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Mostafa MA, Abueissa MA, Soliman MZ, Ahmad MI, Soliman EZ. Association between Blood Lead Levels and Silent Myocardial Infarction in the General Population. J Clin Med 2024; 13:1582. [PMID: 38541807 PMCID: PMC10970933 DOI: 10.3390/jcm13061582] [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: 02/10/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 07/25/2024] Open
Abstract
Background: Although the link between lead exposure and patterns of cardiovascular disease (CVD) has been reported, its association with silent myocardial infarction (SMI) remains unexplored. We aimed to assess the association between blood lead levels (BLLs) and SMI risk. Methods: We included 7283 (mean age 56.1 ± 2.52 years, 52.5% women) participants free of CVD from the Third National Health and Nutrition Examination Survey. BLL was measured using graphite-furnace atomic absorption spectrophotometry. SMI was defined as ECG evidence of myocardial infarction (MI) without history of MI. The association between SMI and BLLs was examined using multivariable logistic regression. Results: SMI was detected in 120 participants with an unweighted prevalence of 1.65%. Higher BLL correlated with higher SMI prevalence across BLL tertiles. In multivariable-adjusted models, participants in the third BLL tertile had more than double the odds of SMI (OR: 3.42, 95%CI: 1.76-6.63) compared to the first tertile. Each 1 µg/dL increase in BLL was linked to a 9% increase in SMI risk. This association was consistent across age, sex, and race subgroups. Conclusions: Higher BLLs are associated with higher odds of SMI in the general population. These results underscore the significance of the ongoing efforts to mitigate lead exposure and implement screening strategies for SMI in high-risk populations.
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Affiliation(s)
- Mohamed A. Mostafa
- Epidemiological Cardiology Research Center (EPICARE), Department of Internal Medicine, Section Cardiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
| | - Mohammed A. Abueissa
- Department of Cardiothoracic Surgery, Al Manial Specialized Cairo University Hospital, Cairo 11956, Egypt;
| | | | - Muhammad Imtiaz Ahmad
- Department of Internal Medicine, Section on Hospital Medicine, Medical College of Wisconsin, Wauwatosa, WI 53226, USA;
| | - Elsayed Z. Soliman
- Epidemiological Cardiology Research Center (EPICARE), Department of Internal Medicine, Section Cardiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
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Eid R, Guzman DSM, Keller KA, Wiggans KT, Murphy CJ, LaDouceur EEB, Keel MK, Reilly CM. Choroidal Vasculopathy and Retinal Detachment in a Bald Eagle (Haliaeetus leucocephalus) With Lead Toxicosis. J Avian Med Surg 2016; 30:357-363. [DOI: 10.1647/2015122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Zeng X, Xu X, Boezen HM, Huo X. Children with health impairments by heavy metals in an e-waste recycling area. CHEMOSPHERE 2016; 148:408-15. [PMID: 26829309 DOI: 10.1016/j.chemosphere.2015.10.078] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 10/10/2015] [Accepted: 10/19/2015] [Indexed: 02/05/2023]
Abstract
E-waste recycling has become a global environmental health issue. Pernicious chemicals escape into the environment due to informal and nonstandard e-waste recycling activities involving manual dismantling, open burning to recover heavy metals and open dumping of residual fractions. Heavy metals derived from electronic waste (e-waste), such as, lead (Pb), cadmium (Cd), chromium (Cr), manganese (Mn), nickel (Ni), mercury (Hg), arsenic (As), copper (Cu), zinc (Zn), aluminum (Al) and cobalt (Co), differ in their chemical composition, reaction properties, distribution, metabolism, excretion and biological transmission. Our previous studies showed that heavy metal exposure have adverse effects on children's health including lower birth weight, lower anogenital distance, lower Apgar scores, lower current weight, lower lung function, lower hepatitis B surface antibody levels, higher prevalence of attention-deficit/hyperactivity disorder, and higher DNA and chromosome damage. Heavy metals influence a number of diverse systems and organs, resulting in both acute and chronic effects on children's health, ranging from minor upper respiratory irritation to chronic respiratory, cardiovascular, nervous, urinary and reproductive disease, as well as aggravation of pre-existing symptoms and disease. These effects of heavy metals on children's health are briefly discussed.
