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Pefferkorn E, Clément B, Bascou A, Guilbeau-Frugier C, Telmon N, Savall F, Dedouit F. Death following cylindrical battery ingestion associated with toxic manganese levels. Forensic Sci Med Pathol 2024:10.1007/s12024-024-00854-z. [PMID: 38951377 DOI: 10.1007/s12024-024-00854-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2024] [Indexed: 07/03/2024]
Abstract
Cases of battery ingestion are well documented in the scientific literature, especially concerning button cell battery ingestion in children. In this instance, the authors present an atypical case of a young man who voluntarily ingested a cylindrical alkaline battery containing manganese. The patient died approximately a week later, despite not exhibiting any specific symptoms. The battery was found in the cecum during the autopsy, showing deterioration at its positive pole. The cecal mucosa exhibited two ulcerations without perforation. Histological analysis revealed intestinal ischemia in the cecum, with no microscopic lesions in other organs. Toxicology reports indicated high levels of manganese in both cardiac and peripheral blood. Considering all the results from the additional analyses, the experts concluded that the death was likely of multifactorial origin, associated with a toxic blood concentration of manganese. To the best of our knowledge, this is the first recorded death following the ingestion of a cylindrical battery, and the first instance of manganese intoxication resulting from the ingestion of an alkaline battery. The authors will present the case and provide a literature review to assess the extent to which the presence of manganese may have contributed to the fatality.
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Affiliation(s)
- Eulalie Pefferkorn
- Institute of Legal medicine, CHRU TOURS, Trousseau Hospital, Avenue de la république, Chambray-lès-Tours, 37170, France.
| | - Bruno Clément
- Department of Medical Pharmacology and toxicology, Bretonneau Hospital, 2 Boulevard Tonnellé, Tours, 37000, France
| | - Agathe Bascou
- Institute of Legal medicine, Rangueil-Larrey Hospital, 1 avenue du Professeur Jean-Poulhès, Toulouse, 31400, France
| | - Céline Guilbeau-Frugier
- Institute of Legal medicine, Rangueil-Larrey Hospital, 1 avenue du Professeur Jean-Poulhès, Toulouse, 31400, France
| | - Norbert Telmon
- Centre d'Anthropobiologie et de Génomique de Toulouse, UMR 5288 (CNRS/UT3) - Faculté de Médecine de Purpan - 37 allées J. Guesde, Toulouse, 31000, France
| | - Frédéric Savall
- Centre d'Anthropobiologie et de Génomique de Toulouse, UMR 5288 (CNRS/UT3) - Faculté de Médecine de Purpan - 37 allées J. Guesde, Toulouse, 31000, France
| | - Fabrice Dedouit
- Centre d'Anthropobiologie et de Génomique de Toulouse, UMR 5288 (CNRS/UT3) - Faculté de Médecine de Purpan - 37 allées J. Guesde, Toulouse, 31000, France
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Shi X, Wang X, Zhang J, Dang Y, Ouyang C, Pan J, Yang A, Hu X. Associations of mixed metal exposure with chronic kidney disease from NHANES 2011-2018. Sci Rep 2024; 14:13062. [PMID: 38844557 PMCID: PMC11156859 DOI: 10.1038/s41598-024-63858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
Metals have been proved to be one of risk factors for chronic kidney disease (CKD) and diabetes, but the effect of mixed metal co-exposure and potential interaction between metals are still unclear. We assessed the urine and whole blood levels of cadmium (Cd), manganese (Mn), lead (Pb), mercury (Hg), and renal function in 3080 adults from National Health and Nutrition Survey (NHANES) (2011-2018) to explore the effect of mixed metal exposure on CKD especially in people with type 2 diabetes mellitus (T2DM). Weighted quantile sum regression model and Bayesian Kernel Machine Regression model were used to evaluate the overall exposure impact of metal mixture and potential interaction between metals. The results showed that the exposure to mixed metals was significantly associated with an increased risk of CKD in blood glucose stratification, with the risk of CKD being 1.58 (1.26,1.99) times in urine and 1.67 (1.19,2.34) times in whole blood higher in individuals exposed to high concentrations of the metal mixture compared to those exposed to low concentrations. The effect of urine metal mixture was elevated magnitude in stratified analysis. There were interactions between urine Pb and Cd, Pb and Mn, Pb and Hg, Cd and Mn, Cd and Hg, and blood Pb and Hg, Mn and Cd, Mn and Pb, Mn and Hg on the risk of CKD in patients with T2DM and no significant interaction between metals was observed in non-diabetics. In summary, mixed metal exposure increased the risk of CKD in patients with T2DM, and there were complex interactions between metals. More in-depth studies are needed to explore the mechanism and demonstrate the causal relationship.
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MESH Headings
- Humans
- Renal Insufficiency, Chronic/chemically induced
- Renal Insufficiency, Chronic/blood
- Renal Insufficiency, Chronic/epidemiology
- Renal Insufficiency, Chronic/urine
- Female
- Male
- Middle Aged
- Nutrition Surveys
- Adult
- Environmental Exposure/adverse effects
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/complications
- Cadmium/blood
- Cadmium/urine
- Cadmium/adverse effects
- Cadmium/toxicity
- Risk Factors
- Lead/blood
- Lead/urine
- Lead/toxicity
- Metals, Heavy/blood
- Metals, Heavy/urine
- Metals, Heavy/adverse effects
- Metals, Heavy/toxicity
- Aged
- Metals/urine
- Metals/blood
- Metals/adverse effects
- Manganese/urine
- Manganese/blood
- Manganese/adverse effects
- Bayes Theorem
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Affiliation(s)
- Xiaoru Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Xiao Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Jia Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Ying Dang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Changping Ouyang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Jinhua Pan
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Aimin Yang
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Xiaobin Hu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China.
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McBride DE, Bhattacharya A, Sucharew H, Brunst KJ, Barnas M, Cox C, Altman L, Hilbert TJ, Burkle J, Westneat S, Martin KV, Parsons PJ, Praamsma ML, Palmer CD, Kannan K, Smith DR, Wright R, Amarasiriwardena C, Dietrich KN, Cecil KM, Haynes EN. Child and Adolescent Manganese Biomarkers and Adolescent Postural Balance in Marietta CARES Cohort Participants. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57010. [PMID: 38780454 PMCID: PMC11114102 DOI: 10.1289/ehp13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 03/04/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Manganese (Mn) plays a significant role in both human health and global industries. Epidemiological studies of exposed populations demonstrate a dose-dependent association between Mn and neuromotor effects ranging from subclinical effects to a clinically defined syndrome. However, little is known about the relationship between early life Mn biomarkers and adolescent postural balance. OBJECTIVES This study investigated the associations between childhood and adolescent Mn biomarkers and adolescent postural balance in participants from the longitudinal Marietta Communities Actively Researching Exposures Study (CARES) cohort. METHODS Participants were recruited into CARES when they were 7-9 y old, and reenrolled at 13-18 years of age. At both time points, participants provided samples of blood, hair, and toenails that were analyzed for blood Mn and lead (Pb), serum cotinine, hair Mn, and toenail Mn. In adolescence, participants completed a postural balance assessment. Greater sway indicates postural instability (harmful effect), whereas lesser sway indicates postural stability (beneficial effect). Multivariable linear regression models were conducted to investigate the associations between childhood and adolescent Mn biomarkers and adolescent postural balance adjusted for age, sex, height-weight ratio, parent/caregiver intelligence quotient, socioeconomic status, blood Pb, and serum cotinine. RESULTS CARES participants who completed the adolescent postural balance assessment (n = 123 ) were 98% White and 54% female and had a mean age of 16 y (range: 13-18 y). In both childhood and adolescence, higher Mn biomarker concentrations were significantly associated with greater adolescent sway measures. Supplemental analyses revealed sex-specific associations; higher childhood Mn biomarker concentrations were significantly associated with greater sway in females compared with males. DISCUSSION This study found childhood and adolescent Mn biomarkers were associated with subclinical neuromotor effects in adolescence. This study demonstrates postural balance as a sensitive measure to assess the association between Mn biomarkers and neuromotor function. https://doi.org/10.1289/EHP13381.
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Affiliation(s)
- Danielle E. McBride
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Amit Bhattacharya
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Heidi Sucharew
- Department of Emergency Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kelly J. Brunst
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Mary Barnas
- Department of Psychology, Marietta College, Marietta, Ohio, USA
| | - Cyndy Cox
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Lorenna Altman
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Timothy J. Hilbert
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jeff Burkle
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Susan Westneat
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Kaitlin Vollet Martin
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Patrick J. Parsons
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, New York, USA
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Meredith L. Praamsma
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, New York, USA
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Christopher D. Palmer
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, New York, USA
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Kurunthachalam Kannan
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, New York, USA
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
| | - Donald R. Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, California, USA
| | - Robert Wright
- Environmental Medicine and Public Health, Mount Sinai School of Medicine, New York, New York, USA
| | - Chitra Amarasiriwardena
- Environmental Medicine and Public Health, Mount Sinai School of Medicine, New York, New York, USA
| | - Kim N. Dietrich
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kim M. Cecil
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Erin N. Haynes
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
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Aschner M, Martins AC, Oliveira-Paula GH, Skalny AV, Zaitseva IP, Bowman AB, Kirichuk AA, Santamaria A, Tizabi Y, Tinkov AA. Manganese in autism spectrum disorder and attention deficit hyperactivity disorder: The state of the art. Curr Res Toxicol 2024; 6:100170. [PMID: 38737010 PMCID: PMC11088232 DOI: 10.1016/j.crtox.2024.100170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/27/2024] [Accepted: 04/23/2024] [Indexed: 05/14/2024] Open
Abstract
The objective of the present narrative review was to synthesize existing clinical and epidemiological findings linking manganese (Mn) exposure biomarkers to autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), and to discuss key pathophysiological mechanisms of neurodevelopmental disorders that may be affected by this metal. Existing epidemiological data demonstrated both direct and inverse association between Mn body burden and ASD, or lack of any relationship. In contrast, the majority of studies revealed significantly higher Mn levels in subjects with ADHD, as well as direct relationship between Mn body burden with hyperactivity and inattention scores in children, although several studies reported contradictory results. Existing laboratory studies demonstrated that impaired attention and hyperactivity in animals following Mn exposure was associated with dopaminergic dysfunction and neuroinflammation. Despite lack of direct evidence on Mn-induced neurobiological alterations in patients with ASD and ADHD, a plethora of studies demonstrated that neurotoxic effects of Mn overexposure may interfere with key mechanisms of pathogenesis inherent to these neurodevelopmental disorders. Specifically, Mn overload was shown to impair not only dopaminergic neurotransmission, but also affect metabolism of glutamine/glutamate, GABA, serotonin, noradrenaline, thus affecting neuronal signaling. In turn, neurotoxic effects of Mn may be associated with its ability to induce oxidative stress, apoptosis, and neuroinflammation, and/or impair neurogenesis. Nonetheless, additional detailed studies are required to evaluate the association between environmental Mn exposure and/or Mn body burden and neurodevelopmental disorders at a wide range of concentrations to estimate the potential dose-dependent effects, as well as environmental and genetic factors affecting this association.
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Affiliation(s)
- Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Airton C. Martins
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA
| | | | - Anatoly V. Skalny
- Department of Medical Elementology, and Department of Human Ecology and Bioelementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119435, Russia
| | - Irina P. Zaitseva
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Yaroslavl 150003, Russia
| | - Aaron B. Bowman
- School of Health Sciences, Purdue University, West Lafayette, IN 47907-2051, USA
| | - Anatoly A. Kirichuk
- Department of Medical Elementology, and Department of Human Ecology and Bioelementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
| | - Abel Santamaria
- Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Laboratorio de Nanotecnología y Nanomedicina, Departamento de Cuidado de la Salud, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 04960, Mexico
| | - Yousef Tizabi
- Department of Pharmacology, Howard University College of Medicine, Washington, DC 20059, USA
| | - Alexey A. Tinkov
- Department of Medical Elementology, and Department of Human Ecology and Bioelementology, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Center of Bioelementology and Human Ecology, IM Sechenov First Moscow State Medical University (Sechenov University), Moscow 119435, Russia
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Yaroslavl 150003, Russia
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5
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Durin Z, Raynor A, Fenaille F, Cholet S, Vuillaumier-Barrot S, Alili JM, Poupon J, Oussedik ND, Tuchmann-Durand C, Attali J, Touzé R, Dupré T, Lebredonchel E, Akaffou MA, Legrand D, de Lonlay P, Bruneel A, Foulquier F. Efficacy of oral manganese and D-galactose therapy in a patient bearing a novel TMEM165 variant. Transl Res 2024; 266:57-67. [PMID: 38013006 DOI: 10.1016/j.trsl.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/06/2023] [Accepted: 11/17/2023] [Indexed: 11/29/2023]
Abstract
TMEM165-CDG has first been reported in 2012 and manganese supplementation was shown highly efficient in rescuing glycosylation in isogenic KO cells. The unreported homozygous missense c.928G>C; p.Ala310Pro variant leading to a functional but unstable protein was identified. This patient was diagnosed at 2 months and displays a predominant bone phenotype and combined defects in N-, O- and GAG glycosylation. We administered for the first time a combined D-Gal and Mn2+ therapy to the patient. This fully suppressed the N-; O- and GAG hypoglycosylation. There was also striking improvement in biochemical parameters and in gastrointestinal symptoms. This study offers exciting therapeutic perspectives for TMEM165-CDG.
