The blood copper isotopic composition is a prognostic indicator of the hepatic injury in Wilson disease

Impact of aging on copper isotopic composition in the murine brain

Aging is the main risk factor for Alzheimer's disease (AD). AD is linked to alterations in metal homeostasis and changes in stable metal isotopic composition can occur, possibly allowing the latter to serve as relevant biomarkers for potential AD diagnosis. Copper stable isotopes are used to investigate changes in Cu homeostasis associated with various diseases. Prior work has shown that in AD mouse models, the accumulation of 63Cu in the brain is associated with the disease's progression. However, our understanding of how the normal aging process influences the brain's isotopic composition of copper remains limited. In order to determine the utility and predictive power of Cu isotopes in AD diagnostics, we aim-in this study-to develop a baseline trajectory of Cu isotopic composition in the normally aging mouse brain. We determined the copper concentration and isotopic composition in brains of 30 healthy mice (WT) ranging in age from 6 to 12 mo, and further incorporate prior data obtained for 3-mo-old healthy mice; this range approximately equates to 20-50 yr in human equivalency. A significant 65Cu enrichment has been observed in the 12-mo-old mice compared to the youngest group, concomitant with an increase in Cu concentration with age. Meanwhile, literature data for brains of AD mice display an enrichment in 63Cu isotope compared to WT. It is acutely important that this baseline enrichment in 65Cu is fully constrained and normalized against if any coherent diagnostic observations regarding 63Cu enrichment as a biomarker for AD are to be developed.

Metal-binding amino acid ligands commonly found in metalloproteins differentially fractionate copper isotopes

Copper (Cu) is a cofactor in numerous key proteins and, thus, an essential element for life. In biological systems, Cu isotope abundances shift with metabolic and homeostatic state. However, the mechanisms underpinning these isotopic shifts remain poorly understood, hampering use of Cu isotopes as biomarkers. Computational predictions suggest that isotope fractionation occurs when proteins bind Cu, with the magnitude of this effect dependent on the identity and arrangement of the coordinating amino acids. This study sought to constrain equilibrium isotope fractionation values for Cu bound by common amino acids at protein metal-binding sites. Free and bound metal ions were separated via Donnan dialysis using a cation-permeable membrane. Isotope ratios of pre- and post-dialysis solutions were measured by MC-ICP-MS following purification. Sulfur ligands (cysteine) preferentially bound the light isotope (63Cu) relative to water (Δ65Cucomplex-free = - 0.48 ± 0.18‰) while oxygen ligands favored the heavy isotope (65Cu; + 0.26 ± 0.04‰ for glutamate and + 0.16 ± 0.10‰ for aspartate). Binding by nitrogen ligands (histidine) imparted no isotope effect (- 0.01 ± 0.04‰). This experimental work unequivocally demonstrates that amino acids differentially fractionate Cu isotopes and supports the hypothesis that metalloprotein biosynthesis affects the distribution of transition metal isotopes in biological systems.

Copper isotope ratios in serum do not track cancerous tumor evolution, but organ failure

Relative to healthy controls, lighter copper isotopic compositions have been observed in the serum of breast cancer and end-stage liver disease patients, raising the possibility that Cu isotope ratios could be used as a tracer for disease progression. Here, we assess the potential of natural Cu isotopic variations (expressed as δ65Cu) as diagnostic tools for cancer progression and/or liver failure by performing a first-order analysis of Cu isotopic cycling in the human body. Using a box model, we simulate the kinetics of Cu mass transfer throughout significant reservoirs in the body, allowing isotopic fractionation to occur during Cu uptake/release from these reservoirs. With this model, we determine under which conditions the serum δ65Cu values would reflect perturbation related to cancer growth and/or liver failure at a level resolvable with modern mass spectrometry. We find that tumor growth alone is unable to explain the light isotopic signature observed in serum. Instead, we find that metabolic changes to the liver function resulting in a ∼1‰ isotope fractionation during Cu uptake from the blood into the liver can readily explain the long-term serum isotopic shift of ∼0.2‰ observed in cancer patients. A similar fractionation (∼1.3‰) during Cu uptake into the liver also readily explains the -1.2‰ shift observed in the serum of cirrhosis patients with ascites, suggesting a potentially common driver of isotopic fractionation in both cases. Using this model, we then test hypotheses put forward by previous studies and begin to probe the mechanisms behind the measured isotopic compositions.

