Assessment of trace metal alterations in the blood, cerebrospinal fluid and tissue samples of patients with malignant brain tumors

Assess human blood uranium levels of some Iraqi companies

The goal of this study is to measure the uranium concentration levels in the blood of Iraqi workers employed in certain government companies. Assessing the initial level of uranium toxicity in their blood and the possibility of health problems occurring. 184 blood samples from Iraqi government companies and the control group were collected in this study. A solid-state nuclear track detector (CR-39) was used to measure the amount of uranium present. Two drops of blood (100 μl) were placed on CR-39. The CR-39 was irradiated with a thermal neutron using the fission-track technique (241Am-9Be) to determine the uranium concentration in blood samples. The statistical analysis is carried out using the Origin Lab 2024 version. The results show the average of uranium concentration at all locations has a higher level compared to the control group. The blood samples from workers at the phosphate company had the highest amount (1.021 ± 0.050 μg/l), compared to samples from other factories. This result confirms that there is a connection between the concentration of uranium and phosphate substances. The results suggest that there is a slight increase in uranium levels that is related to both age and years of employment.

Determination of copper and other trace elements in serum samples from patients with biliary tract cancers: prospective noninterventional nonrandomized clinical study protocol

BACKGROUND

Biliary tract cancers (BTCs) are usually diagnosed at an advanced stage, when the disease is incurable. Currently used tumor biomarkers have limited diagnostic value for BTCs, so there is an urgent need for sensitive and specific biomarkers for their earlier diagnosis. Deregulation of the homeostasis of trace elements is involved in the carcinogenesis of different cancers, including BTCs. The objective of the study is to determine/compare the total concentrations of copper (Cu), zinc (Zn) and iron (Fe) and the proportions of free Cu and Cu bound to ceruloplasmin (Cp) and the isotopic ratio of 65Cu/63Cu in serum samples from healthy volunteers and cancer patients using inductively coupled plasma-mass spectrometry-based methods (ICP-MS).

PATIENTS AND METHODS

In this prospective, noninterventional, nonrandomized study 20 patients and 20 healthy volunteers will be enrolled to identify serum Cu, Zn and Fe levels, Cu isotopic fractionation as a predictive biomarker of response to systemic therapy of BTCs, which will be evaluated by computed tomography. Newly developed analytical methods based on ICP-MS will be applied to metal-based biomarker research in oncology.

CONCLUSIONS

In the study the comparison of the total concentration of selected trace elements, the proportion of free Cu and Cu bound to Cp and the isotopic ratio of 65Cu/63Cu in serum samples from healthy volunteers and cancer patients will be conducted to provide the foundation for the development of a BTC cancer screening methodology and the data on their usability as a potential predictive biomarker for BTCs of response to systemic therapy.

Insufficient evidence to link human exposure to heavy metals with biomarkers of glioma

Information on molecular mechanisms has implicated potential association between the concentrations of heavy metals and incidences of glioma, but experimental data on human brain tissue remain sparse. To address this data gap, 13 heavy metals were measured in 137 glioma and 35 non-glioma samples collected from 161 alive patients in Guangdong Province, China in 2019 - 2020. All target heavy metals were detected, suggesting they could cross the blood-brain barrier. Concentrations of Mn, Cu, and Zn were higher in glioma than in non-glioma samples, while those of Ni and Se were higher in non-glioma samples, probably suggesting that these five heavy metals are more prone to be altered by changing pathological conditions. In addition, Cu/Zn, Cr/Mn, Cr/Se, Ni/Se, Pb/Mn, and Pb/Se were statistically different between glioma and non-glioma samples by a difference test and a multiple logistic regression model. These concentration ratios may serve as chemical markers to assist pathological analysis for differentiating between tumor and healthy tissues. However, no direct link between heavy metal concentrations or concentration ratios and biomarkers of glioma (i.e., tumor grade, P53, and Ki-67) was observed. No sufficient evidence was obtained to implicate the role of heavy metals in inducing glioma, largely caused by the limited number of samples. Different concentrations and concentration ratios of heavy metals may be the consequence rather than the cause of pathological changes in brain tumors.

