A prophylactic multi-strain probiotic treatment to reduce the absorption of toxic elements: In-vitro study and biomonitoring of breast milk and infant stools

Preventive effect of prenatal maternal oral probiotic supplementation on neonatal jaundice (POPS Study): A protocol for the randomised double-blind placebo-controlled clinical trial

INTRODUCTION

Neonatal jaundice is a common and life-threatening health problem in neonates due to overaccumulation of circulating unconjugated bilirubin. Gut flora has a potential influence on bilirubin metabolism. The infant gut microbiome is commonly copied from the maternal gut. During pregnancy, due to changes in dietary habits, hormones and body weight, maternal gut dysbiosis is common, which can be stabilised by probiotics supplementation. However, whether probiotic supplements can reach the baby through the mother and reduce the incidence of neonatal jaundice has not been studied yet. Therefore, we aim to evaluate the effect of prenatal maternal probiotic supplementation on the incidence of neonatal jaundice.

METHODS AND ANALYSIS

This is a randomised double-blind placebo-controlled clinical trial among 94 pregnant women (47 in each group) in a tertiary hospital in Hong Kong. Voluntary eligible participants will be recruited between 28 and 35 weeks of gestation. Computer-generated randomisation and allocation to either the intervention or control group will be carried out. Participants will take either one sachet of Vivomixx (450 billion colony-forming units per sachet) or a placebo per day until 1 week post partum. Neither the study participants nor researchers will know the randomisation and allocation. The intervention will be initiated at 36 weeks of gestation. Neonatal bilirubin level will be measured to determine the primary outcome (hyperbilirubinaemia) while the metagenomic microbiome profile of breast milk and maternal and infant stool samples as well as pregnancy outcomes will be secondary outcomes. Binary logistic and linear regressions will be carried out to assess the association of the microbiome data with different clinical outcomes.

ETHICS AND DISSEMINATION

Ethics approval is obtained from the Joint CUHK-NTEC Clinical Research Ethics Committee, Hong Kong (CREC Ref: 2023.100-T). Findings will be published in peer-reviewed journals and presented at international conferences.

TRIAL REGISTRATION NUMBER

NCT06087874.

Phosphate Uptake and Its Relation to Arsenic Toxicity in Lactobacilli

The use of probiotic lactobacilli has been proposed as a strategy to mitigate damage associated with exposure to toxic metals. Their protective effect against cationic metal ions, such as those of mercury or lead, is believed to stem from their chelating and accumulating potential. However, their retention of anionic toxic metalloids, such as inorganic arsenic, is generally low. Through the construction of mutants in phosphate transporter genes (pst) in Lactiplantibacillus plantarum and Lacticaseibacillus paracasei strains, coupled with arsenate [As(V)] uptake and toxicity assays, we determined that the incorporation of As(V), which structurally resembles phosphate, is likely facilitated by phosphate transporters. Surprisingly, inactivation in Lc. paracasei of PhoP, the transcriptional regulator of the two-component system PhoPR, a signal transducer involved in phosphate sensing, led to an increased resistance to arsenite [As(III)]. In comparison to the wild type, the phoP strain exhibited no differences in the ability to retain As(III), and there were no observed changes in the oxidation of As(III) to the less toxic As(V). These results reinforce the idea that specific transport, and not unspecific cell retention, plays a role in As(V) biosorption by lactobacilli, while they reveal an unexpected phenotype for the lack of the pleiotropic regulator PhoP.

Lactational Exposure of Human Infants to Metal (loid)s: A Comparison of Industrial and Urban Inhabitants in North of the Persian Gulf

In this study, postnatal metal (loid)s (MLs) exposure was compared between the petrochemical and gas area of Asaluyeh (PGA) and urban area of Kaki (UA) in Bushehr province, Iran. Two hundred human breast milk (BM) samples from the industrial and urban areas were analyzed for MLs using Inductivity Coupled Plasma-Optical Emission Spectrometry (ICP-OES). Boron (B), copper (Cu), iron (Fe), and nickel (Ni) were found at the highest levels in both study areas. Adjusted multiple linear regression models revealed that the mean concentration of total MLs in BM samples collected from the PGA was statistically significantly greater than that of the UA (655.85 vs. 338.17 µg/L). Also, the mean concentrations of all detected MLs in BM samples collected from the PGA were statistically significantly higher than those collected from the UA. The hazard index (HI) of combined MLs in the PGA and UA illustrated non-cancer risk for infants. Lead (Pb) and chromium (Cr) in the PGA and Cr in the UA showed the risk of cancer. So it can be concluded that nursing infants from an industrial area are most at risk for MLs exposure during entire lactation course than those from an urban area.

Protective effects of oral administration of lactic acid bacteria strains against methylmercury-induced intestinal toxicity in a murine model

The utilization of lactic acid bacteria has been proposed to mitigate the burden of heavy metal exposure through processes probably involving chelation and reduced metal bioaccessibility. We evaluated the effects of daily intake of two strains of lactobacilli (Lactobacillus intestinalis LE1 or Lactobacillus johnsonii LE2) on intestinal toxicity during methylmercury (MeHg) exposure through drinking water (5 mg/L) for two months in mice. MeHg exposure resulted in inflammation and oxidative stress at the colon, as well as an increase in intestinal permeability accompanied by decreased fecal short-chain fatty acids (SCFA). The administration of the strains resulted in a differential protective effect that, based on their chelation capacity, supported the existence of additional mechanisms of action besides chelation. Both strains reduced IL-1β levels and oxidative stress, while LE1 lowered TNF-α, diminished MeHg-induced mucus over-secretion triggered by the IL-4/IL-13/STAT6 pathway, reduced intestinal permeability, and ameliorated inflammation and oxidative stress, probably by acting on the Keap1/Nrf2/ARE pathway. Administration of LE1 partially restored SCFA contents, which could be partly responsible for the positive effects of this strain in alleviating MeHg toxicity. These results demonstrate that lactobacilli strains can be useful tools in reducing the intestinal toxicity of MeHg, the main mercurial form conveyed by food.

