Traditional Tibetan Medicine Induced High Methylmercury Exposure Level and Environmental Mercury Burden in Tibet, China

Study on arsenic speciation, bioaccessibility, and gut microbiota in realgar-containing medicines by DGT technique and artificial gastrointestinal extraction (PBET) combine with simulated human intestinal microbial ecosystem (SHIME)

It is well-known that several Chinese patent medicines use realgar as a specific component. People are more aware of the health dangers associated with realgar since it includes arsenic. Previous research overstated the arsenic toxicity of realgar-containing Chinese prescription medications because little thought was given to the influence of arsenic bioaccessibility by gut microbiota. In light of this, this study examined the total content, bioaccessibility and speciation of targeted medications while also examining intestinal epithelial transit utilizing the diffusive gradients in thin-films (DGT). All samples contained arsenic, and the bioaccessibilities of the colon, intestine and gastric regions ranged from 0.19% to 1.73%, 0.25-1.88% and 0.21-1.70% respectively. The range of DGT-bioaccessibility is 0.01-0.0018%. Three steps of analysis were conducted on inorganic As(III) and As(V). In health risk assessment, the ADDs and HQs of DGT-bioaccessibility were below the threshold levels when compared to computing average daily intake dose (ADD) and hazard quotient (HQ) by bioaccessibility of gastric, intestinal and colon. Additionally, Proteobacteria and Firmicutes were discovered to be the two predominant kinds of gut microbes in this study. Under arsenic exposure, the abundance of Christensenellaceae, Desulfovibrionaceae and Akkermansiaceae increased, but the quantity of Rikenellaceae decreased. These findings revealed that alterations in gut microbiota had an impact on host metabolism.

Mercury biomagnification at higher rates than the global average in aquatic ecosystems of the Qinghai-Tibet Plateau

Mercury biomagnification in aquatic ecosystems is a global issue. Biomagnification patterns and drivers in alpine regions remain poorly understood. Hg biomagnification in the aquatic food web of the Qinghai-Tibetan Plateau (Q-T Plateau) was investigated. A total of 302 fish and macroinvertebrate tissue samples were analysed for total mercury (THg) and nitrogen (δ¹⁵N) stable isotope ratios. Overall, 26.75% of fish individuals exceeded the USFWS consumption guidelines. A total of 52.17% of the sampling sites covering different habitats exhibited a significantly positive THg-δ¹⁵N relationship, which confirmed the Hg biomagnification potential of Q-T Plateau aquatic ecosystems. The Q-T Plateau Hg biomagnification rates were generally far higher than global averages regardless of the habitat type. Hg in sediments, elevation and population density were positively related to the Hg biomagnification magnitude on the Q-T Plateau, which could be attributed to the disproportionate response of Hg concentrations in macroinvertebrates and fishes along environmental gradients. Our findings offer empirical evidence that fish consumption on the Q-T Plateau poses a substantial Hg exposure risk to people living along river and lake shores. Higher biomagnification rates could further disproportionately accelerate Hg pollution in Q-T Plateau aquatic ecosystems under future anthropogenic activities and climate warming trajectories.

Elemental and Chemical Phase Analyses of Ras-Family Ayurvedic Medicinal Products

Fifteen Ayurvedic medicines of Ras-family (herbo-mineral-metallic preparations) from three reputed manufactures were analysed for elemental quantification and their chemical phase identification using the energy-dispersive (ED) and wavelength-dispersive (WD) X-ray fluorescence (XRF) techniques, and powder X-ray diffraction (XRD) technique, respectively. The low-Z elements C, H, N, S and O constituting a major portion of these medicines were also determined by CHNSO analyser and further used as input for XRF analyses. The elements of concern, Hg, Pb and As, are identified in different medicine products with disquiet concentration values (maximum concentration values range ~ 4-10%) and that too with substantial variations in the products from different manufacturers. These elements are identified mainly in the cinnabar (α-HgS)/metacinnabar (β-HgS), litharge (PbO) and alacranite (As₄S₄) phases in different medicines. Keeping in view the high concentration of chemicals of the Hg, Pb and As elements in the Ras-family medicines, it is vitally required to investigate their bioaccessibility and surmise the associated toxicological aspects. It is suggested that the formation of the bioaccessible toxic chemical forms of the Hg, Pb and As elements be avoided during preparation of the mineral ingredients or these soluble chemical forms be removed at suitable stage of the preparation. In view of large variations observed for the Hg, Pb and As based ingredients in the Ras family Ayurvedic medicine products from different manufacturers, adequate quality control mechanisms and production regulations are recommended.

