory of Jining First People's Hospital, Jining Medical University, Jining 272000, China.
| | - Dadi Xie
- Department of Endocrinology, Tengzhou Central People's Hospital, Tengzhou 277500, China.
| | - Xi Liu
- Department of Pharmacy, Linfen People's Hospital, Linfen 041000, China.
| | - Qingqing Yu
- Department of Oncology, Jining First People's Hospital, Jining Medical University, Jining 272000, China; Laboratory of Biochemistry and Biomedical Materials, College of Marine Life Science, Ocean University of China, Qingdao 266003, China.
| | - Haitao Zhong
- Translational pharmaceutical laboratory of Jining First People's Hospital, Jining Medical University, Jining 272000, China.
| | - Pei Jiang
- Translational pharmaceutical laboratory of Jining First People's Hospital, Jining Medical University, Jining 272000, China.
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11
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Pan Q, Yang W, Zhang Z, Shao Z. Rare Bone Metastasis of Neuroendocrine Tumors of Unknown Origin: A Case Report and Literature Review. Orthop Surg 2022; 14:2766-2775. [PMID: 35856167 PMCID: PMC9531072 DOI: 10.1111/os.13384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/26/2022] [Accepted: 06/05/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The neuroendocrine tumor (NET) is rare, accounting for about 0.5% of all tumors. NETs have the characteristics of metastasis, especially lymph nodes, liver, spleen, and bone. CASE PRESENTATION We report a 30-year-old man diagnosed with a NET with bone metastasis and presented with waist and leg pain. The imaging findings of this case showed multiple osteosclerosis and no apparent bone destruction. We collected the patient's previous examinations, including laboratory, imaging, and pathological examination to get a precise diagnosis. Given this case, we carried out symptomatic support treatment to relieve the patients' pain symptoms. CONCLUSION Bone metastases from NETs of unknown primary site are rare in both clinical and imaging manifestations. The disease is mainly manifested as multiple osteosclerosis, accompanied by muscle soreness and pain. It is recommended to try chemotherapy for this disorder.
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Affiliation(s)
- Qing Pan
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenbo Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhicai Zhang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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12
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Salles Rosa Neto N, Englert D, McAlister WH, Mumm S, Mills D, Veis DJ, Burshell A, Boyde A, Whyte MP. Periarticular calcifications containing giant pseudo-crystals of francolite in skeletal fluorosis from 1,1-difluoroethane "huffing". Bone 2022; 160:116421. [PMID: 35429657 DOI: 10.1016/j.bone.2022.116421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/03/2022] [Accepted: 04/08/2022] [Indexed: 01/28/2023]
Abstract
Inhalant use disorder is a psychiatric condition characterized by repeated deliberate inhalation from among a broad range of household and industrial chemical products with the intention of producing psychoactive effects. In addition to acute intoxication, prolonged inhalation of fluorinated compounds can cause skeletal fluorosis (SF). We report a young woman referred for hypophosphatasemia and carrying a heterozygous ALPL gene variant (c.457T>C, p.Trp153Arg) associated with hypophosphatasia, the heritable metabolic bone disease featuring impaired skeletal mineralization, who instead suffered from SF. Manifestations of her SF included recurrent articular pain, axial osteosclerosis, elevated bone mineral density, maxillary exostoses, and multifocal periarticular calcifications. SF was suspected when a long history was discovered of 'huffing' a computer cleaner containing 1,1-difluoroethane. Investigation revealed markedly elevated serum and urine levels of F-. Histopathology and imaging techniques including backscattered electron mode scanning electron microscopy, X-ray microtomography, energy dispersive and wavelength dispersive X-ray emission microanalysis, and polarized light microscopy revealed that her periarticular calcifications were dystrophic deposition of giant pseudo-crystals of francolite, a carbonate-rich fluorapatite. Identifying unusual circumstances of F- exposure is key for diagnosing non-endemic SF. Increased awareness of the disorder can be lifesaving.
