Manganese and neurobehavioral impairment. A preliminary risk assessment

Manganese exposure and cognitive performance: A meta-analytical approach

Occupational manganese exposure is associated with serious health concerns, ultimately leading to an illness called manganism. Competing meta-analytic results were published over a decade ago, ranging from undetectable to serious effects on cognitive performance among working adults. Novel studies and findings about the relationship between occupational manganese and cognitive functions have been proposed since. First of all, a systematic literature search was carried out until October 2022 via multiple electronic databases investigating the relationship between occupational manganese exposure and cognitive functions. Differences between the exposure and control groups in cognitive testing were synthesized by effect size Hedge's g. A random effects model was deployed with a restricted likelihood estimator using Hedges' invariance weighting. Publication bias, p-hacking and exposure-effect relationships were investigated. We included 18 studies with 75 effect sizes comparing n = 888 controls and 1092 exposed participants. After exclusion of outliers, we found significantly lower performances in processing speed, attention, working memory, reaction time, cognitive control and visual attention in workers exposed to manganese. Regression analysis revealed an indication of exposure-effect relationships between manganese exposure and cognitive functioning in exposed workers. We provide results of impaired cognitive functions for working adults exposed to manganese in processing speed, attention, working memory, reaction time and visual attention. Indications of quadratic exposure-effect relationships are discussed. We provide several recommendations for further studies to investigate possible exposure effects in the context of occupational health and safety.

Sesamol alleviates manganese-induced neuroinflammation and cognitive impairment via regulating the microglial cGAS-STING/NF-κB pathway

Toxic effects of excessive manganese (Mn) from occupational or environmental exposure cause harm to human health. Excessive Mn exposure is intimately associated with neurodegeneration and cognitive dysfunction. Inflammatory responses mediated by microglia are essential contributors to the pathogenesis of Mn-induced neurotoxicity. Inhibition of microglia-mediated inflammation has been shown to alleviate Mn-induced neurotoxicity. Sesamol, derived from sesame, has neuroprotective properties in various disease models, including neurological diseases. Whether sesamol protects against Mn-induced neurological injuries has not been determined. Here, both in vivo and in vitro Mn exposure models were established to address the beneficial effects of sesamol on Mn-induced neurotoxicity. We showed that administration of sesamol mitigated learning and memory deficits of mice treated by Mn. Furthermore, sesamol reduced Mn-induced microglial activation and the expression of proinflammatory mediators (TNF-α, iNOS, and Cxcl10), while exerting a marginal effect on anti-inflammation and microglial phagocytosis. Mn exposure activated the microglial cGAS-STING pathway and sesamol inhibited this pathway by reducing the phosphorylation of STING and NF-κB, concomitantly decreasing IFN-α and IFN-β synthesis. In summary, our novel results indicated that sesamol exerted its protective effects on Mn-induced neuroinflammation and cognitive impairment via the microglial cGAS-STING/NF-κB pathway, providing evidence that sesamol may serve as an effective therapeutic for preventing and treating Mn-induced neurotoxicity.

Multiple exposure pathways and health risk assessment of potentially harmful elements for children and adults living in a coal region in Brazil

Energy generated by coal can contaminate the environment by releasing toxic elements, including metals. The human health risk assessment (HHRA) associated with geographic information system (GIS) tools can assist the management of contaminated areas, such as coal mining areas. The objective of the study was to carry out the assessment and spatialization of the risk to human health of potentially hazards elements (PHEs) in the soil for children and adults, from multiple exposure routes (oral, inhalation and dermal) in the Candiota mines, largest coal mining region of Brazil. The non-carcinogenic risks (HQ) of PHEs (Cu, Pb, Zn, Ni, Cr, Fe, Mn, Cd, As and Se) and carcinogenic risks of As were estimated and spatialized. The results revealed a risk for children exposure to Mn, with greatest contribution through dermal route. Mn (HQ_derm 72.41-96.09% and HQ_inh 40.84-82.52%) and Fe (HQ_o 43.90-81.44%) were the metals with greatest contribution to human health risk among studied population. As did not present carinogenic risk to adults. The spatial distribution of non-carcinogenic risk showed that Cr, As, Fe, Pb, Ni, Zn and Cu have higher HInc close to the coal mining areas, while Mn, Se and Cd have the highest HInc values in surrounding municipalities (Pinheiro Machado; Pedras Altas and Hulha Negra). The use of HHRA associated with GIS tools provides important elements for decision-making in the management of contaminated sites, indicating chemical elements, locations, routes of exposure and priority target populations.