Optimizing glycation control in diabetes: An integrated approach for inhibiting nonenzymatic glycation reactions of biological macromolecules

Diabetes is a multifactorial disorder that increases mortality and disability due to its complications. A key driver of these complications is nonenzymatic glycation, which generates advanced glycation end-products (AGEs) that impair tissue function. Therefore, effective nonenzymatic glycation prevention and control strategies are urgently needed. This review comprehensively describes the molecular mechanisms and pathological consequences of nonenzymatic glycation in diabetes and outlines various anti-glycation strategies, such as lowering plasma glucose, interfering with the glycation reaction, and degrading early and late glycation products. Diet, exercise, and hypoglycemic medications can reduce the onset of high glucose at the source. Glucose or amino acid analogs such as flavonoids, lysine and aminoguanidine competitively bind to proteins or glucose to block the initial nonenzymatic glycation reaction. In addition, deglycation enzymes such as amadoriase, fructosamine-3-kinase, parkinson's disease protein, glutamine amidotransferase-like class 1 domain-containing 3A and terminal FraB deglycase can eliminate existing nonenzymatic glycation products. These strategies involve nutritional, pharmacological, and enzymatic interventions that target different stages of nonenzymatic glycation. This review also emphasizes the therapeutic potential of anti-glycation drugs for preventing and treating diabetes complications.

The silver linings of mercury: Reconsideration of its impacts on living organisms from a multi-timescale perspective

Research on mercury (Hg), a naturally occurring element in Earth's lithosphere, has been extremely hot in the past few decades due to the outbreak of a series of disastrous poisoning incidents. However, such studies might provide us a biased view towards Hg if no thorough review about its long-term effects on living organisms from a multi-timescale perspective was performed. Hg might have played a mysterious role in critical intervals (e.g., mass extinction and oceanic anoxia events) in several geologic periods due to the elevated Hg levels induced by volcanism whereas it has long been used for various purposes in human history. Therefore, it is necessary to go through previous studies and historical records of different timescales (10⁰ to 10⁶ yr). In this work, we conducted a thorough review of Hg knowledge at three different timescales, i.e., geologic periods (10⁶ yr), human history (10³ yr), and contemporary history (10⁰ yr), summarizing recent advances and indicated potential research gaps. By doing so, we demonstrated that it is possible to achieve safe and sustainable Hg applications despite the current Hg crisis. However, such silver linings depend on a better understanding of ecosystem dynamics. Besides, considering the possible dire consequences of erupted Hg levels as suggested in geological periods, swift actions to mitigate the impacts of anthropogenic activities on the Hg cycle will be another key point. Overall, this review presented a unique perspective of Hg combining different timescales, shedding light on the importance of a better understanding of the global ecosystem as a whole and maintaining the sustainability of planet Earth in the future.

Human Methylmercury Exposure and Potential Impacts in Central Tibet: Food and Traditional Tibetan Medicine

Methylmercury presents potent neurotoxicity to humans. Fish consumption is the leading source of human exposure to methylmercury worldwide. However, the exposure source in Tibet remains poorly understood because of the scarcity of observational data on most Tibetan foods, although high mercury levels were recently detected in some traditional Tibetan medicines. Here, the results of field investigations show that the joint consumption of traditional Tibetan medicines (TTMs), fish, and rice constitutes a primary exposure pathway to methylmercury in Tibetans and that the probable daily intake of methylmercury is close to that for many coastal regions. People who are young and high-income may have higher methylmercury exposure levels mainly because of economic development and cultural exchanges among regions. Our analysis indicates that a large proportion of the Tibetan population are likely to face a high methylmercury exposure risk and that mercury-susceptible populations in Tibet should be attentive to consuming TTMs with fish.