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Affiliation(s)
- Nilton Salles Rosa Neto
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children - St. Louis, St. Louis, MO 63110, USA.
| | - Daniel Englert
- Endocrinology Department, Ochsner Medical Center, New Orleans, LA 70121, USA.
| | - William H McAlister
- Pediatric Radiology Section, Mallinckrodt Institute of Radiology at St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO 63110, USA.
| | - Steven Mumm
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children - St. Louis, St. Louis, MO 63110, USA.
| | - David Mills
- Dental Physical Sciences, Dental Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK.
| | - Deborah J Veis
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children - St. Louis, St. Louis, MO 63110, USA.
| | - Alan Burshell
- Endocrinology Department, Ochsner Medical Center, New Orleans, LA 70121, USA.
| | - Alan Boyde
- Dental Physical Sciences, Dental Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK.
| | - Michael P Whyte
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children - St. Louis, St. Louis, MO 63110, USA.
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13
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Berger MM, Shenkin A, Schweinlin A, Amrein K, Augsburger M, Biesalski HK, Bischoff SC, Casaer MP, Gundogan K, Lepp HL, de Man AME, Muscogiuri G, Pietka M, Pironi L, Rezzi S, Cuerda C. ESPEN micronutrient guideline. Clin Nutr 2022; 41:1357-1424. [PMID: 35365361 DOI: 10.1016/j.clnu.2022.02.015] [Citation(s) in RCA: 175] [Impact Index Per Article: 87.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. Recent research has shown the importance of MNs in common pathologies, with significant deficiencies impacting the outcome. OBJECTIVE This guideline aims to provide information for daily clinical nutrition practice regarding assessment of MN status, monitoring, and prescription. It proposes a consensus terminology, since many words are used imprecisely, resulting in confusion. This is particularly true for the words "deficiency", "repletion", "complement", and "supplement". METHODS The expert group attempted to apply the 2015 standard operating procedures (SOP) for ESPEN which focuses on disease. However, this approach could not be applied due to the multiple diseases requiring clinical nutrition resulting in one text for each MN, rather than for diseases. An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL. The search focused on physiological data, historical evidence (published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations. RESULTS There was a limited number of interventional trials, preventing meta-analysis and leading to a low level of evidence. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90% of votes. Altogether the guideline proposes sets of recommendations for 26 MNs, resulting in 170 single recommendations. Critical MNs were identified with deficiencies being present in numerous acute and chronic diseases. Monitoring and management strategies are proposed. CONCLUSION This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases. In particular, it offers practical advice on MN provision and monitoring during nutritional support.
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Affiliation(s)
- Mette M Berger
- Department of Adult Intensive Care, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Anna Schweinlin
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Karin Amrein
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Austria.
| | - Marc Augsburger
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Geneva University Hospital and University of Geneva, Lausanne-Geneva, Switzerland.
| | | | - Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Michael P Casaer
- KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium.
| | - Kursat Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey.
| | | | - Angélique M E de Man
- Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università di Napoli (Federico II), Naples, Italy; United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair for Health Education and Sustainable Development, Federico II, University, Naples, Italy.
| | - Magdalena Pietka
- Pharmacy Department, Stanley Dudrick's Memorial Hospital, Skawina, Poland.
| | - Loris Pironi
- Alma Mater Studiorum - University of Bologna, Department of Medical and Surgical Sciences, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Centre for Chronic Intestinal Failure - Clinical Nutrition and Metabolism Unit, Italy.
| | - Serge Rezzi
- Swiss Nutrition and Health Foundation (SNHf), Epalinges, Switzerland.
| | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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14
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Bian S, Hu A, Lu G, Cao Z, Wang J, Wang J. Study of Chitosan Ingestion Remitting the Bone Damage on Fluorosis Mice with Micro-CT. Biol Trace Elem Res 2022; 200:2259-2267. [PMID: 34518961 DOI: 10.1007/s12011-021-02838-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
Chronic excessive fluoride exposure may lead to fluorosis, which causes health problems like a decrease in bone mechanical strength. It was speculated that chitosan may combine with fluorine to form in vivo organic fluorine, and may reduce the damage caused by fluorine. Hence, it is necessary to conduct a study to investigate the influence of chitosan on fluorosis mice. To investigate this problem, forty-four 4-week-old male Kunming mice were randomly divided into four groups, the control group, the fluoride group, the fluoride plus chitosan group, and the chitosan group. After 100 days of feeding, the femurs were collected to scan the Micro-CT image. The ultimate load of the femur in the fluoride group was significantly lower than control group. The trabecular separation was increased in the fluoride group compared with the fluoride plus chitosan group and the chitosan group. The level of trabecular thickness was increased in the fluoride plus chitosan group compared with the fluoride group. Our findings suggest that chitosan ingestion can improve the condition of cancellous bone and cortical bone affected by fluorine.