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Affiliation(s)
- Zoé Durin
- Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France
| | - Alexandre Raynor
- AP-HP, Biochimie Métabolique et Cellulaire, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France
| | - François Fenaille
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), MetaboHUB, 91191 Gif sur Yvette, France
| | - Sophie Cholet
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), MetaboHUB, 91191 Gif sur Yvette, France
| | - Sandrine Vuillaumier-Barrot
- AP-HP, Biochimie Métabolique et Cellulaire, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France; Laboratoire de biologie médicale multisites Seqoia - FMG2025, 75014 Paris, France
| | - Jean-Meidi Alili
- Filière G2m, Hôpital Universitaire Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - Joël Poupon
- Laboratoire de Toxicologie biologique Groupe hospitalier Saint Louis - Lariboisière - Fernand Widal, 75475, Paris, France
| | - Nouzha Djebrani Oussedik
- Laboratoire de Toxicologie biologique Groupe hospitalier Saint Louis - Lariboisière - Fernand Widal, 75475, Paris, France
| | - Caroline Tuchmann-Durand
- Institut Imagine, Biothérapie, Hôpital Universitaire Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Imagine, 75015 Paris, France
| | - Jennifer Attali
- Service de Radiologie Pédiatrique, Hôpital Universitaire Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Imagine,75015 Paris, France
| | - Romain Touzé
- Service d'Ophtalmologie Pédiatrique, Hôpital Universitaire Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - Thierry Dupré
- AP-HP, Biochimie Métabolique et Cellulaire, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France
| | - Elodie Lebredonchel
- AP-HP, Biochimie Métabolique et Cellulaire, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France
| | - Marlyse Angah Akaffou
- AP-HP, Biochimie Métabolique et Cellulaire, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France
| | - Dominique Legrand
- Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France
| | - Pascale de Lonlay
- Filière G2m, Hôpital Universitaire Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France; Hôpital Universitaire Necker-Enfants-Malades, Institut Imagine, G2M, MetabERN, Université Paris Cité, 75015 Paris, France.
| | - Arnaud Bruneel
- AP-HP, Biochimie Métabolique et Cellulaire, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France; INSERM UMR1193, Faculté de Pharmacie, Université Paris-Saclay, bâtiment Henri Moissan, 92400 Orsay, France.
| | - François Foulquier
- Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France.
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Mattison DR, Momoli F, Alyanak C, Aschner M, Baker M, Cashman N, Dydak U, Farhat N, Guilarte TR, Karyakina N, Ramoju S, Shilnikova N, Taba P, Krewski D. Diagnosis of manganism and manganese neurotoxicity: A workshop report. MEDICINE INTERNATIONAL 2024; 4:11. [PMID: 38410758 PMCID: PMC10895461 DOI: 10.3892/mi.2024.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024]
Abstract
With declining exposures to manganese (Mn) in occupational settings, there is a need for more sensitive exposure assessments and clinical diagnostic criteria for manganism and Mn neurotoxicity. To address this issue, a workshop was held on November 12-13, 2020, with international experts on Mn toxicity. The workshop discussions focused on the history of the diagnostic criteria for manganism, including those developed by the Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST) in Quebec in 2005 and criteria developed by the Chinese government in 2002 and updated in 2006; the utility of biomarkers of exposure; recent developments in magnetic resonance imaging (MRI) for assessing Mn accumulation in the brain and diagnosing manganism; and potential future applications of metabolomics. The suggestions of the participants for updating manganism diagnostic criteria included the consideration of: i) A history of previous occupational and environmental exposure to Mn; ii) relevant clinical symptoms such as dystonia; iii) MRI imaging to document Mn accumulation in the neural tissues, including the basal ganglia; and iv) criteria for the differential diagnosis of manganism and other neurological conditions. Important research gaps include the characterization of Mn exposure and other co-exposures, exploration of the roles of different brain regions with MRI, understanding the complexity of metal ion transporters involved in Mn homeostasis, and a need for information on other neurotransmitter systems and brain regions underlying the pathophysiology of manganism.
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Affiliation(s)
- Donald R. Mattison
- Risk Sciences International, Ottawa, ON K1P 5J6, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Franco Momoli
- Risk Sciences International, Ottawa, ON K1P 5J6, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Cemil Alyanak
- Risk Sciences International, Ottawa, ON K1P 5J6, Canada
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Marissa Baker
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
| | - Neil Cashman
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- ProMIS Neurosciences, Inc., Toronto, ON M4S 3E2, Canada
| | - Ulrike Dydak
- School of Health Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Nawal Farhat
- Risk Sciences International, Ottawa, ON K1P 5J6, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Tomás R. Guilarte
- Department of Environmental Health Sciences, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA
| | | | - Siva Ramoju
- Risk Sciences International, Ottawa, ON K1P 5J6, Canada
| | - Natalia Shilnikova
- Risk Sciences International, Ottawa, ON K1P 5J6, Canada
- R. Samuel McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Pille Taba
- Department of Neurology and Neurosurgery, Institute of Clinical Medicine, University of Tartu, 50406 Tartu, Estonia
- Neurology Clinic, Tartu University Hospital, 50406 Tartu, Estonia
| | - Daniel Krewski
- Risk Sciences International, Ottawa, ON K1P 5J6, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
- R. Samuel McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
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7
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Baj J, Flieger W, Barbachowska A, Kowalska B, Flieger M, Forma A, Teresiński G, Portincasa P, Buszewicz G, Radzikowska-Büchner E, Flieger J. Consequences of Disturbing Manganese Homeostasis. Int J Mol Sci 2023; 24:14959. [PMID: 37834407 PMCID: PMC10573482 DOI: 10.3390/ijms241914959] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/01/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
Manganese (Mn) is an essential trace element with unique functions in the body; it acts as a cofactor for many enzymes involved in energy metabolism, the endogenous antioxidant enzyme systems, neurotransmitter production, and the regulation of reproductive hormones. However, overexposure to Mn is toxic, particularly to the central nervous system (CNS) due to it causing the progressive destruction of nerve cells. Exposure to manganese is widespread and occurs by inhalation, ingestion, or dermal contact. Associations have been observed between Mn accumulation and neurodegenerative diseases such as manganism, Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. People with genetic diseases associated with a mutation in the gene associated with impaired Mn excretion, kidney disease, iron deficiency, or a vegetarian diet are at particular risk of excessive exposure to Mn. This review has collected data on the current knowledge of the source of Mn exposure, the experimental data supporting the dispersive accumulation of Mn in the brain, the controversies surrounding the reference values of biomarkers related to Mn status in different matrices, and the competitiveness of Mn with other metals, such as iron (Fe), magnesium (Mg), zinc (Zn), copper (Cu), lead (Pb), calcium (Ca). The disturbed homeostasis of Mn in the body has been connected with susceptibility to neurodegenerative diseases, fertility, and infectious diseases. The current evidence on the involvement of Mn in metabolic diseases, such as type 2 diabetes mellitus/insulin resistance, osteoporosis, obesity, atherosclerosis, and non-alcoholic fatty liver disease, was collected and discussed.
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Affiliation(s)
- Jacek Baj
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (W.F.); (A.F.)
| | - Wojciech Flieger
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (W.F.); (A.F.)
| | - Aleksandra Barbachowska
- Department of Plastic, Reconstructive and Burn Surgery, Medical University of Lublin, 21-010 Łęczna, Poland;
| | - Beata Kowalska
- Department of Water Supply and Wastewater Disposal, Lublin University of Technology, 20-618 Lublin, Poland;
| | - Michał Flieger
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | - Alicja Forma
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (W.F.); (A.F.)
| | - Grzegorz Teresiński
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | - Piero Portincasa
- Clinica Medica A. Murri, Department of Biomedical Sciences & Human Oncology, Medical School, University of Bari, 70124 Bari, Italy;
| | - Grzegorz Buszewicz
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | | | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, 20-093 Lublin, Poland
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8
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Martinez-Morata I, Sobel M, Tellez-Plaza M, Navas-Acien A, Howe CG, Sanchez TR. A State-of-the-Science Review on Metal Biomarkers. Curr Environ Health Rep 2023; 10:215-249. [PMID: 37337116 PMCID: PMC10822714 DOI: 10.1007/s40572-023-00402-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW Biomarkers are commonly used in epidemiological studies to assess metals and metalloid exposure and estimate internal dose, as they integrate multiple sources and routes of exposure. Researchers are increasingly using multi-metal panels and innovative statistical methods to understand how exposure to real-world metal mixtures affects human health. Metals have both common and unique sources and routes of exposure, as well as biotransformation and elimination pathways. The development of multi-element analytical technology allows researchers to examine a broad spectrum of metals in their studies; however, their interpretation is complex as they can reflect different windows of exposure and several biomarkers have critical limitations. This review elaborates on more than 500 scientific publications to discuss major sources of exposure, biotransformation and elimination, and biomarkers of exposure and internal dose for 12 metals/metalloids, including 8 non-essential elements (arsenic, barium, cadmium, lead, mercury, nickel, tin, uranium) and 4 essential elements (manganese, molybdenum, selenium, and zinc) commonly used in multi-element analyses. RECENT FINDINGS We conclude that not all metal biomarkers are adequate measures of exposure and that understanding the metabolic biotransformation and elimination of metals is key to metal biomarker interpretation. For example, whole blood is a good biomarker of exposure to arsenic, cadmium, lead, mercury, and tin, but it is not a good indicator for barium, nickel, and uranium. For some essential metals, the interpretation of whole blood biomarkers is unclear. Urine is the most commonly used biomarker of exposure across metals but it should not be used to assess lead exposure. Essential metals such as zinc and manganese are tightly regulated by homeostatic processes; thus, elevated levels in urine may reflect body loss and metabolic processes rather than excess exposure. Total urinary arsenic may reflect exposure to both organic and inorganic arsenic, thus, arsenic speciation and adjustment for arsebonetaine are needed in populations with dietary seafood consumption. Hair and nails primarily reflect exposure to organic mercury, except in populations exposed to high levels of inorganic mercury such as in occupational and environmental settings. When selecting biomarkers, it is also critical to consider the exposure window of interest. Most populations are chronically exposed to metals in the low-to-moderate range, yet many biomarkers reflect recent exposures. Toenails are emerging biomarkers in this regard. They are reliable biomarkers of long-term exposure for arsenic, mercury, manganese, and selenium. However, more research is needed to understand the role of nails as a biomarker of exposure to other metals. Similarly, teeth are increasingly used to assess lifelong exposures to several essential and non-essential metals such as lead, including during the prenatal window. As metals epidemiology moves towards embracing a multi-metal/mixtures approach and expanding metal panels to include less commonly studied metals, it is important for researchers to have a strong knowledge base about the metal biomarkers included in their research. This review aims to aid metals researchers in their analysis planning, facilitate sound analytical decision-making, as well as appropriate understanding and interpretation of results.
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Affiliation(s)
- Irene Martinez-Morata
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA.
| | - Marisa Sobel
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
| | - Maria Tellez-Plaza
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
| | - Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Tiffany R Sanchez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
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9
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Alikunju M, Misiriyyah N, Sayeed Iqbal S, Khan M. Manganese Neurotoxicity as a Stroke Mimic: A Case Report. Cureus 2023; 15:e37247. [PMID: 37168188 PMCID: PMC10166376 DOI: 10.7759/cureus.37247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 05/13/2023] Open
Abstract
Manganese (Mn)-induced cerebral toxicity is a rare neurological condition that can present as a stroke mimic in high-risk populations. We present a case of a 40-year-old male with no known comorbidities who was brought to the emergency department with complaints of nonprogressive slurred speech and left facial weakness for eight days. Further history revealed that he had been working as a welder in a steel factory for the past seven years without using proper personal protective equipment (PPE). On physical examination, an upper motor neuron (UMN) type weakness on the left side of his face and spastic dysarthria could be appreciated. Following a brain computed tomography (CT) scan that showed ill-defined hypodensities in the basal ganglia without any signs of a hemorrhage, he was admitted to the stroke unit for conservative management and further investigations. A magnetic resonance imaging (MRI) scan of the brain done later showed features of manganese deposition and absorption in the globus pallidus and corticospinal tracts, indicating a diagnosis of manganese-induced cerebral toxicity. His serum manganese levels obtained during admission were normal. He was managed conservatively with intravenous rehydration and was discharged after symptomatic improvement. He was counseled and educated regarding the importance of wearing protective equipment while at work to reduce further exposure to the metal. During his follow-up visit, his symptoms had considerably improved with proper adherence to workplace safety measures.
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10
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Jenkins JA, Musgrove M, White SJO. Outlining Potential Biomarkers of Exposure and Effect to Critical Minerals: Nutritionally Essential Trace Elements and the Rare Earth Elements. TOXICS 2023; 11:toxics11020188. [PMID: 36851062 PMCID: PMC9958731 DOI: 10.3390/toxics11020188] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 05/21/2023]
Abstract
Emerging and low-carbon technologies and innovations are driving a need for domestic sources, sustainable use, and availability of critical minerals (CMs)-those vital to the national and economic security of the United States. Understanding the known and potential health effects of exposures to such mineral commodities can inform prudent and environmentally responsible handling and harvesting. We review the occurrence, use, predominant exposure pathways, and adverse outcome pathways (AOP) for human and fish receptors of those CMs that are nutritionally essential trace metals (specifically, cobalt, chromium, manganese, nickel, and zinc), as well as the rare earth elements. Biological responses to some elements having comparable biogeochemistry can sometimes be similar. Candidate quantifiable biomarkers for assessing potential AOP are conveyed.