High preoperative serum strontium levels increase the risk of acute kidney injury after cardiopulmonary bypass

BACKGROUND

Acute kidney injury (AKI) is a common complication of cardiac surgeries. The incidence of AKI after cardiac surgeries using cardiopulmonary bypass (CPB-AKI) is high, emphasizing the need to determine strategies to prevent CPB-AKI. This study investigates the correlation between CPB-AKI and trace metal levels in clinical and animal studies.

METHODS

Samples and clinical data were obtained from 74 patients from the Nagoya City University Hospital and Okazaki City Hospital. Blood samples were collected before, immediately after, and 2 h after CPB withdrawal. Trace metal levels were measured using inductively coupled plasma mass spectrometry. Sr or vehicle treatment was orally administered to the rats to determine if Sr was associated with CPB-AKI. After the treatment, ischemia-reperfusion (IR) injury was induced, and serum creatinine (SCr) and blood urea nitrogen (BUN) levels were measured.

RESULTS

In this clinical study, the incidence of CPB-AKI was found to be 28% (21/74). The body mass index and estimated glomerular filtration rate were significantly different in patients with AKI. The intensive care unit and hospital stay were longer in AKI patients than in non-AKI patients. The Na, Fe, and Sr levels were significantly higher in AKI patients before CPB. Also, Fe and Sr were higher immediately after CPB withdrawal, and Sr was higher 2 h after CPB withdrawal in AKI patients. Animal studies showed that Sr-treated rats had significantly increased SCr and BUN levels than vehicle-treated rats at 24 h post-IR injury.

CONCLUSIONS

High preoperative serum Sr levels may be associated with CPB-AKI.

Investigation of imbalances in essential/toxic metal levels in the blood of laryngeal cancer patients in comparison with controls

Laryngeal carcinoma is one of the common types of head and neck cancer, with men being more likely than women to develop it. Diet, age, gender, smoking habits, and environmental factors play important roles in its development. The goal of this study was to ascertain if there were imbalances in essential and toxic trace metals owing to the initiation and progression of laryngeal cancer. Atomic absorption spectrometry was employed to quantify selected macroelements, and essential/toxic trace metals in blood of the cancerous patients and matching controls. Significantly higher concentrations of Pb, Cu, Fe, and Sr while substantially lower levels of Na, K, Ca, and Mg were observed in the cancer patients compared with the controls. Considerably disparate mutual relationships among the macroelements, and essential/toxic trace metals in the patients and controls were manifested by their correlation coefficients. Similarly, multivariate apportionment of the metal levels showed appreciably diverse associations and grouping in the patients and controls. The laryngeal cancer patients exhibited significant disparities in the metal levels among various sub-types (supraglottic, subglottic, transglottic, and glottic cancer) and stages (I, II, III, and IV) of the disease. Most of the metals revealed distinct differences based on the gender, habitat, age, eating preferences, and smoking habits in both donor groups. Overall, the study demonstrated significant imbalances among the macroelements, and essential/toxic trace metal levels in the blood of laryngeal cancer patients compared to the controls.

Circulatory Imbalance of Essential and Toxic Trace Elements in Pre-dialysis and Hemodialysis Patients