Dysregulation of Copper Metabolism in a Patient With Acute-on-Chronic Liver Failure Worked up for Fulminant Wilson Disease

Wilson disease (WD) is estimated present in 6%-12% of patients younger than 40 years hospitalized with acute liver failure (ALF). Fulminant WD carries a poor prognosis without treatment. A 36-year-old man with HIV, chronic hepatitis B virus, and alcohol use had ceruloplasmin 6.4 mg/dL and 24-hour urine copper 180 μg/L. WD workup was otherwise negative, including ophthalmic examination, hepatic copper quantification, ATP7B sequencing, and brain MRI. ALF commonly features copper dysregulation. Few studies on WD biomarkers have included fulminant WD. Our patient with WD biomarkers and other causes of liver failure highlights the need to study copper dysregulation in ALF.

Isotopic composition of serum zinc and copper in healthy children and children with autism spectrum disorder in North America

To better understand zinc and copper regulation and their involvement in various biochemical pathways as it relates to autism spectrum disorder (ASD), isotopic composition of serum zinc and copper were evaluated in both healthy children and children with ASD in North America. No significant difference in isotopic composition of serum zinc or copper with respect to healthy controls and ASD children were identified. However, the isotopic composition of serum copper in boys was found to be enriched in ⁶⁵Cu in comparison to previously published healthy adult copper isotopic composition. Furthermore, in both boys and girls, the average isotopic composition of serum zinc is heavier than previously published healthy adult isotopic zinc composition. There was also a negative association between total zinc concentrations in serum and the zinc isotopic composition of serum in boys. Finally, children with heavier isotopic composition of copper also showed a high degree of variability in their zinc isotopic composition. While numerous studies have measured the isotopic composition of serum zinc and copper in adults, this is one of the first studies which measured the isotopic composition of serum copper and zinc in children, specifically those diagnosed with ASD. The results of this study showed that age and gender specific normal ranges of isotopic composition must be established to effectively use isotopic composition analysis in studying various diseases including ASD.

A "turn-on" ESIPT fluorescence probe of 2-(aminocarbonyl)phenylboronic acid for the selective detection of Cu(ii)

Herein, we report a highly selective fluorescent probe for the detection of Cu(ii). The detection mechanism relies on the Cu(ii)-catalyzed oxidative hydroxylation of 2-(aminocarbonyl)phenylboronic acid into salicylamide, thus recovering the excited-state intramolecular proton transfer (ESIPT) effect and inducing more than 35-fold fluorescence enhancement. The simple structure and readily available fluorescent probe give a novel method for quantitatively detecting Cu(ii) in the linear range of 0-22 μM, with a limit of detection down to 68 nM, and exhibiting high selectivity for Cu(ii) over 16 other metal ions.

Emerging applications of high-precision Cu isotopic analysis by MC-ICP-MS

As a component of many minerals and an essential trace element in most aerobic organisms, the transition metal element Cu is important for studying reduction-oxidation (redox) interactions and metal cycling in the total environment (lithosphere, atmosphere, biosphere, hydrosphere, and anthroposphere). The "fractionation" or relative partitioning of the naturally occurring "heavy" (⁶⁵Cu) and "light" (⁶³Cu) isotope between two coexisting phases in a system occurs according to bonding environment and/or as a result of a slight difference in the rate at which these isotopes take part in physical processes and chemical reactions (in absence of equilibrium). Due to this behaviour, Cu isotopic analysis can be used to study a range of geochemical and biological processes that cannot be elucidated with Cu concentrations alone. The shift between Cu⁺ and Cu²⁺ is accompanied by a large degree of Cu isotope fractionation, enabling the Cu isotope to be applied as a vector in mineral exploration, tracer of origin, transport, and fate of metal contaminants in the environment, biomonitor, and diagnostic/prognostic marker of disease, among other applications. In this contribution, we (1) discuss the analytical protocols that are currently available to perform Cu isotopic analysis, (2) provide a compilation of published δ⁶⁵Cu values for matrix reference materials, (3) review Cu isotope fractionation mechanisms, (4) highlight emerging applications of Cu isotopic analysis, and (5) discuss future research avenues.