The Involvement of Lactic Acid Bacteria and Their Exopolysaccharides in the Biosorption and Detoxication of Heavy Metals in the Gut

Heavy metal pollution has become one of the most important global environmental issues. The human health risk posed by heavy metals encountered through the food chain and occupational and environmental exposure is increasing, resulting in a series of serious diseases. Ingested heavy metals might disturb the function of the gut barrier and cause toxicity to organs or tissues in other sites of the body. Probiotics, including some lactic acid bacteria (LAB), can be used as an alternative strategy to detoxify heavy metals in the host body due to their safety and effectiveness. Exopolysaccharides (EPS) produced by LAB possess varied chemical structures and functional properties and take part in the adsorption of heavy metals via keeping the producing cells vigorous. The main objective of this paper was to summarize the roles of LAB and their EPS in the adsorption and detoxification of heavy metals in the gut. Accumulated evidence has demonstrated that microbial EPS play a pivotal role in heavy metal biosorption. Specifically, EPS-producing LAB have been reported to show superior absorption, tolerance, and efficient abatement of the toxicity of heavy metals in vitro and/or in vivo to non-EPS-producing species. The mechanisms underlying EPS-metal binding are mainly related to the negatively charged acidic groups and unique steric structure on the surface of EPS. However, whether the enriched heavy metals on the bacterial cell surface increase toxicity to local mammal cells or tissues in the intestine and whether they are released during excretion remain to be elucidated.

metaProbiotics: a tool for mining probiotic from metagenomic binning data based on a language model

Beneficial bacteria remain largely unexplored. Lacking systematic methods, understanding probiotic community traits becomes challenging, leading to various conclusions about their probiotic effects among different publications. We developed language model-based metaProbiotics to rapidly detect probiotic bins from metagenomes, demonstrating superior performance in simulated benchmark datasets. Testing on gut metagenomes from probiotic-treated individuals, it revealed the probioticity of intervention strains-derived bins and other probiotic-associated bins beyond the training data, such as a plasmid-like bin. Analyses of these bins revealed various probiotic mechanisms and bai operon as probiotic Ruminococcaceae's potential marker. In different health-disease cohorts, these bins were more common in healthy individuals, signifying their probiotic role, but relevant health predictions based on the abundance profiles of these bins faced cross-disease challenges. To better understand the heterogeneous nature of probiotics, we used metaProbiotics to construct a comprehensive probiotic genome set from global gut metagenomic data. Module analysis of this set shows that diseased individuals often lack certain probiotic gene modules, with significant variation of the missing modules across different diseases. Additionally, different gene modules on the same probiotic have heterogeneous effects on various diseases. We thus believe that gene function integrity of the probiotic community is more crucial in maintaining gut homeostasis than merely increasing specific gene abundance, and adding probiotics indiscriminately might not boost health. We expect that the innovative language model-based metaProbiotics tool will promote novel probiotic discovery using large-scale metagenomic data and facilitate systematic research on bacterial probiotic effects. The metaProbiotics program can be freely downloaded at https://github.com/zhenchengfang/metaProbiotics.

Landfill fire impact on bee health: beneficial effect of dietary supplementation with medicinal plants and probiotics in reducing oxidative stress and metal accumulation

The honey bee is an important pollinator insect susceptible to environmental contaminants. We investigated the effects of a waste fire event on elemental content, oxidative stress, and metabolic response in bees fed different nutrients (probiotics, Quassia amara, and placebo). The level of the elements was also investigated in honey and beeswax. Our data show a general increase in elemental concentrations in all bee groups after the event; however, the administration of probiotics and Quassia amara help fight oxidative stress in bees. Significantly lower concentrations of Ni, S, and U for honey in the probiotic group and a general and significant decrease in elemental concentrations for beeswax in the probiotic group and Li in the Quassia amara group were observed after the fire waste event. The comparison of the metabolic profiles through pre- and post-event PCA analyses showed that bees treated with different feeds react differently to the environmental event. The greatest differences in metabolic profiles are observed between the placebo-fed bees compared to the others. This study can help to understand how some stress factors can affect the health of bees and to take measures to protect these precious insects.

Elucidating the Mechanisms of Cell-to-Cell Crosstalk in Probiotics Co-culture: A Proteomics Study of Limosilactobacillus reuteri ZJ625 and Ligilactobacillus salivarius ZJ614

Limosilactobacillus reuteri ZJ625 and Ligilactobacillus salivarius ZJ614 are potential probiotic bacteria with improved benefits when administered to the host as a multi-strain preparation. To elucidate the mechanisms of cell-to-cell crosstalk between these two strains, we studied their intracellular and extracellular proteomes in co-culture by liquid-chromatography mass-spectrometry (LC-MS) using Dionex Nano-RSLC and fusion mass spectrometer. The experiment consisted of five biological replicates, and samples were collected during the mid-exponential growth phase. The quantitative proteomic profiles revealed several differentially expressed proteins (DEPs), which are down- or up-regulated between and within groups for both the intracellular and extracellular proteomes. These DEPs include proteins synthesising autoinducer-2, a sensor compound for cell-to-cell bacterial crosstalk during quorum sensing in mixed culture. Other important DEPs identified include enolase, phosphoglycerate kinase, and l-lactate dehydrogenase, which play roles in carbohydrate metabolism. Proteins associated with transcription, ATP production and transport across the membrane, DNA repair, and those with the potential to bind to the host epithelium were also identified. The post-translational modifications associated with the proteins include oxidation, deamidation, and ammonia loss. Importantly, this study revealed a significant expression of S-ribosylhomocysteine lyase (luxS) involved in synthesising autoinducer-2 that plays important roles in quorum sensing, aiding bacterial cell-to-cell crosstalk in co-cultures. The proteome of L. salivarius ZJ614 was most affected when co-cultured with L. reuteri ZJ625. In contrast, omitting some medium components from the defined medium exerted more effects on L. reuteri ZJ625 than L. salivarius ZJ614.