The status of essential and toxic trace elements in patients with different stages of chronic kidney disease (CKD) is still unclear and not well characterized. The present study examined the circulatory levels of a wide panel of trace elements (Al, Cr, Mn, Co, Ni, Cu, Zn, As, Se, Rb, Sr, Cd, Pb, and U) in hemodialysis patients (HD group) and pre-dialysis patients with stage 3 CKD (PD group). Comparisons were made between groups of patients and healthy individuals from the control group (CG). The levels of Al, Mn, Co, Ni, Cu, As, Se, Sr, and Pb were higher, while the levels of Cr, Zn, Rb, Cd, and U were lower in HD patients than in our CG. Higher levels of Al and Se, as well as lower levels of As, Sr, Zn, Rb, and U were significant and distinguished HD from PD. Among other analyzed elements, Co, Se, and U are the only trace elements that did not distinguish PD from CG at a statistically significant level. The HD group had lower serum U levels than the PD group, and this could be a result of hemodialysis. This study also revealed that the Cu/Zn ratio could be used as a marker for early and late detection of renal failure. Marked changes of essential and toxic trace element levels in sera indicate additional pathophysiological events in CKD, which could additionally contribute to the preexisting increased morbidity of HD patients. Measurement of trace elements in HD patients should be performed routinely.

Profiling of Circulatory Elements Reveals Alteration of Essential and Toxic Trace Metals in Crohn's Disease

The status of essential and toxic trace metals in the blood of Crohn's disease (CD) patients is unexplained. This study aimed to provide the first elemental profiling of the most recognized essential elements (Mn, Cu, Zn, Se) and selected toxic trace elements (As, Cd, Pb, and U) in sera and cell lysate (CL) samples of CD patients (n = 84). The results were compared with sex- and age-matched samples from the control group (CG). CD sera contained significantly higher levels of Mn, As, Cd, Pb, and U than did CG sera. An identical pattern, with the added inclusion of Cu (also higher in CD patients than in the CG), was obtained for CL samples. However, the most important finding was hypermanganesemia, which indicates that Mn could act as a toxic trace metal in CD. As, Cd, and U were the most significant toxic elements that showed antagonistic effects on the extrusion of essential Mn and Cu. Circulatory system screening markers for CD are hereby proposed (Mn/Cu, Mn/As, and Mn/Pb ratios). These three metal ratios were strongly and significantly correlated with F-Calprotectin levels, and deserve consideration as new markers of CD. The target metals and metal ratios should be taken into consideration as novel initiating and/or modifying factors for CD.

Altered Elemental Distribution in Male Rat Brain Tissue as a Predictor of Glioblastoma Multiforme Growth-Studies Using SR-XRF Microscopy

Glioblastoma multiforme (GBM) is a particularly malignant primary brain tumor. Despite enormous advances in the surgical treatment of cancer, radio- and chemotherapy, the average survival of patients suffering from this cancer does not usually exceed several months. For obvious ethical reasons, the search and testing of the new drugs and therapies of GBM cannot be carried out on humans, and for this purpose, animal models of the disease are most often used. However, to assess the efficacy and safety of the therapy basing on these models, a deep knowledge of the pathological changes associated with tumor development in the animal brain is necessary. Therefore, as part of our study, the synchrotron radiation-based X-ray fluorescence microscopy was applied for multi-elemental micro-imaging of the rat brain in which glioblastoma develops. Elemental changes occurring in animals after the implantation of two human glioma cell lines as well as the cells taken directly from a patient suffering from GBM were compared. Both the extent and intensity of elemental changes strongly correlated with the regions of glioma growth. The obtained results showed that the observation of elemental anomalies accompanying tumor development within an animal's brain might facilitate our understanding of the pathogenesis and progress of GBM and also determine potential biomarkers of its extension. The tumors appearing in a rat's brain were characterized by an increased accumulation of Fe and Se, whilst the tissue directly surrounding the tumor presented a higher accumulation of Cu. Furthermore, the results of the study allow us to consider Se as a potential elemental marker of GBM progression.