The impact of the Three Gorges Dam on the fate of metal contaminants across the river-ocean continuum

The Three Gorges Dam (TGD) is the world's largest hydropower construction. It can significantly impact contaminant transport in the Yangtze River-East China Sea Continuum (YR-ECSC). In addition to evaluating the impact of the TGD on the deposition of contaminants in the reservoir, we also address their cycles in the river below the dam and in the coastal East China Sea. A comprehensive study of metal contaminant transport along the YR-ECSC has not been previously attempted. We quantified the fates of mercury (Hg), arsenic (As), lead (Pb), cadmium (Cd) and chromium (Cr) within the YR-ECSC, and the impacts of the TGD, by sampling water and suspended particles along the Yangtze River during spring, summer, fall, and winter and by modeling. We found that the Yangtze River transports substantial amounts of heavy metals into the coastal ocean. In 2016, riverine transport amounted to 48, 5900, 11,000, 230, and 15,000 megagrams (Mg) for Hg, As, Pb, Cd, and Cr, respectively, while other terrestrial contributions were negligible. Metal flux into the coastal ocean was primarily derived from the downstream portion of the river (84-97%), while metals transported from upstream were largely trapped in the Three Gorges Reservoir (TGR, 72%-96%). For example, 34 Mg of Hg accumulated in the TGR owing to river damming, large-scale soil erosion, and anthropogenic point source releases, while 21 Mg of Hg was depleted from the riverbed downstream owing to the altered river hydrology caused by the TGD. Overall the construction of TGD resulted in a 6.9% net decrease in the Hg burden of the East China Sea, compared to the pre-TGD period.

Mineral and bone disorder in hemodialysis patients in the Tibetan Plateau: a multicenter cross-sectional study

Background: Mineral and bone disorder (MBD) in hemodialysis patients is associated with increased morbidity and mortality. Studies on the MBD status of hemodialysis patients at high altitudes are extremely limited.

Methods: A total of 146 hemodialysis patients from 5 local hospitals across all districts with hemodialysis centers in the Tibetan Plateau were enrolled in this cross-sectional study. Parameters related to MBD, including serum phosphorus (P), calcium (Ca), and intact parathyroid hormone (iPTH) levels, were measured. The achievement of MBD goals was compared with the achievement in the Dialysis Outcomes and Practice Study (DOPPS) 3, DOPPS 4 and a multicenter study of MBD in China. Factors associated with hyperphosphatemia were examined.

Results: Altogether, 146 hemodialysis patients were recruited from the Tibetan Plateau. According to the K/DIGO guidelines, there were low achievement rates for serum Ca (40.4%), P (29.7%), and iPTH (47.1%). As for the (KDOQI) guidelines, the rates of achievement of defined targets were 38.4%, 33.7% and 16.4% for serum Ca, P and iPTH, respectively. The percentages of patients reaching the KDOQI targets for corrected Ca, P, and iPTH were significantly lower for Tibetan patients than the percentages found in DOPPS 3 (38.4% vs. 50.4%, 33.7% vs. 49.8%, and 16.4% vs. 31.4%, respectively, all p < .001) and DOPPS 4 (38.4% vs. 56.0%, 33.7% vs. 54.5%, and 16.4% vs. 35.3%, respectively, all p < .001). The percentage of patients reaching the KDOQI targets for iPTH was significantly lower in Tibet than in the plain areas of China (16.4% vs. 26.5%, p < .001). The proportion of patients with hypocalcemia was higher in Tibet than in the plain areas (44.5% vs. 19.4%, p < .001). The percentage of local patients with optimal P was significantly higher for patients with an activated vitamin D prescription than for patients without an activated vitamin D prescription (45.3% vs. 19.3%, p < .001). Age and the activated vitamin D prescription were independently associated with hyperphosphatemia.