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Affiliation(s)
- Shengtai Bian
- Shaxi Key Laboratory of Ecological Animal Science and Environmental Veterinary Medicine, Shanxi Agricultural University, Jinzhong, 030801, Shanxi, People's Republic of China
- School of Sport Science, Beijing Sport University, Beijing, 100084, People's Republic of China
| | - Anqi Hu
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing, 100084, People's Republic of China
| | - Gui Lu
- School of Energy Power and Mechanical Engineering, North China Electric Power University, Beijing, 102206, People's Republic of China
| | - Zemei Cao
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing, 100084, People's Republic of China
| | - Jinming Wang
- Shaxi Key Laboratory of Ecological Animal Science and Environmental Veterinary Medicine, Shanxi Agricultural University, Jinzhong, 030801, Shanxi, People's Republic of China
| | - Jundong Wang
- Shaxi Key Laboratory of Ecological Animal Science and Environmental Veterinary Medicine, Shanxi Agricultural University, Jinzhong, 030801, Shanxi, People's Republic of China.
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15
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Muderrisoglu S, Cenesiz S, Yarim M. Determination of the effect of Quercetinon oxidant- antioxidant parameters in the blood and liver tissues of rats given sodium fluoride experimentally. J INDIAN CHEM SOC 2022. [DOI: 10.1016/j.jics.2022.100486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Natesan V, Kim SJ. Metabolic Bone Diseases and New Drug Developments. Biomol Ther (Seoul) 2022; 30:309-319. [PMID: 35342038 PMCID: PMC9252877 DOI: 10.4062/biomolther.2022.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/03/2022] [Accepted: 03/05/2022] [Indexed: 11/05/2022] Open
Abstract
Metabolic bone diseases are serious health issues worldwide, since several million individuals over the age of 50 are at risk of bone damage and should be worried about their bone health. One in every two women and one in every four men will break a bone during their lifetime due to a metabolic bone disease. Early detection, raising bone health awareness, and maintaining a balanced healthy diet may reduce the risk of skeletal fractures caused by metabolic bone diseases. This review compiles information on the most common metabolic bone diseases (osteoporosis, primary hyperparathyroidism, osteomalacia, and fluorosis disease) seen in the global population, including their symptoms, mechanisms, and causes, as well as discussing their prevention and the development of new drugs for treatment. A large amount of research literature suggests that balanced nutrition and balanced periodic supplementation of calcium, phosphate, and vitamin D can improve re-absorption and the regrowth of bones, and inhibit the formation of skeletal fractures, except in the case of hereditary bone diseases. Meanwhile, new and improved drug formulations, such as raloxifene, teriparatide, sclerostin, denosumab, and abaloparatide, have been successfully developed and administered as treatments for metabolic bone diseases, while others (romososumab and odanacatib) are in various stages of clinical trials.
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Affiliation(s)
- Vijayakumar Natesan
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar 608002, Tamil Nadu, India
| | - Sung-Jin Kim
- Department of Pharmacology and Toxicology, Metabolic Diseases Research Laboratory, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
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17
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Mayer MJ, Gliedt JA, Shaker JA, Symanski JS. Case 298: Skeletal Fluorosis Secondary to Huffing. Radiology 2022; 302:484-488. [PMID: 35073201 DOI: 10.1148/radiol.203739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
History A 37-year-old man from the United States presented with a 1-year history of neck pain and stiffness that had been unsuccessfully treated with manipulative therapy by a chiropractor at another institution. Past medical history was remarkable only for marijuana and air duster abuse. He denied use of any prescription medications. Physical examination was notable for markedly reduced range of motion of the cervical spine. Laboratory work-up revealed an elevated alkaline phosphatase level (302 U/L [5.0 μkat/L]; normal range, 40-100 U/L [0.7-1.67 μkat/L]), but all other laboratory findings, including complete blood count, renal function, liver function, vitamin A level, serum protein electrophoresis, and hepatitis C antibodies were within normal limits. Cervical spine radiography was performed, followed by MRI. Subsequently, a full skeletal survey was ordered. Included are representative radiographs of the pelvis, left forearm, and distal right leg with ankle.