First Investigation of the Physiological Distribution of Legacy and Emerging Perfluoroalkyl Substances in Raw Bovine Milk According to the Component Fraction

Bovine milk is a pillar of the human diet and plays a key role in the nutrition of infants. Perfluoroalkyl substances (PFASs) are well-recognized highly stable organic compounds that are able to pollute ecosystems persistently and threaten both human and animal health. The study aimed to analyze the distribution of 14 PFASs within the milk matrix by comparing their content in whole milk, and its skimmed and creamed fractions. Raw milk samples were individually collected from 23 healthy cows (10 primiparous and 13 multiparous) reared on a farm in Northern Italy not surrounded by known point sources of PFASs. Each sample was fractioned in whole, skim, and cream components to undergo PFAS analysis using liquid chromatography-high-resolution mass spectrometry. All samples contained at least one PFAS, with perfluorobutanoic acid (PFBA) being the primary contaminant in all three fractions, followed by perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). PFOS was shown to be significantly (p < 0.001) more concentrated in cream than in raw and skimmed milk. Multiparous cows showed a higher frequency of positive samples in all analyzed fractions. Further research is necessary to assess the risk of dairy diets and high-fat dairy products and to investigate the toxicological effects of PFASs on cattle, even in environments without known PFAS sources.

Challenges and strategies for preventing intestinal damage associated to mercury dietary exposure

Food represents the major risk factor for exposure to mercury in most human populations. Therefore, passage through the gastrointestinal tract plays a fundamental role in its entry into the organism. Despite the intense research carried out on the toxicity of Hg, the effects at the intestinal level have received increased attention only recently. In this review we first provide a critical appraisal of the recent advances on the toxic effects of Hg at the intestinal epithelium. Next, dietary strategies aimed to diminish Hg bioavailability or modulate the epithelial and microbiota responses will be revised. Food components and additives, including probiotics, will be considered. Finally, limitations of current approaches to tackle this problem and future lines of research will be discussed.

What happens to gut microorganisms and potential repair mechanisms when meet heavy metal(loid)s

Heavy metal (loid) pollution is a significant threat to human health, as the intake of heavy metal (loid)s can cause disturbances in intestinal microbial ecology and metabolic disorders, leading to intestinal and systemic diseases. Therefore, it is important to understand the effects of heavy metal (loid)s on intestinal microorganisms and the necessary approaches to restore them after damage. This review provides a summary of the effects of common toxic elements, such as lead (Pb), cadmium (Cd), chromium (Cr), and metalloid arsenic (As), on the microbial community and structure, metabolic pathways and metabolites, and intestinal morphology and structure. The effects of heavy metal (loid)s on metabolism are focused on energy, nitrogen, and short-chain fatty acid metabolism. We also discussed the main solutions for recovery of intestinal microorganisms from the effects of heavy metal (loid)s, namely the supplementation of probiotics, recombinant bacteria with metal resistance, and the non-toxic transformation of heavy metal (loid) ions by their own intestinal flora. This article provides insight into the toxic effects of heavy metals and As on gut microorganisms and hosts and provides additional therapeutic options to mitigate the damage caused by these toxic elements.

Probiotics as a promising prophylactic tool to reduce levels of toxic or potentially toxic elements in bees

Bees are precious living beings for our planet. Thanks to their essential service of pollination, these insects allow the maintenance of biodiversity and the variety and amount of food available. Unfortunately, we are observing an increasingly devastating reduction of bee families and other pollinating insects for factors related to human activities, environmental pollution, diseases and parasites, compromise of natural habitats, and climate change. We show that probiotics can protect bees from element pollution. We collected bees, beeswax, honey, pollen, and propolis directly from hives in a rural area of central Italy to investigate the content of 41 elements in control (not supplemented with probiotics) and experimental (supplemented with probiotics) groups. Our data show a significantly lower concentration of some elements (Ba, Be, Cd, Ce, Co, Cu, Pb, Sn, Tl, and U) in experimental bees than in control groups, indicating a possible beneficial effect of probiotics in reducing the absorption of chemicals. This study presents the first data on element levels after probiotics have been fed to bees and provides the basis for future research in several activities relating to the environment, agriculture, economy, territory, and medicine.

A Multi-Strain Probiotic Formulation Improves Intestinal Barrier Function by the Modulation of Tight and Adherent Junction Proteins

In healthy individuals, tight junction proteins (TJPs) maintain the integrity of the intestinal barrier. Dysbiosis and increased intestinal permeability are observed in several diseases, such as inflammatory bowel disease. Many studies highlight the role of probiotics in preventing intestinal barrier dysfunction. The present study aims to investigate the effects of a commercially available probiotic formulation of L. rhamnosus LR 32, B. lactis BL 04, and B. longum BB 536 (Serobioma, Bromatech s.r.l., Milan, Italy) on TJPs and the integrity of the intestinal epithelial barrier, and the ability of this formulation to prevent lipopolysaccharide-induced, inflammation-associated damage. An in vitro model of the intestinal barrier was developed using a Caco-2 cell monolayer. The mRNA expression levels of the TJ genes were analyzed using real-time PCR. Changes in the amounts of proteins were assessed with Western blotting. The effect of Serobioma on the intestinal epithelial barrier function was assessed using transepithelial electrical resistance (TEER) measurements. The probiotic formulation tested in this study modulates the expression of TJPs and prevents inflammatory damage. Our findings provide new insights into the mechanisms by which probiotics are able to prevent damage to the gut epithelial barrier.