Differences between antioxidant defense parameters and specific trace element concentrations in healthy, benign, and malignant brain tissues

There are only a few reports examining the impact of oxidative stress in patients with benign and malignant brain tumors. In this study we investigated whether there are changes in antioxidant system (AOS) parameters and key trace elements between control, benign and malignant brain tissues. The study also aimed to examine correlations between the analyzed parameters. The study enrolled both types of brain tumors, benign tumors (BT) and malignant tumors (MT). The results were compared with control tissue (CT) without tumor infiltration collected from patients with BT. The following antioxidant parameters were determined: activities of total, manganese-containing, and copper/zinc-containing superoxide dismutase (TotSOD, MnSOD and CuZnSOD), activities of catalase, glutathione peroxidase, glutathione S-transferase, glutathione reductase and acetylcholine esterase (AChE), the concentrations of glutathione and sulfhydryl groups and of manganese (Mn), copper (Cu), zinc (Zn), and selenium (Se). BT and MT had altered activities/levels of multiple AOS parameters as compared to CT, indicating that tumor cells had an altered cell metabolism and changes in AOS represent adaptive response to increased oxidative stress. Low MnSOD and AChE and high GST activities were significant for distinguishing between MT and CT. Malignant tissue was also characterized by lower Mn and Cu concentrations relative to CT and BT. Principal Component Analysis clearly discriminated BT from CT and MT (PC1, 66.97%), while PC2 clearly discriminated CT from BT and MT (33.03%). Most correlative relationships were associated with Se in the BT group and Cu in the MT group. The results of this study reveal differences between the AOS parameters and the essential trace elements between the analyzed groups. The observed dysregulations show that oxidative stress could have an important role in disrupting brain homeostasis and its presence in the pathogenesis of benign and malignant brain tumors.

Therapeutic Potential of Selenium in Glioblastoma

Little progress has been made in the long-term management of malignant brain tumors, leaving patients with glioblastoma, unfortunately, with a fatal prognosis. Glioblastoma remains the most aggressive primary brain cancer in adults. Similar to other cancers, glioblastoma undergoes a cellular metabolic reprogramming to form an oxidative tumor microenvironment, thereby fostering proliferation, angiogenesis and tumor cell survival. Latest investigations revealed that micronutrients, such as selenium, may have positive effects in glioblastoma treatment, providing promising chances regarding the current limitations in surgical treatment and radiochemotherapy outcomes. Selenium is an essential micronutrient with anti-oxidative and anti-cancer properties. There is additional evidence of Se deficiency in patients suffering from brain malignancies, which increases its importance as a therapeutic option for glioblastoma therapy. It is well known that selenium, through selenoproteins, modulates metabolic pathways and regulates redox homeostasis. Therefore, selenium impacts on the interaction in the tumor microenvironment between tumor cells, tumor-associated cells and immune cells. In this review we take a closer look at the current knowledge about the potential of selenium on glioblastoma, by focusing on brain edema, glioma-related angiogenesis, and cells in tumor microenvironment such as glioma-associated microglia/macrophages.

Assessment of uranium concentration in blood of Iraqi females diagnosed with breast cancer

Cancer is a widespread significant health problem in Iraq and contributes 11% to total deaths. Throughout the Gulf Wars of 1991 and 2003, about 1200 tons of ammunition were dropped around Iraq. After the wars, cancer incidence in Iraq is about 7,000 to 8,000 cancers cases per year, and the overall incidence of lymphoma, leukemia, breast cancer, and lung cancer has increased twofold and even tripled, as compared to the time before the wars. This increase could result from environmental pollution with radioactive materials including uranium, as cancer can be caused by ionizing radiation. To investigate this hypothesis, uranium concentration in the blood of 64 Iraqi females has been measured by means of CR-39 track etch detectors (42 blood samples collected from females diagnosed with breast cancer and 22 blood samples from females without breast cancer). The results show that the uranium concentrations ranged from 19.1 ± 0.3 to 238.4 ± 0.4 with an average value of 94.9 ± 5.0 ng L^-1 in the blood of women with breast cancer and from 5.2 ± 0.2 to 18.7 ± 0.04 with an average value of 10.5 ± 0.1 ng L^-1 in the blood of women without breast cancer. In comparison with the literature data, elevated levels of uranium concentration were recorded in both groups, and significantly higher average uranium concentrations were found in the blood of women with breast cancer as compared to those in the blood samples of women without breast cancer. It is concluded that there is a correlation between the incidence of breast cancer in Iraqi women and elevated levels of uranium concentrations in their blood. Whether this is a casual relationship is unclear, because cancer can be caused by various carcinogens, including environmental pollution in the region.