Metallome deregulation and health-related impacts due to long-term exposure to recent volcanic ash deposits: New chemical and isotopic insights

Volcanic ash exposure can lead to significant health risks. Damage to the respiratory and pulmonary systems are the most evident toxic side effects although the causes of these symptoms remain unclear. Conversely, the effects on other organs remain largely under-explored, limiting our understanding of the long-term volcanic ash-related risk at the whole-body scale. The metallome i.e. metal concentrations and isotopic compositions within the body, is suspected to be affected by volcanic ash exposure, having thus the potential for capturing some specificities of ash toxicity. However, the means by and extent to which the metallome is affected at the entire body scale and how the consequent chemical and isotopic deregulations correlate with pathophysiological dysfunctions are currently poorly understood. Here, we adopt a transdisciplinary approach combining high precision chemical analyses (major and trace element concentrations) and CuZn isotope measurements in seven organs and two biological fluids of isogenic mice (C57BL/6) exposed to eruption products from La Soufrière de Guadeloupe (Eastern Carribean), in tandem with biological parameters including physiological and morphological data. Based on principal component analysis, we show that after one month of exposure to volcanic ash deposits, the mice metallome; originally organ-specific and isotopically-typified, is highly disrupted as shown for example by heavy metal accumulation in testis (e.g., Fe, Zn) and Cu, Zn isotopic divergence in liver, intestine and blood. These metallomic variations are correlated with early testicular defects and might reflect the warning signs of premature (entero)hepatic impairments that may seriously affect fertility and favor the emergence of liver diseases after prolonged exposure. Monitoring the temporal evolution of the Cu and Zn isotope compositions seems to be a promising technique to identify the main biological processes and vital functions that are vulnerable to environmental volcanogenic pollutants although this will require further validation on human subjects.

Magnesium stable isotope composition, but not concentration, responds to obesity and early insulin-resistant conditions in minipig

Hypomagnesemia is frequently associated with type 2 diabetes and generally correlates with unfavorable disease progression, but the magnesium status in pre-diabetic conditions remains unclear. Here, the magnesium metabolism is scrutinized in a minipig model of obesity and insulin resistance by measuring variations of the metallome—the set of inorganic elements—and the magnesium stable isotope composition in six organs of lean and obese minipigs raised on normal and Western-type diet, respectively. We found that metallomic variations are most generally insensitive to lean or obese phenotypes. The magnesium stable isotope composition of plasma, liver, kidney, and heart in lean minipigs are significantly heavier than in obese minipigs. For both lean and obese minipigs, the magnesium isotope composition of plasma and liver were negatively correlated to clinical phenotypes and plasma lipoproteins concentration as well as positively correlated to hyperinsulinemic-euglycemic clamp output. Because the magnesium isotope composition was not associated to insulin secretion, our results suggest that it is rather sensitive to whole body insulin sensitivity, opening perspectives to better comprehend the onset of insulin-resistant diabetic conditions.

Copper isotope composition of hemocyanin

BACKGROUND

Copper is a metal that plays a central role in biology, for example, as co-factor in various redox enzymes. Its stable isotopic composition is being used as tracer of its transport in living organisms and as a biomarker for diseases affecting its homeostasis. While the application of copper stable isotopes to biological studies is a growing field, there are presently no biological standards that are systematically analyzed in the different laboratories, as it is the case for geological samples (e.g., by using widely available basalt samples). It is therefore paramount for the community to establish such standard. Copper also binds oxygen in the respiratory protein, hemocyanin, in the hemolymph of mollusks and arthropods and is thus critical to respiration for these species.

METHODS

Here, the Cu isotope composition of hemocyanin of different modern species of mollusks and arthropods (Megathura crenulate Keyhole limpet, Limulus polyphemus Horseshoe crab and Concholepas concholepas Chilean abalone), as well as theoretical constraints on the origin of these isotopic fractionations through ab initio calculations are reported.

RESULTS

The isotopic fractionation factors for Cu(I) and Cu(II), both in hemocyanin and in seawater, predict an enrichment in the lighter isotope of Cu in the hemocyanin by over 1 permil compared to seawater. The hemocyanin of Chilean abalone and Horseshoe crab have Cu isotope compositions (δ65Cu = +0.63 ± 0.04‰ and +0.61 ± 0.04‰, respectively, with δ65Cu the permil deviation of the 65Cu/63Cu ratio from the NIST SRM 976 standard), similar to that of the octopus reported in literature (+0.62‰), that are undistinguishable from seawater, suggesting quantitative Cu absorption for these organisms. Conversely, the Keyhole limpet is enriched in the lighter isotope of Cu, which is in line with the ab initio calculation and therefore Cu isotopic fractionation during incorporation of Cu into the hemocyanin.

CONCLUSIONS

Because these hemocyanin standard samples are widely available, they could serve in the future as inter-laboratory standards to verify the accuracy of the Cu isotopic measurements on biological matrices.