Human health risk assessment of lead (Pb) through the environmental-food pathway

Drinking water and farm-to-fork pathways have been identified as the predominant environmental pathways associated with human exposure (HE) to Pb. This study integrates a GIS-based survey of metal concentrations in soil and a probabilistic quantitative risk assessment of Pb through the food chain. The case study area was selected in the east of Ireland. A step-wise exposure assessment collated the data for Pb concentration in soil and water media, bioaccumulation of Pb in unprocessed food products, such as potatoes, carrots, green vegetables, and salad vegetables. The daily mean HE to Pb through selected food products was found to be 0.073 mg day^-1, where a mean weekly exposure was estimated as 0.0065 mg kg body weight^-1 week^-1. Multiple risk estimates were used. Hazard Quotient (HQ), Daily Dietary Index (DDI), Daily Intake of Metal (DIM), Health Risk Index (HRI), Target Hazard Quotient (THQ) and Cancer Risk (CR) were found as 0.234 to 0.669, 0.002, 0.0002, 0.020 to 0.057, 0.234 to 0.669, and 0.00001, respectively which signify a low to moderate risk. A sensitivity analysis revealed that intake of potato is the most sensitive parameter of the model, which is positively correlated (coeff. + 0.66) followed by concentration of Pb in the arable soil (+0.49), bioaccumulation in tubers (+0.37), consumption of salad vegetables (+0.20), and consumption of green vegetables (+0.13) (top 5). A back-calculated limit of Pb in the soil (51 mg kg^-1) justifies the lower threshold limit of Pb (50-300 mg kg^-1) in agricultural soil set by the European Union to mitigate potential bio-transfer into food products. The study concludes there is a low to moderate risk posed by Pb, within the system boundary of the probabilistic model, and highlights the significance of limiting Pb concentrations in the vegetable producing agricultural soil.

Parkinson's Disease and the Metal-Microbiome-Gut-Brain Axis: A Systems Toxicology Approach

Parkinson's Disease (PD) is a neurodegenerative disease, leading to motor and non-motor complications. Autonomic alterations, including gastrointestinal symptoms, precede motor defects and act as early warning signs. Chronic exposure to dietary, environmental heavy metals impacts the gastrointestinal system and host-associated microbiome, eventually affecting the central nervous system. The correlation between dysbiosis and PD suggests a functional and bidirectional communication between the gut and the brain. The bioaccumulation of metals promotes stress mechanisms by increasing reactive oxygen species, likely altering the bidirectional gut-brain link. To better understand the differing molecular mechanisms underlying PD, integrative modeling approaches are necessary to connect multifactorial perturbations in this heterogeneous disorder. By exploring the effects of gut microbiota modulation on dietary heavy metal exposure in relation to PD onset, the modification of the host-associated microbiome to mitigate neurological stress may be a future treatment option against neurodegeneration through bioremediation. The progressive movement towards a systems toxicology framework for precision medicine can uncover molecular mechanisms underlying PD onset such as metal regulation and microbial community interactions by developing predictive models to better understand PD etiology to identify options for novel treatments and beyond. Several methodologies recently addressed the complexity of this interaction from different perspectives; however, to date, a comprehensive review of these approaches is still lacking. Therefore, our main aim through this manuscript is to fill this gap in the scientific literature by reviewing recently published papers to address the surrounding questions regarding the underlying molecular mechanisms between metals, microbiota, and the gut-brain-axis, as well as the regulation of this system to prevent neurodegeneration.

Dietary Habits and Relationship with the Presence of Main and Trace Elements, Bisphenol A, Tetrabromobisphenol A, and the Lipid, Microbiological and Immunological Profiles of Breast Milk

Breastfeeding is the best way to feed an infant, although it can also be a source of abiotic contaminants such as heavy metals or bisphenol A (BPA). The early life exposure to these compounds can lead to serious toxic effects in both the short and long-term. These substances can reach breast milk through the mother’s habits, diet being one of the main routes of exposure. The aim of the present work was to analyse possible associations between the dietary habits of women and the content of major trace elements, BPA, fatty acids and lipids, and the microbiological and immunological profiles of human milk. Possible associations between major trace elements and BPA and the lipid, microbiological and immunological profiles were also analysed. The results of this study support that the microbiological composition of human milk is associated with the dietary habits of the women, and that the consumption of canned drinks is related to the presence of BPA in human milk. Furthermore, some relationships were found between the amount of major trace elements and the microbiological and immunological profile of the milk samples. Finally, the presence of BPA was associated with changes in the immunological profile of human milk.

Salivary Lead Levels among Workers in Different Industrial Areas in the West Bank of Palestine: a Cross-Sectional Study

Saliva is a biofluid that can easily be obtained and used for biomonitoring lead levels in occupationally and environmentally exposed individuals. The aims of this study were to determine salivary lead levels among workers in different industrial areas in the West Bank of Palestine and investigate the association between sociodemographic and occupational characteristics of the workers and their salivary lead levels. Salivary samples were obtained from workers in different industrial areas in metal-free polyethylene tubes. The samples were analyzed for their lead contents using a pre-validated inductively coupled plasma-mass spectrometric method. A total of 97 salivary samples were analyzed. The median salivary lead level was 1.84 μg/dL an IQR of 5.04 μg/dL. Salivary lead levels were significantly higher in workers who were 40 years and older (p value = 0.031), had 3 children or more (p value = 0.048), worked in repair workshops (p value = 0.012), worked in industrial areas for 20 years or more (p value = 0.048), did not consume fruits on regular basis (p value = 0.031), and smoked for 30 years or more (p value = 0.013). Multiple linear regression showed that smoking of 30 years old or more was a significant (p value < 0.001) predictor of higher salivary lead levels. Salivary lead levels among workers from different industrial areas of the West Bank were comparable to those occupationally exposed to lead in more industrialized and urbanized areas of the world. Smoking was a predictor of higher salivary lead levels.

