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Pietrzak S, Wójcik J, Baszuk P, Marciniak W, Wojtyś M, Dębniak T, Cybulski C, Gronwald J, Alchimowicz J, Masojć B, Waloszczyk P, Gajić D, Grodzki T, Jakubowska A, Scott RJ, Lubiński J, Lener MR. Influence of the Levels of Arsenic, Cadmium, Mercury and Lead on Overall Survival in Lung Cancer. Biomolecules 2021; 11:biom11081160. [PMID: 34439826 PMCID: PMC8392714 DOI: 10.3390/biom11081160] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 12/24/2022] Open
Abstract
The effects of heavy metals on cancer risk have been widely studied in recent decades, but there is limited data on the effects of these elements on cancer survival. In this research, we examined whether blood concentrations of the heavy metals arsenic, cadmium, mercury and lead were associated with the overall survival of lung cancer patients. The study group consisted of 336 patients with lung cancer who were prospectively observed. Blood concentrations of heavy metals were measured to study the relationship between their levels and overall survival using Cox proportional hazards analysis. The hazard ratio of death from all causes was 0.99 (p = 0.94) for arsenic, 1.37 (p = 0.15) for cadmium, 1.55 (p = 0.04) for mercury, and 1.18 (p = 0.47) for lead in patients from the lowest concentration quartile, compared with those in the highest quartile. Among the patients with stage IA disease, this relationship was statistically significant (HR = 7.36; p < 0.01) for cadmium levels in the highest quartile (>1.97–7.77 µg/L) compared to quartile I (0.23–0.57 µg/L, reference). This study revealed that low blood cadmium levels <1.47 µg/L are probably associated with improved overall survival in treated patients with stage IA disease.
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Affiliation(s)
- Sandra Pietrzak
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; (P.B.); (T.D.); (C.C.); (J.G.); (A.J.); (J.L.); (M.R.L.)
- Correspondence: ; Tel.: +48-91-441-72-50
| | - Janusz Wójcik
- Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, ul. A. Sokołowskiego 11, 70-891 Szczecin, Poland; (J.W.); (M.W.); (J.A.); (D.G.); (T.G.)
| | - Piotr Baszuk
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; (P.B.); (T.D.); (C.C.); (J.G.); (A.J.); (J.L.); (M.R.L.)
| | | | - Małgorzata Wojtyś
- Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, ul. A. Sokołowskiego 11, 70-891 Szczecin, Poland; (J.W.); (M.W.); (J.A.); (D.G.); (T.G.)
| | - Tadeusz Dębniak
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; (P.B.); (T.D.); (C.C.); (J.G.); (A.J.); (J.L.); (M.R.L.)
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; (P.B.); (T.D.); (C.C.); (J.G.); (A.J.); (J.L.); (M.R.L.)
- Read-Gene, ul. Alabastrowa 8, 72-003 Grzepnica, Poland;
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; (P.B.); (T.D.); (C.C.); (J.G.); (A.J.); (J.L.); (M.R.L.)
- Read-Gene, ul. Alabastrowa 8, 72-003 Grzepnica, Poland;
| | - Jacek Alchimowicz
- Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, ul. A. Sokołowskiego 11, 70-891 Szczecin, Poland; (J.W.); (M.W.); (J.A.); (D.G.); (T.G.)
| | - Bartłomiej Masojć
- Radiation Oncology Department, West Pomeranian Oncology Center, ul. Strzałkowska 22, 71-730 Szczecin, Poland;
| | - Piotr Waloszczyk
- Independent Laboratory of Pathology, Zdunomed, ul. Energetyków 2, 70-656 Szczecin, Poland;
| | - Darko Gajić
- Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, ul. A. Sokołowskiego 11, 70-891 Szczecin, Poland; (J.W.); (M.W.); (J.A.); (D.G.); (T.G.)
| | - Tomasz Grodzki
- Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, ul. A. Sokołowskiego 11, 70-891 Szczecin, Poland; (J.W.); (M.W.); (J.A.); (D.G.); (T.G.)
| | - Anna Jakubowska
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; (P.B.); (T.D.); (C.C.); (J.G.); (A.J.); (J.L.); (M.R.L.)
| | - Rodney J. Scott
- Priority Research Centre for Cancer Research, Innovation and Translation, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Division of Molecular Medicine, Pathology North, John Hunter Hospital, New Lambton, NSW 2305, Australia
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; (P.B.); (T.D.); (C.C.); (J.G.); (A.J.); (J.L.); (M.R.L.)