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Affiliation(s)
- Xiang Zeng
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou University, 22 Xinling Road, Shantou 515041, China; Department of Epidemiology, University Medical Center Groningen, University of Groningen, 1 Hanzeplein, Groningen 9700RB, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, 1 Hanzeplein, Groningen 9700RB, The Netherlands
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou University, 22 Xinling Road, Shantou 515041, China; Department of Cell Biology and Genetics, Shantou University Medical College, Shantou University, 22 Xinling Road, Shantou 515041, China
| | - H Marike Boezen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 1 Hanzeplein, Groningen 9700RB, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, 1 Hanzeplein, Groningen 9700RB, The Netherlands
| | - Xia Huo
- School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China.
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Aspelin T, Eriksen M, Ilebekk A, Cataliotti A, Carlson CR, Lyberg T. β-blockade abolishes the augmented cardiac tPA release induced by transactivation of heterodimerised bradykinin receptor-2 and β2-adrenergic receptor in vivo. Thromb Haemost 2014; 112:951-9. [PMID: 25078038 DOI: 10.1160/th14-01-0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 06/16/2014] [Indexed: 11/05/2022]
Abstract
Bradykinin (BK) receptor-2 (B2R) and β2-adrenergic receptor (β2AR) have been shown to form heterodimers in vitro. However, in vivo proofs of the functional effects of B2R-β2AR heterodimerisation are missing. Both BK and adrenergic stimulation are known inducers of tPA release. Our goal was to demonstrate the existence of B2R-β2AR heterodimerisation in myocardium and to define its functional effect on cardiac release of tPA in vivo. We further investigated the effects of a non-selective β-blocker on this receptor interplay. To investigate functional effects of B2R-β2AR heterodimerisation (i. e. BK transactivation of β2AR) in vivo, we induced serial electrical stimulation of cardiac sympathetic nerves (SS) in normal pigs that underwent concomitant BK infusion. Both SS and BK alone induced increases in cardiac tPA release. Importantly, despite B2R desensitisation, simultaneous BK infusion and SS (BK+SS) was characterised by 2.3 ± 0.3-fold enhanced tPA release compared to SS alone. When β-blockade (propranolol) was introduced prior to BK+SS, tPA release was inhibited. A persistent B2R-β2AR heterodimer was confirmed in BK-stimulated and non-stimulated left ventricular myocardium by immunoprecipitation studies and under non-reducing gel conditions. All together, these results strongly suggest BK transactivation of β2AR leading to enhanced β2AR-mediated release of tPA. Importantly, non-selective β-blockade inhibits both SS-induced release of tPA and the functional effects of B2R-β2AR heterodimerisation in vivo, which may have important clinical implications.
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Affiliation(s)
- Trude Aspelin
- Trude Aspelin, Institute for Experimental Medical Research, Oslo University Hospital, Ullevål, Postbox 4956 Nydalen, 0424 Oslo, Norway, Tel.: +47 22119685, Fax: +47 23016799, E-mail:
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Shinkai Y, Kaji T. Cellular defense mechanisms against lead toxicity in the vascular system. Biol Pharm Bull 2013; 35:1885-91. [PMID: 23123461 DOI: 10.1248/bpb.b212018] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Lead is a toxic heavy metal that can cause a range of health problems. In this context, the vascular system is a particular target of the deleterious effects of lead. Lead exerts its toxicity through substitution of other divalent cations such as calcium and zinc, resulting in disruption of homeostasis. Based on the evidence that lead up-regulates endoplasmic reticulum (ER) chaperone glucose-regulated protein 78 (GRP78) and/or antioxidant proteins such as hemeoxygenase-1, it is believed that the heavy metal is able to induce ER and/or oxidative stress in cells. These events also suggest that the unfolded protein response (UPR) system and the antioxidant defense system Kelch-like ECH-associated protein 1-nuclear factor (NF)-E2-related factor 2 (Keap1-Nrf2) play a critical role in adaptive response to lead. In this review, we summarize recent progress in lead toxicity in terms of cellular defense systems, including stress proteins and transcription factors involved in the vascular system.