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Affiliation(s)
- Matthieu J Mayer
- From the Departments of Radiology (M.J.M., J.S.S.), Neurosurgery (J.A.G.), and Endocrinology (J.A.S.), Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226
| | - Jordan A Gliedt
- From the Departments of Radiology (M.J.M., J.S.S.), Neurosurgery (J.A.G.), and Endocrinology (J.A.S.), Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226
| | - Joseph A Shaker
- From the Departments of Radiology (M.J.M., J.S.S.), Neurosurgery (J.A.G.), and Endocrinology (J.A.S.), Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226
| | - John S Symanski
- From the Departments of Radiology (M.J.M., J.S.S.), Neurosurgery (J.A.G.), and Endocrinology (J.A.S.), Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226
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18
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Mohideen H, Dahiya DS, Parsons D, Hussain H, Ahmed RS. Skeletal Fluorosis: A Case of Inhalant Abuse Leading to a Diagnosis of Colon Cancer. J Investig Med High Impact Case Rep 2022; 10:23247096221084919. [PMID: 35343855 PMCID: PMC8966097 DOI: 10.1177/23247096221084919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Skeletal fluorosis is a long-term bone disease that develops when prolonged fluoride toxicity leads to osteosclerosis and bone deformities that result in crippling pain and debility. The disease is endemic to many countries due to environmental or industrial exposures. However, rare cases in the United States have been reported from various causes including heavy toothpaste ingestion, excessive tea consumption, voriconazole use, and inhalant abuse. Here, we present a case of a 41-year-old man who presented for weight loss and severe joint pains due to bony sclerotic lesions found on X-rays. Social history revealed that he had been recreationally inhaling compressed air dusters used for cleaning electronics. Owing to concern for malignancy, he underwent an extensive work-up which led to a diagnosis of colon cancer, but positron emission tomography/computed tomography (PET/CT) and bone biopsy were unexpectedly negative for metastatic bone disease. Further characterization of his lesions by skeletal survey led to a diagnosis of skeletal fluorosis secondary to inhalant abuse. As in this patient, the disease can be difficult for clinicians to recognize as it can be mistaken for various boney diseases such as metastatic cancer. However, once there is clinical suspicion for skeletal fluorosis, various tests to help confirm the diagnosis can include serum and urine fluoride levels, skeletal survey, and bone ash fluoride concentration. Treatment of skeletal fluorosis primarily involves cessation of fluoride exposure, and recovery can take years. Ultimately, further study is required to develop recommendations and guidelines for diagnosis, management, and prognosis of the disease in the United States.
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Affiliation(s)
| | | | - Dustin Parsons
- Indiana University School of Medicine, Indianapolis, USA
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19
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Guo N, Yu Y, Gao Y. miR-21-5p and canonical Wnt signaling pathway promote osteoblast function through a feed-forward loop induced by fluoride. Toxicology 2021; 466:153079. [PMID: 34942272 DOI: 10.1016/j.tox.2021.153079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/23/2021] [Accepted: 12/17/2021] [Indexed: 11/24/2022]
Abstract
Long-term excessive exposure to fluoride from environmental sources can cause serious public health problems such as dental fluorosis and skeletal fluorosis. The aberrant activation of osteoblasts in the early stage is one of the critical steps during the pathogenesis of skeletal fluorosis and canonical Wnt signaling pathway participate in the progress. However, the specific mechanism that how canonical Wnt signaling pathway was mediated is not yet clear. In this study, we found that miR-21-5p induced the activation of canonical Wnt signaling pathway via targeting PTEN and DKK2 during fluoride induced osteoblasts activation and firstly demonstrated the forward loop between canonical Wnt signaling and miR-21-5p in the process. These findings suggested an important regulatory role of miR-21-5p on canonical Wnt signaling pathway during skeletal fluorosis and miR-21-5p might be a potential therapeutic target for skeletal fluorosis.