- Read-Gene, ul. Alabastrowa 8, 72-003 Grzepnica, Poland;
| | - Marcin R. Lener
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland; (P.B.); (T.D.); (C.C.); (J.G.); (A.J.); (J.L.); (M.R.L.)
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Signes-Pastor AJ, Gutiérrez-González E, García-Villarino M, Rodríguez-Cabrera FD, López-Moreno JJ, Varea-Jiménez E, Pastor-Barriuso R, Pollán M, Navas-Acien A, Pérez-Gómez B, Karagas MR. Toenails as a biomarker of exposure to arsenic: A review. ENVIRONMENTAL RESEARCH 2021; 195:110286. [PMID: 33075355 PMCID: PMC7987585 DOI: 10.1016/j.envres.2020.110286] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/26/2020] [Accepted: 09/27/2020] [Indexed: 05/04/2023]
Abstract
This systematic review summarizes the current evidence related to the reliability of toenail total arsenic concentrations (thereafter "arsenic") as a biomarker of long-term exposure. Specifically, we reviewed literature on consistency of repeated measures over time, association with other biomarkers and metal concentrations, factors influencing concentrations, and associations with health effects. We identified 129 papers containing quantitative original data on arsenic in toenail samples covering populations from 29 different countries. We observed geographic differences in toenail arsenic concentrations, with highest median or mean concentrations in Asian countries. Arsenic-contaminated drinking water, occupational exposure or living in specific industrial areas were associated with an increased toenail arsenic content. The effects of other potential determinants and sources of arsenic exposure including diet, gender and age on the concentrations in toenails need further investigations. Toenail arsenic was correlated with the concentrations in hair and fingernails, and with urine arsenic mainly among highly exposed populations with a toenail mean or median ≥1 μg/g. Overall, there is a growing body of evidence suggesting that arsenic content from a single toenail sample may reflect long-term internal dose-exposure. Toenail arsenic can serve as a reliable measure of toxic inorganic arsenic exposure in chronic disease research, particularly promising for cancer and cardiovascular conditions.
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Affiliation(s)
- Antonio J Signes-Pastor
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr, Williamson Translational Research Bldg, Lebanon NH, 03756, USA.
| | - Enrique Gutiérrez-González
- Spanish Agency of Food Safety and Nutrition, Ministry of Consumer Affairs, Alcalá, 56, 28014, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Monforte de Lemos 5, 28029, Madrid, Spain
| | - Miguel García-Villarino
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Monforte de Lemos 5, 28029, Madrid, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA) - Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain
| | - Francisco D Rodríguez-Cabrera
- Public Health Teaching Unit, National School of Public Health, Carlos III Institute of Health, Monforte de Lemos 5, 28029. Madrid, Spain
| | - Jorge J López-Moreno
- Public Health Teaching Unit, National School of Public Health, Carlos III Institute of Health, Monforte de Lemos 5, 28029. Madrid, Spain
| | - Elena Varea-Jiménez
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029, Madrid, Spain
| | - Roberto Pastor-Barriuso
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Monforte de Lemos 5, 28029, Madrid, Spain; Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029, Madrid, Spain
| | - Marina Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Monforte de Lemos 5, 28029, Madrid, Spain; Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Beatriz Pérez-Gómez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Monforte de Lemos 5, 28029, Madrid, Spain; Public Health Teaching Unit, National School of Public Health, Carlos III Institute of Health, Monforte de Lemos 5, 28029. Madrid, Spain; Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029, Madrid, Spain
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr, Williamson Translational Research Bldg, Lebanon NH, 03756, USA
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Lee HE, Kim EA, Zaitsu M, Kawachi I. Occupational disparities in survival in Korean women with cancer: a nationwide registry linkage study. BMJ Open 2020; 10:e039259. [PMID: 32912993 PMCID: PMC7485248 DOI: 10.1136/bmjopen-2020-039259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES We sought to examine occupational disparities in survival among Korean women diagnosed with cancer. DESIGN Population-based, registry-linkage study. SETTING South Korea. PARTICIPANTS Our study population comprised female workers registered in the Korean national employment insurance programme during 1995-2000 and diagnosed with cancer between 1995 and 2008. A total of 61 110 women with cancer diagnoses was included in analysis. The occupation was categorised into four groups: (1) managers, professionals and technical workers, (2) clerks, (3) service/sales workers and (4) blue-collar workers. PRIMARY AND SECONDARY OUTCOME MEASURE Study population were linked to the national death registry until 2009. HRs for mortality adjusting for age and year of diagnosis were calculated in the study sample and subgroups with 10 specific cancer sites including thyroid, breast, stomach, cervix, colon or lung cancer using managers, professionals and technical workers as the reference. RESULTS Women in service/sales (HR 1.25, 95% CI 1.15 to 1.35) and blue-collar occupations (HR 1.34, 95% CI 1.25 to 1.44) had poorer survival for all cancer sites combined, while blue-collar workers showed poorer survival for lung (HR 1.41, 95% CI 1.14 to 1.77), breast (HR 1.28, 95% CI 1.06 to 1.54), cervical cancer (HR 1.42, 95% CI 1.02 to 2.06) and non-Hodgkin's lymphoma (HR 1.69, 95% CI 1.09 to 2.77) compared with women in professional and managerial positions. CONCLUSION We found substantial and significant inequalities in overall survival by the occupational group among Korean women with cancer, even in the context of universal access to cancer screening and treatment.