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Affiliation(s)
- Yasuhiro Shinkai
- Environmental Medicine Section, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Poręba R, Poręba M, Gać P, Pilecki W, Andrzejak R. Impaired endothelial function assessed by flow-mediated vasodilatation in workers occupationally exposed to lead. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2010; 29:266-270. [PMID: 21787612 DOI: 10.1016/j.etap.2010.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Revised: 02/28/2010] [Accepted: 03/02/2010] [Indexed: 05/31/2023]
Abstract
The aim of the study was to examine endothelial function in workers occupationally exposed to lead by means of FMD (flow-mediated dilatation). 44 men professionally exposed to lead, smelters and refiners, employees working at copper smelter and control group of 41 healthy men were enrolled into the study. Within the group of men occupationally exposed to lead the absolute increase in diameter after ischaemia (BAD, brachial artery diameter) and flow-mediated dilation were statistically less significant when compared to those of the control group. There was a negative linear correlation between FMD and lead concentration in copper smelters (r=-0.64). Multivariate backward step-wise regression analysis showed that blood lead concentration in copper smelters independently influenced the impairment of endothelial function expressed as decreased FMD value. In conclusion, results of our study suggest that endothelial function assessed by flow-mediated dilatation was impaired in workers occupationally exposed to lead.
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Affiliation(s)
- Rafał Poręba
- Department of Internal Medicine and Hypertension, Medical University of Wrocław, Pasteur 4, PL 50-367 Wrocław, Poland
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Abstract
Lead is a ubiquitous environmental toxin that is capable of causing numerous acute and chronic illnesses. Population studies have demonstrated a link between lead exposure and subsequent development of hypertension (HTN) and cardiovascular disease. In vivo and in vitro studies have shown that chronic lead exposure causes HTN and cardiovascular disease by promoting oxidative stress, limiting nitric oxide availability, impairing nitric oxide signaling, augmenting adrenergic activity, increasing endothelin production, altering the renin-angiotensin system, raising vasoconstrictor prostaglandins, lowering vasodilator prostaglandins, promoting inflammation, disturbing vascular smooth muscle Ca(2+) signaling, diminishing endothelium-dependent vasorelaxation, and modifying the vascular response to vasoactive agonists. Moreover, lead has been shown to cause endothelial injury, impede endothelial repair, inhibit angiogenesis, reduce endothelial cell growth, suppress proteoglycan production, stimulate vascular smooth muscle cell proliferation and phenotypic transformation, reduce tissue plasminogen activator, and raise plasminogen activator inhibitor-1 production. Via these and other actions, lead exposure causes HTN and promotes arteriosclerosis, atherosclerosis, thrombosis, and cardiovascular disease. In conclusion, studies performed in experimental animals, isolated tissues, and cultured cells have provided compelling evidence that chronic exposure to low levels of lead can cause HTN, endothelial injury/dysfunction, arteriosclerosis, and cardiovascular disease. More importantly, these studies have elucidated the cellular and molecular mechanisms of lead's action on cardiovascular/renal systems, a task that is impossible to accomplish using clinical and epidemiological investigations alone.
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Affiliation(s)
- Nosratola D Vaziri
- Division of Nephrology and Hypertension, UCI Medical Center, 101 The City Dr., Bldg. 53, Rm. 125, Rt. 81, Orange, CA 92868, USA.