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Affiliation(s)
- Ning Guo
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin Medical University, Harbin, 150081, Heilongjiang Province, China.
| | - Yanling Yu
- Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, Heilongjiang Province, China.
| | - Yanhui Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin Medical University, Harbin, 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China.
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20
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Ferjani HL, Zouaoui K, Maatallah K, Nessib DB, Riahi H, Kaffel D, Hamdi W. Osteomalacia and Skeletal Fluorosis: Consequential or Fortuitous Association. J Clin Rheumatol 2021; 27:S873-S874. [PMID: 32701538 DOI: 10.1097/rhu.0000000000001494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Yu FF, Zuo J, Fu X, Gao MH, Sun L, Yu SY, Li Z, Zhou GY, Ba Y. Role of the hippo signaling pathway in the extracellular matrix degradation of chondrocytes induced by fluoride exposure. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 225:112796. [PMID: 34555722 DOI: 10.1016/j.ecoenv.2021.112796] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/02/2021] [Accepted: 09/15/2021] [Indexed: 06/13/2023]
Abstract
To identify the role of the Hippo signaling pathway in the extracellular matrix degradation of chondrocytes induced by fluoride exposure. Environmental response genes (ERGs) of bone injury induced by fluoride exposure were obtained from the Comparative Toxicogenomics Database, and annotated by STRING for KEGG pathway enrichment analysis. The CCK-8 kit was used to measure the proliferation of ATDC5 cells. The malondialdehyde (MDA), total antioxidant capacity (T-AOC), total superoxide dismutase (T-SOD), and glutathione peroxidase (GSH-PX) levels in ATDC5 cells were measured using oxidative stress detection kit. Western blot analysis was used to measure the p-MST1/2, p-LATS1/2, and p-YAP/YAP1 expression levels in the Hippo pathway and the COL2A1, ACAN and MMP13 expression levels in the cartilage matrix. Localizations of YAP1 and COL2A1 proteins in chondrocytes were performed using cell immunofluorescence. Continuous data from the multiple groups were compared using one-way analysis of variance, and then the differences between groups were tested with Dunnett's t-test, with the test level α = 0.05. The 145 ERGs of bone injury induced by fluoride exposure were identified, and KEGG enrichment analysis revealed Hippo signaling pathways significantly related to bone injury. A CCK-8 assay revealed that the viability of the ATDC5 cells was significantly decreased with increased fluorine concentration. The MDA content in 20 mg/L sodium fluoride (NaF) exposure group was significantly higher than that in the control group, the T-SOD, T-AOC and GSH-PX activities in 15 and 20 mg/L NaF exposure groups were significantly lower than those in the control group (P < 0.05). Western blot results showed the protein levels of p-MST1/2, p-LATS1/2 and p-YAP1 in 15 and 20 mg/L NaF exposure groups were significantly lower than those in the control group, while the YAP1 protein level in 20 mg/L NaF group was significantly higher than that in the control group. The COL2A1 and ACAN proteins in 20 mg/L NaF group were significantly decreased, while the MMP13 protein level in 15 and 20 mg/L NaF groups were significantly increased (P < 0.05). It was observed that the expression of YAP1 protein expression level in the cytoplasm decreased with the increased fluoride exposure, whereas that the expression level of YAP1 protein in the nucleus increased. Fluoride inhibited the proliferation of ATDC5 cells, induced oxidative stress, inhibited the activity of the Hippo pathway, and eventually led to cartilage matrix degradation.
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Affiliation(s)
- Fang-Fang Yu
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan 450001, PR China.
| | - Juan Zuo
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan 450001, PR China.
| | - Xiaoli Fu
- School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China.
| | - Ming-Hui Gao
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan 450001, PR China.
| | - Lei Sun
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan 450001, PR China.
| | - Shui-Yuan Yu
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan 450001, PR China.
| | - Zhiyuan Li
- School of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, PR China.
| | - Guo-Yu Zhou
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan 450001, PR China.
| | - Yue Ba
- Department of Environmental Health, School of Public Health, Zhengzhou University, Environment and Health Innovation Team, Zhengzhou, Henan 450001, PR China.