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Affiliation(s)
- Hye-Eun Lee
- Korea Institute of Labor Safety and Health, Seoul, Republic of Korea
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Eun-A Kim
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Republic of Korea
| | - Masayoshi Zaitsu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Fernández MI, Valdebenito P, Delgado I, Segebre J, Chaparro E, Fuentealba D, Castillo M, Vial C, Barroso JP, Ziegler A, Bustamante A. Impact of arsenic exposure on clinicopathological characteristics of bladder cancer: A comparative study between patients from an arsenic-exposed region and nonexposed reference sites. Urol Oncol 2019; 38:40.e1-40.e7. [PMID: 31630994 DOI: 10.1016/j.urolonc.2019.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/15/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Beyond exposure to arsenic in drinking-water, there is few information about demographic and clinicopathological features of patients with bladder cancer living in arsenic-exposed regions. The aim of the study was to assess the impact of arsenic exposure on clinicopathological characteristics in patients with bladder cancer from a contaminated region compared to those of 2 reference areas. METHODS Data of 285 patients with bladder cancer (83 with arsenic exposure from Antofagasta and 202 controls from 2 different sites in Santiago) were obtained through personal interviews and from review of medical records. Demographic, clinicopathological parameters, and information on relevant environmental risk factors were compared with parametric and nonparametric tests as needed. Multivariable analysis was performed to identify independent predictors for high grade and muscle-invasive disease (T2-4). RESULTS We found no significant differences between groups regarding age at presentation (66.4 vs. 66.5 and 67.2 years; P = 0.69, for exposed vs. the 2 nonexposed groups, respectively) and female gender (28.9% vs. 29.8% and 26.2%; P = 0.84). Proportion of current smokers was significantly lower in the exposed population (10.7% vs. 38.6% and 26.9%; P < 0.001). There was a significantly higher proportion of locally advanced (10.8 vs. 1.8 and 0.7% T3/4; P = 0.002) and high-grade tumors (79.5% vs. 63.2% and 64.1%; P = 0.001) within arsenic-exposed patients. Arsenic exposure was the only significant predictor for the presence of high-grade tumors (adjusted OR: 5.10; 95%CI: 2.03-12.77) on multivariable analysis. CONCLUSIONS Our study revealed relevant clinical differences in bladder cancer patients with a history of arsenic exposure as compared to nonexposed cases. The more aggressive phenotype associated to arsenic-related bladder cancer should be considered when designing efficient screening strategies for this high-risk population.