Association Between the Ratios of Selenium to Several Elements and Mild Cognitive Impairment in the Elderly

To investigate the relationship between the correlation ratios of selenium (Se) and other elements and mild cognitive impairment (MCI) among older adults. A total of 1000 individuals participated in our research analysis. The concentrations of elements in whole blood were determined using inductively coupled plasma mass spectrometry to reflect their exposure levels. Participants' cognitive function was assessed using the Mini-Mental State Examination. Logistic regression analysis was used to evaluate the relationship between elemental ratios and MCI. Se concentration was positively correlated with red blood cell count (r = 0.219, p < 0.001), haemoglobin level (r = 0.355, p < 0.001), haematocrit (r = 0.215, p < 0.001), mean corpuscular haemoglobin (r = 0.294, p < 0.001) and mean corpuscular haemoglobin concentration (r = 0.428, p < 0.001) and negatively correlated with red cell volume distribution width-standard deviation (r = -0.232, p < 0.001) and platelet distribution width (r = -0.382, p < 0.001). Compared with the normal group, the ratios of Se/vanadium (V), Se/lead (Pb) and Se/cadmium (Cd) in the whole blood of the MCI group were significantly lower (all p < 0.001), while the ratios of manganese (Mn)/Se and iron (Fe)/Se were higher (all p < 0.001). The increase in the ratios of Se/V, Se/Pb and Se/Cd is related to a decreased risk of MCI among older adults; contrarily, an increase in the ratios of Mn/Se and Fe/Se may be a risk factor for MCI.

Curcumin protects against manganese-induced neurotoxicity in rat by regulating oxidative stress-related gene expression via H3K27 acetylation

Long-term manganese exposure causes a neurodegenerative disorder referred to as manganese poisoning, but the mechanism remains unclear and no specific treatment is available. Oxidative stress is widely recognised as one of the main causes of manganese-induced neurotoxicity. In recent years, the role of histone acetylation in neurodegenerative diseases has been widely concerned. curcumin is a natural polyphenol compound extracted from the rhizome of turmeric and exhibits both antioxidant and neuroprotective properties. Therefore, we aimed to investigate whether and how curcumin protects against manganese-induced neurotoxicity from the perspective of histone acetylation, based on the reversibility of histone acetylation modification. In this study, rats were treated with or without curcumin and subjected to long-term manganese exposure. Results that treatment of manganese decreased the protein expression of H3K18 acetylation and H3K27 acetylation at the promoters of oxidative stress-related genes and inhibited the expression of these genes. Nevertheless, curcumin increased the H3K27 acetylation level at the manganese superoxide dismutase (SOD2) gene promoter and promoted the expression of SOD2 gene. Oxidative damage in the rat striatum as well as learning and memory dysfunction were ameliorated after curcumin treatment. Taken together, our results suggest that the regulation of oxidative stress by histone acetylation may be a key mechanism of manganese-induced neurotoxicity. In addition, curcumin ameliorates Mn-induced neurotoxicity may be due to alleviation of oxidative damage mediated by increased activation of H3K27 acetylation at the SOD2 gene promoter.

Protective effect of calpain inhibitors against manganese-induced toxicity in rats

Development of manganism is a major complication of manganese exposure in which neurological dysfunction is linked to accumulation of metal in the brain. Current therapies do not prevent progression of the disease. Therefore, development of effective therapeutic strategies for treatment of manganism is of utmost importance. Since the hyperactivation of calpain family proteases in CNS during manganism in an animal model is observed, we assumed that inhibition of calpains can suppress the development of Mn-induced neurological disturbances. The goal of this study is to delineate protective effect and the mechanism of neuroprotection of calpain inhibitor in rat model of Mn-induced neurological symptoms. Using the Gait analysis test, we found that chronic intranasal administration of the calpain inhibitor Cast (184-210) (peptide, which is corresponding to the 184-210 amino acid of the endogenous inhibitor of calpains-human calpastatin) to Mn-treated rats contributed to a significant decrease in the severity of gait disorders, although it did not lead to a decrease in the Mn deposition in the striatum and hippocampus. Accordingly to the results of PCR-RT, this effect was accompanied by a partial reduction in the content of neuro-inflammatory markers (IL-1β, TNF-α, NFκB mRNA in the hippocampus and, additionally, IBA-1 mRNA in the striatum), as well as normalization of the content of dopamine and its metabolites in the hippocampus and striatum, which was assessed by HPLC. In striatum cells, the application of Cast (184-210) also led to a significant increase in the production of tyrosine hydroxylase, which was analyzed by immunoblotting method. These findings suggest that calpain inhibitors may be a valid therapeutic agent in manganism.