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Affiliation(s)
- Jill A. Jenkins
- Wetland and Aquatic Research Center, U.S. Geological Survey, 700 Cajundome Boulevard, Lafayette, LA 70506, USA
- Correspondence:
| | - MaryLynn Musgrove
- Oklahoma-Texas Water Science Center, U.S. Geological Survey, 1505 Ferguson Lane, Austin, TX 78754, USA
| | - Sarah Jane O. White
- Geology, Energy & Minerals Science Center, U.S. Geological Survey, 12201 Sunrise Valley Dr., Reston, VA 20192, USA
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11
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Markiv B, Ruiz-Azcona L, Expósito A, Santibáñez M, Fernández-Olmo I. Short- and long-term exposure to trace metal(loid)s from the production of ferromanganese alloys by personal sampling and biomarkers. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:4595-4618. [PMID: 35190915 PMCID: PMC8860625 DOI: 10.1007/s10653-022-01218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/27/2022] [Indexed: 05/06/2023]
Abstract
The environmental exposure to trace metal(loid)s (As, Cd, Cu, Fe, Mn, Pb, and Zn) was assessed near a ferromanganese alloy plant using filters from personal particulate matter (PM) samplers (bioaccessible and non-bioaccessible fine and coarse fractions) and whole blood as short-term exposure markers, and scalp hair and fingernails as long-term biomarkers, collected from volunteers (n = 130) living in Santander Bay (northern Spain). Bioaccessible and non-bioaccessible metal(loid) concentrations in coarse and fine PM from personal samplers were determined by ICP-MS after extraction/digestion. Metal(loid) concentration in biomarkers was measured after alkaline dilution (whole blood) and acid digestion (fingernails and scalp hair) by ICP-MS as well. Results were discussed in terms of exposure, considering the distance to the main Mn source, and sex. In terms of exposure, significant differences were found for Mn in all the studied fractions of PM, As in whole blood, Mn and Cu in scalp hair and Mn and Pb in fingernails, with all concentrations being higher for those living closer to the Mn source, with the exception of Cu in scalp hair. Furthermore, the analysis of the correlation between Mn levels in the studied biomarkers and the wind-weighted distance to the main source of Mn allows us to conclude that scalp hair and mainly fingernails are appropriate biomarkers of long-term airborne Mn exposure. This was also confirmed by the significant positive correlations between scalp hair Mn and bioaccessible Mn in coarse and fine fractions, and between fingernails Mn and all PM fractions. This implies that people living closer to a ferromanganese alloy plant are exposed to higher levels of airborne metal(loid)s, mainly Mn, leading to higher levels of this metal in scalp hair and fingernails, which according to the literature, might affect some neurological outcomes. According to sex, significant differences were observed for Fe, Cu and Pb in whole blood, with higher concentrations of Fe and Pb in males, and higher levels of Cu in females; and for Mn, Cu, Zn, Cd and Pb in scalp hair, with higher concentrations in males for all metal(loid)s except Cu.
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Affiliation(s)
- B Markiv
- Departamento de Ingenierías Química y Biomolecular, Universidad de Cantabria, Santander, Spain.
| | - L Ruiz-Azcona
- Departamento de Enfermería, Universidad de Cantabria, Santander, Spain
| | - A Expósito
- Departamento de Ingenierías Química y Biomolecular, Universidad de Cantabria, Santander, Spain
| | - M Santibáñez
- Departamento de Enfermería, Universidad de Cantabria, Santander, Spain
| | - I Fernández-Olmo
- Departamento de Ingenierías Química y Biomolecular, Universidad de Cantabria, Santander, Spain
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12
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Shilnikova N, Karyakina N, Farhat N, Ramoju S, Cline B, Momoli F, Mattison D, Jensen N, Terrell R, Krewski D. Biomarkers of environmental manganese exposure. Crit Rev Toxicol 2022; 52:325-343. [PMID: 35894753 DOI: 10.1080/10408444.2022.2095979] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We conducted a critical review on biomarkers of environmental manganese (Mn) exposure to answer the following questions: 1) are there reliable biomarkers of internal Mn exposure (Mn in biological matrices) associated with external metrics of Mn exposure (Mn in environmental media)? and 2) are there accurate reference values (RVs) for Mn in biological matrices? Three bibliographic databases were searched for relevant references and identified references were screened by two independent reviewers. Of the 6342 unique references identified, 86 articles were retained for data abstraction. Our analysis of currently available evidence suggests that Mn levels in blood and urine are not useful biomarkers of Mn exposure in non-occupational settings. The strength of the association between Mn in environmental media and saliva was variable. Findings regarding the utility of hair Mn as a biomarker of environmental Mn exposure are inconsistent. Measurements of Mn in teeth are technically challenging and findings on Mn in tooth components are scarce. In non-occupationally exposed individuals, bone Mn measurements using in vivo neutron activation analysis (IVNAA) are associated with large uncertainties. Findings suggest that Mn in nails may reflect Mn in environmental media and discriminate between groups of individuals exposed to different environmental Mn levels, although more research is needed. Currently, there is no strong evidence for any biological matrix as a valid biomarker of Mn exposure in non-occupational settings. Because of methodological limitations in studies aimed at derivation of RVs for Mn in biological materials, accurate RVs are scarce.
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Affiliation(s)
- Natalia Shilnikova
- Risk Sciences International, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - Nataliya Karyakina
- Risk Sciences International, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - Nawal Farhat
- Risk Sciences International, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.,School of Mathematics and Statistics, Carleton University, Ottawa, Canada
| | | | | | - Franco Momoli
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Donald Mattison
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Natalie Jensen
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Rowan Terrell
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Daniel Krewski
- Risk Sciences International, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.,School of Mathematics and Statistics, Carleton University, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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13
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Methylcyclopentadienyl Manganese Tricarbonyl Alter Behavior and Cause Ultrastructural Changes in the Substantia Nigra of Rats: Comparison with Inorganic Manganese Chloride. Neurochem Res 2022; 47:2198-2210. [PMID: 35513760 DOI: 10.1007/s11064-022-03606-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/23/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
Abstract
The antiknock additive methylcyclopentadienyl manganese tricarbonyl (MMT) is an organic manganese(Mn) compound. Mn neurotoxicity caused by occupational Mn exposure (mostly inorganic MnCl2) is associated with motor and cognitive disturbances, referred to as Manganism. However, the impact of environmentally relevant Mn exposure on MMT-induced Manganism is poorly understood. In this investigation, we studied the effects of MMT on motor function and brain structure, and compared its effects with those of inorganic MnCl2. After adaptive feeding for 7 days, male and female Sprague-Dawley (SD) rats in the MMT-treated groups and positive control group were treated for 8 weeks with MMT (1, 2 and 4 mg/kg/i.g.) or MnCl2·4H2O (200 mg/kg/i.g.). Mn content in blood, liver, spleen and distinct brain regions was determined by inductively coupled plasma-mass spectrometer (ICP-MS). We found that MMT and MnCl2 exposure led to slower body-weight-gain in female rats, impaired motor and balance function and spatial learning and memory both in male and female rats. HE staining showed that MMT and MnCl2 led to altered structure of the substantia nigra pars compacta (SNpc), and Nissl staining corroborated MMT's propensity to damage the SNpc both in male and female rat. In addition, Immunostaining of the SNpc showed decreased TH-positive neurons in MMT- and MnCl2-treated rats, concomitant with Iba1 activation in microglia. Moreover, no statistically significant difference was noted between the rats in the H-MMT and MnCl2 groups. In summary, these findings suggest that MMT and MnCl2 exposure cause ultrastructural changes in the SNpc neurons culminating in altered motor behavior and cognition, suggesting that altered SNpc structure and function may underline the motor and cognitive deficits inherent to Manganism, and accounting for MMT and MnCl2's manifestations of atypical parkinsonism.
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14
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Jensen N, Terrell R, Ramoju S, Shilnikova N, Farhat N, Karyakina N, Cline BH, Momoli F, Mattison D, Krewski D. Magnetic resonance imaging T1 indices of the brain as biomarkers of inhaled manganese exposure. Crit Rev Toxicol 2022; 52:358-370. [PMID: 36412542 DOI: 10.1080/10408444.2022.2128719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Excessive exposure to manganese (Mn) is linked to its accumulation in the brain and adverse neurological effects. Paramagnetic properties of Mn allow the use of magnetic resonance imaging (MRI) techniques to identify it in biological tissues. A critical review was conducted to evaluate whether MRI techniques could be used as a diagnostic tool to detect brain Mn accumulation as a quantitative biomarker of inhaled exposure. A comprehensive search was conducted in MEDLINE, EMBASE, and PubMed to identify potentially relevant studies published prior to 9 May 2022. Two reviewers independently screened identified references using a two-stage process. Of the 6452 unique references identified, 36 articles were retained for data abstraction. Eligible studies used T1-weighted MRI techniques and reported direct or indirect T1 measures to characterize Mn accumulation in the brain. Findings demonstrate that, in subjects exposed to high levels of Mn, deposition in the brain is widespread, accumulating both within and outside the basal ganglia. Available evidence indicates that T1 MRI techniques can be used to distinguish Mn-exposed individuals from unexposed. Additionally, T1 MRI may be useful for semi-quantitative evaluation of inhaled Mn exposure, particularly when interpreted along with other exposure indices. T1 MRI measures appear to have a nonlinear relationship to Mn exposure duration, with R1 signal only increasing after critical thresholds. The strength of the association varied depending on the regions of interest imaged and the method of exposure measurement. Overall, available evidence suggests potential for future clinical and risk assessment applications of MRI as a diagnostic tool.
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Affiliation(s)
- N Jensen
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - R Terrell
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - S Ramoju
- Risk Sciences International, Ottawa, Canada
| | - N Shilnikova
- Risk Sciences International, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - N Farhat
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,School of Mathematics and Statistics, Carleton University, Ottawa, Canada
| | - N Karyakina
- Risk Sciences International, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - B H Cline
- International Manganese Institute, Paris, France
| | - F Momoli
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - D Mattison
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - D Krewski
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.,School of Mathematics and Statistics, Carleton University, Ottawa, Canada
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15
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Ruiz-Azcona L, Markiv B, Expósito A, Pozueta A, García-Martínez M, Fernández-Olmo I, Santibáñez M. Poorer cognitive function and environmental airborne Mn exposure determined by biomonitoring and personal environmental monitors in a healthy adult population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 815:152940. [PMID: 35007600 DOI: 10.1016/j.scitotenv.2022.152940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/15/2021] [Accepted: 01/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM In the Santander Bay (Cantabria, northern Spain), a ferromanganese alloy plant is located. Our objective was to characterize the Mn personal exposure of adult healthy volunteers living in this highly Mn exposed region, and to determine its association with a poorer cognitive function. METHODS Cross-sectional study analyzing 130 consecutive participants. Cognitive function was assessed by Stroop Color Word, Verbal Fluency tests, Trail Making Test (TMT), Digit Span (WAIS III) and Rey Osterrieth Complex Figure (ROCF) tests and crude scores were standardized according to NEURONORMA norms. Exposure to Mn was assessed in terms of source distance, by Personal Environmental Monitors (PEMs) allowing the separation of fine (PM2.5) and coarse (PM10-2.5) particles (obtaining the bioaccessible fraction by in-vitro bioaccessibility tests), and by biomarkers (blood, hair and fingernails). Age, sex, study level and number of years of residence were predefined as confounding variables and adjusted Mean Differences (MDs) were obtained. RESULTS Statistically significant lower scores (negative MDs) in all test were observed when living near the industrial emission source, after adjusting for the predefined variables. Regarding PEMs results, statistically significant lower scores in all Stroop parts were obtained in participants with higher levels of Total Mn in All fractions (PM10). For Verbal Fluency tests, negative MDs were obtained for both bioaccessible fractions. Digit Span Backward scores were lower for those with higher levels in the bioaccessible coarse fraction, and negative MDs were also observed for the ROCF Delayed part and the non-bioaccessible fine fraction. As regards to Mn in fingernails, adjusted MDs of -1.60; 95%CI (-2.57 to -0.64) and -1.45; 95%CI (-2.29 to -0.61) for Digit Span Forward and Backward parts were observed. CONCLUSIONS Our results support an association between poorer cognitive function and environmental airborne Mn exposure.
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Affiliation(s)
- Laura Ruiz-Azcona
- Global Health Research Group. Dpto Enfermería, Universidad de Cantabria, Avda. Valdecilla, s/n., 39008 Santander, Cantabria, Spain
| | - Bohdana Markiv
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Avda. Los Castros s/n, 39005 Santander, Cantabria, Spain
| | - Andrea Expósito
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Avda. Los Castros s/n, 39005 Santander, Cantabria, Spain
| | - Ana Pozueta
- Service of Neurology, IDIVAL, University Hospital Marqués de Valdecilla, University of Cantabria, 39008 Santander, Spain; CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28031 Madrid, Spain
| | - María García-Martínez
- Service of Neurology, IDIVAL, University Hospital Marqués de Valdecilla, University of Cantabria, 39008 Santander, Spain; CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, 28031 Madrid, Spain
| | - Ignacio Fernández-Olmo
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Avda. Los Castros s/n, 39005 Santander, Cantabria, Spain
| | - Miguel Santibáñez
- Global Health Research Group. Dpto Enfermería, Universidad de Cantabria, Avda. Valdecilla, s/n., 39008 Santander, Cantabria, Spain; Nursing Research Group, IDIVAL, Calle Cardenal Herrera Oria s/n, 39011 Santander, Cantabria, Spain.
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16
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Savinov SS, Drobyshev AI. Determination of Trace Elements in Biological Fluids by Arc Atomic Emission Spectrometry. JOURNAL OF ANALYTICAL CHEMISTRY 2022. [DOI: 10.1134/s1061934822010129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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17
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Gonzalez-Alvarez MA, Hernandez-Bonilla D, Plascencia-Alvarez NI, Riojas-Rodriguez H, Rosselli D. Environmental and occupational exposure to metals (manganese, mercury, iron) and Parkinson's disease in low and middle-income countries: a narrative review. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:1-11. [PMID: 33768768 DOI: 10.1515/reveh-2020-0140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES We designed and conducted a narrative review consistent with the PRISMA guidelines (PROSPERO registration number: CRD42018099498) to evaluate the association between environmental metals (manganese, mercury, iron) and Parkinson's Disease (PD) in low and middle-income countries (LMIC). METHODS Data sources: A total of 19 databases were screened, and 2,048 references were gathered. Study selection: Randomized controlled trials, cluster trials, cohort studies, case-control studies, nested case-control studies, ecological studies, cross-sectional studies, case series, and case reports carried out in human adults of LMIC, in which the association between at least one of these three metals and the primary outcome were reported. Data extraction: We extracted qualitative and quantitative data. The primary outcome was PD cases, defined by clinical criteria. A qualitative analysis was conducted. RESULTS Fourteen observational studies fulfilled the selection criteria. Considerable variation was observed between these studies' methodologies for the measurement of metal exposure and outcome assessment. A fraction of studies suggested an association between the exposure and primary outcome; nevertheless, these findings should be weighted and appraised on the studies' design and its implementation limitations, flaws, and implications. CONCLUSIONS Further research is required to confirm a potential risk of metal exposure and its relationship to PD. To our awareness, this is the first attempt to evaluate the association between environmental and occupational exposure to metals and PD in LMIC settings using the social determinants of health as a framework.