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Affiliation(s)
- Mario I Fernández
- Department of Urology, Clínica Alemana de Santiago, Vitacura, Santiago, Chile; Center for Genetics and Genomics, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Lo Barnechea, Santiago, Chile.
| | | | - Iris Delgado
- Center for Public Policies, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Lo Barnechea, Santiago, Chile
| | - Jorge Segebre
- Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Lo Barnechea, Santiago, Chile
| | - Eduardo Chaparro
- Department of Urology, Hospital Regional de Antofagasta, Antofagasta, Chile
| | - David Fuentealba
- Department of Urology, Hospital Regional de Antofagasta, Antofagasta, Chile
| | - Martín Castillo
- Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Lo Barnechea, Santiago, Chile
| | - Cecilia Vial
- Center for Genetics and Genomics, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Lo Barnechea, Santiago, Chile
| | - Juan P Barroso
- Department of Urology, Clínica Alemana de Santiago, Vitacura, Santiago, Chile; Department of Urology, Hospital Padre Hurtado, Santiago, Chile; Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Lo Barnechea, Santiago, Chile
| | - Annemarie Ziegler
- Center for Genetics and Genomics, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Lo Barnechea, Santiago, Chile
| | - Alberto Bustamante
- Department of Urology, Clínica Alemana de Santiago, Vitacura, Santiago, Chile; Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Lo Barnechea, Santiago, Chile
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Wang H, Li J, Zhang X, Zhu P, Hao JH, Tao FB, Xu DX. Maternal serum arsenic level during pregnancy is positively associated with adverse pregnant outcomes in a Chinese population. Toxicol Appl Pharmacol 2018; 356:114-119. [DOI: 10.1016/j.taap.2018.07.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/22/2018] [Accepted: 07/30/2018] [Indexed: 01/07/2023]
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Holcomb N, Goswami M, Han SG, Scott T, D'Orazio J, Orren DK, Gairola CG, Mellon I. Inorganic arsenic inhibits the nucleotide excision repair pathway and reduces the expression of XPC. DNA Repair (Amst) 2017; 52:70-80. [PMID: 28237621 DOI: 10.1016/j.dnarep.2017.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 01/11/2017] [Accepted: 02/12/2017] [Indexed: 11/17/2022]
Abstract
Chronic exposure to arsenic, most often through contaminated drinking water, has been linked to several types of cancer in humans, including skin and lung cancer. However, the mechanisms underlying its role in causing cancer are not well understood. There is evidence that exposure to arsenic can enhance the carcinogenicity of UV light in inducing skin cancers and may enhance the carcinogenicity of tobacco smoke in inducing lung cancers. The nucleotide excision repair (NER) pathway removes different types of DNA damage including those produced by UV light and components of tobacco smoke. The aim of the present study was to investigate the effect of sodium arsenite on the NER pathway in human lung fibroblasts (IMR-90 cells) and primary mouse keratinocytes. To measure NER, we employed a slot-blot assay to quantify the introduction and removal of UV light-induced 6-4 photoproducts (6-4 PP) and cyclobutane pyrimidine dimers (CPDs). We find a concentration-dependent inhibition of the removal of 6-4 PPs and CPDs in both cell types treated with arsenite. Treatment of both cell types with arsenite resulted in a significant reduction in the abundance of XPC, a protein that is critical for DNA damage recognition in NER. The abundance of RNA expressed from several key NER genes was also significantly reduced by treatment of IMR-90 cells with arsenite. Finally, treatment of IMR-90 cells with MG-132 abrogated the reduction in XPC protein, suggesting an involvement of the proteasome in the reduction of XPC protein produced by treatment of cells with arsenic. The inhibition of NER by arsenic may reflect one mechanism underlying the role of arsenic exposure in enhancing cigarette smoke-induced lung carcinogenesis and UV light-induced skin cancer, and it may provide some insights into the emergence of arsenic trioxide as a chemotherapeutic agent.
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Affiliation(s)
- Nathaniel Holcomb
- Department of Toxicology and Cancer Biology, The Markey Cancer Center, University of Kentucky, Lexington, KY, United States
| | - Mamta Goswami
- Department of Toxicology and Cancer Biology, The Markey Cancer Center, University of Kentucky, Lexington, KY, United States
| | - Sung Gu Han
- Toxicology Laboratory, Department of Food Science and Biotechnology of Animal Resources, College of Animal Bioscience and Technology, Konkuk University, Seoul 05029, Republic of Korea
| | - Tim Scott
- Department of Toxicology and Cancer Biology, The Markey Cancer Center, University of Kentucky, Lexington, KY, United States
| | - John D'Orazio
- Department of Toxicology and Cancer Biology, The Markey Cancer Center, University of Kentucky, Lexington, KY, United States
| | - David K Orren
- Department of Toxicology and Cancer Biology, The Markey Cancer Center, University of Kentucky, Lexington, KY, United States
| | - C Gary Gairola
- Department of Toxicology and Cancer Biology, The Markey Cancer Center, University of Kentucky, Lexington, KY, United States
| | - Isabel Mellon
- Department of Toxicology and Cancer Biology, The Markey Cancer Center, University of Kentucky, Lexington, KY, United States.