Copper Isotope Evidence of Oxidative Stress-Induced Hepatic Breakdown and the Transition to Hepatocellular Carcinoma

Background and Aims

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide, and finding a single reliable biomarker to follow liver degradation is a challenging task. To document the relationship between liver failure, hypoxia, and HCC, copper isotope variations (δ65Cu) were evaluated in the serum of HCC-negative and HCC-positive patients as a biomarker of hepatic failure.

Methods

We analyzed Cu isotope variations in serum samples from 293 patients with potentially degraded liver functions presenting hepatitis B virus, hepatitis C virus, nonalcoholic steatohepatitis, and alcohol uptake (OH) etiologies and 105 controls. Ninety-five of the patients were diagnosed with HCC.

Results

On average, the δ65Cu values of the serum of patients with F3-F4 fibrosis score or HCC-positive are low. The Cu isotope data are strikingly bimodal with well-defined δ65Cu modes which imperfectly reflect etiology. The population with normal values (ca -0.3‰) is progressively replaced by a population with atypical δ65Cu values (ca -0.8‰), which reflects the progressive degradation of hepatic functions.

Conclusion

The clear bimodality does not correspond to a progressive shift of the δ65Cu values but to a replacement of one population by another. This bimodality sheds light on the persisting difficulties epitomized by α-fetoprotein in finding high-sensitivity and high-specificity HCC biomarkers. It is interpreted as a switch in the resistance of hepatic tissues to the oxidative stress that eventually leads to HCC oncogenesis.

Longitudinal isotope ratio variations in human hair and nails

Due to the straightforward and non-invasive sampling, ease of transport and long-term storage and access to time-resolved information, determination of element concentrations and isotope ratios in hair and nails finds increasing use. Multi-isotopic information preserved in keratinous tissues allows one to reveal dietary, physiological and environmental influences, but progress in this area is still limited by complicated and time-consuming analytical procedures and challenges in accuracy assessment. In this study, longitudinal distributions of δ³⁴S, ⁸⁷Sr/⁸⁶Sr, ^207,208Pb/²⁰⁶Pb, δ⁶⁶Zn, δ⁵⁶Fe, δ⁶⁵Cu, δ²⁶Mg, and δ¹¹⁴Cd were obtained for hair and nails collected from nine subjects with different age, biological sex, diet and/or place of residence. For S and Zn, the distribution along hair strands revealed a trend towards a heavier isotopic signature from the proximal to the distal end, with a maximum difference within the hair of a single subject of 1.2‰ (Δ³⁴S) and 0.4‰ (Δ⁶⁶Zn). For Fe, Cu, Mg and Cd, a shift towards either a lighter (Cu) or heavier (Fe, Mg and Cd) isotopic composition is accompanied by increasing concentration towards the distal hair end, indicating possible isotope fractionation during deposition or external contamination with a different isotopic composition. Pb and Sr isotope ratios are relatively stable throughout the hair strands despite notable concentration increases towards the distal end, likely reflecting external contamination. The isotopic composition of Sr points to tap water as a probable main source, explaining the relative stability of the ratio for individuals from the same geographical location. For Pb, isotopic compositions suggest tap water and/or indoor dust as possible sources. Similar δ³⁴S, ⁸⁷Sr/⁸⁶Sr, ^207,208Pb/²⁰⁶Pb, δ⁶⁶Zn, δ⁵⁶Fe, and δ⁶⁵Cu observed for hair, fingernails and toenails sampled from the same individual suggest that keratinous tissues are conservative receivers of internal and external inputs and can be used complementary. Seasonal variation in δ³⁴S, ^207,208Pb/²⁰⁶Pb, and δ⁶⁵Cu was observed for fingernails.

Stable Isotope Abundance and Fractionation in Human Diseases

The natural abundance of heavy stable isotopes (¹³C, ¹⁵N, ¹⁸O, etc.) is now of considerable importance in many research fields, including human physiology. In fact, it varies between tissues and metabolites due to isotope effects in biological processes, that is, isotope discriminations between heavy and light isotopic forms during enzyme or transporter activity. The metabolic deregulation associated with many diseases leads to alterations in metabolic fluxes, resulting in changes in isotope abundance that can be identified easily with current isotope ratio technologies. In this review, we summarize the current knowledge on changes in natural isotope composition in samples (including various tissues, hair, plasma, saliva) found in patients compared to controls, caused by human diseases. We discuss the metabolic origin of such isotope fractionations and highlight the potential of using isotopes at natural abundance for medical diagnosis and/or prognostic.