1
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Satarug S, Vesey DA, Gobe GC, Phelps KR. Estimation of health risks associated with dietary cadmium exposure. Arch Toxicol 2023; 97:329-358. [PMID: 36592197 DOI: 10.1007/s00204-022-03432-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/13/2022] [Indexed: 01/03/2023]
Abstract
In much of the world, currently employed upper limits of tolerable intake and acceptable excretion of cadmium (Cd) (ECd/Ecr) are 0.83 µg/kg body weight/day and 5.24 µg/g creatinine, respectively. These figures were derived from a risk assessment model that interpreted β2-microglobulin (β2MG) excretion > 300 μg/g creatinine as a "critical" endpoint. However, current evidence suggests that Cd accumulation reduces glomerular filtration rate at values of ECd/Ecr much lower than 5.24 µg/g creatinine. Low ECd/Ecr has also been associated with increased risks of kidney disease, type 2 diabetes, osteoporosis, cancer, and other disorders. These associations have cast considerable doubt on conventional guidelines. The goals of this paper are to evaluate whether these guidelines are low enough to minimize associated health risks reliably, and indeed whether permissible intake of a cumulative toxin like Cd is a valid concept. We highlight sources and levels of Cd in the human diet and review absorption, distribution, kidney accumulation, and excretion of the metal. We present evidence for the following propositions: excreted Cd emanates from injured tubular epithelial cells of the kidney; Cd excretion is a manifestation of current tissue injury; reduction of present and future exposure to environmental Cd cannot mitigate injury in progress; and Cd excretion is optimally expressed as a function of creatinine clearance rather than creatinine excretion. We comprehensively review the adverse health effects of Cd and urine and blood Cd levels at which adverse effects have been observed. The cumulative nature of Cd toxicity and the susceptibility of multiple organs to toxicity at low body burdens raise serious doubt that guidelines concerning permissible intake of Cd can be meaningful.
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Affiliation(s)
- Soisungwan Satarug
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia.
| | - David A Vesey
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Glenda C Gobe
- Kidney Disease Research Collaborative, Level 5, Translational Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
- NHMRC Centre of Research Excellence for CKD QLD, UQ Health Sciences, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Kenneth R Phelps
- Stratton Veterans Affairs Medical Center and Albany Medical College, Albany, NY, USA
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Chen X, Li G, Zhang W, Ou J, Li H, Huang Y, He S, Zhou J, Zhao Z, Chen J, Meng X, Liu L. Urine metabolomic characteristics of female patients with occupational chronic cadmium poisoning after 15 years of treatment. Biomed Chromatogr 2023; 37:e5523. [PMID: 36336973 DOI: 10.1002/bmc.5523] [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: 08/05/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
Occupational chronic cadmium poisoning (OCCP) can cause irreversible organ damage. Currently, no effective treatment is available for OCCP, and effective and sensitive biomarkers for treatment evaluation are still lacking. In this study, metabolomics techniques were used to analyze changes in endogenous metabolites in the urine of patients with OCCP after 15 years of treatment. Thirty urine samples from female patients with OCCP and healthy female controls (n = 15 per group) were assessed using gas chromatography-time-of-flight mass spectrometry and ultra-high-performance liquid chromatography-Q-Exactive mass spectrometry. The OCCP group had higher concentrations of blood urea nitrogen and urinary cadmium but near-normal urinary concentrations of β2 -microglobulin and retinol-binding protein. Compared with the control group, the OCCP group had 66 significantly different metabolites with a variable importance in projection score >1 and p < 0.05. These differential metabolites were involved in various metabolic pathways, such as creatine metabolism, nicotinate and nicotinamide metabolism, the pentose phosphate pathway, d-glutamine and d-glutamate metabolism, and amino acid metabolism. Compared with the control group, the OCCP group had significantly higher urinary concentrations of creatine, glutamic acid, quinolinic acid and nicotinic acid. In a receiver operator characteristic analysis, the area under the curve of creatine was higher than those for glutamic acid, quinolinic acid and nicotinic acid, indicating that urinary concentrations of creatine could be used as a sensitive biomarker for the diagnosis and prognosis of OCCP and for monitoring its treatment.
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Affiliation(s)
- Xingyu Chen
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Guoliang Li
- Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
| | - Weipeng Zhang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Jiayi Ou
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Hecheng Li
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Yiqi Huang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Shuirong He
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiazhen Zhou
- Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
| | - Zhiqiang Zhao
- Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
| | - Jiabin Chen
- Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
| | - Xiaojing Meng
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Lili Liu
- School of Public Health, Southern Medical University, Guangzhou, China.,Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, China
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The Effect of Cadmium on GFR Is Clarified by Normalization of Excretion Rates to Creatinine Clearance. Int J Mol Sci 2021; 22:ijms22041762. [PMID: 33578883 PMCID: PMC7916559 DOI: 10.3390/ijms22041762] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/02/2021] [Accepted: 02/06/2021] [Indexed: 01/13/2023] Open
Abstract
Erroneous conclusions may result from normalization of urine cadmium and N-acetyl-β-D-glucosaminidase concentrations ([Cd]u and [NAG]u) to the urine creatinine concentration ([cr]u). In theory, the sources of these errors are nullified by normalization of excretion rates (ECd and ENAG) to creatinine clearance (Ccr). We hypothesized that this alternate approach would clarify the contribution of Cd-induced tubular injury to nephron loss. We studied 931 Thai subjects with a wide range of environmental Cd exposure. For x = Cd or NAG, Ex/Ecr and Ex/Ccr were calculated as [x]u/[cr]u and [x]u[cr]p/[cr]u, respectively. Glomerular filtration rate (GFR) was estimated according to the Chronic Kidney Disease (CKD) Epidemiology Collaboration (eGFR), and CKD was defined as eGFR < 60 mL/min/1.73m2. In multivariable logistic regression analyses, prevalence odds ratios (PORs) for CKD were higher for log(ECd/Ccr) and log(ENAG/Ccr) than for log(ECd/Ecr) and log(ENAG/Ecr). Doubling of ECd/Ccr and ENAG/Ccr increased POR by 132% and 168%; doubling of ECd/Ecr and ENAG/Ecr increased POR by 64% and 54%. As log(ECd/Ccr) rose, associations of eGFR with log(ECd/Ccr) and log(ENAG/Ccr) became stronger, while associations of eGFR with log(ECd/Ecr) and log(ENAG/Ecr) became insignificant. In univariate regressions of eGFR on each of these logarithmic variables, R2 was consistently higher with normalization to Ccr. Our tabular and graphic analyses uniformly indicate that normalization to Ccr clarified relationships of ECd and ENAG to eGFR.
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Chandravanshi L, Shiv K, Kumar S. Developmental toxicity of cadmium in infants and children: a review. Environ Anal Health Toxicol 2021; 36:e2021003-0. [PMID: 33730790 PMCID: PMC8207007 DOI: 10.5620/eaht.2021003] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/09/2021] [Indexed: 02/06/2023] Open
Abstract
Several millions of people are exposed to cadmium worldwide due to natural and anthropogenic activities that led to their widespread distribution in the environment and have shown potential adverse effects on the kidneys, liver, heart and nervous system. Recently human and animal-based studies have been shown that In utero and early life exposure to cadmium can have serious health issues that are related to the risk of developmental disabilities and other outcomes in adulthood. Since, cadmium crosses the placental barrier and reaches easily to the fetus, even moderate or high-level exposure of this metal during pregnancy could be of serious health consequences which might be reflected either in the children’s early or later stages of life. Mortality from various diseases including cancer, cardiovascular, respiratory, kidney and neurological problems, correlation with In utero or early life exposure to cadmium has been found in epidemiological studies. Animal studies with strong evidence of various diseases mostly support for the human studies, as well as suggested a myriad mechanism by which cadmium can interfere with human health and development. More studies are needed to establish the mechanism of cadmium-induced toxicity with environmentally relevant doses in childhood and later life. In this review, we provide a comprehensive examination of the literature addressing potential long- term health issues with In utero and early life exposure to cadmium, as well as correlating with human and animal exposure studies.
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Affiliation(s)
- Lalit Chandravanshi
- Department of Forensic Science, College and Traffic Management- Institute of Road and Traffic Education, Faridabad - Haryana - 121010, India
| | - Kunal Shiv
- Division of Forensic Science, School of Basic & Applied Sciences, Galgotias University Greater Noida - 201306, India
| | - Sudhir Kumar
- Forensic Science laboratory, Modinagar, Ghaziabad - 201204, India
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Cadmium and Lead Exposure, Nephrotoxicity, and Mortality. TOXICS 2020; 8:toxics8040086. [PMID: 33066165 PMCID: PMC7711868 DOI: 10.3390/toxics8040086] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/07/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Abstract
The present review aims to provide an update on health risks associated with the low-to-moderate levels of environmental cadmium (Cd) and lead (Pb) to which most populations are exposed. Epidemiological studies examining the adverse effects of coexposure to Cd and Pb have shown that Pb may enhance the nephrotoxicity of Cd and vice versa. Herein, the existing tolerable intake levels of Cd and Pb are discussed together with the conventional urinary Cd threshold limit of 5.24 μg/g creatinine. Dietary sources of Cd and Pb and the intake levels reported for average consumers in the U.S., Spain, Korea, Germany and China are summarized. The utility of urine, whole blood, plasma/serum, and erythrocytes to quantify exposure levels of Cd and Pb are discussed. Epidemiological studies that linked one of these measurements to risks of chronic kidney disease (CKD) and mortality from common ailments are reviewed. A Cd intake level of 23.2 μg/day, which is less than half the safe intake stated by the guidelines, may increase the risk of CKD by 73%, and urinary Cd levels one-tenth of the threshold limit, defined by excessive ß2-microglobulin excretion, were associated with increased risk of CKD, mortality from heart disease, cancer of any site and Alzheimer's disease. These findings indicate that the current tolerable intake of Cd and the conventional urinary Cd threshold limit do not provide adequate health protection. Any excessive Cd excretion is probably indicative of tubular injury. In light of the evolving realization of the interaction between Cd and Pb, actions to minimize environmental exposure to these toxic metals are imperative.
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The Source and Pathophysiologic Significance of Excreted Cadmium. TOXICS 2019; 7:toxics7040055. [PMID: 31635341 PMCID: PMC6958378 DOI: 10.3390/toxics7040055] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 12/23/2022]
Abstract
In theory, the identification of the source of excreted cadmium (Cd) might elucidate the pathogenesis of Cd-induced chronic kidney disease (CKD). With that possibility in mind, we studied Thai subjects with low, moderate, and high Cd exposure. We measured urine concentrations of Cd, ([Cd]u); N-acetyl-β-d-glucosaminidase, a marker of cellular damage ([NAG]u); and β2-microglobulin, an indicator of reabsorptive dysfunction ([β2MG]u). To relate excretion rates of these substances to existing nephron mass, we normalized the rates to creatinine clearance, an approximation of the glomerular filtration rate (GFR) (ECd/Ccr, ENAG/Ccr, and Eβ2MG/Ccr). To link the loss of intact nephrons to Cd-induced tubular injury, we examined linear and quadratic regressions of estimated GFR (eGFR) on ECd/Ccr, eGFR on ENAG/Ccr, and ENAG/Ccr on ECd/Ccr. Estimated GFR varied inversely with both ratios, and ENAG/Ccr varied directly with ECd/Ccr. Linear and quadratic regressions of Eβ2MG/Ccr on ECd/Ccr and ENAG/Ccr were significant in moderate and high Cd-exposure groups. The association of ENAG/Ccr with ECd/Ccr implies that both ratios depicted cellular damage per surviving nephron. Consequently, we infer that excreted Cd emanated from injured tubular cells, and we attribute the reduction of eGFR to the injury. We suggest that ECd/Ccr, ENAG/Ccr, and eGFR were associated with one another because each parameter was determined by the tubular burden of Cd.
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Chen X, Zhu G, Wang Z, Liang Y, Chen B, He P, Nordberg M, Nordberg GF, Ding X, Jin T. The association between dietary cadmium exposure and renal dysfunction - the benchmark dose estimation of reference levels: the ChinaCad study. J Appl Toxicol 2018; 38:1365-1373. [PMID: 29888394 DOI: 10.1002/jat.3647] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/22/2018] [Accepted: 04/24/2018] [Indexed: 11/08/2022]
Abstract
The tolerable dietary intake of cadmium was recommended at provisional tolerable monthly intake of 25 μg kg-1 body weight. However, several studies indicated that this tolerable level should be re-evaluated for sufficient health protection. In this study, we show the reference levels of dietary cadmium intake for renal dysfunction by using a benchmark dose (BMD) approach. A total of 790 subjects (302 men and 488 women) living in control and cadmium-polluted areas were included. The dietary cadmium intake was estimated by a food survey. Blood cadmium, urinary cadmium and renal function markers (microalbuminuria, N-acetyl-β-d-glucosaminidase [NAG] and its isoform B [NAGB], β2 -microglobulin and retinol binding protein) in urine were measured. We calculated the 95% lower confidence bounds of BMD (BMDLs) of cumulative cadmium intake. In control and two polluted areas, the median cumulative cadmium intake was 0.5, 2.1 and 11.1 g. The odds ratio of the intermediate (1.0-3.0 g), second highest (3.0-11.0 g) and the highest cumulative cadmium intake (>11.0 g) compared with the lowest cumulative cadmium intake (<1.0 g) were 2.8 (95% CI: 1.4-5.8), 8.1 (95% CI: 3.8-17.2) and 11.4 (95% CI: 6.5-26.4) for urinary NAG and 6.6 (95% CI: 3.2-13.8), 14.8 (95% CI: 6.8-32.2) and 22.5 (95% CI: 10.7-47.5) for urinary NAGB. The BMDLs of cumulative cadmium intake were 1.1-1.2 g (benchmark response [BMR] = 5%) for urinary NAG, and were 0.7-0.9 g (BMR = 5%) for urinary NAGB, and were 1.3-1.4 g (BMR = 5%) for urinary β2 -microglobulin. The BMDLs of cumulative cadmium intake in a Chinese population were lower than the critical standard previously reported. Further evaluations are needed for sufficient health protection.
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Affiliation(s)
- Xiao Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.,Department of Nephrology, Zhongshan Hospital Fudan University, Key Laboratory of Kidney and Dialysis, Shanghai, 200032, China
| | - Guoying Zhu
- Institute of Radiation Medicine, Fudan University, Shanghai, 200032, China
| | - Zhongqiu Wang
- Department of Nephrology, Zhongshan Hospital Fudan University, Key Laboratory of Kidney and Dialysis, Shanghai, 200032, China
| | - Yihuai Liang
- Department of Occupational Medicine, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Bo Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Ping He
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Monica Nordberg
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Gunnar F Nordberg
- Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital Fudan University, Key Laboratory of Kidney and Dialysis, Shanghai, 200032, China
| | - Taiyi Jin
- Department of Occupational Medicine, School of Public Health, Fudan University, Shanghai, 200032, China
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Cui X, Cheng H, Liu X, Giubilato E, Critto A, Sun H, Zhang L. Cadmium exposure and early renal effects in the children and adults living in a tungsten-molybdenum mining areas of South China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:15089-15101. [PMID: 29557043 DOI: 10.1007/s11356-018-1631-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 02/28/2018] [Indexed: 06/08/2023]
Abstract
Adverse health effects related to accumulative cadmium (Cd) exposure have aroused widespread attention from the public in China. Knowledge on the relationships between Cd exposure and early renal effects is particularly limited for children, who are more susceptible to absorbing metals than adults. A typical Cd-polluted area of South China was selected to determine the Cd exposure and related early renal effects of the general population, including children. In total, 211 children and 806 adults were enrolled in the study. The urinary levels of Cd (U-Cd), β2-microglobulin (U-BMG), retinol binding protein (U-RBP), and N-acetyl-β-D-glucosaminidase (U-NAG) were measured. The relationship between U-Cd and ranked indicators of early renal effects was examined by multiple regression analysis. The average U-Cd ranged from 7.01 μg/g creatinine (boys) to 13.55 μg/g creatinine (women) in the Cd-polluted areas. These values are much higher than those of the control group and those that have been reported by other countries. In agreement with previous studies, environmental Cd pollution resulted in elevated Cd accumulation in the bodies of children, and it increased the concentration of NAG in their urine. Similarly, environmental Cd pollution increased NAG and BMG in the urine of adults. Multivariate models showed that the urinary excretion of BMG, RBP, and NAG was positively associated with Cd levels in the urine of both children and adults. The reference thresholds of U-Cd in relation to elevated U-BMG, U-RBP, and U-NAG were higher in children than adults after standardization for other covariates. These results reinforce the need to control and regulate the sources of environmental Cd contamination and to promote more effective risk management measures, especially for vulnerable groups.
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Affiliation(s)
- Xiangfen Cui
- School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People's Republic of China
| | - Hongguang Cheng
- School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People's Republic of China.
| | - Xuelian Liu
- Green Development Institute, Beijing Normal University, Beijing, 100875, People's Republic of China
| | - Elisa Giubilato
- Department of Environmental Sciences, Informatics and Statistics, University Ca' Foscari, Venice, Italy
| | - Andrea Critto
- Department of Environmental Sciences, Informatics and Statistics, University Ca' Foscari, Venice, Italy.
| | - Haixu Sun
- School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People's Republic of China
| | - Lei Zhang
- School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People's Republic of China
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Vervaet BA, D’Haese PC, Verhulst A. Environmental toxin-induced acute kidney injury. Clin Kidney J 2017; 10:747-758. [PMID: 29225803 PMCID: PMC5716161 DOI: 10.1093/ckj/sfx062] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/24/2017] [Indexed: 02/07/2023] Open
Abstract
Human beings are exposed to various potentially toxic agents and conditions in their natural and occupational environments. The kidney, due to its concentrating ability and excretory function, is highly vulnerable to the effects of environmental toxins. Identifying the precise cause and mechanisms of environmentally induced renal injury remains a challenge for which various scientific disciplines need to be involved. Investigations in this field are confronted with the apparent infinite types of toxins, their mutual interaction, handling/metabolization by the body, ways of exposure, etc. Although interdisciplinary efforts and persistence are required to identify, mechanistically unravel and tackle environmental toxin-induced pathologies, research eventually pays off in ameliorated working/living conditions and development of preventive/therapeutic strategies. This review was compiled to particularly emphasize the need for a maintained awareness of environmental threats in general and those targeting the kidney. Different mechanisms of renal toxicity are illustrated and discussed, thereby focusing on three types of environmental toxins, namely aristolochic acid, melamine and heavy metals.
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Affiliation(s)
- Benjamin A Vervaet
- Department of Biomedical Sciences, Laboratory of Pathophysiology, University Antwerp, Antwerp, Belgium
| | - Patrick C D’Haese
- Department of Biomedical Sciences, Laboratory of Pathophysiology, University Antwerp, Antwerp, Belgium
| | - Anja Verhulst
- Department of Biomedical Sciences, Laboratory of Pathophysiology, University Antwerp, Antwerp, Belgium
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Al-Saleh I, Al-Rouqi R, Elkhatib R, Abduljabbar M, Al-Rajudi T. Risk assessment of environmental exposure to heavy metals in mothers and their respective infants. Int J Hyg Environ Health 2017; 220:1252-1278. [PMID: 28869188 DOI: 10.1016/j.ijheh.2017.07.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/26/2017] [Accepted: 07/31/2017] [Indexed: 12/17/2022]
Abstract
Exposure to heavy metals can cause renal injury, which has been well documented in occupational exposure. Studies of low exposure in the general population, however, are still scarce, particularly for vulnerable populations such as mothers and young children. This study evaluated exposure to heavy metals, and biomarkers of renal function and oxidative stress in 944 lactating mothers and their infants and investigated the role of the interaction between heavy metals and oxidative stress in altering renal function. Mother and infant urine samples were analyzed to measure mercury (Hg), cadmium (Cd), and lead (Pb) concentrations for determining body-burden exposure; N-acetyl-β-d-glucosaminidase (NAG), α1-microglobulin (α1-MG), albumin (ALB), and creatinine (Cr) concentrations for determining early renal injury; and 8-hydroxy-2-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) concentrations for determining oxidative stress. The median concentrclearlyations in mothers presented as μg/g Cr (infants as μg/l) for Hg, Cd, and Pb were 0.695 (0.716), 0.322 (0.343), and 3.97 (5.306) respectively. The mothers and their infants had clearly been exposed to heavy metals and had levels higher than the reference values reported for the general populations of USA, Germany, and Canada. Multiple regression analyses clearly demonstrated associations between urinary heavy metals in quartiles and several renal and oxidative biomarkers in mothers and to a lesser extent their infants. ß coefficients for urinary excretions of MDA, 8-OHdG, ALB, α1-MG, NAG, and Cr in mothers were high in the highest quartile of Hg (1.183-51.29μg/g Cr or 1.732-106.95μg/l), Cd (0.565-765.776μg/g Cr or 0.785-1347.0μg/l), and Pb (6.606-83.937μg/g Cr or 9.459-80.826μg/l), except Pb was not associated with ALB. Infants in the highest Pb quartile (9.293-263.098μg/l) had the highest ß coefficients of urinary excretion of MDA, 8-OHdG, ALB, NAG, and Cr. Significant increasing trend in biomarkers across the quartiles of the three metals was seen in both mothers and infants (ptrend <0.001). A receiver operating characteristic analysis supported the predictive abilities of the four renal biomarkers in discriminating between low versus high metal quartiles. The interaction between heavy metals and oxidative stress contributed to the high excretions of renal biomarkers, but the mechanism remains unclear. These findings add to the limited evidence that low exposure to heavy metals in the general population is associated with alterations in renal function that could eventually progress to renal damage if exposure continues and that children are more susceptible due to the immaturity of their body organs.
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Affiliation(s)
- Iman Al-Saleh
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia.
| | - Reem Al-Rouqi
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Rola Elkhatib
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Mai Abduljabbar
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
| | - Tahreer Al-Rajudi
- Environmental Health Program, Research Centre, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh 11211, Saudi Arabia
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11
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Stajnko A, Falnoga I, Tratnik JS, Mazej D, Jagodic M, Krsnik M, Kobal AB, Prezelj M, Kononenko L, Horvat M. Low cadmium exposure in males and lactating females-estimation of biomarkers. ENVIRONMENTAL RESEARCH 2017; 152:109-119. [PMID: 27770711 DOI: 10.1016/j.envres.2016.09.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/31/2016] [Accepted: 09/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Urine cadmium (Cd) and renal function biomarkers, mostly analysed in urine spot samples, are well established biomarkers of occupational exposure. Their use and associations at low environmental level are common, but have recently been questioned, particularly in terms of physiological variability and normalisation bias in the case of urine spot samples. AIM To determine the appropriateness of spot urine and/or blood Cd exposure biomarkers and their relationships with renal function biomarkers at low levels of exposure. To this end, we used data from Slovenian human biomonitoring program involving 1081 Slovenians (548 males, mean age 31 years; 533 lactating females, mean age 29 years; 2007-2015) who have not been exposed to Cd occupationally. RESULTS Geometric means (GMs) of Cd in blood and spot urine samples were 0.27ng/mL (0.28 for males and 0.33 for females) and 0.19ng/mL (0.21 for males and 0.17 for females), respectively. Differing results were obtained when contrasting normalisation by urine creatinine with specific gravity. GMs of urine albumin (Alb), alpha-1-microglobulin (A1M), N-acetyl-beta-glucosaminidase (NAG), and immunoglobulin G (IgG) were far below their upper reference limits. Statistical analysis of unnormalised or normalised urine data often yielded inconsistent and conflicting results (or trends), so association analyses with unnormalised data were taken as more valid. Relatively weak positive associations were observed between urine Cd (ng/mL) and blood Cd (β=0.11, p=0.002 for males and β=0.33, p<0.001 for females) and for females between urine NAG and blood Cd (β=0.14, p=0.04). No associations were found between other renal function biomarkers and blood Cd. Associations between Cd and renal function biomarkers in urine were stronger (p<0.05, β=0.11-0.63). Mostly, all of the associations stayed significant but weakened after normalisation for diuresis. In the case of A1M, its associations with Cd were influenced by current smoking and blood Pb in males and by pre-pregnancy smoking and blood Se in females (β up to 0.34, p<0.001). Statistical analysis of unnormalised or normalised urine data often yielded inconsistent and conflicting results (or trends), so association analyses data with unnormalised were taken as more valid. CONCLUSIONS The observed uncertainties introduced by urine normalisation, particularly by creatinine, confirm blood Cd as a superior low-Cd exposure biomarker versus urine Cd in cases when 24h urine is unattainable. Evidence that A1M can be positively related to Cd, smoking (current or pre-pregnancy), Pb, and Se status, points to the versatile biological functions of A1M.
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Affiliation(s)
- Anja Stajnko
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova 39, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova 39, Ljubljana, Slovenia
| | - Ingrid Falnoga
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova 39, Ljubljana, Slovenia.
| | - Janja Snoj Tratnik
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova 39, Ljubljana, Slovenia
| | - Darja Mazej
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova 39, Ljubljana, Slovenia
| | - Marta Jagodic
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova 39, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova 39, Ljubljana, Slovenia
| | - Mladen Krsnik
- Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Njegoševa 4, Ljubljana, Slovenia
| | - Alfred B Kobal
- Department of Occupational Health, Idrija Mercury Mine, Arkova 43, Idrija, Slovenia
| | - Marija Prezelj
- Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Njegoševa 4, Ljubljana, Slovenia
| | - Lijana Kononenko
- Chemical Office of RS, Ministry of Health of RS, Ajdovščina 4, Ljubljana, Slovenia
| | - Milena Horvat
- Department of Environmental Sciences, Jožef Stefan Institute, Jamova 39, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova 39, Ljubljana, Slovenia
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Liu C, Li Y, Zhu C, Dong Z, Zhang K, Zhao Y, Xu Y. Benchmark dose for cadmium exposure and elevated N-acetyl-β-D-glucosaminidase: a meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:20528-20538. [PMID: 27464656 DOI: 10.1007/s11356-016-7214-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/08/2016] [Indexed: 06/06/2023]
Abstract
Cadmium (Cd) is a well-known nephrotoxic contaminant, and N-acetyl-β-D-glucosaminidase (NAG) is considered to be an early and sensitive marker of tubular dysfunction. The link between Cd exposure and NAG level enables us to derive the benchmark dose (BMD) of Cd. Although several reports have already documented urinary Cd (UCd)-NAG relationships and BMD estimations, high heterogeneities arise due to the sub-populations (age, gender, and ethnicity) and BMD methodologies being employed. To clarify the influences that these variables exert, firstly, a random effect meta-analysis was performed in this study to correlate the UCd and NAG based on 92 datasets collected from 30 publications. Later, this established correlation (Ln(NAG) = 0.51 × Ln(UCd) + 0.83) was applied to derive the UCd BMD5 of 1.76 μg/g creatinine and 95 % lower confidence limit of BMD5 (BMDL5) of 1.67 μg/g creatinine. While the regressions for different age groups and genders differed slightly, it is age and not gender that significantly affects BMD estimations. Ethnic differences may require further investigation given that limited data is currently available. Based on a comprehensive and systematic literature review, this study is a new attempt to quantify the UCd-NAG link and estimate BMD.
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Affiliation(s)
- CuiXia Liu
- School of Environmental Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, Hubei, China
- Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), Mawson Lakes, 5095, SA, Australia
| | - YuBiao Li
- School of Resources and Environmental Engineering, Wuhan University of Technology, Wuhan, 430070, Hubei, China
| | - ChunShui Zhu
- Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), Mawson Lakes, 5095, SA, Australia
- School of Chemical Engineering, Huaihai Institute of Technology, LianYungang, 222005, JiangSu, China
| | - ZhaoMin Dong
- Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), Mawson Lakes, 5095, SA, Australia.
- Global Centre for Environmental Remediation, the Faculty of Science and Information Technology, University of Newcastle, University Drive, Newcastle, NSW, 2308, Australia.
- ATC Building, Global Center for Environmental Remediation, the Faculty of Science and Information Technology, University of Newcastle, Newcastle, 2308, NSW, Australia.
| | - Kun Zhang
- School of Life Sciences, University of Applied Sciences and Arts Northwestern Switzerland, Gründenstrasse 40, CH-4132, Muttenz, Switzerland
| | - YanBin Zhao
- School of Life Sciences, University of Applied Sciences and Arts Northwestern Switzerland, Gründenstrasse 40, CH-4132, Muttenz, Switzerland
| | - YiLu Xu
- Global Centre for Environmental Remediation, the Faculty of Science and Information Technology, University of Newcastle, University Drive, Newcastle, NSW, 2308, Australia
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Wang X, Wang Y, Feng L, Tong Y, Chen Z, Ying S, Chen T, Li T, Xia H, Jiang Z, Shang Q, Lou X, Lou J. Application of the Benchmark Dose (BMD) Method to Identify Thresholds of Cadmium-Induced Renal Effects in Non-Polluted Areas in China. PLoS One 2016; 11:e0161240. [PMID: 27537182 PMCID: PMC4990304 DOI: 10.1371/journal.pone.0161240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 08/02/2016] [Indexed: 11/18/2022] Open
Abstract
The benchmark dose (BMD) method has been increasingly used to assess the health risks of cadmium (Cd) in epidemiological studies. The aim of our study was to estimate the threshold levels of urinary Cd (UCd) using the BMD method in a general population of Jiangshan City, Zhejiang Province of China. In our study, a total of 934 people (469 men, 465 women) were recruited and morning urine samples were collected from all the participants. Levels of Cd, creatinine, and renal dysfunction indicators such as retinol binding protein (RBP), β2-microglobulin (β2-MG), and N-acetyl-b-glucosaminidase (NAG) in urine were detected for analysis of BMD and BMD low (BMDL) of UCd. RBP, β2-MG, and NAG in urine all correlated significantly (P < 0.001) with UCd except of age (P = 0.767). When the benchmark response (BMR) was 5%, the BMD/BMDL of UCd for RBP, β2-MG, and NAG was 1.69/ 0.89, 1.24/0.62, 0.85/0.49 μg/g Cr in men and 1.70/0.76, 1.35/0.64, 1.36/0.65 μg/g Cr in women, respectively. If the BMR was set at 10%, the BMD/BMDL of UCd for RBP, β2-MG, and NAG was 2.44/1.59, 2.09/1.30, 1.80/1.04 μg/g Cr in men and 2.43/1.53, 2.10/1.34, 2.31/1.37 μg/g Cr in women, respectively. Our results provided evidence for Cd-induced tubular effects in cadmium non-polluted areas in China. Both β2-MG and NAG were more sensitive than RBP in response to Cd exposure. But β2-MG was the most sensitive indicator in women, and NAG was the most sensitive one in men.
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Affiliation(s)
- Xiaofeng Wang
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, P.R. China
| | - Yu Wang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Lingfang Feng
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Yan Tong
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Zhijian Chen
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Shibo Ying
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Tianhui Chen
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Tao Li
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Hailing Xia
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Zhaoqiang Jiang
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
| | - Qi Shang
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, P.R. China
| | - Xiaoming Lou
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, P.R. China
- * E-mail: (JL); (XL)
| | - Jianlin Lou
- Institute of Occupational Diseases, Zhejiang Academy of Medical Sciences, Hangzhou 310013, Zhejiang, P.R. China
- * E-mail: (JL); (XL)
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Weaver VM, Kotchmar DJ, Fadrowski JJ, Silbergeld EK. Challenges for environmental epidemiology research: are biomarker concentrations altered by kidney function or urine concentration adjustment? JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:1-8. [PMID: 25736163 DOI: 10.1038/jes.2015.8] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 01/07/2015] [Accepted: 01/07/2015] [Indexed: 05/28/2023]
Abstract
Biomonitoring has become a standard approach for exposure assessment in occupational and environmental epidemiology. The use of biological effect markers to identify early adverse changes in target organs has also become widely adopted. However, the potential for kidney function to affect biomarker levels in the body and the optimal approach to adjustment of biomarker concentrations in spot urine samples for hydration status are two important but underappreciated challenges associated with biomarker use. Several unexpected findings, such as positive associations between urine nephrotoxicant levels and estimated glomerular filtration rate (eGFR), have been reported recently in research using biomarkers. These and other findings, discussed herein, suggest an impact of kidney glomerular filtration or tubule processing on biomarker levels. This is more commonly raised in the context of decreased kidney filtration, traditionally referred to as reverse causality; however, recent data suggest that populations with normal kidney filtration may be affected as well. Misclassification bias would result if biomarkers reflect kidney function as well as either exposures or early biological effect outcomes. Furthermore, urine biomarker associations with eGFR that differ markedly by approach used to adjust for urine concentration have been reported. Associations between urine measures commonly used for this adjustment, such as urine creatinine, and specific research outcomes could alter observed biomarker associations with outcomes. Research recommendations to address the potential impact of kidney function and hydration status adjustment on biomarkers are provided, including a range of approaches to study design, exposure and outcome assessment, and adjustment for urine concentration.
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Affiliation(s)
- Virginia M Weaver
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Dennis J Kotchmar
- National Center for Environmental Assessment, United States Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Jeffrey J Fadrowski
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ellen K Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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15
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Woo HD, Chiu WA, Jo S, Kim J. Benchmark Dose for Urinary Cadmium based on a Marker of Renal Dysfunction: A Meta-Analysis. PLoS One 2015; 10:e0126680. [PMID: 25970611 PMCID: PMC4430293 DOI: 10.1371/journal.pone.0126680] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 04/06/2015] [Indexed: 01/26/2023] Open
Abstract
Background Low doses of cadmium can cause adverse health effects. Benchmark dose (BMD) and the one-sided 95% lower confidence limit of BMD (BMDL) to derive points of departure for urinary cadmium exposure have been estimated in several previous studies, but the methods to derive BMD and the estimated BMDs differ. Objectives We aimed to find the associated factors that affect BMD calculation in the general population, and to estimate the summary BMD for urinary cadmium using reported BMDs. Methods A meta-regression was performed and the pooled BMD/BMDL was estimated using studies reporting a BMD and BMDL, weighted by sample size, that were calculated from individual data based on markers of renal dysfunction. Results BMDs were highly heterogeneous across studies. Meta-regression analysis showed that a significant predictor of BMD was the cut-off point which denotes an abnormal level. Using the 95th percentile as a cut off, BMD5/BMDL5 estimates for 5% benchmark responses (BMR) of β2-microglobulinuria (β2-MG) estimated was 6.18/4.88 μg/g creatinine in conventional quantal analysis and 3.56/3.13 μg/g creatinine in the hybrid approach, and BMD5/BMDL5 estimates for 5% BMR of N-acetyl-β-d-glucosaminidase (NAG) was 10.31/7.61 μg/g creatinine in quantal analysis and 3.21/2.24 g/g creatinine in the hybrid approach. However, the meta-regression showed that BMD and BMDL were significantly associated with the cut-off point, but BMD calculation method did not significantly affect the results. The urinary cadmium BMDL5 of β2-MG was 1.9 μg/g creatinine in the lowest cut-off point group. Conclusion The BMD was significantly associated with the cut-off point defining the abnormal level of renal dysfunction markers.
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Affiliation(s)
- Hae Dong Woo
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Korea
| | - Weihsueh A. Chiu
- National Center for Environmental Assessment, U.S. Environmental Protection Agency (EPA), Washington, DC, United States of America
| | - Seongil Jo
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Korea
| | - Jeongseon Kim
- Molecular Epidemiology Branch, National Cancer Center, Goyang-si, Korea
- * E-mail:
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16
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Hu J, Li M, Han TX, Chen JW, Ye LX, Wang Q, Zhou YK. Benchmark dose estimation for cadmium-induced renal tubular damage among environmental cadmium-exposed women aged 35-54 years in two counties of China. PLoS One 2014; 9:e115794. [PMID: 25536107 PMCID: PMC4275258 DOI: 10.1371/journal.pone.0115794] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 11/26/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A number of factors, including gender, age, smoking habits, and occupational exposure, affect the levels of urinary cadmium. Few studies have considered these influences when calculating the benchmark dose (BMD) of cadmium. In the present study, we aimed to calculate BMDs and their 95% lower confidence bounds (BMDLs) for cadmium-induced renal tubular effects in an age-specific population in south-central China. METHODS In this study, urinary cadmium, β2-microglobulin, and N-acetyl-β-D-glucosaminidase levels were measured in morning urine samples from 490 randomly selected non-smoking women aged 35-54 years. Participants were selected using stratified cluster sampling in two counties (counties A and B) in China. Multiple regression and logistic regression analyses were used to investigate the dose-response relationship between urinary cadmium levels and tubular effects. BMDs/BMDLs corresponding to an additional risk (benchmark response) of 5% and 10% were calculated with assumed cut-off values of the 84th and 90th percentile of urinary β2-microglobulin and N-acetyl-β-D-glucosaminidase levels of the controls. RESULTS Urinary levels of β2-microglobulin and N-acetyl-β-D-glucosaminidase increased significantly with increasing levels of urinary cadmium. Age was not associated with urinary cadmium levels, possibly because of the narrow age range included in this study. Based on urinary β2-microglobulin and N-acetyl-β-D-glucosaminidase, BMDs and BMDLs of urinary cadmium ranged from 2.08 to 3.80 (1.41-2.18) µg/g cr for subjects in county A and from 0.99 to 3.34 (0.74-1.91) µg/g cr for those in county B. The predetermined benchmark response of 0.05 and the 90th percentiles of urinary β2-microglobulin and N-acetyl-β-D-glucosaminidase levels of the subjects not exposed to cadmium (i.e., the control group) served as cut-off values. CONCLUSIONS The obtained BMDs of urinary cadmium were similar to the reference point of 1 µg/g cr, as suggested by the European Food Safety Authority, indicating that cadmium exposure must be reduced to protect human health.
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Affiliation(s)
- Jia Hu
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Mei Li
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Tian-xu Han
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jian-wei Chen
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lin-xiang Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail: (QW); (YZ)
| | - Yi-kai Zhou
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail: (QW); (YZ)
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17
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Blood lead, cadmium and mercury among children from urban, industrial and rural areas of Fez Boulemane Region (Morocco): relevant factors and early renal effects. Int J Occup Med Environ Health 2014; 27:641-59. [PMID: 25060400 DOI: 10.2478/s13382-014-0275-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 03/31/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To describe blood lead (Pb-B), cadmium (Cd-B) and mercury (Hg-B) levels in children living in urban, industrial and rural areas in Fez city (north of Morocco) and to identify the determinants and some renal effects of exposure. MATERIAL AND METHODS The study was conducted from June 2007 to January 2008 in 209 school children (113 girls, 96 boys), aged 6-12 years, from urban, industrial and rural areas in Fez city. Interview and questionnaires data were obtained. Blood and urinary samples were analyzed. RESULTS The mean of blood lead levels (Pb-B) in our population was 55.53 μg/l (range: 7.5-231.1 μg/l). Children from the urban area had higher blood lead levels (BLLs) mean (82.36 μg/l) than children from industrial and rural areas (48.23 and 35.99 μg/l, respectively); with no significant difference between boys and girls. BLLs were associated with traffic intensity, passive smoking and infancy in the urban area. The mean of blood cadmium levels (BCLs) was 0.22 μg/l (range: 0.06-0.68 μg/l), with no difference between various areas. Rural boys had higher BCLs mean than rural girls, but no gender influence was noticed in the other areas. BCLs were associated with the number of cigarettes smoked at children's homes. The blood mercury levels (BMLs) mean was 0.49 μg/l (range: 0.01-5.31 μg/l). The BMLs mean was higher in urban and industrial areas than in the rural area with no gender-related difference. BMLs were associated with amalgam fillings and infancy in the urban area. About 8% of the children had BLLs ≥ 100 μg/l particularly in the urban area, microalbuminuria and a decrease in height were noticed in girls from the inner city of Fez and that can be related to high BLLs (89.45 μg/l). CONCLUSIONS There is a need to control and regulate potential sources of contamination by these trace elements in children; particularly for lead.
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Hambach R, Lison D, D'Haese PC, Weyler J, De Graef E, De Schryver A, Lamberts LV, van Sprundel M. Co-exposure to lead increases the renal response to low levels of cadmium in metallurgy workers. Toxicol Lett 2013; 222:233-8. [PMID: 23806787 DOI: 10.1016/j.toxlet.2013.06.218] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Research on the effect of co-exposure to Cd and Pb on the kidney is scarce. The objective of the present study was to assess the effect of co-exposure to these metals on biomarkers of early renal effect. METHODS Cd in blood (Cd-B), Cd in urine (Cd-U), Pb in blood (Pb-B) and urinary renal biomarkers, i.e., microalbumin (μ-Alb), beta-2-microglobulin (β₂-MG), retinol binding protein (RBP), N-acetyl-β-d-glucosaminidase (NAG), intestinal alkaline phosphatase (IAP) were measured in 122 metallurgic refinery workers examined in a cross-sectional survey. RESULTS AND CONCLUSIONS The median Cd-B, Cd-U, Pb-B were: 0.8 μg/l (IQR = 0.5, 1.2), 0.5 μg/g creatinine (IQR = 0.3, 0.8) and 158.5 μg/l (IQR = 111.0, 219.3), respectively. The impact of Cd-B on the urinary excretion of NAG and IAP was only evident among workers with Pb-B concentrations ≥ 75th percentile. The association between Cd-U and the renal markers NAG and RBP was also evidenced when Pb-B ≥ 75th percentile. No statistically significant interaction terms were observed for the associations between Cd-B or Cd-U and the other renal markers under study (i.e., μ-Alb and β2-MG). Our findings indicate that Pb increases the impact of Cd exposure on early renal biomarkers.
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Affiliation(s)
- R Hambach
- Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
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19
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Liang Y, Lei L, Nilsson J, Li H, Nordberg M, Bernard A, Nordberg GF, Bergdahl IA, