Heavy metal concentrations in human eyes

Immunogenetic and Environmental Factors in Age-Related Macular Disease

Age-related macular degeneration (AMD) is a chronic disease, which often develops in older people, but this is not the rule. AMD pathogenesis changes include the anatomical and functional complex. As a result of damage, it occurs, in the retina and macula, among other areas. These changes may lead to partial or total loss of vision. This disease can occur in two clinical forms, i.e., dry (progression is slowly and gradually) and exudative (wet, progression is acute and severe), which usually started as dry form. A coexistence of both forms is possible. AMD etiology is not fully understood. Extensive genetic studies have shown that this disease is multifactorial and that genetic determinants, along with environmental and metabolic-functional factors, are important risk factors. This article reviews the impact of heavy metals, macro- and microelements, and genetic factors on the development of AMD. We present the current state of knowledge about the influence of environmental factors and genetic determinants on the progression of AMD in the confrontation with our own research conducted on the Polish population from Kuyavian-Pomeranian and Lubusz Regions. Our research is concentrated on showing how polluted environments of large agglomerations affects the development of AMD. In addition to confirming heavy metal accumulation, the growth of risk of acute phase factors and polymorphism in the genetic material in AMD development, it will also help in the detection of new markers of this disease. This will lead to a better understanding of the etiology of AMD and will help to establish prevention and early treatment.

Retinal toxicity of heavy metals and its involvement in retinal pathology

The objective of the present review is to discuss epidemiological evidence demonstrating the association between toxic metal (Cd, Pb, Hg, As, Sn, Ti, Tl) exposure and retinal pathology, along with the potential underlying molecular mechanisms. Epidemiological studies demonstrate that Cd, and to a lesser extent Pb exposure, are associated with age-related macular degeneration (AMD), while the existing evidence on the levels of these metals in patients with diabetic retinopathy is scarce. Epidemiological data on the association between other toxic metals and metalloids including mercury (Hg) and arsenic (As), are limited. Clinical reports and laboratory in vivo studies have shown structural alterations in different layers of retina following metal exposure. Examination of retina samples demonstrate that toxic metals can accumulate in the retina, and the rate of accumulation appears to increase with age. Experimental studies in vivo and in vitro studies in APRE-19 and D407 cells demonstrate that toxic metal exposure may cause retinal damage through oxidative stress, apoptosis, DNA damage, mitochondrial dysfunction, endoplasmic reticulum stress, impaired retinogenesis, and retinal inflammation. However, further epidemiological as well as laboratory studies are required for understanding the underlying molecular mechanisms and identifying of the potential therapeutic targets and estimation of the dose-response effects.

Trace Element Concentration in the Blood and Aqueous Humor of Subjects with Eye Cataract

Cataract, characterized by the opacification of the lens, is the leading cause of reversible blindness and visual impairment globally. The study aims to investigate the role of trace elements such as Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se, and Zn in the development and severity of cataract. Elements were quantified by inductively coupled plasma mass spectrometry in blood and aqueous humor of 32 cataract cases and 27 controls living in the Latium region, Italy. The association between element concentration in blood and aqueous humor and cataract severity, gender, and age of subjects were also assessed. Results showed Cr levels significantly elevated in both blood and aqueous humor of cataract cases, with concentrations that increased with cataract severity. In addition, blood Pb levels were significantly higher in older cases and positively correlated with the age of cataract cases, while blood Co and Cu levels negatively correlated with cataract severity, suggesting changes in the levels of these elements. In conclusion, this study provides evidence of the involvement of specific elements in cataract development and severity, and the findings highlighted important avenues for future research. Understanding the biological mechanism underlying element-induced cataract may contribute to preventing cataractogenesis and providing targeted interventions.

Environmental influences on ophthalmic conditions: A scoping review

BACKGROUND

Environmental factors have been implicated in various eye pathologies. The purpose of this review is to synthesise the published research on environmental effects on eye disease.

METHODS

Four databases were searched for terms relating to environmental exposures and ophthalmic disease. Titles and abstracts were screened followed by full-text review. Data was extracted from 118 included studies. Quality assessment was conducted for each study.

RESULTS

Air pollutants, including nitrogen dioxide, nitrites, sulphur dioxide, particulate matter, carbon monoxide, ozone and hydrocarbons are associated with ocular conditions ranging from corneal damage to various retinopathies, including central retinal artery occlusion. Certain chemicals and metals, such as cadmium, are associated with increased risk of age-related macular degeneration. Climate factors, such as sun exposure, have been associated with the development of cataracts. Living in rural areas was associated with various age-related eye diseases whereas people living in urban settings had higher risk for dry eye disease and uveitis.

CONCLUSION

Environmental exposures in every domain are associated with various ophthalmic conditions. These findings underscore the importance of continued research on the interplay between the environment and eye health.

Selenite Ameliorates Cadmium-induced Cytotoxicity Through Downregulation of ROS Levels and Upregulation of Selenoprotein Thioredoxin Reductase 1 in SH-SY5Y Cells

Cadmium (Cd) as a ubiquitous toxic heavy metal in the environment, causes severe hazards to human health, such as cellular stress and organ injury. Selenium (Se) was reported to reduce Cd toxicity and the mechanisms have been intensively studied so far. However, it is not yet crystal clear whether the protective effect of Se against Cd-induced cytotoxicity is related to selenoproteins in nerve cells or not. In this study, we found that Cd inhibited selenoprotein thioredoxin reductase 1 (TrxR1; TXNRD1) and decreased the expression level of TrxR1, resulting in cellular oxidative stress, and Se supplements ameliorated Cd-induced cytotoxicity in SH-SY5Y cells. Mechanistically, the detoxification of Se against Cd is attributed to the increase of the cellular TrxR activity and upregulated TrxR1 protein level, culminating in strengthened antioxidant capacity. Results showed that Se supplements attenuated the ROS production and apoptosis in SH-SY5Y cells, and significantly mitigated Cd-induced SH-SY5Y cell death. This study may be a valuable reference for shedding light on the mechanism of Cd-induced cytotoxicity and the role of TrxR1 in Se-mitigated cytotoxicity of Cd in neuroblast cells, which may be helpful for understanding the therapeutic potential of Cd and Se in treating or preventing neurodegenerative diseases, like Alzheimer's disease (AD) and Parkinson's disease (PD).

Multiomic Mass Spectrometry Imaging to Advance Future Pathological Understanding of Ocular Disease

Determining the locations of proteins within the eye thought to be involved in ocular pathogenesis is important to determine how best to target them for therapeutic benefits. However, immunohistochemistry is limited by the availability and specificity of antibodies. Additionally, the perceived role of both essential and non-essential metals within ocular tissue has been at the forefront of age-related macular degeneration (AMD) pathology for decades, yet even key metals such as copper and zinc have yet to have their roles deconvoluted. Here, mass spectrometry imaging (MSI) is employed to identify and spatially characterize both proteomic and metallomic species within ocular tissue to advance the application of a multiomic imaging methodology for the investigation of ocular diseases.

Characterization of the Toxicological Impact of Heavy Metals on Human Health in Conjunction with Modern Analytical Methods

Increased environmental pollution, urbanization, and a wide variety of anthropogenic activities have led to the release of toxic pollutants into the environment, including heavy metals (HMs). It has been found that increasing concentrations of HMs lead to toxicity, mineral imbalances, and serious diseases, which are occurring more and more frequently. Therefore, testing has become imperative to detect these deficiencies in a timely manner. The detection of traces of HMs, especially toxic ones, in human tissues, various biological fluids, or hair is a complex, high-precision analysis that enables early diagnosis, addressing people under constant stress or exposed to a toxic environment; the test also targets people who have died in suspicious circumstances. Tissue mineral analysis (TMA) determines the concentration of toxic minerals/metals at the intracellular level and can therefore determine correlations between measured concentrations and imbalances in the body. Framing the already-published information on the topic, this review aimed to explore the toxicity of HMs to human health, the harmful effects of their accumulation, the advantages vs. the disadvantages of choosing different biological fluids/tissues/organs necessary for the quantitative measurement of HM in the human body, as well as the choice of the optimal method, correlated with the purpose of the analysis.

Clinical association between trace elements of tear and dry eye metrics

Trace elements exposure is proposed to play a role in the pathogenesis of the systemic disease. Emerging studies have suggested that trace metal exposure may contribute to dry eye disease. Our study primarily aimed to investigate the association between trace metal exposure in tear samples and the presence of dry eye metrics in the shipyard industry. Overall, 84 eligible participants from the shipyard industry were included in this cross-sectional study. The parameters for identifying dry eye symptoms included O.S.D.I., SPEED, N.I.B.U.T., and ocular surface conditions, such as tear meniscus height, eye blinking, and meibomian gland area were performed by S.B.M. sistemi ocular surface analyzer. The concentration of tear trace elements was detected by inductively coupled plasma mass spectroscopy (ICP-MS). The association between tear trace elements and dry eye parameters was investigated using regression models. Participants in the exposure group had significantly higher levels of tear Pb than the control group. In the exposure group, tear Pb was significantly associated with increased SPEED and O.S.D.I. score with beta coefficients of 0.144 (95% CI 0.092, 0.197), 0.121 (95% CI 0.049, 0.194), respectively, and decreased lower and upper meibomian gland area with beta coefficients of - 0.158 (- 0.283, - 0.033) and - 0.228 (- 0.396, - 0.061), respectively. Tear trace elements exposure is considered to impact the appearance of dry eye metrics. Improving the occupational environment and monitoring the ocular surface health may benefit workers under exposure to trace elements.

Biomolecular modifications in the sacfry of Mogurnda adspersa in response to copper stress

Copper (Cu) is one of the most harmful contaminants in fresh-water systems. Fish larvae such as sacfry are particularly vulnerable to metals such as copper (Cu) due to a less-developed excretory organ system and permeable skin that can absorb metals directly from the water. However, the sublethal effects of metals on this life stage are not well understood. This study assessed the sublethal toxicity of Cu on purple-spotted gudgeon sacfry (PSG, Mogurnda adspersa). For this purpose, 96 h Cu toxicity bioassays were performed and toxic effects of Cu on PSG were measured at different levels of biological organization, from the individual (loss of equilibrium, wet weight), to tissue (chemical changes in retinal tissue composition) and molecular responses (whole body amino acid (AA) profiles). The EC₁₀ and EC₅₀ (ECx: effect concentration that affected X% of test organisms) were found to be 12 (9 - 15) µg Cu L^-1 and 22 (19 - 24) µg Cu L^-1, respectively. Copper stress caused a decrease in total amino acid content and changed the AA profile of PSG compared to the controls. Proton-induced X-ray emission (PIXE) mapping techniques showed accumulation of Cu in the retinal tissues disturbing the distribution of other elements such as zinc, sulfur, phosphorus and potassium. Fourier-transform infrared (FTIR) microspectroscopy of control and Cu treated eye tissues revealed a change in protein secondary structure in retinal tissues in response to Cu accumulation, as well as decreased levels of the molecular retinal, consistent with the degradation of rhodopsin, a key protein in the visual sensory system. This is the first study to demonstrate the multi-level responses of PSG arising from exposure to environmentally realistic Cu concentrations and suggests that AA profiling can serve as a useful tool to assess the impacts of metals on fresh-water organisms.

Development of an analytical method for determination of lead and cadmium in biological materials by GFAAS using Escherichia coli as model substance

In this work, an analytical method was developed for the determination of lead and cadmium in biological samples using graphite furnace atomic absorption spectrometry. Escherichia coli (E. coli) was chosen as model substance for this purpose as it is readily available in most laboratories and can be quickly and easily prepared with a high turnaround rate. Four different sample preparation methods were initially evaluated with respect to percent recovery, limit of detection, and limit of quantification, and the most promising one was developed further. The final process involving microwave assisted digestion of the sample with nitric acid and hydrogen peroxide showed high recovery, repeatability, and specificity. The process was first applied to lead and then extended for the determination of cadmium in the same E. coli substrates. Finally, to validate the process, a certified references material was analyzed, and the results obtained were evaluated with respect to accuracy by comparing them to the reported ones.

Advanced human developmental toxicity and teratogenicity assessment using human organoid models

Tremendous progress has been made in the field of toxicology leading to the advance of developmental toxicity assessment. Conventional animal models and in vitro two-dimensional models cannot accurately describe toxic effects and predict actual in vivo responses due to obvious inter-species differences between humans and animals, as well as the lack of a physiologically relevant tissue microenvironment. Human embryonic stem cell (hESC)- and induced pluripotent stem cell (iPSC)-derived three-dimensional organoids are ideal complex and multicellular organotypic models, which are indispensable in recapitulating morphogenesis, cellular interactions, and molecular processes of early human organ development. Recently, human organoids have been used for drug discovery, chemical toxicity and safety in vitro assessment. This review discusses the recent advances in the use of human organoid models, (i.e., brain, retinal, cardiac, liver, kidney, lung, and intestinal organoid models) for developmental toxicity and teratogenicity assessment of distinct tissues/organs following exposure to pharmaceutical compounds, heavy metals, persistent organic pollutants, nanomaterials, and ambient air pollutants. Combining next-generation organoid models with innovative engineering technologies generates novel and powerful tools for developmental toxicity and teratogenicity assessment, and the rapid progress in this field is expected to continue.

Associations between Biomarkers of Metal Exposure and Dry Eye Metrics in Shipyard Welders: A Cross-Sectional Study

Shipyard welders are often exposed to welding metal fumes. Ocular surfaces are continually exposed to environmental hazards. However, limited information on the associations between metal exposure and dry eye metrics in occupational settings is available. This study employed a cross-sectional design that involved the participation of 59 welders and 25 administrative staff in a shipyard in northern Taiwan from September 2020 to October 2020. The participants' individual information, laboratory data, exposure to particulate matter < 2.5 μm, urinary, and toenail metal concentrations were collected. Dry eye metrics were evaluated using standardized questionnaires and a noninvasive ocular surface analyzer. Urinary V and Cr and toenail V, Cr, Mn, Fe, Ni, Zn, As, and Cd and Pb were significantly higher in the exposed group than in the control group. After adjustment for confounding factors, dry eye metrics were associated with urinary Cd (β = 0.407; p = 0.007) and toenail Pb (β = 0.482; p = 0.002). The participants with higher urinary Cd exhibited higher odds ratios for elevated dry eye metrics. Our study revealed that exposure to welding procedures increases several metal biomarkers. In addition, urinary Cd, and toenail Pb might be related to dry eye disease in shipyard welders.

The Multi-Elemental Composition of the Aqueous Humor of Patients Undergoing Cataract Surgery, Suffering from Coexisting Diabetes, Hypertension, or Diabetic Retinopathy

The aim of the study was the multi-elemental analysis of aqueous humor (AH) collected from patients undergoing cataract surgery. The study included: 16 patients with age-related macular degeneration AMD (99 controls), 10 patients with retinopathy (105 controls), 61 patients with hypertension (54 controls), and 33 patients with coexisting diabetes (82 controls). The control groups were recruited from patients with a lack of co-existing disease characterizing the specified studied group. The measurements were performed by the use of inductively coupled plasma optical emission spectrometry (ICP-OES). The statistical analysis was carried out using non-parametric testing (Mann–Whitney U). The level of significance was set at p = 0.05. The data obtained revealed substantial variations in elemental composition between the test groups in comparison to the controls. However, the significant variations concerned only a few elements. The phosphorous (P) level and the ratio of P/Ca were significant in retinopathy and diabetes, whereas cobalt (0.091 ± 0.107 mg/L vs. 0.031 ± 0.075 mg/L; p = 0.004) was significant in AMD. In co-existing hypertension, the levels of tin (0.293 ± 0.409 mg/L vs. 0.152 ± 0.3 mg/L; p = 0.031), titanium (0.096 ± 0.059 mg/L vs. 0.152 ± 0.192 mg/L; p = 0.045), and ruthenium (0.035 ± 0.109 mg/L vs. 0.002 ± 0.007 mg/L; p = 0.006) varied in comparison to the controls. The study revealed inter-elemental interactions. The correlation matrices demonstrated the domination of the positive correlations, whereas negative correlations mainly concerned sodium.

Protein posttranslational modification (PTM) by glycation: Role in lens aging and age-related cataractogenesis

Crystallins, the most prevalent lens proteins, have no turnover throughout the entire human lifespan. These long-lived proteins are susceptible to post-synthetic modifications, including oxidation and glycation, which are believed to be some of the primary mechanisms for age-related cataractogenesis. Thanks to high glutathione (GSH) and ascorbic acid (ASA) levels as well as low oxygen content, the human lens is able to maintain its transparency for several decades. Aging accumulates substantial changes in the human lens, including a decreased glutathione concentration, increased reactive oxygen species (ROS) formation, impaired antioxidative defense capacity, and increased redox-active metal ions, which induce glucose and ascorbic acid degradation and protein glycation. The glycated lens crystallins are either prone to UVA mediated free radical production or they attract metal ion binding, which can trigger additional protein oxidation and modification. This vicious cycle is expected to be exacerbated with older age or diabetic conditions. ASA serves as an antioxidant in the human lens under reducing conditions to protect the human lens from damage, but ASA converts to the pro-oxidative role and causes lens protein damage by ascorbylation in high oxidation or enriched redox-active metal ion conditions. This review is dedicated in honor of Dr. Frank Giblin, a great friend and superb scientist, whose pioneering and relentless work over the past 45 years has provided critical insight into lens redox regulation and glutathione homeostasis during aging and cataractogenesis.

Trace elements exposure and risk in age-related eye diseases: a systematic review of epidemiological evidence

This systematic review aimed to evaluate existing evidence on the associations between trace elements exposure and age-related eye diseases. PubMed and Google scholar databases were searched for epidemiological and postmortem studies on the relationship between exposure to trace elements and Age-related eye diseases such as age-related macular degeneration (AMD), cataract, glaucoma and diabetic retinopathy (DR), in population groups aged 40 years and above. Available evidence suggests that cadmium (Cd) exposure may be positively associated with the risks of AMD and cataract. There is also evidence that exposure to lead (Pb) may be positively associated with higher risk of cataract and glaucoma. There is limited number of relevant studies and lack of prospective studies for most of the investigated associations. Evidence for other trace elements is weak and inconsistent, and the number of available studies is small. Likewise, there are very few relevant studies on the role of trace elements in DR. Chemical elements that affect the distribution and absorption of other trace elements have never been investigated. The suggestive but limited evidence motivates large and quality prospective studies to fully characterize the impact of exposure to trace (toxic and essential) elements on age-related eye diseases.

An inadvertent issue of human retina exposure to endocrine disrupting chemicals: A safety assessment

Endocrine disrupting chemicals (EDCs) are a group of chemical compounds that present a considerable public health problem due to their pervasiveness and associations with chronic diseases. EDCs can interrupt the endocrine system and interfere with hormone homeostasis, leading to abnormalities in human physiology. Much attention has been focused on the adverse effects EDCs have on the reproductive system, neurogenesis, neuroendocrine system, and thyroid dysfunction. The eye is usually directly exposed to the surrounding environment; however, the influences of EDCs on the eye have received comparatively little attention. Ocular diseases, such as ocular surface diseases and retinal diseases, have been implicated in hormone deficiency or excess. Epidemiologic studies have shown that EDC exposure not only causes ocular surface disorders, such as dry eye, but also associates with visual deficits and retinopathy. EDCs can pass through the human blood-retinal barrier and enter the neural retina, and can then accumulate in the retina. The retina is an embryologic extension of the central nervous system, and is extremely sensitive and vulnerable to EDCs that could be passed across the placenta during critical periods of retinal development. Subtle alterations in the retinal development process usually result in profound immediate, long-term, and delayed effects late in life. This review, based on extensive literature survey, briefly summarizes the current knowledge about the impact of representative manufactured EDCs on retinal toxicity, including retinal structure alterations and dysfunction. We also highlight the potential mechanism of action of EDCs on the retina, and the predictive retinal models of EDC exposure.

A comprehensive risk assessment of toxic elements in international brands of face foundation powders

Despite the COVID-19 pandemic and wearing masks in many countries, women are keen on elegance, beauty and the use of face foundations. Assessment of health risks associated with the regular use of face foundation by females is dynamic due to the emerging products. The most common international 14 brands of face foundation powders were collected and the concentrations of different elements (Ag, Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cu, Fe, Hg, K, Li, Mg, Mn, Mo, Na, P, Pb, Sb, Se, Sn, V and Zn) in each sample were determined. A combined approach merging the conventional and computational tools was used for investigating the risk of exposure to toxic elements. Monte Carlo simulations were applied to calculate risks associated with twenty elements. We attempted different probability distribution functions for concentrations because the actual distribution functions are not known, and the only data available are the mean value and standard deviation of concentrations obtained from experiment. Our results indicate that the total non-carcinogenic health risk through exposure to different elements (Hazardous Index, HI) does not strongly depend on the choice of the probability distribution function for the concentrations. We also show that taking into account probability distributions of other variables and parameters such as body weight, exposed skin area, skin adhesion, etc. does not significantly change the main result rather just slightly broadening the final Hazardous Index distribution function. We found that calculated HI is well below unity for all considered samples, i.e., the dermal exposure to toxic elements in the considered facial powders is negligible and the considered face foundation powders are quite safe to use.

Association of plasma trace element levels with neovascular age-related macular degeneration

Although the triggers causing angiogenesis in the context of neovascular age-related macular degeneration (nAMD) are not fully understood, oxidative stress is likely involved. Oxidative stress in the eye can occur through exposure of macular tissues to sunlight and local or systemic exposure to oxidative stressors associated with environmental or lifestyle factors. Because trace elements have been implicated as regulators of oxidative stress and cellular antioxidant defense mechanisms, we hypothesized that they may play a role as a risk factor, modifying the progression toward nAMD. Herein, we determined whether levels of human plasma trace elements are different in 236 individuals with nAMD compared to 236 age-matched controls without AMD. Plasma levels of 16 trace elements including arsenic, barium, calcium, cadmium, cobalt, chromium, copper, iron, magnesium, manganese, molybdenum, lead, antimony, selenium, vanadium and zinc were measured using inductively coupled plasma mass spectrometry. Associations of trace elements with demographic, environmental and lifestyle factors and AMD-associated genetic variants were assessed. Elevated levels of barium and cadmium and reduced levels of chromium were observed in nAMD patients compared to controls. Mean plasma concentrations of barium were 1.35 μg/L (standard deviation [SD] 0.71) in nAMD and 1.15 μg/L (SD 0.63) in controls (P = 0.001). Mean levels of chromium were 0.37 μg/L (SD 0.22) in nAMD and 0.46 μg/L (SD 0.34) in controls (P = 0.001). Median levels for cadmium, which were not normally distributed, were 0.016 μg/L (interquartile range [IQR] 0.001-0.026) in nAMD and 0.012 μg/L (IQR 0.001-0.022) in controls (P = 0.002). Comparison of the Spearman's correlation coefficients between nAMD patients and controls identified a difference in correlations for 8 trace elements. Cadmium levels were associated with the smoking status (P < 0.001), while barium levels showed a trend of association with the usage of antihypertensive drugs. None of the AMD-associated genetic variants were associated with any trace element levels. In conclusion, in this case-control study we detected elevated plasma levels of barium and cadmium and reduced plasma levels of chromium in nAMD patients. An imbalance in plasma trace elements, which is most likely driven by environmental and lifestyle factors, might have a role in the pathogenesis of AMD. These trace elements may be incorporated as biomarkers into models for prediction of disease risk and progression. Additionally, population-based preventive strategies to decrease Cd exposure, especially by the cessation of smoking, could potentially reduce the burden of nAMD. Future studies are warranted to investigate whether supplementation of Cr would have a beneficial effect on nAMD.

The distribution of toxic metals in the human retina and optic nerve head: Implications for age-related macular degeneration

Objective

Toxic metals are suspected to play a role in the pathogenesis of age-related macular degeneration. However, difficulties in detecting the presence of multiple toxic metals within the intact human retina, and in separating primary metal toxicity from the secondary uptake of metals in damaged tissue, have hindered progress in this field. We therefore looked for the presence of several toxic metals in the posterior segment of normal adult eyes using elemental bioimaging.

Methods

Paraffin sections of the posterior segment of the eye from seven tissue donors (age range 54–74 years) to an eye bank were examined for toxic metals in situ using laser ablation-inductively coupled plasma-mass spectrometry, a technique that detects multiple elements in tissues, as well as the histochemical technique of autometallography that demonstrates inorganic mercury, silver, and bismuth. No donor had a visual impairment, and no significant retinal abnormalities were seen on post mortem fundoscopy and histology.

Results

Metals found by laser ablation-inductively coupled plasma-mass spectrometry in the retinal pigment epithelium and choriocapillaris were lead (n = 7), nickel (n = 7), iron (n = 7), cadmium (n = 6), mercury (n = 6), bismuth (n = 5), aluminium (n = 3), and silver (n = 1). In the neural retina, mercury was present in six samples, and iron in one. Metals detected in the optic nerve head were iron (N = 7), mercury (N = 7), nickel (N = 4), and aluminium (N = 1). No gold or chromium was seen. Autometallography demonstrated probable inorganic mercury in the retinal pigment epithelium of one donor.

Conclusion

Several toxic metals are taken up by the human retina and optic nerve head. Injury to the retinal pigment epithelium from toxic metals could damage the neuroprotective functions of the retinal pigment epithelium and allow toxic metals to enter the outer neural retina. These findings support the hypothesis that accumulations of toxic metals in the retina could contribute to the pathogenesis of age-related macular degeneration.

Linking molecular targets of Cd in the bloodstream to organ-based adverse health effects

The chronic exposure of human populations to toxic metals remains a global public health concern. Although chronic Cd exposure is linked to kidney damage, osteoporosis and cancer, the underlying biomolecular mechanisms remain incompletely understood. Since other diseases could also be causally linked to chronic Cd exposure, a systems toxicology-based approach is needed to gain new insight into the underlying exposure-disease relationship. This approach requires one to integrate the cascade of dynamic bioinorganic chemistry events that unfold in the bloodstream after Cd enters with toxicological events that unfold in target organs over time. To this end, we have conducted a systematic literature search to identify all molecular targets of Cd in plasma and in red blood cells (RBCs). Based on this information it is impossible to describe the metabolism of Cd and the toxicological relevance of it binding to molecular targets in/on RBCs is elusive. Perhaps most importantly, the role that peptides, amino acids and inorganic ions, including HCO₃^-, Cl^- and HSeO₃^- play in terms of mediating the translocation of Cd to target organs and its detoxification is poorly understood. Causally linking human exposure to this metal with diseases requires a much better integration of the bioinorganic chemistry of Cd that unfolds in the bloodstream with target organs. This from a public health point of view important goal will require collaborations between scientists from different disciplines to untangle the complex mechanisms which causally link Cd exposure to disease.

Heavy metal concentrations in tissues of marine fish and crab collected from the middle coast of Zhejiang Province, China

Concentrations of the heavy metals As, Cd, Cu, Hg, Pb, and Zn in various tissues of five marine fish species and one crab species collected from the middle coast of Zhejiang Province of China were investigated in this study. The results indicated considerable variation in heavy metal concentrations in different tissues and species. Elevated concentrations of most heavy metals were identified in fish gills and crab gills and hepatopancreas, with some differences by heavy metal type. In addition, carnivorous and benthivorous fish species generally contained relatively high concentrations of heavy metals due to feeding habits and habitats. Geographical variations of heavy metal concentrations in muscle may be attributable to species-dependent differences and terrigenous contamination. The potential health risk assessment suggested that exposure doses of most heavy metals were safe for human consumption, with the exception of As.

The Beast of Beauty: Environmental and Health Concerns of Toxic Components in Cosmetics

Cosmetic products are used in large quantities across the world. An increasing number of chemical compounds are being added to the formulation of cosmetic products as additives, fragrances, preservatives, stabilizers, surfactants, dye and shine to potentiate their quality, property and shelf life. Owing to their widespread use, active residues of cosmetic products are continuously introduced into the environment in several ways. Many of these chemicals are bioactive and are characterized by potential bioaccumulation ability and environmental persistence, thus exerting a major risk to humans and the health of ecosystems. Hence, the indiscriminate consumption of cosmetics may present a looming issue with significant adverse impacts on public health. This review intends to spotlight a current overview of toxic ingredients used in formulating cosmetics such as parabens, triclosan, benzalkonium chloride, 1,4-dioxane, plastic microbeads, formaldehyde, diazolidinyl urea, imidazolidinyl urea, sunscreen elements (organic and inorganic UV filters) and trace metals. Specific focus is given to illustrate the biological risks of these substances on human health and aquatic system in terms of genotoxicity, cytotoxicity, neurotoxicity mutagenicity, and estrogenicity. In addition to conclusive remarks, future directions are also suggested.

Heavy metal toxicity and the aetiology of glaucoma

Despite recent advances, our understanding of the aetiological mechanisms underlying glaucoma remains incomplete. Heavy metals toxicity has been linked to the development of neurodegenerative diseases and various ocular pathologies. Given the similarities in pathophysiology between glaucoma and some neurodegenerative disorders, it is plausible that heavy metal toxicity may play a role in the development of glaucoma. Heavy metal exposure may be occupational, or through water or dietary contamination. In this report, we review mechanisms for systemic and neurotoxicity for arsenic, cadmium, chromium, cobalt, lead, mercury, and manganese, and weigh the evidence for an association between glaucoma and the accumulation of heavy metals either in ocular tissues or in the central nervous system.