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Affiliation(s)
| | - David Hernandez-Bonilla
- Environmental Health Department, National Institute of Public Health, Ciudad de Mexico, CDMX, Mexico
- Environmental Health Department, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Horacio Riojas-Rodriguez
- Environmental Health Department, National Institute of Public Health, Ciudad de Mexico, CDMX, Mexico
- Environmental Health Department, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Diego Rosselli
- Clinical Epidemiology and Biostatistics Department, Pontificia Universidad Javeriana, Bogotá, Colombia
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18
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Occupational Exposure to Manganese Among Welders: Association Between Airborne Manganese Concentration and Blood Manganese Levels. HEALTH SCOPE 2022. [DOI: 10.5812/jhealthscope.120968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Manganese (Mn) is an essential element for the human body, but it can cause adverse effects on the Central Nervous System at high doses. Exposure to manganese fumes during welding can harm welders' health. Objectives: The current study aimed to measure manganese produced by shielded metal arc welding (SMAW) in the breathing zone air and blood of welders and investigate the relationship between manganese concentrations in air and blood. Methods: In this descriptive-analytical cross-sectional study, 35 welders were enrolled as the exposed group and 40 office workers as the control group. Manganese concentration in air was measured according to NIOSH method 7301. Air and blood sample analyses were carried out by ICP-OES. Statistical analysis was performed with MINITAB 17. Data were analyzed using Pearson correlation coefficient, one-sample t-test, paired t-test, and logistic regression. The significance level was set at P < 0.05. Result: The mean concentration of welding respirable particles and manganese fumes were 9.56 ± 1.67 and 0.45 ± 0.08 mg/m3, three and 22 times the exposure limit recommended by ACGIH, respectively. Average manganese was significantly higher in the welders’ blood (0.16 ± 0.02 µg/mL) than in the controls’ blood (0.04 ± 0.002 µg/mL). There were strong and significant correlations between the welding respirable particles and manganese concentration in welders’ breathing zone and blood manganese levels. Also, with each year of work experience, the manganese concentration in the welders’ blood increased by 1.5%. Conclusions: Welders are at risk of contamination with manganese. Manganese exposure reduction through more efficient ventilation systems, reducing welder’s exposure time, staff training, and appropriate respiratory protection equipment should be applied to reduce manganese exposure among welders and prevent health complications.
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Haque E, Moran ME, Wang H, Adamcakova-Dodd A, Thorne PS. Validation of blood arsenic and manganese assessment from archived clotted erythrocyte fraction in an urban cohort of mother-child dyads. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 810:152320. [PMID: 34915002 PMCID: PMC9709768 DOI: 10.1016/j.scitotenv.2021.152320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 05/03/2023]
Abstract
Exposure to arsenic (As) and manganese (Mn) from contaminated food, drinking water and dust are linked to a host of adverse health effects. The recent discovery of unmonitored community exposures to hazardous levels of metals, as seen in the Flint Water Crisis and East Chicago, have demonstrated a need for novel biomonitoring methods utilizing samples other than whole blood. Here, we present a method utilizing clotted erythrocyte fraction samples, a blood component commonly archived in biorepositories, to predict whole blood levels of As and Mn. This method would allow for innovative retrospective assessments of environmental exposures in previously unused samples. Whole blood and clotted erythrocyte fraction samples were simultaneously collected from 84 participants in the Airborne Exposure to Semivolatile Organic Pollutants (AESOP) cohort study of mother-child dyads in East Chicago. Clotted erythrocyte fraction samples were prepared by alkaline dilution and subsequently analyzed using inductively coupled plasma-mass spectrometry. A strong linear relationship was observed between whole blood and clotted erythrocyte fraction with Pearson correlation coefficients (r, p < 0.001) of 0.74, and 0.82 for As and Mn, respectively. Modeled whole blood Mn levels predicted from clotted erythrocyte fractions evaluated at a test threshold representing the NHANES median of 9.7 μg/L, were found to have diagnostic sensitivity of 88% and specificity of 71%. Clotted erythrocyte partitioning of As was tested on a wide range of oral gavage doses using a rat model. Results from this investigation demonstrate clotted erythrocyte fraction samples are a viable alternative biological sample for retrospective public health surveillance of environmental exposure to As and Mn.
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Affiliation(s)
- Ezazul Haque
- Human Toxicology Program, Graduate College, University of Iowa, United States of America; Department of Occupational and Environmental Health, College of Public Health, University of Iowa, United States of America
| | - Margaret E Moran
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, United States of America
| | - Hui Wang
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, United States of America
| | - Andrea Adamcakova-Dodd
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, United States of America
| | - Peter S Thorne
- Human Toxicology Program, Graduate College, University of Iowa, United States of America; Department of Occupational and Environmental Health, College of Public Health, University of Iowa, United States of America.
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20
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Rolle-McFarland D, Liu Y, Mostafaei F, Zauber SE, Zhou Y, Li Y, Fan Q, Zheng W, Nie LH, Wells EM. The association of bone and blood manganese with motor function in Chinese workers. Neurotoxicology 2022; 88:224-230. [PMID: 34896555 PMCID: PMC8748420 DOI: 10.1016/j.neuro.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 01/03/2023]
Abstract
Manganese (Mn) is an essential element. However, Mn overexposure is associated with motor dysfunction. This cross-sectional study assessed the association between bone Mn (BnMn) and whole blood Mn (BMn) with motor function in 59 Chinese workers. BnMn and BMn were measured using a transportable in vivo neutron activation analysis system and inductively coupled plasma mass spectrometry, respectively. Motor function (manual coordination, postural sway, postural hand tremor, and fine motor function) was assessed using the Coordination Ability Test System (CATSYS) and the Purdue Pegboard. Relationships between Mn biomarkers and motor test scores were analyzed with linear regression models adjusted for age, education, current employment, and current alcohol consumption. BMn was significantly inversely associated with hand tremor intensity (dominant hand (β=-0.04, 95 % confidence interval (CI):-0.07, -0.01; non-dominant hand β=-0.05, 95 % CI:-0.08, -0.01) hand tremor center frequency (non-dominant hand β=-1.61, 95 % CI:-3.03, -0.19) and positively associated with the Purdue Pegboard Assembly Score (β = 4.58, 95 % CI:1.08, 8.07). BnMn was significantly inversely associated with finger-tapping performance (non-dominant hand β=-0.02, 95 % CI:-0.04,-0.004), mean sway (eyes closed and foam β=-0.68, 95 % CI:-1.31,-0.04), and positively associated with hand tremor center frequency (dominant hand, β = 0.40, 95 % CI:0.002, 0.80). These results suggest BMn is related to better postural hand tremor and fine motor control and BnMn is related to worse motor coordination and postural hand tremor but better (i.e., less) postural sway. The unexpected positive results might be explained by choice of biomarker or confounding by work-related motor activities. Larger, longitudinal studies in this area are recommended.
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Affiliation(s)
- Danelle Rolle-McFarland
- School of Health Sciences, Purdue University, West
Lafayette, IN, USA.,OncoSynergy, Inc., Greenwich, CT, USA
| | - Yingzi Liu
- School of Health Sciences, Purdue University, West
Lafayette, IN, USA.,Department of Radiation Oncology, School of Medicine, Emory
University, Atlanta, GA, USA
| | - Farshad Mostafaei
- School of Health Sciences, Purdue University, West
Lafayette, IN, USA.,Department of Radiation Oncology, Augusta University,
Medical College of Georgia, Augusta, USA
| | - S. Elizabeth Zauber
- Department of Neurology, Indiana University School of
Medicine, Indianapolis, IN, USA
| | - Yuanzhong Zhou
- School of Public Health, Zunyi Medical University, Zunyi,
Guizhou, China
| | - Yan Li
- School of Public Health, Zunyi Medical University, Zunyi,
Guizhou, China
| | - Quiyan Fan
- Zunyi Medical and Pharmaceutical College, Zunyi, Guizhou,
China
| | - Wei Zheng
- School of Health Sciences, Purdue University, West
Lafayette, IN, USA
| | - Linda H. Nie
- School of Health Sciences, Purdue University, West
Lafayette, IN, USA
| | - Ellen M. Wells
- School of Health Sciences, Purdue University, West
Lafayette, IN, USA.,Corresponding author: Address: 550
Stadium Mall Drive; West Lafayette, IN 47907; USA, Phone: 1-765-496-3535,
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21
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Wang X, Li R, He R, Fang F. Effects of repeated manganese treatment on proton magnetic resonance spectra of the globus pallidus in rat brain. NMR IN BIOMEDICINE 2022; 35:e4617. [PMID: 34562038 DOI: 10.1002/nbm.4617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
Excessive manganese is neurotoxic, which means that it can affect the concentrations of metabolite in 1 H MRS. In addition, manganese is paramagnetic and it may influence the relaxation times of the metabolite. The aim of this study is to assess the sensitivity of the metabolite relaxation properties and concentrations to exogenous manganese deposition in the globus pallidus (GP) of rat brain after repeated manganese injection. Proton magnetic resonance spectroscopy (1 H MRS) experiments in vivo and ex vivo were carried out to evaluate the changes in the metabolite concentration and the major metabolite relaxation times, and histological experiments were also performed after repeated manganese administration. Only the T1 value for N-acetylaspartate (NAA) of the GP was significantly reduced after 1 day of manganese injection compared with that of the control group (p < 0.025). The T1 and T2 values for NAA and total creatine (tCr) (p < 0.025), along with the amounts of NAA, tCr, myo-inositol, choline, and glutamate (p < 0.0086) in the GP, were all significantly decreased after 5 days of manganese administration compared with that of the control group. The changes in the concentration and relaxation properties of NAA and tCr in the GP of rat brain indicated that manganese represented paramagnetism and neurotoxicity after repeated administration. Accurate knowledge of relaxation properties and concentrations of NAA and tCr in this study could help appropriate selection of sequence parameters to improve the ability to distinguish the brain regions affected in cases of manganese poisoning.
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Affiliation(s)
- Xuxia Wang
- State Key Laboratory of Magnetic Resonance and Atomic Molecular Physics, National Center for Magnetic Resonance in Wuhan, Key Laboratory of Magnetic Resonance in Biological Systems, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Ronghui Li
- State Key Laboratory of Magnetic Resonance and Atomic Molecular Physics, National Center for Magnetic Resonance in Wuhan, Key Laboratory of Magnetic Resonance in Biological Systems, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, China
| | - Rui He
- State Key Laboratory of Magnetic Resonance and Atomic Molecular Physics, National Center for Magnetic Resonance in Wuhan, Key Laboratory of Magnetic Resonance in Biological Systems, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, China
| | - Fang Fang
- State Key Laboratory of Magnetic Resonance and Atomic Molecular Physics, National Center for Magnetic Resonance in Wuhan, Key Laboratory of Magnetic Resonance in Biological Systems, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, China
- University of Chinese Academy of Sciences, Beijing, China
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22
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Manganese Intoxication Recovery and the Expression Changes of Park2/Parkin in Rats. Neurochem Res 2021; 47:897-906. [PMID: 34839452 DOI: 10.1007/s11064-021-03493-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/18/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
Occupational overexposure to manganese (Mn) produces Parkinson's disease-like manganism. Acute Mn intoxication in rats causes dopaminergic neuron loss, impairment of motor activity and reduction of the expression of Park2/Parkin. The expression of Park2/Parkin is also reduced. Whether these changes are reversible after cessation of Mn exposure is unknown, and is the goal of this investigation. Adult male rats were injected with Mn2+ at doses 1 mg/kg and 5 mg/kg in the form of MnCl2·4H2O, every other day for one-month to produce acute Mn neurotoxicity. For a half of rats Mn exposure was suspended for recovery for up to 5 months. Mn neurotoxicity was evaluated by the accumulation of Mn in blood and brain, behavioral activities, dopaminergic neuron loss, and the expression of Park2/Parkin in the blood cells and brain. Dose-dependent Mn neurotoxicity in rats was evidenced by Mn accumulation, rotarod impairments, reduction of tyrosine hydroxylase (TH)-positive neurons in the substantia nigra, decreased level of Park2 mRNA in the blood and brain, and decreased Parkin protein in the brain. After cessation of Mn exposure, the amount of Park2 mRNA in the blood started to increase one month after the recovery. After 5-month of recovery, blood and brain Mn returned to normal, rotarod activity recovered, the reduction of TH-positive dopaminergic neurons ameliorated, and the level of Park2 mRNA in the blood and Park2/Parkin in the midbrain and striatum were returned to the normal. Mn neurotoxicity in rats is reversible after cessation of Mn exposure. The level of Park2 mRNA in the blood could be used as a novel biomarker for Mn exposure and recovery.
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Ruiz-Azcona L, Markiv B, Expósito A, González-Aramburu I, Sierra M, Fernández-Olmo I, Santibáñez M. Biomonitoring and bioaccessibility of environmental airborne manganese in relation to motor function in a healthy adult population. Neurotoxicology 2021; 87:195-207. [PMID: 34678399 DOI: 10.1016/j.neuro.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND/AIM Santander, the capital of Cantabria, Spain (172,000 inhabitants) is 7 km from an industrial emission source (IES) of Mn located in a 10,000 inhabitants town (Maliaño) (annual air Mn arithmetic mean = 231.8 ng/m3; reference WHO guideline = 150 ng/m3). Our objective was to compare the motor function of adult healthy volunteers living in both places. METHODS Cross-sectional study analyzing 130 consecutive participants. Exposure to Mn was assessed in terms of source distance from the IES, by Personal Environmental Monitors (PEMs) carried for 24 h by participants consisting of a portable impactor connected to a personal pump, and by biomarkers (blood, hair and fingernails). The impactor allowed the separation of fine (PM2.5) and coarse (PM10-2.5) particles and for each particle size in-vitro bioaccessibility tests with biologically active fluids were performed to separate the soluble (bioaccessible) from the insoluble (non-bioaccessible) fraction. Mean Differences (MDs) adjusted for age, sex, and study level, were obtained for motor function tests results. RESULTS Regarding Grooved Pegboard, overall mean time to complete the test was 59.31 and 65.27 seconds (Standard Deviation = 10.11 and 11.69) for dominant and nondominant hands respectively. Statistically significant higher times (indicating worse function) were observed when living near the IES in both hands but MDs of only 1.22 and 2.05 seconds were obtained after adjusting for the predefined confounders (p = 0.373 and 0.221 respectively). Regarding Mn levels in their PEMs (in both bioaccessible and non-bioaccessible coarse&fine fractions) higher times were computed in participants with higher levels for the bioaccessible-fine fraction, with a MD that diminished but still yielded statistical significance after controlling for confounding: adjusted MD = 3.01 more seconds; 95%CI (0.44-5.38), p = 0.022. Poorer results were also observed for fingernails levels. Regarding Finger Tapping Test, no statistically significant differences were found with the exception of Mn fingernails levels. CONCLUSIONS Our results suggest poorer motor function as assessed by Grooved Pegboard test in relation to "proximity to IES", "bioaccessible-fine fraction as determined by PEMs and "Mn fingernails levels". However, our findings were affected by confounding, and only the adjusted MD for the Mn bioaccessible-fine fraction remained of sufficient magnitude to maintain statistical significance.