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Rare Case of Diffuse Skeletal Fluorosis Due to Inhalant Abuse of Difluoroethane. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2021; 5:01979360-202110000-00009. [PMID: 34637407 DOI: 10.5435/jaaosglobal-d-21-00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/22/2021] [Indexed: 11/18/2022]
Abstract
CASE We present a rare case of diffuse skeletal fluorosis in a 56-year-old man with a history of inhalation and topical abuse of aerosolized dust cleaner containing difluoroethane and prior industrial exposure to chlorofluorocarbon-rich organic solvent cleaners. This patient had diffuse osteosclerotic bone disease on radiographs that elicited concern for a potentially aggressive physiologic or pathologic process, until increased fluoremia was identified as the cause. Management was conservative with removal of the causative agent. CONCLUSION Skeletal fluorosis is an osteosclerotic bone disease caused by excessive ingestion of fluoride. Although this pathology is endemic in some parts of the world where drinking water contains high levels of fluoride, it should be considered as a differential diagnosis for patients with characteristic radiographic findings and a history of inhalant abuse. Chronic exposure to chlorofluorocarbon-rich products should also be considered.
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23
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Iwar RT, Ogedengbe K, Katibi KK, Jabbo JN. Fluoride levels in deep aquifers of Makurdi, North-central, Nigeria: an appraisal based on multivariate statistics and human health risk analysis. ENVIRONMENTAL MONITORING AND ASSESSMENT 2021; 193:477. [PMID: 34232399 DOI: 10.1007/s10661-021-09230-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Fluoride enrichment of groundwater has been adjudged to be a global environmental challenge in the past decade as most humans depend on groundwater for their domestic needs. This study was conducted to investigate the ionic and fluoride concentrations in borehole water and its associated health risk potentials to residents of Makurdi town and its environs, Benue state, Nigeria. Multivariate statistical techniques were for the first time used to explain the mechanisms of fluoride occurrence in groundwater in the study area. An aggregate of sixty-three (63) groundwater samples were retrieved from boreholes in twenty-one (21) diverse points within the study area and assessed for its physico-chemical composition with emphasis on fluoride content and health risk potentials following standard field and laboratory procedures. It was observed that fluoride content in the sampled water exceeded the stipulated safe limit of 1.5 mg/L in about 33.33% of the total samples and ranged from 0.34 to 2.06 mg/L with an average of 1.26 ± 0.41 mg/L. Moderate affirmative relationships were observed to exist between F- and TDS, F- and EC, F- and Cl-, and F- and NO3- in the water samples indicative of a common source pollution. Principal component analysis (PCA) revealed that high fluoride content in the water samples was associated with the dissolutions from quartzite and shale into the underlying deep aquifers as well as from contributions from anthropogenic activities including fertilizer and pesticide uses. Fluoride risk assessment indicated that the hazard quotient (HQ) for ingestion of fluoride laden water exceeded the threshold value in 66.7, 71.4, 52.4, and 9.5% of the samples for infants, children, teenagers, and adults respectively. It was found that multivariate statistical procedures such as PCA and correlation analysis (CA) are capable of establishing the relationship among groundwater pollutants, while hierarchical cluster analysis (HCA) was found suitable for explaining the likely sources/processes of pollutant enrichment in the groundwater. It is recommended that the findings of this study would serve as a basis for policy makers and regulatory bodies towards ameliorating the menace of groundwater contamination within the study area.
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Affiliation(s)
- Raphael Terungwa Iwar
- Department of Agricultural and Environmental Engineering, Federal University of Agriculture, Makurdi, Nigeria.
| | - Kola' Ogedengbe
- Department of Agricultural and Environmental Engineering, University of Ibadan, Ibadan, Nigeria
| | - Kamil Kayode Katibi
- Department of Food, Agricultural and Biological Engineering, Kwara State University, Malete, Nigeria
| | - Josiah Nuhu Jabbo
- Department of Environmental Science, Faculty of Forestry and Environment, Universiti Putra Malaysia, Serdang, Malaysia
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24
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Kharouf F, Greenberg A, Liebergall M, Azraq Y, Gur C. The Osteosclerosis Challenge Toothpaste Unveiling Secrets. Arthritis Care Res (Hoboken) 2021; 74:549-554. [PMID: 34057309 DOI: 10.1002/acr.24715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/09/2021] [Accepted: 05/20/2021] [Indexed: 11/10/2022]
Abstract
The patient, then a 35-year-old female, presented with an 18-month history of bilateral hip and groin pain, limiting her ability to ambulate. The pain appeared upon rest and exertion, and responded poorly to simple analgesics. No other systemic complaints were present.
