Feasibility of measuring zinc in human nails using portable x-ray fluorescence

Quantitative analysis of human hairs and nails

Hair and nails are human biomarkers capable of providing a continuous assessment of the concentrations of elements inside the human body to indicate the nutritional status, metabolic changes, and the pathogenesis of various human diseases. Laser-induced breakdown spectroscopy (LIBS) and X-ray fluorescence (XRF) spectrometry are robust and multi-element analytical techniques able to analyze biological samples of various kinds for disease diagnosis. The primary objective of this review article is to focus on the major developments and advances in LIBS and XRF for the elemental analysis of hair and nails over the last 10-year period. The developments in the qualitative and quantitative analyses of human hair and nail samples are discussed in detail, with special emphasis on the key aspects of elemental imaging and distribution of essential and non-essential elements within the hair and nail tissue samples. Microchemical imaging applications by LIBS and XRF (including micro-XRF and scanning electron microscopy, SEM) are also presented for healthy as well as diseased tissue hair and nail samples in the context of disease diagnosis. In addition, main challenges, prospects, and complementarities of LIBS and XRF toward analyzing human hair and nails for disease diagnosis are also thoroughly discussed here.

Assessment of X-ray fluorescence capabilities for nail and hair matrices through zinc measurement in keratin reference materials

BACKGROUND

Novel and emerging biomarkers of zinc status are being developed to help study and address zinc deficiency around the world. Two potential biomarkers, nail and hair, involve the measurement of zinc from easily accessible keratin-based components of the body. Portable X-ray fluorescence (XRF) is a relatively new approach to the assessment of zinc in nail or hair, and has a number of compelling advantages compared with other techniques. The aim of the current study was to test the ability of XRF to measure zinc in keratinized reference materials (RMs) designed to simulate nail and hair.

METHODS

Four Keratin Matrix RMs were prepared and characterized for numerous trace elements by the New York State Department of Health's Wadsworth Center. The Keratin Matrix RMs consisted of powdered samples of caprine (goat) horns pooled from several animals. Concentrations of zinc, as assessed by inductively coupled plasma mass spectrometry (ICP-MS), were similar to what would be expected from human nail or hair tissues. Repeat measurements of the RMs were made using a portable XRF system. The XRF zinc results were compared with the ICP-MS zinc concentrations. Three different approaches to quantifying the zinc content by XRF were performed: (1) zinc signal to total signal ratio, (2) zinc signal to sulfur signal ratio, and (3) system output zinc concentration.

RESULTS

The portable XRF results from a given RM were found to be consistent across repeat trials under all three approaches to XRF quantitation. Precision, calculated as the relative standard deviation of repeat measurements ranged from an average result of 0.8 % (using the system output zinc concentration method) to 6.1 % (using the zinc signal to sulfur signal ratio method). Measurement of the RMs provided XRF zinc results which scaled well with ICP-MS zinc concentration, particularly when using the XRF zinc to total and system zinc concentration methods. A Bland-Altman plot showed that the XRF system zinc concentration output exceeded the ICP-MS zinc concentration by, on average, 10.2 % ± 1.2 %.

CONCLUSION

Overall, both accuracy and precision of measurement were found to be promising for portable XRF, provided appropriate conversions to concentration are introduced. The results of this study indicate that portable XRF is an effective and dependable method of assessing zinc concentration in keratinized tissue RMs. This will have implications for the future use of portable XRF to monitor zinc status in humans through measurements of nail and hair.

Different accumulation of some elements in the fry and adults of alpine bullheads (Cottus poecilopus)

Skulls of alpine bullhead sampled from the Javorinka stream in the Tatra Mountains, West Carpathians, were analyzed to determine concentrations of S, Cl, K, Ca, P, Rb, Zn, Mn, Mb, Fe, Ti, Sn, Co, Ni, Cu, As, Se, Pb, Sb, Ba, Hg, Cr, Ag, and Cd. The stage of development is the most influential factor determining element concentrations in the sampled bullhead, as fry were more polluted than adult fish. The different diets consumed by fry and adult bullhead plays a key role in the accumulation of chemical elements in their bodies. Young bullheads live in small natural embankments containing higher levels of a mixture of sedimentary minerals and microorganisms than in running water. Thus, newly hatched bullheads may serve as excellent indicators of water quality in mountain creeks or streams, as they can indicate the higher pollution of water or prey in their habitats (small bays with sandy bottoms) when compared to the preferred habitat of adult individuals.

Portable X-ray Fluorescence as a Rapid Determination Tool to Detect Parts per Million Levels of Ni, Zn, As, Se, and Pb in Human Toenails: A South India Case Study

Chronic exposure to inorganic pollutants adversely affects human health. Inductively coupled plasma mass spectrometry (ICP-MS) is the most common method used for trace metal(loid) analysis of human biomarkers. However, it leads to sample destruction, generation of secondary waste, and significant recurring costs. Portable X-ray fluorescence (XRF) instruments can rapidly and nondestructively determine low concentrations of metal(loid)s. In this work, we evaluated the applicability of portable XRF as a rapid method for analyzing trace metal(loid)s in toenail samples from three populations (n = 97) near the city of Chennai, India. A Passing-Bablok regression analysis of results from both methods revealed that there was no proportional bias among the two methods for nickel (measurement range ∼25 to 420 mg/kg), zinc (10 to 890 mg/kg), and lead (0.29 to 4.47 mg/kg). There was a small absolute bias between the two methods. There was a strong proportional bias (slope = 0.253, 95% CI: 0.027, 0.614) between the two methods for arsenic (below detection to 3.8 mg/kg) and for selenium when the concentrations were lower than 2 mg/kg. Limits of agreement between the two methods using Bland-Altman analysis were derived for nickel, zinc, and lead. Overall, a suitably calibrated and evaluated portable XRF shows promise in making high-throughput assessments at population scales.

Portable X-ray fluorescence of zinc applied to human toenail clippings

Zinc is an essential trace element in humans. Zinc deficiency can result in a range of serious medical conditions which include effects on growth and development, the immune system, the central nervous system, and the gastrointestinal system. Diagnosis of zinc deficiency is often precluded by the lack of a noninvasive and reliable biomarker. Zinc concentration in nail is considered an emerging biomarker of zinc status in humans. Whether zinc in nail accurately reflects zinc status is beyond the scope of the current study, but is an important research question. The development of a portable method to quickly assess zinc concentration from a single nail clipping could be a useful advance. In this study, single toenail clippings from 60 individuals living in Atlantic Canada were measured for zinc using a portable X-ray fluorescence (XRF) technique. These samples were obtained from the Atlantic PATH cohort, part of the largest chronic disease study ever performed in Canada. Each toenail clipping was measured using three 300 s trials with a mono-energetic portable XRF system. Results were then assessed using two different approaches to the XRF analysis: (1) factory-calibrated zinc concentrations were output from each trial, and (2) energy spectra were analyzed for the characteristic X-rays resulting from zinc. Following the measurement of zinc using the non-destructive portable XRF method, the same clippings were measured for zinc concentration using the "gold standard" technique of inductively coupled plasma-mass spectrometry (ICP-MS). A linear equation of best fit was determined for the relationship between average XRF output zinc concentration and ICP-MS zinc concentration, with a correlation coefficient r = 0.60. Similarly, a linear equation of best fit was found for the relationship between a normalized XRF energy spectrum zinc signal and ICP-MS zinc concentration, with a correlation coefficient r = 0.68. Individual ICP-MS zinc concentrations ranged from 32 μg/g to 140 μg/g, with a population average of 85 μg/g. The results of this study indicate that portable XRF is a sensitive method for the measurement of zinc in a single nail clipping, and provides a reasonable estimation of zinc concentration. Further method development is required before portable XRF be considered a routine alternative to ICP-MS for the assessment of zinc in nail clippings.

Biofortification of wheat with zinc for eliminating deficiency in Pakistan: study protocol for a cluster-randomised, double-blind, controlled effectiveness study (BIZIFED2)

INTRODUCTION

Micronutrient deficiencies, commonly referred to as 'hidden hunger', affect more than two billion people worldwide, with zinc and iron-deficiency frequently reported. The aim of this study is to examine the impact of consuming zinc biofortified flour (Zincol-2016) on biochemical and functional measures of status in adolescent girls and children living in a low-resource setting in Pakistan.

METHODS AND ANALYSIS

We are conducting a pragmatic, cluster-randomised, double-blind, controlled trial. A total of 482 households have been recruited from two catchment areas approximately 30-40 km distance from Peshawar. Household inclusion criteria are the presence of both an adolescent girl, aged 10-16 years, and a child aged 1-5 years. The study duration is 12 months, divided into two 6-month phases. During phase 1, all households will be provided with locally procured flour from standard varieties of wheat. During phase 2, clusters will be paired, and randomised to either the control or intervention arm of the study. The intervention arm will be provided with zinc biofortified wheat flour, with a target zinc concentration of 40 mg/kg. The control arm will be provided with locally procured wheat flour from standard varieties with an expected zinc concentration of 20 mg/kg. The primary outcome measure is plasma zinc concentration. Secondary outcomes include anthropometric measurements, biomarkers of iron and zinc status, and the presence and duration of respiratory tract infections and diarrhoea.

ETHICS AND DISSEMINATION

Ethical approval was granted from the University of Central Lancashire STEMH Ethics Committee (reference number: STEMH 1014) and Khyber Medical University Ethics Committee (DIR/KMU-EB/BZ/000683). The final study methods will be published in peer-reviewed journals, alongside the study outcomes. In addition, findings will be disseminated to the scientific community via conference presentations and abstracts and communicated to the study participants through the village elders at an appropriate community forum.

TRIAL REGISTRATION NUMBER

ISRCTN17107812; Pre-results.

Assessing zinc from a nail clipping using mono-energetic portable X-ray fluorescence

A mono-energetic X-ray beam from a portable X-ray fluorescence device was used to excite characteristic X-rays from zinc in a series of nail clipping phantoms. Twenty nail clipping phantoms having equal zinc concentrations of ~40 µg/g, but with different physical characteristics, were measured individually for 300 s using a small diameter (~1 mm) X-ray beam. Energy spectra obtained from the measurements were analyzed using PyMca software. Zinc signal size varied widely between the different clippings, with a relative standard deviation of 41% observed in the combined signal from zinc Kα and Kβ characteristic X-rays. Three different normalization approaches were introduced to account for variation in the amounts of sample interrogated by the X-ray beam. All three approaches produced similar results, and successfully reduced the relative standard deviation to between 12% and 13%. A clear trend was still observed, however, between the normalized zinc signal and the thickness of clipping measured. To account for this effect, normalized signals were adjusted to calculate "thickness-corrected" values. The relative standard deviation of these thickness-corrected values was 6.2%. Reproducibility of measurement from individual clippings was excellent, with relative standard deviations on the order of 1%, with or without normalization. Overall, this new method of measuring zinc in nail shows promise for the assessment of zinc status in humans using a portable device. The method is sensitive, rapid, and requires only a single nail clipping.