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Abstract
Cadmium and lead are heavy metals that have been shown to induce vascular disorders such as atherosclerosis in experimental animals. However, little is known about the mechanisms by which cadmium and lead induce vascular toxicity. The toxicity was investigated using a culture system of vascular endothelial and smooth muscle cells. Cadmium destroys the monolayer of endothelial cells and the cytotoxicity is protected by zinc and copper without metallothionein induction. On the other hand, lead does not exhibit cytotoxicity but inhibits the repair of endothelial monolayers after wounding by a lower response to endogenous basic fibroblast growth factor mediated by suppression of the synthesis of perlecan, a large heparan sulfate proteoglycan. In addition, cadmium and lead reduce endothelial fibrinolytic activity by induction of plasminogen activator inhibitor type 1 synthesis and by inhibition of tissue-type plasminogen activator, respectively. In vascular smooth muscle cells, cadmium and lead can promote their proliferation and influence proteoglycan synthesis and fibrinolysis in different manners. These results indicate that cadmium and lead have specific toxicities in the proliferation, fibrinolysis, and extracellular matrix formation of vascular endothelial and smooth muscle cells.
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Affiliation(s)
- Toshiyuki Kaji
- Department of Environmental Health, Faculty of Pharmaceutical Sciences, Hokuriku University, Ho-3 Kanagawa-machi, Kanazawa 920-1181, Japan.
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Fujiwara Y, Yamamoto C, Kaji T, Plaas AH. Analysis of Chondroitin/Dermatan Sulfate Microstructure in Cultured Vascular Smooth Muscle Cells after Exposure to Lead and Cadmium. ACTA ACUST UNITED AC 2003. [DOI: 10.1248/jhs.49.534] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yasuyuki Fujiwara
- Department of Environmental Health, Faculty of Pharmaceutical Sciences, Hokuriku University
| | - Chika Yamamoto
- Department of Environmental Health, Faculty of Pharmaceutical Sciences, Hokuriku University
| | - Toshiyuki Kaji
- Department of Environmental Health, Faculty of Pharmaceutical Sciences, Hokuriku University
| | - Anna H. Plaas
- Department of Internal Medicine, College of Medicine, University of South Florida
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Yamamoto C, Kaji T. Induction of Plasminogen Activator Inhibitor Type 1 Synthesis by Cadmium in Human Vascular Endothelial Cells in Culture. ACTA ACUST UNITED AC 2002. [DOI: 10.1248/jhs.48.55] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Chika Yamamoto
- Department of Environmental Sciences, Faculty of Pharmaceutical Sciences, Hokuriku University
| | - Toshiyuki Kaji
- Department of Environmental Sciences, Faculty of Pharmaceutical Sciences, Hokuriku University
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Sidransky H, Verney E. Influence of lead acetate and selected metal salts on tryptophan binding to rat hepatic nuclei. Toxicol Pathol 1999; 27:441-7. [PMID: 10485825 DOI: 10.1177/019262339902700408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study evaluated whether lead acetate or other selected metal salts would influence the binding of L-tryptophan to rat hepatic nuclei. Lead salts and other salts of cadmium, zinc, mercury, and molybdenum, when added alone, had only small effects on 3H-tryptophan binding to hepatic nuclei in vitro. However, each of these salts, when added along with unlabeled L-tryptophan (excess, 10(-4) M), caused significantly less inhibition of 3H-tryptophan binding to hepatic nuclei than did unlabeled L-tryptophan alone. Lead acetate (10(-10) to 10(-4) M), when added along with unlabeled L-tryptophan, abrogated the inhibition of binding related to unlabeled L-tryptophan alone. Sodium arsenite (but not potassium arsenate) as well as sodium selenite (at 10(-4) M concentrations) inhibited to a moderate degree the in vitro 3H-tryptophan binding to hepatic nuclei, but addition of 10(-4) dithiothreitol, a protective agent for sulfhydryl groups, diminished this inhibition. Rats receiving a high dose of lead acetate before being tube-fed L-tryptophan displayed a decrease in hepatic protein synthesis compared with the stimulatory response connected with L-tryptophan alone. Thus, the addition of lead acetate and of other metal salts appears to have an inhibitory effect on L-tryptophan binding to hepatic nuclei. Lead acetate was investigated in in vivo experiments and was found to negate the stimulation of hepatic protein synthesis related to L-tryptophan alone.
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Affiliation(s)
- H Sidransky
- Department of Pathology, George Washington University Medical Center, Washington, DC 20037, USA.
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