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Farzan SF, Chen Y, Rees JR, Zens MS, Karagas MR. Risk of death from cardiovascular disease associated with low-level arsenic exposure among long-term smokers in a US population-based study. Toxicol Appl Pharmacol 2015; 287:93-97. [PMID: 26048586 PMCID: PMC4536141 DOI: 10.1016/j.taap.2015.05.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 05/19/2015] [Accepted: 05/26/2015] [Indexed: 01/13/2023]
Abstract
High levels of arsenic exposure have been associated with increases in cardiovascular disease risk. However, studies of arsenic's effects at lower exposure levels are limited and few prospective studies exist in the United States using long-term arsenic exposure biomarkers. We conducted a prospective analysis of the association between toenail arsenic and cardiovascular disease mortality using longitudinal data collected on 3939 participants in the New Hampshire Skin Cancer Study. Using Cox proportional hazard models adjusted for potential confounders, we estimated hazard ratios and 95% confidence intervals associated with the risk of death from any cardiovascular disease, ischemic heart disease, and stroke, in relation to natural-log transformed toenail arsenic concentrations. In this US population, although we observed no overall association, arsenic exposure measured from toenail clipping samples was related to an increased risk of ischemic heart disease mortality among long-term smokers (as reported at baseline), with increased hazard ratios among individuals with ≥ 31 total smoking years (HR: 1.52, 95% CI: 1.02, 2.27), ≥ 30 pack-years (HR: 1.66, 95% CI: 1.12, 2.45), and among current smokers (HR: 1.69, 95% CI: 1.04, 2.75). These results are consistent with evidence from more highly exposed populations suggesting a synergistic relationship between arsenic exposure and smoking on health outcomes and support a role for lower-level arsenic exposure in ischemic heart disease mortality.
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Affiliation(s)
- Shohreh F Farzan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Judy R Rees
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - M Scot Zens
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
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Saint-Jacques N, Parker L, Brown P, Dummer TJB. Arsenic in drinking water and urinary tract cancers: a systematic review of 30 years of epidemiological evidence. Environ Health 2014; 13:44. [PMID: 24889821 PMCID: PMC4088919 DOI: 10.1186/1476-069x-13-44] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 03/05/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Arsenic in drinking water is a public health issue affecting hundreds of millions of people worldwide. This review summarizes 30 years of epidemiological studies on arsenic exposure in drinking water and the risk of bladder or kidney cancer, quantifying these risks using a meta-analytical framework. METHODS Forty studies met the selection criteria. Seventeen provided point estimates of arsenic concentrations in drinking water and were used in a meta-analysis of bladder cancer incidence (7 studies) and mortality (10 studies) and kidney cancer mortality (2 studies). Risk estimates for incidence and mortality were analyzed separately using Generalized Linear Models. Predicted risks for bladder cancer incidence were estimated at 10, 50 and 150 μg/L arsenic in drinking water. Bootstrap randomizations were used to assess robustness of effect size. RESULTS Twenty-eight studies observed an association between arsenic in drinking water and bladder cancer. Ten studies showed an association with kidney cancer, although of lower magnitude than that for bladder cancer. The meta-analyses showed the predicted risks for bladder cancer incidence were 2.7 [1.2-4.1]; 4.2 [2.1-6.3] and; 5.8 [2.9-8.7] for drinking water arsenic levels of 10, 50, and 150 μg/L, respectively. Bootstrapped randomizations confirmed this increased risk, but, lowering the effect size to 1.4 [0.35-4.0], 2.3 [0.59-6.4], and 3.1 [0.80-8.9]. The latter suggests that with exposures to 50 μg/L, there was an 83% probability for elevated incidence of bladder cancer; and a 74% probability for elevated mortality. For both bladder and kidney cancers, mortality rates at 150 ug/L were about 30% greater than those at 10 μg/L. CONCLUSION Arsenic in drinking water is associated with an increased risk of bladder and kidney cancers, although at lower levels (<150 μg/L), there is uncertainty due to the increased likelihood of exposure misclassification at the lower end of the exposure curve. Meta-analyses suggest exposure to 10 μg/L of arsenic in drinking water may double the risk of bladder cancer, or at the very least, increase it by about 40%. With the large number of people exposed to these arsenic concentrations worldwide the public health consequences of arsenic in drinking water are substantial.