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Affiliation(s)
- Fadi Kharouf
- Department of Medicine, Rheumatology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Alexander Greenberg
- Department of Orthopedic Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Meir Liebergall
- Department of Orthopedic Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yusef Azraq
- Department of Diagnostic Radiology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Chamutal Gur
- Department of Medicine, Rheumatology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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25
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Yerawar C, Kabde A, Durugkar S, Deokar P. Skeletal fluorosis: Problem that runs deep. APOLLO MEDICINE 2021. [DOI: 10.4103/am.am_4_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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Liu Y, Yang Y, Wei Y, Liu X, Li B, Chu Y, Huang W, Wang L, Lou Q, Guo N, Wu L, Wang J, Zhang M, Yin F, Fan C, Su M, Zhang Z, Zhang X, Gao Y, Sun D. sKlotho is associated with the severity of brick tea-type skeletal fluorosis in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 744:140749. [PMID: 32721666 DOI: 10.1016/j.scitotenv.2020.140749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
The change of serum soluble Klotho (sKlotho) content is related to a variety of osteoarthropathy. However, its association with the severity of skeletal fluorosis (SF) is not clear. Here, the association of tea fluoride exposure with serum sKlotho levels and the severity of SF were investigated and further verified in a rat model of fluorosis. A cross sectional case control study was conducted in residents over 50 years old from brick-tea drinking areas in Qinghai and Xinjiang Provinces, China. Concentrations of fluoride in brick tea water and urine were determined by ion selective electrode method, and the levels of serum sKlotho were determined by ELISA method. Linear regression and ordered logistic regression models were constructed to examine the relationship among fluoride exposure, serum sKlotho levels and the severity of SF. The kidney and small intestine of Wistar rats were isolated for detection of Klotho by immunohistochemistry (IHC), and femoral artery blood was sampled to measure the serum levels of sKlotho. An increase of 1 mg/day in tea fluoride intake (TFI) was associated with a 12.070 pg/mL (95% CI: 0.452-23.689) increase in serum sKlotho levels and a 1.163-fold (95% CI: 1.007-1.342) increase in the severity of SF after adjusting for age, gender, and ethnicity. Serum sKlotho levels were also positively associated with the severity of SF (P < 0.05). The mediation analysis showed that serum sKlotho levels mediated 17.76% of the increase in the severity of SF caused by an increase of 1 mg/day of TFI. Moreover, a significant increase of serum sKlotho levels in fluoride-exposed groups was also seen in the rat model. The present study suggests that serum sKlotho may be a potential mediator of SF in brick tea-type fluorosis endemic areas.
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Affiliation(s)
- Yang Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Yanmei Yang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon 31207, GA, USA
| | - Xiaona Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Bingyun Li
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Yanru Chu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Wei Huang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Limei Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Qun Lou
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Ning Guo
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Liaowei Wu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Jian Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Meichen Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Fanshuo Yin
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Chenlu Fan
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Mengyao Su
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Zaihong Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Xin Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China
| | - Yanhui Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China.
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin 150081, Heilongjiang Province, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin 150081, Heilongjiang Province, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin 150081, Heilongjiang Province, China.
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27
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Abstract
The pineal gland is an endocrine gland whose main function is the biosynthesis and secretion of melatonin, a hormone responsible for regulating circadian rhythms, e.g., the sleep/wake cycle. Due to its exceptionally high vascularization and its location outside the blood–brain barrier, the pineal gland may accumulate significant amounts of calcium and fluoride, making it the most fluoride-saturated organ of the human body. Both the calcification and accumulation of fluoride may result in melatonin deficiency.
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