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Affiliation(s)
- Laura Ruiz-Azcona
- Global Health Research Group, Dpto Enfermería, Universidad de Cantabria, Avda. Valdecilla, s/n, 39008, Santander, Cantabria, Spain
| | - Bohdana Markiv
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Avda. Los Castros s/n, 39005, Santander, Cantabria, Spain
| | - Andrea Expósito
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Avda. Los Castros s/n, 39005, Santander, Cantabria, Spain
| | - Isabel González-Aramburu
- Service of Neurology, Hospital Universitario Marqués de Valdecilla (HUMV-IDIVAL), Santander, Spain
| | - María Sierra
- Service of Neurology, Hospital Universitario Marqués de Valdecilla (HUMV-IDIVAL), Santander, Spain
| | - Ignacio Fernández-Olmo
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Avda. Los Castros s/n, 39005, Santander, Cantabria, Spain
| | - Miguel Santibáñez
- Global Health Research Group, Dpto Enfermería, Universidad de Cantabria, Avda. Valdecilla, s/n, 39008, Santander, Cantabria, Spain; Nursing Research Group, IDIVAL, Calle Cardenal Herrera Oria s/n, 39011, Santander, Cantabria, Spain.
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24
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Ordak M, Sloniewicz N, Nasierowski T, Muszynska E, Bujalska-Zadrozny M. Manganese concentration in patients with encephalopathy following ephedrone use: a narrative review and analysis of case reports. Clin Toxicol (Phila) 2021; 60:10-17. [PMID: 34521308 DOI: 10.1080/15563650.2021.1973488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Numerous case reports describe manganese encephalopathy in patients using ephedrone (methcathinone). The aim of this narrative review of case reports was to relate manganese ion concentrations in peripheral blood to the reported neurological deficits. METHODS International databases, including Thomson (Web of Knowledge), PubMed/Medline, Science Direct, Scopus and Google Scholar were searched for literature items published between 2007 and 2020, in which the authors measured the manganese concentration in patients taking ephedrone. RESULTS We identified 39 patients in two case series comprising of twenty-three and twelve patients, respectively, and four case reports meeting inclusion criteria. The study showed that 93% of them had elevated blood manganese concentration in relation to the accepted norm (>219 nmol/L), and the median was 364 nmol/L. The median duration of ephedrone use in individual groups of patients was approximately 48 months, and it did not show a relationship with the manganese concentration in the blood. A greater percentage of the people with manganese concentration higher than 250 nmol/L exhibited more severe gait, speech and handwriting disorders. The median duration of ephedrone withdrawal was a month in the group of people with the highest level of manganese ions (>500 nmol/L). CONCLUSION Manganese concentrations did not vary with the duration of ephedrone use.
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Affiliation(s)
- Michal Ordak
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Natalia Sloniewicz
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | | | - Elzbieta Muszynska
- Department of Medical Biology, Medical University of Bialystok, Bialystok, Poland
| | - Magdalena Bujalska-Zadrozny
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
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Tarnacka B, Jopowicz A, Maślińska M. Copper, Iron, and Manganese Toxicity in Neuropsychiatric Conditions. Int J Mol Sci 2021; 22:ijms22157820. [PMID: 34360586 PMCID: PMC8346158 DOI: 10.3390/ijms22157820] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/12/2021] [Accepted: 07/20/2021] [Indexed: 12/18/2022] Open
Abstract
Copper, manganese, and iron are vital elements required for the appropriate development and the general preservation of good health. Additionally, these essential metals play key roles in ensuring proper brain development and function. They also play vital roles in the central nervous system as significant cofactors for several enzymes, including the antioxidant enzyme superoxide dismutase (SOD) and other enzymes that take part in the creation and breakdown of neurotransmitters in the brain. An imbalance in the levels of these metals weakens the structural, regulatory, and catalytic roles of different enzymes, proteins, receptors, and transporters and is known to provoke the development of various neurological conditions through different mechanisms, such as via induction of oxidative stress, increased α-synuclein aggregation and fibril formation, and stimulation of microglial cells, thus resulting in inflammation and reduced production of metalloproteins. In the present review, the authors focus on neurological disorders with psychiatric signs associated with copper, iron, and manganese excess and the diagnosis and potential treatment of such disorders. In our review, we described diseases related to these metals, such as aceruloplasminaemia, neuroferritinopathy, pantothenate kinase-associated neurodegeneration (PKAN) and other very rare classical NBIA forms, manganism, attention-deficit/hyperactivity disorder (ADHD), ephedrone encephalopathy, HMNDYT1-SLC30A10 deficiency (HMNDYT1), HMNDYT2-SLC39A14 deficiency, CDG2N-SLC39A8 deficiency, hepatic encephalopathy, prion disease and “prion-like disease”, amyotrophic lateral sclerosis, Huntington’s disease, Friedreich’s ataxia, and depression.
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Affiliation(s)
- Beata Tarnacka
- Department of Rehabilitation Medicine, Faculty of Medicine, Warsaw Medical University, Spartańska 1, 02-637 Warsaw, Poland
- Correspondence: ; Tel.: +48-603944804
| | - Anna Jopowicz
- Department of Rehabilitation, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637 Warsaw, Poland;
| | - Maria Maślińska
- Department of Early Arthritis, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637 Warsaw, Poland;
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Mostafa HES, Alaa El-Din EA, El-Shafei DA, Abouhashem NS, Abouhashem AA. Protective roles of thymoquinone and vildagliptin in manganese-induced nephrotoxicity in adult albino rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:31174-31184. [PMID: 33595798 DOI: 10.1007/s11356-021-12997-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
Despite being important in the body's mechanisms, excessive accumulation of manganese (Mn) can induce severe toxicity in vital organs of the body. Thymoquinone (TQ) is extracted from Nigella sativa seeds which recently gained popularity as dietary supplements and plant-based antioxidants. Vildagliptin (VLD) is a dipeptidyl peptidase IV (DPPIV) inhibitor, approved as anti-hyperglycemic agents with cardioprotective and renoprotective effects. The present study aimed to investigate the nephrotoxicity of Mn and the potential protective effects of thymoquinone and vildagliptin. Sixty-four adult male albino rats were equally divided into 8 groups: group I (control, received no medication), group II (vehicle, received normal saline), group III (TQ, 50 mg/kg/day), group IV (VLD, 10 mg/kg/day), group V (MnCl2, 50 mg/kg/day), group VI (Mn+TQ), group VII (Mn+VLD), and group VIII (Mn+TQ+VLD). Groups VI, VII, and VIII, received the same previously mentioned doses. All drugs were orally gavaged for 12 weeks. Manganese administration resulted in an elevation in the levels of serum and tissues Mn, blood glucose, serum urea, creatinine, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and reduction in insulin, kidney superoxide dismutase (SOD), glutathione (GSH), and interleukin-10. Histopathological structural renal damage was detected associated with strong positive immunoexpression of caspase-3. On the other hand, individual or combined TQ and VLD administration with Mn significantly decreased the serum and tissue levels of Mn, declined the blood glucose, inflammatory markers, oxidative stress markers, ameliorated the histopathological effects, and down-regulated the immunoexpression of caspase-3. In conclusion, TQ and VLD co-administration elicited protective effects against Mn-induced nephrotoxicity.
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Affiliation(s)
- Heba El-Sayed Mostafa
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt
| | - Eman Ahmed Alaa El-Din
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt.
| | - Dalia Abdallah El-Shafei
- Department of Community, Environmental & Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nehal S Abouhashem
- Department of Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Aisha Abdallah Abouhashem
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt
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27
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Dastych M, Husová L, Aiglová K, Fejfar T, Dastych M. Manganese and copper levels in patients with primary biliary cirrhosis and primary sclerosing cholangitis. Scandinavian Journal of Clinical and Laboratory Investigation 2021; 81:116-120. [PMID: 33428478 DOI: 10.1080/00365513.2020.1864835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The liver and the biliary tree form the main excretory route of manganese (Mn) and copper (Cu). Cholestasis, can lead to the accumulation of these trace elements in the organism, resulting in toxicity to the basal ganglia of the central nervous system. The aim of our study was to reveal the influence of long-term cholestasis on the Mn and Cu levels in the blood of patients with primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC). We recruited patients with PBC (n = 20) and PSC (n = 32). A control group (n = 40) was also set up. We also examined serum bile acid concentrations and liver enzyme activities. We did not observe any significant differences in any of these parameters between the PBC and PSC groups. The Mn and Cu levels in the PBC and PSC patients differed significantly from the that in the control group (p < 0.0001 and p < .021, respectively). Patients in whom the laboratory cholestasis markers normalized during ursodeoxycholic acid treatment (18/52;35%) presented with significantly lower levels of Mn and Cu (p = .015 and p = .012, respectively). Ten PSC patients showed normal levels of Mn and Cu six months after liver transplantation. Fine tremors, rigidity, dysarthria, and hypomimia were reported in nine (23%), eight (20%), four (10%), and eight (20%) patients, respectively. In addition to monitoring the cholestasis levels, liver function, and Mn and Cu levels during the long-term treatment of PBC and PSC patients, it is important to also regularly monitor the occurrence and development of extrapyramidal symptoms of Parkinson's-like syndromes.
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Affiliation(s)
- Milan Dastych
- Department of Clinical Biochemistry, University Hospital Brno, Brno, Czech Republic
| | - Libuše Husová
- Center for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
| | - Květoslava Aiglová
- Department of Internal Medicine II - Gastroenterology and Geriatrics, University Hospital Olomouc, Olomouc, Czech Republic
| | - Tomáš Fejfar
- 2nd Department of Internal Medicine Gastroenterology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Milan Dastych
- Department of Gastroenterology and Internal Medicine, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine Masaryk University, Brno, Czech Republic
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28
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Fernández-Olmo I, Mantecón P, Markiv B, Ruiz-Azcona L, Santibáñez M. A Review on the Environmental Exposure to Airborne Manganese, Biomonitoring, and Neurological/Neuropsychological Outcomes. REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2021; 254:85-130. [PMID: 32474705 DOI: 10.1007/398_2020_46] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The occupational exposure to airborne manganese (Mn) has been linked for decades with neurological effects. With respect to its environmental exposure, the first reviews on this matter stated that the risk posed to human health by this kind of exposure was still unknown. Later, many studies have been developed to analyze the association between environmental Mn exposure and health effects, most of them including the measure of Mn in selected human biomarkers. This review aims at collecting and organizing the literature dealing with the environmental airborne Mn exposure (other routes of exposure were intentionally removed from this review), the biomonitoring of this metal in different body matrices (e.g., blood, urine, nails, hair), and the association between exposure and several adverse health effects, such as, e.g., neurocognitive, neurodevelopmental, or neurobehavioral outcomes. From the different exposure routes, inhalation was the only one considered in this review, to take into account the areas influenced by industrial activities closely related to the Mn industry (ferromanganese and silicomanganese plants, Mn ore mines, and their processing plants) and by traffic in countries where a fuel additive, methylcyclopentadienyl manganese tricarbonyl (MMT), has been used for years. In these areas, high air Mn levels have been reported in comparison with the annual Reference Concentration (RfC) given by the US EPA for Mn, 50 ng/m3. This review was performed using Scopus and MEDLINE databases with a keyword search strategy that took into account that each valid reference should include at least participants that were exposed to environmental airborne Mn and that were subjected to analysis of Mn in biomarkers or subjected to neurological/neuropsychological tests or both. Overall, 47 references matching these criteria were included in the discussion. Most of them report the measure of Mn in selected biomarkers (N = 43) and the assessment of different neurological outcomes (N = 31). A negative association is usually obtained between Mn levels in hair and some neurological outcomes, such as cognitive, motor, olfactory, and emotional functions, but not always significant. However, other biomarkers, such as blood and urine, do not seem to reflect the chronic environmental exposure to low/moderate levels of airborne Mn. Further studies combining the determination of the Mn exposure through environmental airborne sources and biomarkers of exposure and the evaluation of at least cognitive and motor functions are needed to better understand the effects of chronic non-occupational exposure to airborne Mn.