An environmental friendly enrichment method for microextraction of cadmium and lead in groundwater samples: Impact on biological sample of children

A novel ionic liquid-based vortex assisted dispersive liquid-liquid micro extraction procedure(IL-VADLLμE) was proposed for the enrichment of toxic metals, cadmium (Cd) and lead (Pb) in different types of water samples, domestic treated and groundwater (tube well and hand pump). Whereas, the concentration of both toxic metals was also determined in the scalp hair of children (age ranged 1-3 years), drinking contaminated groundwater termed as exposed group, whereas for comparative purposes scalp hair of age matched children consumed domestically treated water, named as non-exposed group. To preconcentrate the trace levels of Cd and Pb, a green chelating agent, l-cysteine (2-amino-3-sulfhydrylpropanoic acid) was used for complexation, an ionic liquid, 1-butyl-3-methylimidazolium hexafluorophosphate [BMIM] [PF₆] utilized as extractant and hexafluorophosphate ion (PF₆^-) as anion pairing agent, which facilitate the enrichment of hydrophobic complexes of analytes into the acceptor phase. Various operative features for the IL-VADLLμE method like pH of standards/samples, volume of ionic liquid and sample solution, concentration of ligand, ion pair reagent and ionic liquid, vortex and electrical shaking time (for comparative purpose), were thoroughly optimized. The projected method was effectively applicable to assess the Cd and Pb in trace level in real water sample (surface and groundwater) and scalp hair samples of children belongs to exposed and non-exposed areas. The high contents of both toxic metals in scalp hair samples of children consuming groundwater indicate that the adverse impacts of both toxic metals especially Pb on the general health as well as neuron and skeletal problem, from child hood.

Levels of Trace Elements in the Aqueous Humor of Cataract Patients Measured by the Inductively Coupled Plasma Optical Emission Spectrometry

Trace elements play an important role in the pathogenesis of several serious ophthalmological disorders, such as glaucoma, age-related macular degeneration (AMD), diabetic retinopathy, cataract, etc. This study aimed to measure alterations of chemical elements' (67) levels in the aqueous humor of patients undergoing cataract surgery. The pilot study included 115 patients, (age 74 ± 7.27, female 64.35%, male 35.65%). The aqueous levels of elements were measured by the use of the inductively coupled plasma optical emission spectrometry (ICP-OES), quality controlled with certified standards. The classification of elements based on their concentration was achieved by hierarchical cluster analysis. This is the first screening study that quantifies over 60 elements which are present in the fluid from the anterior chamber of the eye of cataract patients. The obtained results can be suitable for understanding and identifying the causes that may play a role in the initiation and progression of lens opacity.

The impacts of individual and combined exposure to cadmium and lead on intraocular pressure, electroretinography, and residual changes in the rabbit eyes

The human eye is very vulnerable to various environmental pollutants. Cadmium (Cd) and lead (Pb) are widely spread heavy metals. The goal of the existing study is to explore the impact of single or joint exposure to Cd and Pb on the eye indicators. In this study, male New Zealand white rabbits were treated orally for 30 days with Cd (5 mg Cd Cl₂/kg bw) associated or not with Pb (12.5 mg lead acetate/kg bw). Fundus and slit lamp examinations, electroretinography (ERG), intraocular pressure (IOP), Cd and Pb residues, and the histopathological picture of the eye were studied. The results revealed that the oral dosing of Cd or Pb evoked a significant (p < 0.05) decline in a- and b-wave amplitudes, under scotopic conditions, and IOP values. Single Pb or Cd treatment showed a significant (p < 0.001) increase in their residues in the whole eye tissue of the Pb- or Cd-treated group. Eye structures of Cd- or Pb-intoxicated rabbit showed mild degenerated changes of cornea and sclera tissues with the presence of irregular variably sized eosinophilic droplets in the lens. Notably, the simultaneous exposure to Cd and Pb leads to an antagonistic outcome in all of the estimated parameters. These findings concluded that oral exposure to Cd or Pb could significantly disturb the vision but their joint exposure caused an opposing effect on nearly all of these disturbances.

Determination of heavy metals (lead, cadmium, arsenic, and mercury) in authorized and unauthorized cosmetics

Aim: The present study evaluates lead, cadmium, arsenic, and mercury contamination in lipsticks, mascara, eye shadow, and eyebrow pencils, and compares the amounts of these toxic elements in both legal and contraband products. Background: The presence of heavy metals in cosmetics is of major concern, and requires constant monitoring to ensure the safety of consumers. Cosmetics contaminated with heavy metals can lead them to accumulate in the skin, while the further migration of these toxic elements to blood vessels can cause subsequent difficulties. Material and methods: The graphite Furnace Atomic Absorption Spectrometry (GFAAS) and Direct Mercury Analyzer (DMA) techniques were used. Results: The data indicate that the lead content in the products did not exceed the acceptable limit of the Federal Office of Consumer Protection and Food Safety of Germany (BVL), and that the cadmium values in all products were significantly lower than the limit set by the BVL. The arsenic contents of lipsticks, eye shadows, and eyebrow pencils was significantly higher than the BVL standard, while the mercury content was far below the BVL standards, so there seems to be no concern associated with this toxic element. Legal cosmetics showed better results, except for mascara, which had higher amounts of arsenic than contraband. The higher contents of arsenic in contraband eye shadows and eyebrow pencils is an issue that should be taken into considerations by the relevant authorities. Conclusion: The authors suggest further analysis of the toxic elements in cosmetics and better monitoring of both imported and contraband cosmetics. Moreover, consumers' knowledge of the potential risks of the frequent application of cosmetic products should be improved.

Association between Three Heavy Metals and Dry Eye Disease in Korean Adults: Results of the Korean National Health and Nutrition Examination Survey

PURPOSE

To investigate the associations between blood heavy metal concentrations and dry eye disease using a Korean population-based survey.

METHODS

This study included 23,376 participants >40 years of age who participated in the Korean National Health and Nutrition Examination Survey from 2010 to 2012. Blood concentrations of lead, cadmium, and mercury were measured in all participants. The associations between blood heavy metal concentrations and dry eye disease were assessed using multivariate logistic regression analyses.

RESULTS

After adjusting for potential confounders, including age, sex, lifestyle behaviors and sociodemographic factors, the analyses revealed an increased odds ratio (OR) for dry eye disease with higher blood mercury concentrations (tertile 2: OR, 1.22; 95% confidence interval [CI], 0.91 to 1.64; tertile 3: OR, 1.39; 95% CI, 1.02 to 1.89; p = 0.039). The prevalence of dry eye disease was not associated with blood lead (tertile 2: OR, 1.15; 95% CI, 0.87 to 1.51; tertile 3: OR, 0.83; 95% CI, 0.59 to 1.16; p = 0.283) or cadmium (tertile 2: OR, 1.05; 95% CI, 0.77 to 1.44; tertile 3: OR, 1.15; 95% CI, 0.84 to 1.58; p = 0.389) concentrations. There were no significant associations between any of the three heavy metals and dry eye disease in males after adjusting for potential confounding factors, but blood mercury concentrations in females were associated with dry eye disease (tertile 2: OR, 1.18; 95% CI, 0.83 to 1.69; tertile 3: OR, 1.58; 95% CI, 1.12 to 2.24; p = 0.009).