Risks to children from inhalation of aerosolized aqueous manganese emitted from ultrasonic humidifiers can be greater than for corresponding ingestion

The essential trace element manganese (Mn) can cause neurotoxicity with inhalation acknowledged as a more severe health and cognition threat than ingestion.

METHODS

Over a range of aqueous Mn concentrations present in tap water, this research characterizes exposures and risks for adults and 0.25, 1, 2.5, and 6 yr old children who ingest the water and inhale respirable particles produced by a room-sized ultrasonic humidifier filled with the same water. Aqueous Mn concentrations evaluated included 50 µg/L USEPA esthetic guideline, 80 µg/L WHO infant guideline, and 120 µg/L Canadian regulatory level. Airborne-particle-bound Mn concentrations were generated for water filling an ultrasonic humidifier under four realistic room conditions (33 m³ small or 72 m³ large) with varying ventilation rates from 0.2/h -1.5/h. Average daily doses (ADD) and reference intake doses were calculated for ingestion and 8-h inhalation of humidified air. Hazard quotients (HQ) compared the intake doses and reference doses. Multi-path particle dosimetry (MPPD) model quantified the particle deposition and deposited dose in children's and adults' respiratory tracts.

RESULTS

At only 11 µg/L Mn, the resulting humidified air Mn exceeds USEPA's reference concentration of 0.05 µg/m³ Mn in small room with low, energy-efficient ventilation. Inhalation ADD are 2 magnitudes lower than ingestion ADD for identical water Mn concentrations and daily exposure frequency. Even so, ingestion HQs are approximately 0.2 but inhalation risk is significant (HQ>1) for children and adults when breathing Mn-humidified air under most small room conditions at 50, 80 or 120 µg/L Mn. MPPD model indicates inhaled Mn deposits in head and pulmonary regions, with greater Mn dose deposits in children than adults.

CONCLUSION

Inhalation of Mn-particles produced from ultrasonic humidifiers can pose greater risks than ingestion at the same water concentration, especially for children. Aqueous Mn concentration and room size influence risks. Limiting manganese exposures and setting regulations requires consideration of both ingestion and inhalation of water.

The effects of occupational exposure to manganese fume on neurobehavioral and neurocognitive functions: An analytical cross-sectional study among welders

This study aimed to measure concentrations of manganese fume in breathing zone (BZ) and blood among welders to assess neurocognitive and neurobehavioral functions among them. In this study 38 welders and 27 administrative employees participated. Q16 questionnaire was used to evaluate neurobehavioral symptoms. The computerized Stroop test and Continuous Performance Test (CPT) were used to assess neurocognitive functions. Sampling and analysis of manganese fumes in the BZ and blood samples were performed according to NIOSH-7300 and NIOSH-8005 methods, respectively. Average concentration of manganese in the welders' BZ and blood was 0.81 ± 0.21 mg/m³ and 18.33 ± 5.84 µg/l. Frequency of neurobehavioral symptoms was significantly higher in welders compared with control group. Spearman correlation test showed a moderate correlation between Mn concentrations in the BZ and blood Mn levels (r_s = 0.352). There were statistical moderate and strong correlations between the frequency of neurobehavioral symptoms and manganese concentrations in the BZ (r=0.504) and blood Mn levels (r=0.643).The Pearson correlation coefficient (r=0.433-0.690) obtained on the psychological tests showed a moderate to strong correlation between manganese concentrations in the welders' BZ and blood and some indices of the Stroop test and CPT. The results of this study can confirm the effect of manganese inhalation on creating neurobehavioral and neurocognitive impairments in welders.

Neurotoxicity of manganese: Indications for future research and public health intervention from the Manganese 2016 conference

Manganese is an essential trace element, but also at high levels a neurotoxicant. Manganese neurotoxicity has been extensively studied since its discovery in highly exposed workers. The International conference MANGANESE2016 held at the Icahn School of Medicine at Mount Sinai in New York provided relevant updates on manganese research in relation to both occupational and environmental exposures. Epidemiological, toxicological and cellular studies reported at the conference have yielded new insights on mechanisms of manganese toxicity and on opportunities for preventive intervention. Strong evidence now exists for causal associations between manganese and both neurodevelopmental and neurodegenerative disorders. The neurodevelopmental effects of early life exposures are an example of the developmental origin of health and disease (DOHAD) concept. Brain imaging has rapidly become an important tool for examining brain areas impacted by manganese at various life stages. Candidate biomarkers of exposure are being identified in hair, nails, and teeth and reflect different exposure windows and relate to different health outcomes. Sex differences were reported in several studies, suggesting that women are more susceptible. New evidence indicates that the transporter genes SLC30A10 and SLC39A8 influence both manganese homeostasis and toxicity. New potential chelation modalities are being developed.