The first insight into the trace element status of human adrenal gland accompanied by elemental alterations in adrenal adenomas

BACKGROUND

The baseline status of trace metals in adrenal tissue is unresolved, while the elemental profile for any adrenal pathology has not been examined so far. This study aimed to determine the baseline status of important toxic (Ni, As, Cd, Pb, Th, U) and essential trace elements (Mn, Co, Cu, Zn, Se) in healthy adrenal tissues (HATs) as well as to examine whether there are alterations in the elemental composition of adenomatous adrenal tissues (AATs). Furthermore, this study aimed to find potential trace metals that could play a role in the pathogenesis of adrenal adenoma (AA).

METHODS

The study included 45 patients diagnosed with AA. Impacts of relevant parameters such as gender, age, smoking habits and nodular sizes were considered. All samples were subjected to microwave digestion and the trace elements were determined by inductively coupled plasma mass spectrometry (ICP-MS).

RESULTS

This is the first study that provided an insight into the elemental status of HATs. It was also shown that AATs had altered trace metal contents. Compared to HATs, the most significant findings were related to the high content of essential (Cu, Mn, Se, Zn) and Pb as a non-essential metal. Although gender, age and smoking habits had a modest effect on metal profiles, the most significant alterations were related to the nodular diameter above 4 cm, indicating that the growth of benign tumor could influence changes in elemental composition.

CONCLUSION

For the first time the baseline contents of essential and toxic trace metals in HATs were determined. The results of this study may highlight the role of toxic and essential trace metals in AAs and could provide new insights into the molecular basis of pathophysiological changes caused by the hazardous effects of trace metals on adrenal structure and function.

Comparison of Elemental Anomalies Following Implantation of Different Cell Lines of Glioblastoma Multiforme in the Rat Brain: A Total Reflection X-ray Fluorescence Spectroscopy Study

Glioblastoma multiforme (GBM) is a primary brain tumor with a very high degree of malignancy and is classified by WHO as a glioma IV. At present, the treatment of patients suffering from GBM is based on surgical resection of the tumor with maximal protection of surrounding tissues followed by radio- and pharmacological therapy using temozolomide as the most frequently recommended drug. This strategy, however, does not guarantee success and has devastating consequences. Testing of new substances or therapies having potential in the treatment of GBM as well as detection of their side effects cannot be done on humans. Animal models of the disease are usually used for these purposes, and one possibility is the implantation of human tumor cells into rodent brains. Such a solution was used in the present study the purpose of which was comparison of elemental anomalies appearing in the brain as a result of implantation of different glioblastoma cell lines. These were two commercially available cell lines (U87MG and T98G), as well as tumor cells taken directly from a patient diagnosed with GBM. Using total reflection X-ray fluorescence we determined the contents of P, S, K, Ca, Fe, Cu, Zn, and Se in implanted-left and intact-right brain hemispheres. The number of elemental anomalies registered for both hemispheres was positively correlated with the invasiveness of GBM cells and was the highest for animals subjected to U87MG cell implantation, which presented significant decrease of P, K, and Cu levels and an increase of Se concentration within the left hemisphere. The abnormality common for all three groups of animals subjected to glioma cell implantation was increased Fe level in the brain, which may result from higher blood supply or the presence of hemorrhaging regions. In the case of the intact hemisphere, elevated Fe concentration may also indicate higher neuronal activity caused by taking over some functions of the left hemisphere impaired as a result of tumor growth.