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Affiliation(s)
- Nathalie Saint-Jacques
- Cancer Care Nova Scotia, Surveillance and Epidemiology Unit, Room 560 Bethune Building, 1276 South Street, Halifax B3H 2Y9, Nova Scotia, Canada
- Interdisciplinary PhD program, Dalhousie University, 6299 South Street, Room 314, PO Box 15000, Halifax B3H 4R2, Nova Scotia, Canada
| | - Louise Parker
- Department of Pediatrics and Population Cancer Research Program, Dalhousie University, 1494 Carlton Street, PO Box 15000, Halifax B3H 4R2, Nova Scotia, Canada
| | - Patrick Brown
- Population Studies and Surveillance, Cancer Care Ontario, 620 University Ave, Toronto M5G 2 L7 Ontario, Canada
| | - Trevor JB Dummer
- Department of Pediatrics and Population Cancer Research Program, Dalhousie University, 1494 Carlton Street, PO Box 15000, Halifax B3H 4R2, Nova Scotia, Canada
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Beebe-Dimmer JL, Iyer PT, Nriagu JO, Keele GR, Mehta S, Meliker JR, Lange EM, Schwartz AG, Zuhlke KA, Schottenfeld D, Cooney KA. Genetic variation in glutathione S-transferase omega-1, arsenic methyltransferase and methylene-tetrahydrofolate reductase, arsenic exposure and bladder cancer: a case-control study. Environ Health 2012. [PMID: 22747749 DOI: 10.1186/1476-1069x-1111-1143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Ingestion of groundwater with high concentrations of inorganic arsenic has been linked to adverse health outcomes, including bladder cancer, however studies have not consistently observed any elevation in risk at lower concentrations. Genetic variability in the metabolism and clearance of arsenic is an important consideration in any investigation of its potential health risks. Therefore, we examined the association between genes thought to play a role in the metabolism of arsenic and bladder cancer. METHODS Single nucleotide polymorphisms (SNPs) in GSTO-1, As3MT and MTHFR were genotyped using DNA from 219 bladder cancer cases and 273 controls participating in a case-control study in Southeastern Michigan and exposed to low to moderate (<50 μg/L) levels of arsenic in their drinking water. A time-weighted measure of arsenic exposure was constructed using measures from household water samples combined with past residential history, geocoded and merged with archived arsenic data predicted from multiple resources. RESULTS While no single SNP in As3MT was significantly associated with bladder cancer overall, several SNPs were associated with bladder cancer among those exposed to higher arsenic levels. Individuals with one or more copies of the C allele in rs11191439 (the Met287Thr polymorphism) had an elevated risk of bladder cancer (OR = 1.17; 95% CI = 1.04-1.32 per 1 μg/L increase in average exposure). However, no association was observed between average arsenic exposure and bladder cancer among TT homozygotes in the same SNP. Bladder cancer cases were also 60% less likely to be homozygotes for the A allele in rs1476413 in MTHFR compared to controls (OR = 0.40; 95% CI = 0.18-0.88). CONCLUSIONS Variation in As3MT and MTHFR is associated with bladder cancer among those exposed to relatively low concentrations of inorganic arsenic. Further investigation is warranted to confirm these findings.
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Affiliation(s)
- Jennifer L Beebe-Dimmer
- Program of Population Studies and Disparities Research, Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA.