Health Risk Assessment of Trace Metals Through Breast Milk Consumption in Saudi Arabia

We previously measured the levels of inorganic mercury, methylmercury, lead, cadmium, and manganese in the breast milk of 203 healthy Saudi mothers who participated in a cross-sectional study between 2011 and 2013. The current study aimed to (1) calculate reference values (RVs) for these metals in breast milk based on the 95th percentile of the metal and the corresponding 95% confidence interval following the approach of the German Human Biomonitoring Commission, and (2) assess the health risk associated with these metals (except lead) by determining the hazard quotient (HQ) and hazard index (HI) for breastfed infants. The risk characterization for the lead was applied using the margin of exposure (MOE) approach. Moreover, the cancer risk (CR) associated with lead was calculated. The RV₉₅s (percentage of samples for which the value was higher than the set value) for inorganic mercury, methylmercury, total mercury, cadmium, lead, and manganese in breast milk (μg/L) were 1.5 (7.9%), 1.5 (5.4%), 2.8 (8.9%), 2.5 (8.4%), 53 (11.3%), and 22.3 (11.8%) μg/L, respectively. The methylmercury, lead, and manganese levels in the present study were higher than those reported previously. The HQ for methylmercury greater than 1 was found in 68.5% of the samples, indicating there may be a potential non-carcinogenic health risk of infant exposure to the toxic metal via breast milk consumption. Despite the high cadmium and manganese levels in breast milk, our results suggested no health risk (HQ < 1). The HI representing the combined non-carcinogenic health risk of four metals was > 1, with methylmercury (74%) being the major contributor. The estimated MOE mean value of 0.134, less than 1, indicates that our breastfed infants may be at increased risk of neurodevelopmental impairments. The CR for lead in two infants was higher than the acceptable level of 1 × 10^-4. Although our results may suggest potential carcinogenic and non-carcinogenic risks of infant exposure to toxic metals through breast milk consumption, the benefits of breastfeeding are well recognized and outweigh the potential risks.

Probiotics and gut microbiome - Prospects and challenges in remediating heavy metal toxicity

The gut microbiome, often referred to as "super organ", comprises up to a hundred trillion microorganisms, and the species diversity may vary from person to person. They perform a decisive role in diverse biological functions related to metabolism, immunity and neurological responses. However, the microbiome is sensitive to environmental pollutants, especially heavy metals. There is continuous interaction between heavy metals and the microbiome. Heavy metal exposure retards the growth and changes the structure of the phyla involved in the gut microbiome. Meanwhile, the gut microbiome tries to detoxify the heavy metals by altering the physiological conditions, intestinal permeability, enhancing enzymes for metabolizing heavy metals. This review summarizes the effect of heavy metals in altering the gut microbiome, the mechanism by which gut microbiota detoxifies heavy metals, diseases developed due to heavy metal-induced dysbiosis of the gut microbiome, and the usage of probiotics along with advancements in developing improved recombinant probiotic strains for the remediation of heavy metal toxicity.

The Recent Trend in the Use of Multistrain Probiotics in Livestock Production: An Overview

It has been established that introducing feed additives to livestock, either nutritional or non-nutritional, is beneficial in manipulating the microbial ecosystem to maintain a balance in the gut microbes and thereby improving nutrient utilization, productivity, and health status of animals. Probiotic use has gained popularity in the livestock industry, especially since antimicrobial growth promoter's use has been restricted due to the challenge of antibiotic resistance in both animals and consumers of animal products. Their usage has been linked to intestinal microbial balance and improved performance in administered animals. Even though monostrain probiotics could be beneficial, multistrain probiotics containing two or more species or strains have gained considerable attention. Combining different strains has presumably achieved several health benefits over single strains due to individual isolates' addition and positive synergistic adhesion effects on animal health and performance. However, there has been inconsistency in the effects of the probiotic complexes in literature. This review discusses multistrain probiotics, summarizes selected literature on their effects on ruminants, poultry, and swine productivity and the various modes by which they function.

Reusable Water Bottles: Release of Inorganic Elements, Phthalates, and Bisphenol A in a “Real Use” Simulation Experiment

Reusable water bottles are growing in popularity; thus, possible chemical release from the internal surface into water should be carefully considered to control related health risks. We experimentally evaluated the release into deionized water of 40 elements, six phthalates, and bisphenol-A for 20 different reusable bottles by simulating the use in real world scenario. The 20 bottles, identified as those most purchased in Italy, were made of various materials (stainless steel, aluminum, plastic, and silicone). The experiment was carried out for four consecutive weeks in duplicate for each type of bottle. Our results showed the release, to various extents, of inorganic elements from all 20 bottles, while the release of phthalates and bisphenol-A was never found. The elements most frequently released were Al, Sr, Mo, and Cr, while the highest concentrations were for Ca, K, Mg, and Na; the release of toxic elements (such as Pb, Cd, Ni, Sb) also occurred. The comparison of our results with regulatory limits on drinking water quality revealed no exceeding values except for Al. However, these releases represent a further intake, and the related risks cannot be neglected, especially for highly susceptible populations. Thus, it is essential to correctly inform consumers both with dedicated interventions and exhaustive labelling.