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Affiliation(s)
- Ignacio Fernández-Olmo
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Santander, Cantabria, Spain.
| | - Paula Mantecón
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Santander, Cantabria, Spain
| | - Bohdana Markiv
- Dpto. de Ingenierías Química y Biomolecular, Universidad de Cantabria, Santander, Cantabria, Spain
| | - Laura Ruiz-Azcona
- Global Health Research Group, Dpto. Enfermería, Universidad de Cantabria-IDIVAL, Santander, Cantabria, Spain
| | - Miguel Santibáñez
- Global Health Research Group, Dpto. Enfermería, Universidad de Cantabria-IDIVAL, Santander, Cantabria, Spain
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Mitchell EJ, Frisbie SH, Roudeau S, Carmona A, Ortega R. Estimating daily intakes of manganese due to breast milk, infant formulas, or young child nutritional beverages in the United States and France: Comparison to sufficiency and toxicity thresholds. J Trace Elem Med Biol 2020; 62:126607. [PMID: 32683229 DOI: 10.1016/j.jtemb.2020.126607] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/16/2020] [Accepted: 06/30/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although manganese (Mn) is an essential nutrient, recent research has revealed that excess Mn in early childhood may have adverse effects on neurodevelopment. METHODS We estimated daily total Mn intake due to breast milk at average body weights by reviewing reported concentrations of breast milk Mn and measurements of body weight and breast milk intake at 3 weeks, 4.25 months, 7 months, and 18 months. We compared these figures to the Mn content measured in 44 infant, follow-up, and toddler formulas purchased in the United States and France. We calculated Mn content of formula products made with ultra-trace elemental analysis grade water (0 μg Mn/L) and with water containing 250 μg Mn/L, a concentration which is relatively high but less than the World Health Organization Health-based value of 400 μg Mn/L or the United States Environmental Protection Agency Health Advisory of 350 μg Mn/L. RESULTS Estimated mean daily Mn intake from breast milk ranged from 1.2 μg Mn/kg/day (3 weeks) to 0.16 μg Mn/kg/day (18 months), with the highest intakes at the youngest age stage we considered, 3 weeks. Estimated daily Mn intake from formula products reconstituted with 0 μg Mn/L water ranged from 130 μg Mn/kg/day (3 weeks) to 4.8 μg Mn/kg/day (18 months) with the highest intakes at 3 weeks. Formula products provided 28-520 times greater than the mean daily intake of Mn from breast milk for the 4 age stages that we considered. Estimated daily Mn intake from formula products reconstituted with water containing 250 μg Mn/L ranged from 12 μg Mn/kg/day to 170 μg Mn/kg/day, which exceeds the United States Environmental Protection Agency Reference Dose of 140 μg Mn/kg/day for adults. CONCLUSIONS Mn deficiency is highly unlikely with exclusive breast milk or infant formula feeding, but established tolerable daily intake levels for Mn may be surpassed by some of these products when following labeled instructions.
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Affiliation(s)
- Erika J Mitchell
- Better Life Laboratories, Inc., 293 George Road, East Calais, VT, USA.
| | - Seth H Frisbie
- Department of Chemistry and Biochemistry, Norwich University, Northfield, VT, USA.
| | - Stéphane Roudeau
- University of Bordeaux, Centre d'Etudes Nucléaires de Bordeaux Gradignan (CENBG), UMR 5797, F-33170 Gradignan, France; Centre National de la Recherche Scientifique (CNRS), CENBG, UMR 5797, F-33170 Gradignan, France.
| | - Asuncion Carmona
- University of Bordeaux, Centre d'Etudes Nucléaires de Bordeaux Gradignan (CENBG), UMR 5797, F-33170 Gradignan, France; Centre National de la Recherche Scientifique (CNRS), CENBG, UMR 5797, F-33170 Gradignan, France.
| | - Richard Ortega
- University of Bordeaux, Centre d'Etudes Nucléaires de Bordeaux Gradignan (CENBG), UMR 5797, F-33170 Gradignan, France; Centre National de la Recherche Scientifique (CNRS), CENBG, UMR 5797, F-33170 Gradignan, France.
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Martin KV, Edmondson D, Cecil KM, Bezi C, Vance ML, McBride D, Haynes EN. Manganese Exposure and Neurologic Outcomes in Adult Populations. Neurol Clin 2020; 38:913-936. [PMID: 33040869 PMCID: PMC8978550 DOI: 10.1016/j.ncl.2020.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A review of published articles examining the effects of manganese exposure to workers and community residents shows adverse neurologic outcomes. Innovative biomarkers, including those from neuroimaging, were incorporated into many of these studies to assess both manganese exposure and neurologic outcomes. A variety of health effects were evaluated, including cognitive and motor impairments. Studies of community participants residing near manganese point sources show variability in outcomes, reflecting the complexities of exposure measurement, individual absorption, and assessment of neurologic effects. The aging population provides insight into the impacts of chronic exposure in younger populations.
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Affiliation(s)
- Kaitlin V Martin
- Department of Epidemiology, College of Public Health, University of Kentucky, 111 Washington Avenue Room 212C, Lexington, KY 40536, USA.
| | - David Edmondson
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Imaging Research Center, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5033, Cincinnati, OH 45229, USA
| | - Kim M Cecil
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Imaging Research Center, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5033, Cincinnati, OH 45229, USA; Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Cassandra Bezi
- Division of Infectious Diseases, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7017, Cincinnati, OH 45229, USA
| | - Miriam Leahshea Vance
- Department of Epidemiology, College of Public Health, University of Kentucky, 111 Washington Avenue, Lexington, KY 40536, USA
| | - Dani McBride
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Erin N Haynes
- Department of Epidemiology, College of Public Health, University of Kentucky, 111 Washington Avenue Room 212G, Lexington, KY 40536, USA
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Lycopene - A pleiotropic neuroprotective nutraceutical: Deciphering its therapeutic potentials in broad spectrum neurological disorders. Neurochem Int 2020; 140:104823. [DOI: 10.1016/j.neuint.2020.104823] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/09/2020] [Accepted: 07/30/2020] [Indexed: 02/06/2023]
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32
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Du X, Zheng W, Ye Q. Rare cases of severe life-threatening lead poisoning due to accident or chronic occupational exposure to lead and manganese: Diagnosis, treatment, and prognosis. Toxicol Ind Health 2020; 36:951-959. [PMID: 33094697 DOI: 10.1177/0748233720958969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chronic long-term, low-dose environmental and occupational exposure to lead (Pb) has been extensively studied in large cohorts worldwide among general populations, miners, smelters, or battery workers. However, studies on severe life-threatening Pb poisoning due to accidental or chronic occupational exposure to Pb and manganese (Mn) were rarely reported. METHODS We present one case of acute severe Pb poisoning and compare it with another severe chronic occupational exposure case involving Pb and Mn. A 27-year-old woman mistakenly took a large quantity of pure Pb powder as an herbal remedy; she developed abdominal colic, severe nausea, vomiting, fatigue, and cutaneous and sclera icterus. Laboratory tests showed her blood lead level (BLL) of 173.5 µg dL-1 and urinary lead level (ULL) of 1240 µg dL-1. The patient was diagnosed with acute Pb poisoning and acute liver failure. In another chronic exposure case, a 56-year-old man worked in a Pb and Mn smelting factory for 15 years. He was brought to the emergency room with severe nausea, vomiting, and paroxysmal abdominal colic, which was intolerable during the onset of pain. His BLL was 64.8 µg dL-1 and ULL was 38 µg dL-1, but his blood and urinary Mn levels were normal. The patient was diagnosed with chronic Pb poisoning. Both patients received chelation therapy with calcium disodium ethylene-diamine-tetraacetate (CaNa2EDTA). The woman with acute severe Pb intoxication recovered well and was discharged from the hospital after treatment, and the man who survived severe Pb poisoning was diagnosed with lung cancer. CONCLUSION Clinical manifestations of acute and chronic severe Pb poisoning are different. Chelation therapy with CaNa2EDTA is proven to be an effective life-saving therapy in both cases by reducing BLL. Occupational exposure to both Pb and Mn does not appear to increase Mn neurotoxicity; however, the probability that co-exposure to Mn may increase Pb toxicity in the same patient cannot be excluded.
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Affiliation(s)
- Xuqin Du
- Department of Occupational Medicine and Toxicology, 74639Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,138262School of Health Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Wei Zheng
- 138262School of Health Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Qiao Ye
- Department of Occupational Medicine and Toxicology, 74639Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Liu W, Xin Y, Li Q, Shang Y, Ping Z, Min J, Cahill CM, Rogers JT, Wang F. Biomarkers of environmental manganese exposure and associations with childhood neurodevelopment: a systematic review and meta-analysis. Environ Health 2020; 19:104. [PMID: 33008482 PMCID: PMC7531154 DOI: 10.1186/s12940-020-00659-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/22/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Although prior studies showed a correlation between environmental manganese (Mn) exposure and neurodevelopmental disorders in children, the results have been inconclusive. There has yet been no consistent biomarker of environmental Mn exposure. Here, we summarized studies that investigated associations between manganese in biomarkers and childhood neurodevelopment and suggest a reliable biomarker. METHODS We searched PubMed and Web of Science for potentially relevant articles published until December 31th 2019 in English. We also conducted a meta-analysis to quantify the effects of manganese exposure on Intelligence Quotient (IQ) and the correlations of manganese in different indicators. RESULTS Of 1754 citations identified, 55 studies with 13,388 subjects were included. Evidence from cohort studies found that higher manganese exposure had a negative effect on neurodevelopment, mostly influencing cognitive and motor skills in children under 6 years of age, as indicated by various metrics. Results from cross-sectional studies revealed that elevated Mn in hair (H-Mn) and drinking water (W-Mn), but not blood (B-Mn) or teeth (T-Mn), were associated with poorer cognitive and behavioral performance in children aged 6-18 years old. Of these cross-sectional studies, most papers reported that the mean of H-Mn was more than 0.55 μg/g. The meta-analysis concerning H-Mn suggested that a 10-fold increase in hair manganese was associated with a decrease of 2.51 points (95% confidence interval (CI), - 4.58, - 0.45) in Full Scale IQ, while the meta-analysis of B-Mn and W-Mn generated no such significant effects. The pooled correlation analysis revealed that H-Mn showed a more consistent correlation with W-Mn than B-Mn. Results regarding sex differences of manganese associations were inconsistent, although the preliminary meta-analysis found that higher W-Mn was associated with better Performance IQ only in boys, at a relatively low water manganese concentrations (most below 50 μg/L). CONCLUSIONS Higher manganese exposure is adversely associated with childhood neurodevelopment. Hair is the most reliable indicator of manganese exposure for children at 6-18 years of age. Analysis of the publications demonstrated sex differences in neurodevelopment upon manganese exposure, although a clear pattern has not yet been elucidated for this facet of our study.
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Affiliation(s)
- Weiwei Liu
- Department of Nutrition, Precision Nutrition Innovation Center, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yongjuan Xin
- Department of Nutrition, Precision Nutrition Innovation Center, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Qianwen Li
- Department of Nutrition, Precision Nutrition Innovation Center, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yanna Shang
- Department of Nutrition, Precision Nutrition Innovation Center, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhiguang Ping
- Department of Nutrition, Precision Nutrition Innovation Center, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Junxia Min
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Catherine M. Cahill
- Neurochemistry Laboratory, Department of Psychiatry-Neuroscience, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA USA
| | - Jack T. Rogers
- Neurochemistry Laboratory, Department of Psychiatry-Neuroscience, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA USA
| | - Fudi Wang
- Department of Nutrition, Precision Nutrition Innovation Center, School of Public Health, Zhengzhou University, Zhengzhou, China
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
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Ibrahim F, Nomier MA, Sabik LME, Shaheen MA. Manganese-induced neurotoxicity and the potential protective effects of lipoic acid and Spirulina platensis. Toxicol Mech Methods 2020; 30:497-507. [PMID: 32441205 DOI: 10.1080/15376516.2020.1771803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Manganese (Mn) is essential for many physiological processes; however, its excessive accumulation in the brain causes severe dysfunctions in the nervous system. Oxidative stress is thought to be involved in Mn-induced neurotoxicity. The aim of this study was to evaluate the neurotoxic effects of Mn and the potential protective effects of alpha lipoic acid (ALA) and Spirulina platensis (SP), each alone and in combination. Sixty-four male albino rats were divided into eight equal groups: group 1 was used as control, group 2 received saline, which used as a vehicle, group 3 received ALA (50 mg/kg/day), group 4 received SP (300 mg/kg/day), group 5 received Mn (74 mg/kg, 5 days/week), group 6 received Mn + ALA, group 7 received Mn + SP, group 8 received Mn + ALA + SP. Groups 6, 7 and 8 received the same previously mentioned doses. All treatments were orally gavaged for 8 weeks. Mn administration caused neurobehavioral changes, increases of brain and serum Mn and malondialdehyde (MDA), with decreased glutathione peroxidase (GPx), dopamine and acetylcholine levels. The co-treatment with ALA and SP revealed their ability to protect against oxidative damage, neurobehavioral and biochemical changes induced by Mn.
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Affiliation(s)
- Fatma Ibrahim
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mahmoud A Nomier
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Laila M E Sabik
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed A Shaheen
- Department of Histology and Cell Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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35
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de Andrade VL, Cota M, Serrazina D, Mateus ML, Aschner M, Dos Santos APM. Metal environmental contamination within different human exposure context- specific and non-specific biomarkers. Toxicol Lett 2020; 324:46-53. [PMID: 31935480 PMCID: PMC7083091 DOI: 10.1016/j.toxlet.2019.12.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/23/2019] [Accepted: 12/16/2019] [Indexed: 01/13/2023]
Abstract
Exposure to high levels of persistent pollutants, such as metal mixtures, is commonly encountered by the general population especially in industrialized countries. The aim of this work was to evaluate how metal pollution in contaminated areas is reflected in terms of biomarkers (BMs) of exposure and effect in human sub-populations living in distinct non-occupational environmental contexts. Thus, four Portuguese sub-populations living in different areas of Portugal were studied: i- the exposure of each member of these sub-populations to lead (Pb), manganese (Mn) and arsenic (As) was evaluated by determining metal levels in urine; ii- biochemical changes were assessed, establishing the levels of urinary metabolites of heme biosynthesis; iii- the ability of combinations of these BMs to predict the context of exposure of each subject was tested, as to develop a tool to identify adverse health effects in these environmentally exposed populations. Concerning the combinations of BMs, heme precursors in urine (delta-aminolevulinic acid and porphyrins), were predictive of contexts of environmental exposures, with 94.2% of the studied subjects correctly identified as to their sub-population origin. The use of non-specific BMs may affirm the exposure to Pb, Mn and As, also reflecting health effects induced by a chemical environmental mixture. Our studies affirm the difficulty in establishing a metal reference population.
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Affiliation(s)
- Vanda Lopes de Andrade
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal.
| | - Madalena Cota
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal; Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal.
| | - Daniela Serrazina
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal; Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal.
| | - Maria Luisa Mateus
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal.
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, United States.
| | - Ana Paula Marreilha Dos Santos
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal.