Conclusion: The MBD status of hemodialysis patients in Tibet is far from the ideal level. High altitude is one of the possible causes of the differences found, but not the principal one. It is necessary for medical staff in Tibet to improve the detection and treatment of MBD.

The three 'B' of fish mercury in China: Bioaccumulation, biodynamics and biotransformation

Mercury (Hg) is a global toxic pollutant and has raised the world's attention for decades. In this study, we reviewed the fish mercury levels in China (both marine and freshwater, as well as wild and farmed) documented over the past decade and their controlling environmental and biological factors. China is the largest contributor of global Hg cycling and the largest nation for the consumption and export of fish and fish product, thus Hg level in fish becomes a critical issue for food safety and public health. In China, Hg in fish is generally accumulated at a low level, but significant geographical differences were evident and formed the "hot spots" from the north to the south. For marine fish, the east (median: 70 ng g^-1 ww, range: 5.0-330 ng g^-1 ww) and southeast (median: 72 ng g^-1 ww, range: 0.3-329 ng g^-1 ww) of China have higher total Hg concentrations than the other coastal areas. For freshwater fish, Tibetan Plateau exhibited the highest total Hg levels (median: 104 ng g^-1 ww, range: 5.0-868 ng g^-1 ww). Risk assessment of the exposure of low-Hg-level fish to China's population deserves more attention and detailed fish consumption advisories to specific populations are urgently needed. The biokinetic model is a useful tool to characterize the underlying processes involved in Hg accumulation by fish. The diet (Hg concentration, speciation, food quality and quantity) and growth appear to be the important factors affecting the Hg levels of fish in China. The Hg biotransformation can also make contributions to Hg speciation and overall accumulation in fish. The intestinal microbes play an important role in Hg biotransformation and the potential for minimizing Hg contamination in fish deserves further investigation.

Mercury in Municipal Sewage and Sewage Sludge

Wide occurrence of mercury species, including the highly toxic and readily bioaccumulative methylmercury (MeHg), in municipal sewage (MS) and sewage sludge (SS) has been evidenced in recent studies. Considering that vast amounts of MS and SS are produced globally each year and the majority of MS is discharged into aqueous environments, i.e., the main sites for MeHg bioaccumulation, special attention should be paid on the source and environmental behaviors of sewage-borne and sludge-borne mercury species. This review aims to summarize the findings on the occurrence of mercury species in MS and SS, their transport and transformation in MS treatment plants, as well as their fate and environmental implications.

Impacts of farmed fish consumption and food trade on methylmercury exposure in China

The global pollutant mercury (Hg), especially as methylmercury (MeHg), threatens human and ecosystem health. But major contributors of MeHg exposure to people in China remain highly debated. We developed the China Mercury Exposure Assessment (CMEA) model, which incorporates human exposure pathways for MeHg and total Hg (THg), the interregional, including international and interprovincial, food trading as well as human physiology to provide a comprehensive system that can evaluate the pathway of Hg forms to human consumers in China. Based on the CMEA model that employed the most comprehensive and recent data, we have found that the Probable Daily Intake (PDI) of MeHg for the Chinese population was 0.057 (range: 0.036-0.091 as 60% confidence interval) μg·kg^-1·day^-1, while that of THg was 0.35 (range: 0.22-0.55) μg·kg^-1·day^-1. MeHg exposure was dominated by fish intake, especially by farm-raised freshwater fish due to higher consumption of these fish. In 2011, fish intake contributed to 56% to the total MeHg exposure, followed by rice (26%). Consumption of farm-raised fish reduced human exposure to MeHg by 33%. On the other hand, interregional food trading increased MeHg exposure of the Chinese population, as a whole, by 7.6%. The international and interprovincial food trades contributed to 5.1% and 22% of MeHg intake, respectively. For the whole China, fish intake related exposure to MeHg was highest for the Eastern and Northeastern populations, while Tibetans were chronically exposed to the highest MeHg from other sources. Our findings highlight the importance of farmed fish and food trade for MeHg exposure.