An Analytical Method for the Biomonitoring of Mercury in Bees and Beehive Products by Cold Vapor Atomic Fluorescence Spectrometry

Bees and their products are useful bioindicators of anthropogenic activities and could overcome the deficiencies of air quality networks. Among the environmental contaminants, mercury (Hg) is a toxic metal that can accumulate in living organisms. The first aim of this study was to develop a simple analytical method to determine Hg in small mass samples of bees and beehive products by cold vapor atomic fluorescence spectrometry. The proposed method was optimized for about 0.02 g bee, pollen, propolis, and royal jelly, 0.05 g beeswax and honey, or 0.1 g honeydew with 0.5 mL HCl, 0.2 mL HNO₃, and 0.1 mL H₂O₂ in a water bath (95 °C, 30 min); samples were made up to a final volume of 5 mL deionized water. The method limits sample manipulation and the reagent mixture volume used. Detection limits were lower than 3 µg kg⁻¹ for a sample mass of 0.02 g, and recoveries and precision were within 20% of the expected value and less than 10%, respectively, for many matrices. The second aim of the present study was to evaluate the proposed method’s performances on real samples collected in six areas of the Lazio region in Italy.

Current applications and future perspectives on elemental analysis of non-invasive samples for human biomonitoring

Humans are continuously exposed to numerous environmental pollutants including potentially toxic elements. Essential elements play an important role in human health. Abnormal elemental levels in the body, in different forms that existed, have been reported to be correlated with different diseases and environmental exposure. Blood is the conventional biological sample used in human biomonitoring. However, blood samples can only reflect short-term exposure and require invasive sampling, which poses infection risk to individuals. In recent years, the number of research evaluating the effectiveness of non-invasive samples (hair, nails, urine, meconium, breast milk, placenta, cord blood, saliva and teeth) for human biomonitoring is increasing. These samples can be collected easily and provide extra information in addition to blood analysis. Yet, the correlation between the elemental concentration in non-invasive samples and in blood is not well established, which hinders the application of those samples in routine human biomonitoring. This review aims at providing a fundamental overview of analytical methods of non-invasive samples in human biomonitoring. The content covers the sample collection and pretreatment, sample preparation and instrumental analysis. The technical discussions are separated into solution analysis and solid analysis. In the last section, the authors highlight some of the perspectives on the future of elemental analysis in human biomonitoring.

Neurodevelopment and exposure to neurotoxic metal(loid)s in environments polluted by mining, metal scrapping and smelters, and e-waste recycling in low and middle-income countries

This review covers a wide body of literature to gain an understanding of the impacts of informal activities related to metal extraction (primary mining and recycling) on early life exposure to neurotoxicants and on neurodevelopment. In primary mining, gold extraction with Hg amalgamation is the main environmental cause of Hg pollution in most artisanal small-scale gold mining (ASGM) activities around the world. Nevertheless, in Sub-Saharan Africa (SSA), Pb disrupted from gold-related ores, mining, and artisanal cookware production are an important neurotoxicant that seriously contaminates the affected population, with devastating effects on children. In e-waste recycling settings, the range of neurotoxic substances that contaminate mothers and children is wider than in primary mining environments. Thus, Hg and Pb are major pre- and postnatal neurotoxicants affecting children in the informal metal extraction activities and SSA countries show the highest record of human contamination and of neurotoxic effects on children. There are additional sources of neurotoxic contamination from mining and metal processing activities (cyanide tailing in South America and SSA) and/or co-exposure to Hg-containing products such as cosmetics (soaps and Hg-based skin lightning creams in Africa) and pediatric Thimerosal-containing vaccines (TCVs, that breaks down to ethyl-mercury) in current use in middle and low income countries. However, the action of these neurotoxicants (per se or in combination) on children needs more attention and research. Studies show a negative association between biomarkers of all environmental metal(loid)s (As, Cd, Hg, Mn, and Pb) studied and neurodevelopment in young children. Sadly, in many unregulated activities, child labor is widely employed, thus presenting an additional occupational exposure. Children living in polluted environments related to metal processing are disproportionately exposed to a wide range of co-occurring neurotoxic substances. The review showed compelling evidence from highly representative parts of the world (Africa, Asia, and Latin America) that the studied neurotoxic substances negatively affected areas of the brain associated with language, memory and executive function, as well as psychosocial behavior. Protecting the environment and children from unregulated and highly polluting metal extraction and processing are inextricably intertwined and deserve urgent attention.

Determination of 40 Elements in Powdered Infant Formulas and Related Risk Assessment

The aim of the study was to analyze all powdered infant formulas authorized and commercialized in Italy at the time of the study to measure the concentrations of 40 elements, and to estimate the infants’ intake of some toxic heavy metals for assessing possible related health risks. For this purpose, an optimized multi-element method was used through inductively coupled plasma mass spectrometry. Be, B, Al, Zr, Nb, Sb, Te, W, V, Cr and As concentrations were <LOD in more than 30% of samples. The levels of the other elements resulted to be very variable (more than 2000 µg g⁻¹ for Ca and K or less than 1 ng g⁻¹ for others). The results were similar to those reported by other European Union (EU) studies, but different from those recovered outside the EU. These differences should be eliminated to guarantee the right to health worldwide. The concentrations of Cd, Mn, Ni, Pb, and Zn in the infant formulas studied were always below the considered limits. However, it is important to check for potentially toxic elements in infant formulas to protect the health of this sensitive population. The data found in this study could be used as benchmark data for future research.

Multi-Strain Probiotics: Synergy among Isolates Enhances Biological Activities

The use of probiotics for health benefits is becoming popular because of the quest for safer products with protective and therapeutic effects against diseases and infectious agents. The emergence and spread of antimicrobial resistance among pathogens had prompted restrictions over the non-therapeutic use of antibiotics for prophylaxis and growth promotion, especially in animal husbandry. While single-strain probiotics are beneficial to health, multi-strain probiotics might be more helpful because of synergy and additive effects among the individual isolates. This article documents the mechanisms by which multi-strain probiotics exert their effects in managing infectious and non-infectious diseases, inhibiting antibiotic-resistant pathogens and health improvement. The administration of multi-strain probiotics was revealed to effectively alleviate bowel tract conditions, such as irritable bowel syndrome, inhibition of pathogens and modulation of the immune system and gut microbiota. Finally, while most of the current research focuses on comparing the effects of multi-strain and single-strain probiotics, there is a dearth of information on the molecular mechanisms of synergy among multi-strain probiotics isolates. This forms a basis for future research in the development of multi-strain probiotics for enhanced health benefits.

A review on Cadmium Exposure in the Population and Intervention Strategies Against Cadmium Toxicity

The rapid industrial development has led to serious cadmium (Cd) pollution. Cd is a toxic heavy metal placing severe health threat to human. Cd can enter the body through the atmosphere, water, soil and food, and has a long half-life (10-30 years), it largely accumulates in kidneys, liver, bone and other organs and causes irreversible damage to the target organs. Cd pollution has also further caused certain carcinogenic and non-carcinogenic health risk. This study summarizes the current situation of Cd pollution, the toxicity of specific target organs, carcinogenic risk and non-carcinogenic risk in the general population, as well as dietary supplements to prevent and mitigate Cd toxication, which aims to focus on the adverse effects of Cd to human from both individual and population perspectives, hoping that not only the health risk of Cd poisoning can be reduced, but also the accurate prevention and control of Cd poisoning can be achieved in the future.

Urinary Mercury Levels and Predictors of Exposure among a Group of Italian Children

Urinary mercury (Hg) levels are suitable to assess long-term exposure to both elemental and inorganic Hg. In this study, the urinary Hg levels of 250 children (aged 6–11 years) from three areas with different anthropogenic impacts in the Rieti province, central Italy, were assessed. The Hg concentrations were in the range of 0.04–2.18 µg L⁻¹ with a geometric mean equal to 0.18 µg L⁻¹ [95% confidence interval (CI), 0.17–0.20 µg L⁻¹] or 0.21 µg g⁻¹ creatinine (95% CI, 0.19–0.23 µg g⁻¹ creatinine), and a reference value calculated as 95th percentile of 0.53 µg L⁻¹ (95% CI, 0.44–0.73 µg L⁻¹) or 0.55 µg g⁻¹ creatinine (95% CI, 0.50–0.83 µg g⁻¹ creatinine). In all cases, urinary Hg data were below the HBM-I values (7 µg L⁻¹ or 5 µg g⁻¹ creatinine) established for urine, while the 95th percentile was above the German Human Biomonitoring Commission’s RV95 (0.4 µg L⁻¹) set for children without amalgam fillings. A significant correlation (p < 0.05) was found between creatinine-corrected results and residence area, with higher urinary Hg levels in children living in the industrial area. Multiple linear regression analysis showed that creatinine was the main predictor of urinary Hg.

Element Levels and Predictors of Exposure in the Hair of Ethiopian Children

Children's development and health may be affected by toxic heavy metal exposure or suboptimal essential element intake. This study aimed to provide updated information regarding the concentrations of 41 elements in children's hair (aged under 18) living in a rural area of the Benishangul-Gumuz region, Ethiopia. The highest average levels (as a geometric mean) for toxic heavy metals were obtained for Al (1 mg kg^-1), Pb (3.1 mg kg^-1), and Ni (1.2 mg kg^-1), while the lowest concentrations among the essential elements were found for Co (0.32 mg kg^-1), Mo (0.07 mg kg^-1), Se (0.19 mg kg^-1), and V (0.8 mg kg^-1). Hair analysis was combined with a survey to evaluate relationships and variations among subgroups and potential metal exposure predictors. Females showed significantly higher concentrations for most hair elements, excluding Zn, than males, and the 6-11 years age group reported the highest levels for Be, Ce, Co, Fe, La, Li, Mo, and Na. The main predictors of exposure to toxic elements were fish consumption for Hg and drinking water for Ba, Be, Cs, Li, Ni, Tl, and U. The data from this study can be used to develop prevention strategies for children's health and protection in developing countries.

Elemental concentration and migratability in bioplastics derived from organic waste

In line with the Circular Economy approach, the production of polyhydroxyalkanoate (PHA) with organic waste as the feedstock may a biotechnological application to reduce waste and recover high-value materials. The potential contaminants that could transfer from bio-waste to a PHA include inorganic elements, such as heavy metals. Hence, the total content and migratability of certain elements were evaluated in several PHA samples produced from different origins and following different methods. The total content of certain elements in PHA ranged between 0.0001 (Be) and 49,500 mg kg^-1 (Na). The concentrations of some alkaline (Na and K) and alkaline earth (Ca and Mg) metals were highest, which are of little environmental concern. The feedstock type and PHA stabilisation and extraction procedures affected the element contents. Several sets of experiments were conducted to evaluate the migration of elements from the PHA samples under different storage times, temperatures, and pH levels. The total contents of some heavy metals (As, Cd, Fe, Hg, Ni, Pb, and Zn) in PHA produced from fruit waste or crops (commercial PHA) were lower than those in the PHA samples produced from the mixture of the organic fraction of municipal waste and sludge from wastewater treatment. Both the PHA obtained by extraction from wet biomass (acid storage) with aqueous phase extraction reagents and commercial PHA were below the migration limits stipulated by the current Toy Safety Directive and by Commission Regulation (EU) October 2011 on plastic materials and articles intended to come into contact with food under frozen and refrigerated conditions.

The Role of Probiotics in the Amelioration of Cadmium Toxicity

Cadmium is extremely toxic heavy metal, and there is no specific, safe, and efficacious therapeutic management of cadmium toxicity. Scientific literature reveals several probiotic microorganisms which alleviate experimentally induced cadmium toxicity in animals. The present review attempts to collate the experimental studies on probiotics and probiotic-derived natural products with cadmium toxicity ameliorative effects. Literature survey revealed that seven (7) types of probiotic microorganisms exhibited significant protection from cadmium toxicity in experimental pre-clinical studies. Clinical study with significant outcome was not found in literature. From the outcomes of the pre-clinical studies, it appears that probiotics have the prospect for alleviation and treatment of cadmium toxicity.

Effectiveness of Different Sample Treatments for the Elemental Characterization of Bees and Beehive Products

Bee health and beehive products’ quality are compromised by complex interactions between multiple stressors, among which toxic elements play an important role. The aim of this study is to optimize and validate sensible and reliable analytical methods for biomonitoring studies and the quality control of beehive products. Four digestion procedures, including two systems (microwave oven and water bath) and different mixture reagents, were evaluated for the determination of the total content of 40 elements in bees and five beehive products (beeswax, honey, pollen, propolis and royal jelly) by using inductively coupled plasma mass and optical emission spectrometry. Method validation was performed by measuring a standard reference material and the recoveries for each selected matrix. The water bath-assisted digestion of bees and beehive products is proposed as a fast alternative to microwave-assisted digestion for all elements in biomonitoring studies. The present study highlights the possible drawbacks that may be encountered during the elemental analysis of these biological matrices and aims to be a valuable aid for the analytical chemist. Total elemental concentrations, determined in commercially available beehive products, are presented.

Occupational Exposure Assessment of Major and Trace Elements in Human Scalp Hair Among a Group of Eritrean Workers

The aim of the study was to evaluate occupational exposure to 40 elements among a group of Eritrean adults employed at the Medeber metal market by analysing human scalp hair samples and by investigating the role of some predictors (gender, age, and body mass index-BMI) on their levels. Scalp hair samples were collected from 60 subjects (32 subjects working at the Medeber metal market and 28 subjects not working at Medeber and not employed in other industrial or artisanal activities) and were analysed through inductively coupled plasma mass spectrometry to determine the contents of 40 major and trace elements. Information on participants was collected via questionnaire. Significant differences were found in the hair levels of certain elements between subjects working at the Medeber metal market and subjects not exposed. In particular, working at the Medeber metal market increased hair levels of Be, B, Cu, Zn, Mo, Cd, Sb, Tl, Pb, and Fe from 25 to 100%, while reduced Na, K, and Rb levels from 30 to 50%. With multivariate adjustment for age, gender, and BMI, the results confirm that working at Medeber significantly increased the hair levels of Cu, Zn, Sb, Pb, and Fe. This finding reveals the need for more accurate and routine biomonitoring surveys and the necessity of health promotion campaigns both for local decision-makers and workers to increase health promotion and safety in this workplace.

Biomonitoring of Mercury in Hair among a Group of Eritreans (Africa)

Small-scale or artisanal mining, using gold-mercury amalgamation to extract gold from ore, is a significant source of exposure for the workers and nearby populations. Few studies on hair mercury (Hg) have been conducted in Africa despite the fact that Africa has several gold deposits. No studies have been conducted in Eritrea that is one of the emerging gold producing countries in Africa. The aim of the study was to assess the Hg concentration in hair samples (n = 120) of a population living in Asmara, capital of Eritrea, and to evaluate the influence of some factors on the Hg levels in hair. Information on age, height, weight, occupation, smoking and fish consumption of participants were collected via questionnaire. Hair Hg concentration was significantly higher among women compared to men (p < 0.001) and among women preparing spicy products in Medeber market compared to those who did other jobs (p = 0.010). These results highlight the need for routine biomonitoring surveys and for health promotion campaigns devoted to local decision makers and workers.

Structural Analysis of Gluco-Oligosaccharides Produced by Leuconostoc lactis and Their Prebiotic Effect

Leuconostoc lactis CCK940, which exhibits glycosyltransferase activity, produces oligosaccharides using sucrose and maltose as donor and receptor molecules, respectively. The oligosaccharides produced were purified by Bio-gel P2 chromatography and the purified oligosaccharides (CCK-oligosaccharides) consisted of only glucose. ¹H-NMR analysis revealed that the CCK-oligosaccharides were composed of 77.6% α-1,6 and 22.4% α-1,4 glycosidic linkages, and the molecular weight of the CCK-oligosaccharides was found to be 9.42 × 10² Da. To determine the prebiotic effect of the CCK-oligosaccharides, various carbon sources were added in modified media. Growth of six probiotic strains, Lactobacillus casei, L. pentosus, L. plantarum, Weissella cibaria, Bifidobacterim animalis, and Saccharomyces cerevisiae, was better when the CCK-oligosaccharides were used as the sole carbon source compared to fructo-oligosaccharides, which are widely used as prebiotics. These results showed that the CCK-oligosaccharides produced from Leu. lactis CCK940 could serve as good candidates for novel prebiotics.

Probiotics against alleviation of lead toxicity: recent advances

Lead is a toxic heavy metal and there is no specific, safe and efficacious therapeutic management of lead toxicity. Scientific literature reported that some probiotic microorganisms alleviated experimentally induced lead toxicity. The present review attempts to collate the experimental studies on probiotics with ameliorative effects. Literature survey revealed that four (4) types of probiotic microorganisms exhibited significant protection from lead toxicity in experimental pre-clinical studies. No clinical study with significant outcome was found in the literature. From the outcomes of the preclinical studies it appears that probiotics are prospective for alleviation and treatment of lead toxicity.