CONCLUSIONS

Mercury concentrations in blood were associated with dry eye disease. Our results suggested that controlling environmental exposure to mercury may be necessary to reduce the incidence of dry eye disease.

Metals(loids) targeting fish eyes and brain in a contaminated estuary - Uncovering neurosensory (un)susceptibility through bioaccumulation, antioxidant and morphometric profiles

This study examined the susceptibility of fish (Liza aurata) eyes and brain to metals(loids) contamination under realistic exposure conditions. A multidimensional approach was applied to fish caught at a chronically contaminated site (BAR) and at a reference site of the Tagus estuary (Portugal), which comprised metals(loids) accumulation in eyes and brain together with a battery of enzymatic and non-enzymatic antioxidants, as well as brain morphometry (i.e. cell density). Trace element levels in the blood, gills, liver and kidney allowed interpretations on their preferential pathway(s) to the eyes and brain. Metals(loids) accumulation pointed out the elevated vulnerability of the fish eyes at BAR, probably related with the direct waterborne uptake. Pb uptake in L. aurata eyes could be associated both with water and indirect pathways. At the most contaminated site, metals(loids) were on the basis of pro-oxidant conditions in the ocular tissues, while no indication of toxicity was recorded in the brain. Overall, the results disclosed a differential bioaccumulation among fish organs, suggesting that, in the L. aurata population studied, metal organotropism underlie the lower susceptibility of the brain comparing to the eyes. However, mechanisms remain little understood and further work is needed.

Blood lead and cadmium in age related macular degeneration in a Turkish urban population

PURPOSE

To evaluate the blood lead (Pb) and cadmium (Cd) levels in age related macular degeneration (AMD) in a turkish urban population.

METHODS

Blood Pb and Cd levels of 31 AMD patients and 24 age and gender matched controls with no sign of AMD were measured using dual atomic absorption spectrophotometer system (AAS). History of hypertension, diabetes mellitus, cigarette smoking, myocardial infarction and stroke were obtained from all subjects. Degree of AMD was grade 4 according to the Age-Related Eye Disease Study grading system. Median blood Pb and Cd levels were compared by using Students' t-test.

RESULTS

Demographic properties like smoking status, presence of diabetes mellitus or hypertension, cerebrovascular occlusion history, serum cholesterol and lipid levels were not significantly different between groups except history of ischemic heart disease (3.22% vs 25% in AMD and control groups respectively, p = .022). Overall in AMD group blood Pb level was 2.83 ± 0.15 μg/l and it was 2.63 ± 0.23 μg/l in control group (p = .36). The Cd level was 3.25 ± 0.20 μg/l in AMD group and 3.11 ± 0.25 μg/l in control group (p = .67). The mean Pb (2.38 ± 0.88 μg/l vs 2.91 ± 1.37 μg/l for AMD vs control, p = .61) and Cd levels (3.06 ± 1.34 μg/l vs 3.35 ± 1.26 μg/l for AMD vs control, p = .56) in current and previous smokers with AMD were not significantly different from those of the current and previous smokers in control group.

CONCLUSION

Blood Pb and Cd levels which reflect short term exposure were not significantly different in AMD patients and the control group. The difference was not significant either after involvement of previous or current smoker subjects.

Morphological, biochemical, and histopathological postmortem ocular indices following subchronic exposure to cadmium and/or lead in a rabbit model

Cadmium (Cd) and lead (Pb) are ubiquitous environmental pollutants. There is a dearth of information on the mutual interaction between the antemortem metal intoxication and the postmortem changes of the eye. Thus, this study aimed to follow the morphological, biochemical, histopathological ocular perturbations and the retinal DNA damage up to 8 h postmortem (PM) in Cd and/or Pb intoxicated rabbits. The animals orally received 5 mg Cd Cl₂/kg bw and/or 12.5 mg lead acetate/kg bw for 30 consecutive days. At time of death, eye pupil of different groups had a normal diameter except Pb-intoxicated group had marked myosis. After 8 h of death, different rabbit's eye corneas appeared wrinkled and covered with thin white cloud while the pupils were in the mydriatic stage. Up to 8 h PM, the individual exposure to Cd or Pb resulted in a significant elevation in GGT, urea, K, DNA damage and obvious retinal lesions. However, their co-exposure evoked an antagonistic outcome. The eye of Cd and/or Pb intoxicated rabbit showed mildly degenerated tissue of cornea and sclera and the presence of irregular eosinophilic droplets of variably size in the lens with a gradual degeneration and vacuolization in the different cell layers of retina especially ganglion up to 8 h PM. Also, by increasing post mortem interval (PMI), retinal DNA damage in Cd and/or Pb intoxicated group significantly decreased. It is concluded that Cd and/or Pb intoxication induced ocular alterations which retain the same trend in correlation with PMI as natural deaths except for the retinal DNA damage. Also, the simultaneous exposure to Cd and Pb evoked an antagonistic outcome in the eye. The findings of the current study should be taken into consideration when estimating PMI in areas with high Cd and/or Pb contamination.

Early and intermediate age-related macular degeneration: update and clinical review

Age-related macular degeneration (AMD) is the leading cause of irreversible central vision loss in developed countries. With the aging of population, AMD will become globally an increasingly important and prevalent disease worldwide. It is a complex disease whose etiology is associated with both genetic and environmental risk factors. An extensive decline in the quality of life and progressive need of daily living assistance resulting from AMD among those most severely affected highlights the essential role of preventive strategies, particularly advising patients to quit smoking. In addition, maintaining a healthy diet, controlling other risk factors (such as hypertension, obesity, and atherosclerosis), and the use of nutritional supplements (antioxidants) are recommendable. Genetic testing may be especially important in patients with a family history of AMD. Recently, unifying criteria for the clinical classification of AMD, defining no apparent aging changes; normal aging changes; and early, intermediate, and late AMD stages, are of value in predicting AMD risk of progression and in establishing recommendations for the diagnosis, therapeutic approach, and follow-up of patients. The present review is focused on early and intermediate AMD and presents a description of the clinical characteristics and ophthalmological findings for these stages, together with algorithms for the diagnosis and management of patients, which are easily applicable in daily clinical practice.

Cadmium Level, Glycemic Control, and Indices of Renal Function in Treated Type II Diabetics: Implications for Polluted Environments

Cadmium (Cd) has recently emerged as a major concern not only in environmental toxicology but also in metabolic diseases such as diabetes mellitus and its complications. Conflicting data aside, these studies have not been examined in a clinical population undergoing management as well as possible modulation by the prominent metabolic antagonist of Cd such as zinc (Zn). This study examined the relationship between cadmium levels, glycemic control, and renal pathology in established type II diabetic patients with focus on populations exposed to modern environmental health hazards (MEHHs). Sixty-five participants, consisting of 45 type-2 diabetics and 20 non-diabetics were enrolled for the study, mean age 61.51 ± 5.27 years. Glycated hemoglobin (HbA_1c) was used to classify them into three sub-groups: (A) good glycemic control (44.4%), (B) fair glycemic control (24.4%), and (C) poor glycemic control (31.1%). Plasma levels of glucose, Cd, Zn, HbA_1c, creatinine, urinary creatinine, microalbuminuria, and estimated glomerular filtration rate (eGFR) were determined in all participants using standard methods. Fasting plasma glucose was higher in diabetics than in non-diabetics (p = 0.000) as well as Zn level, though not significantly. Interestingly, Cd level, Cd/Zn ratio, and urinary creatinine were significantly lower in diabetics than in non-diabetics. The group with poor glycemic control (C) had significantly higher Cd level compared to the one with good glycemic control (group A). The renal function revealed that microalbuminuria and urinary albumin/creatinine ratio (UACR) was significantly higher in diabetics than in non-diabetics, while eGFR was found to be similar in both diabetics and non-diabetics. UACR inversely correlated with Cd level, while plasma creatinine level positively correlated with Cd but not significantly. Correlation between Cd and HbA_1c revealed non-significant inverse correlation (r = −0.007; p > 0.05), while Zn showed a significant inverse correlation with Cd (r = −0.317; p < 0.014). The lower Cd level in diabetics compared to non-diabetics probably reflects the modulating effect of Zn in treated diabetics given nutritional education in addition to their regular regime, including good sources of Zn. The renal insufficiency with increasing Cd level may suggest that the progression of renal impairment may not be responsive to the putative modulating effect of Zn.

Cadmium exposure and age-related macular degeneration

Cadmium (Cd) has been proposed as a risk factor for age-related macular degeneration (AMD), but the association between Cd exposure and AMD risk in large population studies is unknown. This study evaluated the association of Cd exposure with AMD in a large representative sample of Korean men and women. This was a cross-sectional study of 3865 Korean adults ≥ 40 years of age who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) during 2008-2011. Cd concentrations in whole blood were measured by graphite-furnace atomic absorption spectrometry. The presence of AMD was determined in digital non-mydriatic fundus photographs. Cd levels were higher in participants with AMD compared with those without AMD (1.3 vs 1.1 μg/l, respectively, P<0.001). In fully adjusted models, the odds ratio for AMD comparing the highest with the lowest Cd quartiles was 1.92 (95% CI=1.08-3.39; P for trend 0.029). In restricted cubic spline models, the association between Cd and AMD was approximately linear, with no evidence of threshold effects. Blood Cd concentrations were independently associated with the prevalence of AMD. If the association is proven causal, population-based preventive strategies to decrease Cd exposure could reduce the population burden of AMD.

Insights into neurosensory toxicity of mercury in fish eyes stemming from tissue burdens, oxidative stress and synaptic transmission profiles

This study aims to contribute to fill a knowledge gap related with Hg effects in fish eyes. As a pioneering strategy, Hg bioaccumulation in eye wall of the wild grey mullet (Liza aurata) was assessed, together with oxidative stress and synaptic transmission profiles. This approach was complemented by the characterisation of environmental contamination (both in water and sediment). Sampling was conducted in winter and summer in two sites of a Portuguese coastal lagoon (Aveiro lagoon): Largo do Laranjo (LAR) - located in an Hg contaminated/confined area; São Jacinto (SJ) - closer to the lagoon inlet and selected as reference site. Levels of total Hg (tHg), inorganic Hg (iHg) and methylmercury (MeHg) in eye wall were higher at LAR than SJ, both in winter and summer, reflecting the environmental contamination patterns. Moreover, fish caught at LAR in winter showed a significant decrease of catalase and superoxide dismutase activities, in line with the occurrence of peroxidative damage. A different spatial pattern was recorded in summer, being characterised by the increment of glutathione peroxidase and glutathione reductase activities at LAR, as well as total glutathione content, preventing the occurrence of lipid peroxidation. Also in summer, a significant decrease of acetylcholinesterase activity was recorded in fish eyes at LAR, pointed out Hg as an anticholinergic agent. Besides Hg, water salinity had probably an indirect effect on spatial and winter-summer variation patterns of AChE. Current data pointed out that Hg (in iHg and MeHg forms) could exert ocular toxicity both by the promotion of oxidative stress and by the interference with neurotransmission processes.

Age and Smoking Related Changes in Metal Ion Levels in Human Lens: Implications for Cataract Formation

Age-related cataract formation is the primary cause of blindness worldwide and although treatable by surgical removal of the lens the majority of sufferers have neither the finances nor access to the medical facilities required. Therefore, a better understanding of the pathogenesis of cataract may identify new therapeutic targets to prevent or slow its progression. Cataract incidence is strongly correlated with age and cigarette smoking, factors that are often associated with accumulation of metal ions in other tissues. Therefore this study evaluated the age-related changes in 14 metal ions in 32 post mortem human lenses without known cataract from donors of 11 to 82 years of age by inductively coupled plasma mass spectrometry; smoking-related changes in 10 smokers verses 14 non-smokers were also analysed. A significant age-related increase in selenium and decrease in copper ions was observed for the first time in the lens tissue, where cadmium ion levels were also increased as has been seen previously. Aluminium and vanadium ions were found to be increased in smokers compared to non-smokers (an analysis that has only been carried out before in lenses with cataract). These changes in metal ions, i.e. that occur as a consequence of normal ageing and of smoking, could contribute to cataract formation via induction of oxidative stress pathways, modulation of extracellular matrix structure/function and cellular toxicity. Thus, this study has identified novel changes in metal ions in human lens that could potentially drive the pathology of cataract formation.

Association between Blood Lead Levels and Age-Related Macular Degeneration

Purpose

To investigate the association between blood lead levels and prevalence of age-related macular degeneration (AMD).

Methods

A nationwide population-based cross-sectional study included 4,933 subjects aged over 40 years who participated in the 2008–2012 Korean National Health and Nutrition Examination Survey, and for whom fundus photographs were available. All participants underwent a standardized interview, evaluation of blood lead concentration, and a comprehensive ophthalmic examination. Digital fundus photographs (45°) were taken of both eyes under physiological mydriasis. All fundus photographs were graded using an international classification and grading system.

Results

Mean blood lead levels were 3.15 μg/dL in men and 2.27 μg/dL in women (P < 0.001). After adjusting for potential confounders including age, gender, smoking status, total cholesterol levels, triglyceride levels, heart problems and strokes, the adjusted odds ratio (OR) in women for any AMD was 1.86 (95% Confidence Interval [CI], 1.03–3.36) and for early AMD was 1.92 (95% CI, 1.06–3.48), for those in the highest quintile of lead level compared with the lowest quintile. In men, however, blood lead level was not significantly associated with AMD.

Conclusions

Blood lead levels were higher in men, but were only associated with AMD in women. Increased levels of blood lead may be involved in the pathogenesis of AMD development in women.

Retinal and visual system: occupational and environmental toxicology

Occupational chemical exposure often results in sensory systems alterations that occur without other clinical signs or symptoms. Approximately 3000 chemicals are toxic to the retina and central visual system. Their dysfunction can have immediate, long-term, and delayed effects on mental health, physical health, and performance and lead to increased occupational injuries. The aims of this chapter are fourfold. First, provide references on retinal/visual system structure, function, and assessment techniques. Second, discuss the retinal features that make it especially vulnerable to toxic chemicals. Third, review the clinical and corresponding experimental data regarding retinal/visual system deficits produced by occupational toxicants: organic solvents (carbon disulfide, trichloroethylene, tetrachloroethylene, styrene, toluene, and mixtures) and metals (inorganic lead, methyl mercury, and mercury vapor). Fourth, discuss occupational and environmental toxicants as risk factors for late-onset retinal diseases and degeneration. Overall, the toxicants altered color vision, rod- and/or cone-mediated electroretinograms, visual fields, spatial contrast sensitivity, and/or retinal thickness. The findings elucidate the importance of conducting multimodal noninvasive clinical, electrophysiologic, imaging and vision testing to monitor toxicant-exposed workers for possible retinal/visual system alterations. Finally, since the retina is a window into the brain, an increased awareness and understanding of retinal/visual system dysfunction should provide additional insight into acquired neurodegenerative disorders.

Five heavy metallic elements and age-related macular degeneration: Korean National Health and Nutrition Examination Survey, 2008-2011

OBJECTIVE

To investigate the association between age-related macular degeneration (AMD) and 5 heavy metallic elements (lead, mercury, cadmium, manganese, and zinc).

DESIGN

A cross-sectional study using a complex, stratified, multistage, probability cluster survey.

PARTICIPANTS

Participants of the Korean National Health and Nutrition Examination Survey from 2008 to 2011.

METHODS

Using a standardized protocol, AMD was determined by fundus photograph grading. Blood concentrations of lead, mercury, cadmium, manganese, and zinc were measured. Associations between AMD and these 5 elements were estimated using logistic regression analyses (LRAs). The distributions of the 5 metallic elements in blood were analyzed, and the same set of LRAs estimating the association between AMD and logarithmic-transformed blood concentrations of the 5 elements were also conducted.

MAIN OUTCOME MEASURES

Association between AMD and 5 heavy metals.

RESULTS

Lead was positively associated with both early AMD and late AMD in all LRAs. Mercury and cadmium also had a positive association with late AMD in all LRAs, but not with early AMD. In contrast, manganese and zinc had an inverse association with late AMD in all LRAs. Manganese and zinc were not associated with early AMD. Using logarithmic-transformed blood concentrations for each metallic element, the LRAs showed similar results compared with those of the LRAs using nontransformed blood concentrations, despite the skewed distribution of these metallic elements in the blood.

CONCLUSIONS

This study suggests that the toxic heavy metals (lead, mercury, and cadmium) may negatively influence late AMD, whereas essential heavy metals (manganese and zinc) may favorably influence late AMD. Lead may widely affect the pathogenesis of both early and late AMD.

Environmental cadmium and lead exposures and age-related macular degeneration in U.S. adults: the National Health and Nutrition Examination Survey 2005 to 2008

Age-related macular degeneration (AMD) is a complex disease resulting from the interplay of genetic predisposition and environmental exposures, and has been linked to oxidative stress and inflammatory mechanisms. Lead and cadmium can accumulate in human retinal tissues and may damage the retina through oxidative stress, and may thereby play a role in the development of AMD. We examined associations between blood lead, blood cadmium, and urinary cadmium concentrations and the presence of AMD in 5390 participants aged 40 years and older with blood lead and blood cadmium measures and a subsample of 1548 with urinary cadmium measures in the 2005-2008 National Health and Nutrition Examination Surveys. AMD was identified by grading retinal photographs with a modification of the Wisconsin Age-Related Maculopathy Grading System. The weighted prevalence of AMD was 6.6% (n=426). Controlling for age, gender, race/ethnicity, education and body mass index, adults in the highest blood cadmium quartile had higher odds of AMD compared to the lowest quartile (odds ratio [OR], 1.56; 95% CI, 1.02-2.40), with a significant trend across quartiles (p-trend=0.02). After further adjustment for pack-years of cigarette smoking, estimates were somewhat attenuated (OR, 1.43; 95% CI, 0.91-2.27; p-trend=0.08). Similar associations were found with urinary cadmium. The association between urinary cadmium and AMD was stronger in non-Hispanic whites (NHW) than in non-Hispanic blacks (NHB) (OR, 3.31; 95% CI, 1.37-8.01 for levels above versus below the median among NHW; OR,1.45; 95% CI, 0.40-5.32 for levels above versus below the median among NHB; p-interaction=0.03). We found no association between blood lead levels and AMD. Higher cadmium body burden may increase risk of AMD, particularly among non-Hispanic white individuals; however, additional studies are needed before firm conclusions can be drawn.

A review of metal-catalyzed molecular damage: protection by melatonin

Metal exposure is associated with several toxic effects; herein, we review the toxicity mechanisms of cadmium, mercury, arsenic, lead, aluminum, chromium, iron, copper, nickel, cobalt, vanadium, and molybdenum as these processes relate to free radical generation. Free radicals can be generated in cells due to a wide variety of exogenous and endogenous processes, causing modifications in DNA bases, enhancing lipid peroxidation, and altering calcium and sulfhydryl homeostasis. Melatonin, an ubiquitous and pleiotropic molecule, exerts efficient protection against oxidative stress and ameliorates oxidative/nitrosative damage by a variety of mechanisms. Also, melatonin has a chelating property which may contribute in reducing metal-induced toxicity as we postulate here. The aim of this review was to highlight the protective role of melatonin in counteracting metal-induced free radical generation. Understanding the physicochemical insights of melatonin related to the free radical scavenging activity and the stimulation of antioxidative enzymes is of critical importance for the development of novel therapeutic strategies against the toxic action of these metals.

Mechanisms of Hg species induced toxicity in cultured human astrocytes: genotoxicity and DNA-damage response

The toxicologically most relevant mercury (Hg) species for human exposure is methylmercury (MeHg). Thiomersal is a common preservative used in some vaccine formulations. The aim of this study is to get further mechanistic insight into the yet not fully understood neurotoxic modes of action of organic Hg species. Mercury species investigated include MeHgCl and thiomersal. Additionally HgCl2 was studied, since in the brain mercuric Hg can be formed by dealkylation of the organic species. As a cellular system astrocytes were used. In vivo astrocytes provide the environment necessary for neuronal function. In the present study, cytotoxic effects of the respective mercuricals increased with rising alkylation level and correlated with their cellular bioavailability. Further experiments revealed for all species at subcytotoxic concentrations no induction of DNA strand breaks, whereas all species massively increased H2O2-induced DNA strand breaks. This co-genotoxic effect is likely due to a disturbance of the cellular DNA damage response. Thus, at nanomolar, sub-cytotoxic concentrations, all three mercury species strongly disturbed poly(ADP-ribosyl)ation, a signalling reaction induced by DNA strand breaks. Interestingly, the molecular mechanism behind this inhibition seems to be different for the species. Since chronic PARP-1 inhibition is also discussed to sacrifice neurogenesis and learning abilities, further experiments on neurons and in vivo studies could be helpful to clarify whether the inhibition of poly(ADP-ribosyl)ation contributes to organic Hg induced neurotoxicity.

Looking at the aquatic contamination through fish eyes--a faithful picture based on metals burden

This study describes for the first time metal accumulation in the eyes of native golden grey mullet (Liza aurata) coupled with water/sediment quality assessment. Sampling was performed in the Tagus estuary (Portugal) where a confined area (Barreiro) is severely contaminated by metal/loids. Levels of As, Cu, Pb, Hg and Cd in sediments from Barreiro were one order of magnitude higher than those from the reference site. Data on water column pointed also to a higher availability of Cu, Pb, Cd and Hg (including MeHg) at Barreiro. Accordingly, fish eyes accumulated higher levels of metal/loids at Barreiro than at the reference site. These findings support the use of fish eyes as a target organ in environmental health assessment since they reflect sediment and water contamination. It points also to the importance of evaluate eye changes at structural/functional levels in order to examine in what extent accumulated metals could compromise this perceptive system.