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10
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Beebe-Dimmer JL, Iyer PT, Nriagu JO, Keele GR, Mehta S, Meliker JR, Lange EM, Schwartz AG, Zuhlke KA, Schottenfeld D, Cooney KA. Genetic variation in glutathione S-transferase omega-1, arsenic methyltransferase and methylene-tetrahydrofolate reductase, arsenic exposure and bladder cancer: a case-control study. Environ Health 2012; 11:43. [PMID: 22747749 PMCID: PMC3465173 DOI: 10.1186/1476-069x-11-43] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 06/16/2012] [Indexed: 05/19/2023]
Abstract
BACKGROUND Ingestion of groundwater with high concentrations of inorganic arsenic has been linked to adverse health outcomes, including bladder cancer, however studies have not consistently observed any elevation in risk at lower concentrations. Genetic variability in the metabolism and clearance of arsenic is an important consideration in any investigation of its potential health risks. Therefore, we examined the association between genes thought to play a role in the metabolism of arsenic and bladder cancer. METHODS Single nucleotide polymorphisms (SNPs) in GSTO-1, As3MT and MTHFR were genotyped using DNA from 219 bladder cancer cases and 273 controls participating in a case-control study in Southeastern Michigan and exposed to low to moderate (<50 μg/L) levels of arsenic in their drinking water. A time-weighted measure of arsenic exposure was constructed using measures from household water samples combined with past residential history, geocoded and merged with archived arsenic data predicted from multiple resources. RESULTS While no single SNP in As3MT was significantly associated with bladder cancer overall, several SNPs were associated with bladder cancer among those exposed to higher arsenic levels. Individuals with one or more copies of the C allele in rs11191439 (the Met287Thr polymorphism) had an elevated risk of bladder cancer (OR = 1.17; 95% CI = 1.04-1.32 per 1 μg/L increase in average exposure). However, no association was observed between average arsenic exposure and bladder cancer among TT homozygotes in the same SNP. Bladder cancer cases were also 60% less likely to be homozygotes for the A allele in rs1476413 in MTHFR compared to controls (OR = 0.40; 95% CI = 0.18-0.88). CONCLUSIONS Variation in As3MT and MTHFR is associated with bladder cancer among those exposed to relatively low concentrations of inorganic arsenic. Further investigation is warranted to confirm these findings.
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Affiliation(s)
- Jennifer L Beebe-Dimmer
- Program of Population Studies and Disparities Research, Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA
- Department of Oncology, Wayne State University, Detroit, MI, USA
| | - Priyanka T Iyer
- Program of Population Studies and Disparities Research, Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA
| | - Jerome O Nriagu
- Department of Environmental Health Sciences and Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Greg R Keele
- Program of Population Studies and Disparities Research, Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA
- Department of Oncology, Wayne State University, Detroit, MI, USA
| | - Shilpin Mehta
- Department of Oncology, Wayne State University, Detroit, MI, USA
| | - Jaymie R Meliker
- Department of Preventive Medicine and Graduate Program in Public Health, StonyBrook University Medical Center, New York, Stony Brook, USA
| | - Ethan M Lange
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
| | - Ann G Schwartz
- Program of Population Studies and Disparities Research, Karmanos Cancer Institute, 4100 John R, Detroit, MI 48201, USA
- Department of Oncology, Wayne State University, Detroit, MI, USA
| | - Kimberly A Zuhlke
- Department of Internal Medicine, University of Michigan Medical School Ann Arbor, Ann Arbor, MI, USA
| | | | - Kathleen A Cooney
- Department of Internal Medicine, University of Michigan Medical School Ann Arbor, Ann Arbor, MI, USA
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
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Identification of an S-adenosylmethionine (SAM) dependent arsenic methyltransferase in Danio rerio. Toxicol Appl Pharmacol 2012; 262:185-93. [PMID: 22575231 DOI: 10.1016/j.taap.2012.04.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 04/10/2012] [Accepted: 04/27/2012] [Indexed: 11/23/2022]
Abstract
Arsenic methylation is an important cellular metabolic process that modulates arsenic toxicity and carcinogenicity. Biomethylation of arsenic produces a series of mono-, di- and tri-methylated arsenic metabolites that can be detected in tissues and excretions. Here we report that zebrafish exposed to arsenite (As(III)) produces organic arsenicals, including MMA(III), MMA(V) and DMA(V) with characteristic tissue ratios, demonstrating that an arsenic methylation pathway exists in zebrafish. In mammals, cellular inorganic arsenic is methylated by a SAM-dependent arsenic methyltransferase, AS3MT. A zebrafish arsenic methyltransferase homolog, As3mt, was identified by sequence alignment. Western blotting analysis showed that As3mt was universally expressed in zebrafish tissues. Prominent expression in liver and intestine correlated with methylated arsenic metabolites detected in those tissues. As3mt was expressed in and purified from Escherichia coli for in vitro functional studies. Our results demonstrated that As3mt methylated As(III) to DMA(V) as an end product and produced MMA(III) and MMA(V) as intermediates. The activity of As3mt was inhibited by elevated concentrations of the substrate As(III) as well as the metalloid selenite, which is a well-known antagonistic micronutrient of arsenic toxicity. The activity As3mt was abolished by substitution of either Cys160 or Cys210, which corresponds to conserved cysteine residues in AS3MT homologs, suggesting that they are involved in catalysis. Expression in zebrafish of an enzyme that has a similar function to human and rodent orthologs in catalyzing intracellular arsenic biomethylation validates the applicability of zebrafish as a valuable vertebrate model for understanding arsenic-associated diseases in humans.
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Mordukhovich I, Wright RO, Hu H, Amarasiriwardena C, Baccarelli A, Litonjua A, Sparrow D, Vokonas P, Schwartz J. Associations of toenail arsenic, cadmium, mercury, manganese, and lead with blood pressure in the normative aging study. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:98-104. [PMID: 21878420 PMCID: PMC3261928 DOI: 10.1289/ehp.1002805] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 08/30/2011] [Indexed: 05/19/2023]
Abstract
BACKGROUND Arsenic, cadmium, mercury, and lead are associated with cardiovascular disease in epidemiologic research. These associations may be mediated by direct effects of the metals on blood pressure (BP) elevation. Manganese is associated with cardiovascular dysfunction and hypotension in occupational cohorts. OBJECTIVES We hypothesized that chronic arsenic, cadmium, mercury, and lead exposures elevate BP and that manganese lowers BP. METHODS We conducted a cross-sectional analysis of associations between toenail metals and BP among older men from the Normative Aging Study (n = 639), using linear regression and adjusting for potential confounders. RESULTS An interquartile range increase in toenail arsenic was associated with higher systolic BP [0.93 mmHg; 95% confidence interval (CI): 0.25, 1.62] and pulse pressure (0.76 mmHg; 95% CI: 0.22, 1.30). Positive associations between arsenic and BP and negative associations between manganese and BP were strengthened in models adjusted for other toenail metals. CONCLUSIONS Our findings suggest associations between BP and arsenic and manganese. This may be of public health importance because of prevalence of both metal exposure and cardiovascular disease. Results should be interpreted cautiously given potential limitations of toenails as biomarkers of metal exposure.
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Affiliation(s)
- Irina Mordukhovich
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
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Kakehi Y, Hirao Y, Kim WJ, Ozono S, Masumori N, Miyanaga N, Nasu Y, Yokomizo A. Bladder Cancer Working Group Report. Jpn J Clin Oncol 2010; 40 Suppl 1:i57-64. [DOI: 10.1093/jjco/hyq128] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wilhelm-Benartzi CS, Koestler DC, Houseman EA, Christensen BC, Wiencke JK, Schned AR, Karagas MR, Kelsey KT, Marsit CJ. DNA methylation profiles delineate etiologic heterogeneity and clinically important subgroups of bladder cancer. Carcinogenesis 2010; 31:1972-6. [PMID: 20802236 DOI: 10.1093/carcin/bgq178] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
DNA methylation profiles can be used to define molecular cancer subtypes that may better inform disease etiology and clinical decision-making. This investigation aimed to create DNA methylation profiles of bladder cancer based on CpG methylation from almost 800 cancer-related genes and to then examine the relationship of those profiles with exposures related to risk and clinical characteristics. DNA, derived from formalin-fixed paraffin-embedded tumor samples obtained from incident cases involved in a population-based case-control study of bladder cancer in New Hampshire, was used for methylation profiling on the Illumina GoldenGate Methylation Bead Array. Unsupervised clustering of those loci with the greatest change in methylation between tumor and non-diseased tissue was performed to defined molecular subgroups of disease, and univariate tests of association followed by multinomial logistic regression was used to examine the association between these classes, bladder cancer risk factors and clinical phenotypes. Membership in the two most methylated classes was significantly associated with invasive disease (P < 0.001 for both class 3 and 4). Male gender (P = 0.04) and age >70 years (P = 0.05) was associated with membership in one of the most methylated classes. Finally, average water arsenic levels in the highest percentile predicted membership in an intermediately methylated class of tumors (P = 0.02 for both classes). Exposures and demographic associated with increased risk of bladder cancer specifically associate with particular subgroups of tumors defined by DNA methylation profiling and these subgroups may define more aggressive disease.
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Affiliation(s)
- C S Wilhelm-Benartzi
- Department of Community Health, Center for Environmental Health and Technology, Brown University, Providence, RI 02912, USA
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