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Balachandran RC, Mukhopadhyay S, McBride D, Veevers J, Harrison FE, Aschner M, Haynes EN, Bowman AB. Brain manganese and the balance between essential roles and neurotoxicity. J Biol Chem 2020; 295:6312-6329. [PMID: 32188696 PMCID: PMC7212623 DOI: 10.1074/jbc.rev119.009453] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Manganese (Mn) is an essential micronutrient required for the normal development of many organs, including the brain. Although its roles as a cofactor in several enzymes and in maintaining optimal physiology are well-known, the overall biological functions of Mn are rather poorly understood. Alterations in body Mn status are associated with altered neuronal physiology and cognition in humans, and either overexposure or (more rarely) insufficiency can cause neurological dysfunction. The resultant balancing act can be viewed as a hormetic U-shaped relationship for biological Mn status and optimal brain health, with changes in the brain leading to physiological effects throughout the body and vice versa. This review discusses Mn homeostasis, biomarkers, molecular mechanisms of cellular transport, and neuropathological changes associated with disruptions of Mn homeostasis, especially in its excess, and identifies gaps in our understanding of the molecular and biochemical mechanisms underlying Mn homeostasis and neurotoxicity.
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Affiliation(s)
| | - Somshuvra Mukhopadhyay
- Division of Pharmacology and Toxicology, College of Pharmacy, Institute for Cellular and Molecular Biology, and Institute for Neuroscience, University of Texas, Austin, Texas 78712
| | - Danielle McBride
- College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267
| | - Jennifer Veevers
- College of Medicine, University of Cincinnati, Cincinnati, Ohio 45267
| | - Fiona E Harrison
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | | | - Erin N Haynes
- College of Public Health, University of Kentucky, Lexington, Kentucky 40536
| | - Aaron B Bowman
- School of Health Sciences, Purdue University, West Lafayette, Indiana 47907
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Soler-Blasco R, Murcia M, Lozano M, González-Safont L, Amorós R, Ibarluzea J, Broberg K, Irizar A, Lopez-Espinosa MJ, Lertxundi N, Marina LS, Ballester F, Llop S. Prenatal manganese exposure and neuropsychological development in early childhood in the INMA cohort. Int J Hyg Environ Health 2020; 224:113443. [DOI: 10.1016/j.ijheh.2019.113443] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 02/06/2023]
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Sudarshana DM, Nair G, Dwyer JT, Dewey B, Steele SU, Suto DJ, Wu T, Berkowitz BA, Koretsky AP, Cortese ICM, Reich DS. Manganese-Enhanced MRI of the Brain in Healthy Volunteers. AJNR Am J Neuroradiol 2019; 40:1309-1316. [PMID: 31371354 DOI: 10.3174/ajnr.a6152] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/13/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE The manganese ion is used as an intracellular MR imaging contrast agent to study neuronal function in animal models, but it remains unclear whether manganese-enhanced MR imaging can be similarly useful in humans. Using mangafodipir (Teslascan, a chelated manganese-based contrast agent that is FDA-approved), we evaluated the dynamics of manganese enhancement of the brain and glandular structures in the rostral head and neck in healthy volunteers. MATERIALS AND METHODS We administered mangafodipir intravenously at a rate of 1 mL/minute for a total dose of 5 μmol/kg body weight. Nine healthy adult volunteers (6 men/3 women; median age, 43 years) completed baseline history and physical examination, 3T MR imaging, and blood work. MR imaging also followed mangafodipir administration at various time points from immediate to 7 days, with delayed scans at 1-3 months. RESULTS The choroid plexus and anterior pituitary gland enhanced within 10 minutes of infusion, with enhancement persisting up to 7 and 30 days, respectively. Exocrine (parotid, submandibular, sublingual, and lacrimal) glands also enhanced avidly as early as 1 hour postadministration, generally resolving by 1 month; 3 volunteers had residual exocrine gland enhancement, which resolved by 2 months in 1 and by 3 months in the other 2. Mangafodipir did not affect clinical parameters, laboratory values, or T1-weighted signal in the basal ganglia. CONCLUSIONS Manganese ions released from mangafodipir successfully enable noninvasive visualization of intra- and extracranial structures that lie outside the blood-brain barrier without adverse clinical effects, setting the stage for future neuroradiologic investigation in disease.
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Affiliation(s)
- D M Sudarshana
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (D.M.S.), Cleveland, Ohio
| | - G Nair
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
| | - J T Dwyer
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
| | - B Dewey
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
| | - S U Steele
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
| | - D J Suto
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
| | - T Wu
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
| | - B A Berkowitz
- Department of Ophthalmology (B.A.B.), Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, Michigan
| | - A P Koretsky
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
| | - I C M Cortese
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
| | - D S Reich
- From the National Institute of Neurological Disorders and Stroke (D.M.S., G.N., J.T.D., B.D., S.U.S., D.J.S., T.W., A.P.K., I.C.M.C., D.S.R.), National Institutes of Health, Bethesda, Maryland
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Rolle-McFarland D, Liu Y, Mostafaei F, Zauber SE, Zhou Y, Li Y, Fan Q, Zheng W, Nie LH, Wells EM. The association of bone, fingernail and blood manganese with cognitive and olfactory function in Chinese workers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 666:1003-1010. [PMID: 30970467 PMCID: PMC6461352 DOI: 10.1016/j.scitotenv.2019.02.208] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 05/28/2023]
Abstract
Occupational manganese (Mn) exposure has been associated with cognitive and olfactory dysfunction; however, few studies have incorporated cumulative biomarkers of Mn exposure such as bone Mn (BnMn). Our goal was to assess the cross-sectional association between BnMn, blood Mn (BMn), and fingernail Mn (FMn) with cognitive and olfactory function among Mn-exposed workers. A transportable in vivo neutron activation analysis (IVNAA) system was designed and utilized to assess BnMn among 60 Chinese workers. BMn and FMn were measured using inductively coupled plasma mass spectrometry. Cognitive and olfactory function was assessed using Animal and Fruit Naming tests, World Health Organization/University of California-Los Angeles Auditory Verbal Learning Test (AVLT) and the University of Pennsylvania Smell Identification Test (UPSIT). Additional data were obtained via questionnaire. Regression models adjusted for age, education, factory of employment, and smoking status (UPSIT only), were used to assess the relationship between Mn biomarkers and test scores. In adjusted models, increasing BnMn was significantly associated with decreased performance on average AVLT scores [β (95% confidence interval (CI)) = -0.65 (-1.21, -0.09)] and Animal Naming scores [β (95% CI) = -1.54 (-3.00, -0.07)]. Increasing FMn was significantly associated with reduced performance measured by the average AVLT [β (95% CI) = -0.35 (-0.70, -0.006)] and the difference in AVLT scores [β (95% CI) = -0.40 (-0.77, -0.03)]. BMn was not significantly associated with any test scores; no significant associations were observed with Fruit Naming or UPSIT tests. BnMn and FMn, but not BMn, are associated with cognitive function in Mn-exposed workers. None of the biomarkers were significantly associated with olfactory function.
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Affiliation(s)
- Danelle Rolle-McFarland
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; Public Health Graduate Program, Purdue University, West Lafayette, IN, USA; Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Yingzi Liu
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; Department of Radiation Oncology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Farshad Mostafaei
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
| | - S Elizabeth Zauber
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yuanzhong Zhou
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Yan Li
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Qiyuan Fan
- Zunyi Medical and Pharmaceutical College, Zunyi, Guizhou, China
| | - Wei Zheng
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Linda H Nie
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Ellen M Wells
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; Public Health Graduate Program, Purdue University, West Lafayette, IN, USA.
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Chen P, Totten M, Zhang Z, Bucinca H, Erikson K, Santamaría A, Bowma AB, Aschner M. Iron and manganese-related CNS toxicity: mechanisms, diagnosis and treatment. Expert Rev Neurother 2019; 19:243-260. [PMID: 30759034 PMCID: PMC6422746 DOI: 10.1080/14737175.2019.1581608] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 02/08/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Iron (Fe) and manganese (Mn) are essential nutrients for humans. They act as cofactors for a variety of enzymes. In the central nervous system (CNS), these two metals are involved in diverse neurological activities. Dyshomeostasis may interfere with the critical enzymatic activities, hence altering the neurophysiological status and resulting in neurological diseases. Areas covered: In this review, the authors cover the molecular mechanisms of Fe/Mn-induced toxicity and neurological diseases, as well as the diagnosis and potential treatment. Given that both Fe and Mn are abundant in the earth crust, nutritional deficiency is rare. In this review the authors focus on the neurological disorders associated with Mn and Fe overload. Expert commentary: Oxidative stress and mitochondrial dysfunction are the primary molecular mechanism that mediates Fe/Mn-induced neurotoxicity. Although increased Fe or Mn concentrations have been found in brain of patients, it remains controversial whether the elevated metal amounts are the primary cause or secondary consequence of neurological diseases. Currently, treatments are far from satisfactory, although chelation therapy can significantly decrease brain Fe and Mn levels. Studies to determine the primary cause and establish the molecular mechanism of toxicity may help to adapt more comprehensive and satisfactory treatments in the future.
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Affiliation(s)
- Pan Chen
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Melissa Totten
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Ziyan Zhang
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Hana Bucinca
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Keith Erikson
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Abel Santamaría
- Laboratory of Excitatory Amino Acids, National Institute of Neurology and Neurosurgery, Mexico, Mexico City, Mexico
| | - Aaron B. Bowma
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA
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The effects of manganese exposure from drinking water on school-age children: A systematic review. Neurotoxicology 2019; 73:1-7. [PMID: 30797767 DOI: 10.1016/j.neuro.2019.02.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/17/2019] [Accepted: 02/19/2019] [Indexed: 11/22/2022]
Abstract
The aim of this study was to analyse the published literature on the potential effects of manganese exposure from drinking water on school-age children, with emphasis on cognitive, and neurodevelopment and behavioural effects. A systematic review of up-to-date scientific evidence published from 2006 to 2017 was conducted using Science Direct. A further search was carried out using PubMed and Web of Science. A total of 21 studies were reviewed and categorised into 12 cognitive and 9 neurodevelopment and behavioural effects. The most utilised cognitive test was the Wechsler Intelligence Scale for Children (WISC) or some subtests from it. 10 of the 12 studies on cognitive effects reported an adverse effect of manganese exposure from drinking water on children. 3 out of the 9 studies on neurodevelopment and behavioural effects reported that manganese exposure from drinking water was associated with poorer neurobehavioural performances in school children. 4 others implied the presence of some sex-specific associations with manganese exposure. 1 study suggested that children suffering from attention deficit hyperactivity disorder (ADHD) may be more susceptible to manganese exposure. Another study suggested that manganese was a beneficial nutrient as well as a neurotoxicant. Regardless of the limitations of the studies analysed, the adverse effects of manganese exposure from drinking water on school-aged children is sufficiently demonstrated. Further investigation into the subject to address inconsistencies in existing studies is recommended.
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Baker MG, Lin YS, Simpson CD, Shireman LM, Searles Nielsen S, Racette BA, Seixas N. The reproducibility of urinary ions in manganese exposed workers. J Trace Elem Med Biol 2019; 51:204-211. [PMID: 30466932 PMCID: PMC6291012 DOI: 10.1016/j.jtemb.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Manganese (Mn) is found in environmental and occupational settings, and can cause cognitive and motor impairment. Existing Mn exposure studies have not reached consensus on a valid and reproducible biomarker for Mn exposure. METHODS Previously, global metabolomics data was generated from urine collected in October 2014 using mass spectrometry (MS). Nine ions were found to be different between persons exposed and unexposed to Mn occupationally, though their identity was not able to be determined. Here, we investigated these nine ions in a follow-up set of urine samples taken from the same cohort in January 2015, and in urine samples from a separate Mn-exposed cohort from Wisconsin. We fit an elastic net model fit using the nine ions found in the October 2014 data. RESULTS The elastic net correctly predicted exposure status in 72% of the follow-up samples collected in January 2015, and the area under the curve of the receiver operating characteristic (ROC) curve was 0.8. In the Wisconsin samples, the elastic net performed no better than chance in predicting exposure, possibly due to differences in Mn exposure levels, or unmeasured occupational or environmental co-exposures. CONCLUSIONS This work underscores the importance of taking repeat samples for replication studies when investigating the human urine metabolome, as both within- and between-person variances were observed. Validating and identifying promising results remains a challenge in harnessing global metabolomics for biomarker discovery in occupational cohorts.
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Affiliation(s)
- Marissa G Baker
- Department of Environmental and Occupational Health Sciences, 4225 Roosevelt Way NE Suite 100, University of Washington, Seattle, WA, 98105, USA.
| | - Yvonne S Lin
- Department of Pharmaceutics, 1959 NE Pacific St H-272, University of Washington, Seattle, WA, 98195, USA
| | - Christopher D Simpson
- Department of Environmental and Occupational Health Sciences, 4225 Roosevelt Way NE Suite 100, University of Washington, Seattle, WA, 98105, USA
| | - Laura M Shireman
- Department of Pharmaceutics, 1959 NE Pacific St H-272, University of Washington, Seattle, WA, 98195, USA
| | - Susan Searles Nielsen
- Department of Neurology, 660 S Euclid, Washington University, St. Louis, MO, 63110, USA
| | - Brad A Racette
- Department of Neurology, 660 S Euclid, Washington University, St. Louis, MO, 63110, USA
| | - Noah Seixas
- Department of Environmental and Occupational Health Sciences, 4225 Roosevelt Way NE Suite 100, University of Washington, Seattle, WA, 98105, USA
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Biométrologie de l'exposition au manganèse. ARCH MAL PROF ENVIRO 2018. [DOI: 10.1016/j.admp.2018.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Madrigal JM, Persky V, Pappalardo A, Argos M. Association of heavy metals with measures of pulmonary function in children and youth: Results from the National Health and Nutrition Examination Survey (NHANES). ENVIRONMENT INTERNATIONAL 2018; 121:871-878. [PMID: 30343186 PMCID: PMC6277046 DOI: 10.1016/j.envint.2018.09.045] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/25/2018] [Accepted: 09/25/2018] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Exposure to cadmium, cobalt, lead, and manganese has been associated with decreased pulmonary function in adults. Little is known about the magnitude of these associations among children in the United States. OBJECTIVES We evaluated cross-sectional associations of blood and urinary concentrations of cadmium, cobalt, lead, and manganese with pulmonary function measures [forced expiratory volume in one second (FEV1; milliliters), forced vital capacity (FVC; milliliters), ratio of FEV1 to FVC (FEV1:FVC), and mid-exhalation forced expiratory flow rate (FEF 25-75%; milliliters/second)] in a sample of 1234 6-17 year olds, who participated in the 2011-2012 survey cycle of the National Health and Nutrition Examination Survey (NHANES). METHODS Survey-weighted linear regression was used to estimate beta coefficients and 95% confidence intervals (CIs) for the associations between metal exposure tertiles or quartiles and pulmonary function test parameters, with adjustment for relevant covariates. RESULTS Blood manganese concentration was inversely associated with FVC (β for highest versus lowest quartile = -97.1, 95% CI = -230.6, 36.4; p for trend = 0.03). Urinary manganese was inversely associated with FEV1:FVC and FEF 25-75% (p for trend = 0.05 and 0.02, respectively). Urinary lead was inversely associated with FEF 25-75% (p for trend = 0.01). The associations between blood manganese and both FEV1 and FVC differed by age (p for interaction = 0.04 and 0.04, respectively), indicating an inverse trend that was strongest among older youth. CONCLUSIONS Environmental exposure to manganese and lead may adversely impact the pulmonary function of young people in the United States. Our findings highlight a need to prioritize children's environmental health and evaluate these associations prospectively.
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Affiliation(s)
- Jessica M Madrigal
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrea Pappalardo
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
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Ou SY, Luo HL, Mailman RB, Li ZC, Zhang YW, Cai M, Huang XW, Li SJ, Jiang YM. Effect of manganese on neural endocrine hormones in serum of welders and smelters. J Trace Elem Med Biol 2018; 50:1-7. [PMID: 30262264 DOI: 10.1016/j.jtemb.2018.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although manganese (Mn)-induced neurotoxicity effects are well known among occupational Mn exposure, few reports have investigated the effects on endocrine systems among welders and smelters. OBJECTIVE To determine the effect of high level occupational manganese (Mn) exposure on neuropsychological parameters and hormonal status. METHODS We used a cross-sectional design with 52 welders, 48 smelters and 43 age-matched office workers from the same factory in China. We analyzed serum endocrine hormones level and airborne Mn concentrations. Erythrocyte and urine Mn levels were quantified using inductively-coupled plasma atomic emission spectroscopy. RESULTS The geometric mean of air Mn concentrations for the welders and smelters were 19.7 and 273.1 μg/m3, respectively. Mn concentrations in erythrocytes of smelters were markedly greater than those in controls and welders, but there was no difference between the erythrocytes Mn levels of Control and welders. We also found an increase of Mn levels in the urine of both welders and smelters vs. controls; Mn levels in urine of smelters were higher than in welders. Self-reported neurobehavioral symptoms were higher in welders and smelters than in controls. Finally, thyroid-stimulating hormone (TSH) levels of welders were significantly lower than in controls, whereas smelters had lower prolactin (PRL), testosterone (TST) and follicle-stimulating hormone (FSH) concentrations than either controls or welders. CONCLUSIONS These results show that smelters have higher Mn exposure than do welders, and that Mn levels in erythrocytes or urine can be a marker for exposure. Moreover, high level occupational Mn exposure increases adverse neurobehavioral effects, and also may disrupt endocrine systems.
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Affiliation(s)
- Shi-Yan Ou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, China.
| | - Hai-Lan Luo
- Department of Health Toxicology and Functional Testing, Guangxi Center for Disease Control and Prevention, Nanning 530021, Guangxi, China.
| | - Richard B Mailman
- Departments of Pharmacology and Neurology, Penn State College of Medicine 500 University Drive, Hershey, PA, 17033-0850, USA.
| | - Zhao-Cong Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Yu-Wen Zhang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Mei Cai
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Xiao-Wei Huang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Shao-Jun Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Yue-Ming Jiang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
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Ward EJ, Edmondson DA, Nour MM, Snyder S, Rosenthal FS, Dydak U. Toenail Manganese: A Sensitive and Specific Biomarker of Exposure to Manganese in Career Welders. Ann Work Expo Health 2018; 62:101-111. [PMID: 29186301 DOI: 10.1093/annweh/wxx091] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/22/2017] [Indexed: 12/18/2022] Open
Abstract
Manganese (Mn) is an essential trace metal. It is also a component of welding fume. Chronic inhalation of manganese from welding fume has been associated with decreased neurological function. Currently, there is not a universally recognized biomarker for Mn exposure; however, hair and toenails have shown promise. In a cohort of 45 male welders and 35 age-matched factory control subjects, we assessed the sensitivity and specificity of toenail Mn to distinguish occupationally exposed subjects from unexposed controls. Further we examined the exposure time window that best correlates with the proposed biomarker, and investigated if non-occupational exposure factors impacted toenail Mn concentrations. Toenail clippings were analyzed for Mn using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Exposure to respirable Mn-containing particles (<4 µm) was estimated using an exposure model that combines personal air monitoring, work history information, and dietary intake to estimate an individual's exposure to Mn from inhalation of welding fume. We assessed the group differences in toenail concentrations using a Student's t-test between welders and control subjects and performed a receiver operating characteristic (ROC) curve analysis to identify a threshold in toenail concentration that has the highest sensitivity and specificity in distinguishing welders from control subjects. Additionally, we performed mixed-model regressions to investigate the association between different exposure windows and toenail Mn concentrations. We observed that toenail Mn concentrations were significantly elevated among welders compared to control subjects (6.87 ± 2.56 versus 2.70 ± 1.70 µg g-1; P < 0.001). Our results show that using a toenail Mn concentration of 4.14 µg g-1 as cutoff allows for discriminating between controls and welders with 91% specificity and 94% sensitivity [area under curve (AUC) = 0.98]. Additionally, we found that a threshold of 4.66 µg g-1 toenail Mn concentration enables a 90% sensitive and 90% specific discrimination (AUC = 0.96) between subjects with average exposure above or below the American Conference of Governmental Industrial Hygienist (ACGIH) Threshold Limit Value (TLV) of 0.02 mg m-3 during the exposure window of 7-12 months prior to the nail being clipped. Investigating which exposure window was best reflected by toenail Mn reproduced the result from another study of toenail Mn being significantly (P < 0.001) associated with exposure 7-12 months prior to the nail being clipped. Lastly, we found that dietary intake, body mass index, age, smoking status, and ethnicity had no significant effect on toenail Mn concentrations. Our results suggest that toenail Mn is a sensitive, specific, and easy-to-acquire biomarker of Mn exposure, which is feasible to be used in an industrial welder population.
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Affiliation(s)
- Eric J Ward
- School of Health Sciences, Purdue University, USA
| | - David A Edmondson
- School of Health Sciences, Purdue University, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, USA
| | | | - Sandy Snyder
- School of Health Sciences, Purdue University, USA
| | | | - Ulrike Dydak
- School of Health Sciences, Purdue University, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, USA
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Mn Inhibits GSH Synthesis via Downregulation of Neuronal EAAC1 and Astrocytic xCT to Cause Oxidative Damage in the Striatum of Mice. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:4235695. [PMID: 30228854 PMCID: PMC6136513 DOI: 10.1155/2018/4235695] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/24/2018] [Accepted: 07/12/2018] [Indexed: 11/17/2022]
Abstract
Excessive manganese (Mn) can accumulate in the striatum of the brain following overexposure. Oxidative stress is a well-recognized mechanism in Mn-induced neurotoxicity. It has been proven that glutathione (GSH) depletion is a key factor in oxidative damage during Mn exposure. However, no study has focused on the dysfunction of GSH synthesis-induced oxidative stress in the brain during Mn exposure. The objective of the present study was to explore the mechanism of Mn disruption of GSH synthesis via EAAC1 and xCT in vitro and in vivo. Primary neurons and astrocytes were cultured and treated with different doses of Mn to observe the state of cells and levels of GSH and reactive oxygen species (ROS) and measure mRNA and protein expression of EAAC1 and xCT. Mice were randomly divided into seven groups, which received saline, 12.5, 25, and 50 mg/kg MnCl2, 500 mg/kg AAH (EAAC1 inhibitor) + 50 mg/kg MnCl2, 75 mg/kg SSZ (xCT inhibitor) + 50 mg/kg MnCl2, and 100 mg/kg NAC (GSH rescuer) + 50 mg/kg MnCl2 once daily for two weeks. Then, levels of EAAC1, xCT, ROS, GSH, malondialdehyde (MDA), protein sulfhydryl, carbonyl, 8-hydroxy-2-deoxyguanosine (8-OHdG), and morphological and ultrastructural features in the striatum of mice were measured. Mn reduced protein levels, mRNA expression, and immunofluorescence intensity of EAAC1 and xCT. Mn also decreased the level of GSH, sulfhydryl, and increased ROS, MDA, 8-OHdG, and carbonyl in a dose-dependent manner. Injury-related pathological and ultrastructure changes in the striatum of mice were significantly present. In conclusion, excessive exposure to Mn disrupts GSH synthesis through inhibition of EAAC1 and xCT to trigger oxidative damage in the striatum.
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Development of a Cumulative Exposure Index (CEI) for Manganese and Comparison with Bone Manganese and Other Biomarkers of Manganese Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071341. [PMID: 29949870 PMCID: PMC6068959 DOI: 10.3390/ijerph15071341] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/13/2018] [Accepted: 06/22/2018] [Indexed: 01/17/2023]
Abstract
Manganese (Mn) exposure can result in parkinsonism. However, understanding of manganese neurotoxicity has been limited by the lack of a cumulative Mn biomarker. Therefore, the current goal was to develop Mn cumulative exposure indices (MnCEI), an established method to estimate cumulative exposure, and determine associations of MnCEI with blood Mn (BMn), fingernail Mn (FMn), and bone Mn (BnMn). We completed a cross-sectional study of 60 male Chinese workers. Self-reported occupational history was used to create two MnCEIs reflecting the previous 16 years (MnCEI16) and total work history (MnCEITOT). An in vivo neutron activation analysis system was used to quantify BnMn. BMn and FMn were measured using ICP-MS. Mean (standard deviation) MnCEITOT and MnCEI16 were 37.5 (22.0) and 25.0 (11.3), respectively. Median (interquartile range) BMn, FMn, and BnMn were 14.1 (4.0) μg/L, 13.5 (58.5) μg/g, and 2.6 (7.2) μg/g dry bone, respectively. MnCEI16 was significantly correlated with FMn (Spearman’s ρ = 0.44; p = 0.02), BnMn (ρ = 0.44; p < 0.01), and MnCEITOT (ρ = 0.44; p < 0.01). In adjusted regression models, MnCEI16 was significantly associated with BnMn (β = 0.03; 95% confidence interval = 0.001, 0.05); no other biomarkers were associated with MnCEI. This suggests BnMn may be a useful biomarker of the previous 16 years of Mn exposure, but larger studies are recommended.
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Chronic Manganese Toxicity Associated with Voltage-Gated Potassium Channel Complex Antibodies in a Relapsing Neuropsychiatric Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040783. [PMID: 29669989 PMCID: PMC5923825 DOI: 10.3390/ijerph15040783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 01/26/2023]
Abstract
Heavy metal poisoning is a rare but important cause of encephalopathy. Manganese (Mn) toxicity is especially rare in the modern world, and clinicians’ lack of recognition of its neuropsychiatric manifestations can lead to misdiagnosis and mismanagement. We describe the case of a man who presented with recurrent episodes of confusion, psychosis, dystonic limb movement and cognitive impairment and was initially diagnosed with anti-voltage-gated potassium channel (VGKC) complex limbic encephalitis in view of previous positive autoantibodies. His failure to respond to immunotherapy prompted testing for heavy metal poisoning, which was positive for Mn. This is the first report to examine an association between Mn and VGKC antibodies and the effects of Mn on functional brain activity using functional near-infrared spectroscopy (fNIRS).
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Liu Y, Rolle-McFarland D, Mostafaei F, Zhou Y, Li Y, Zheng W, Wells E, Nie LH. In vivo neutron activation analysis of bone manganese in workers. Physiol Meas 2018; 39:035003. [PMID: 29328060 DOI: 10.1088/1361-6579/aaa749] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Manganese (Mn) is a neurotoxin. However, the impact of elevated, chronic Mn exposure is not well understood, partially due to the lack of a cumulative exposure biomarker. To address this gap, our group developed a compact in vivo neutron activation analysis (IVNAA) system to quantify Mn concentration in bone (MnBn). APPROACH In this study, we used this system and determined MnBn among male Chinese workers and compared results to their blood Mn (MnB), a measure of recent exposure, and the years of employment, a measure of cumulative exposure. A cross-sectional study was conducted with 30 ferroalloy smelters (exposed) and 30 general manufacturing workers (controls). MnBn was assessed using IVNAA, MnB was measured with inductively coupled plasma mass spectrometry, and occupational history and demographics were obtained via questionnaire. Mn-doped phantoms were used to generate a calibration curve; spectra from these phantoms were consistent with in vivo spectra. MAIN RESULTS The median (interquartile range (IQR)) values for Mn biomarkers were 2.7 µg g-1 (7.2) for MnBn and 14.1 µg l-1 (4.0) for MnB. In regression models adjusted for age and education, the natural log transformed MnBn (ln(MnBn)) was significantly associated with the exposed/control status (β = 0.44, p = 0.047) and years of employment (β = 0.05, p = 0.002), but not with natural log transformed MnB (ln(MnB)) (β = 0.54, p = 0.188). SIGNIFICANCE Our results support the use of IVNAA to quantify MnBn and the use of MnBn as a biomarker of cumulative Mn exposure.
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Affiliation(s)
- Yingzi Liu
- School of Health Sciences, Purdue University, West Lafayette, IN 47906, United States of America. Willis-Knighton Cancer Center, Shreveport, LA 71105, United States of America
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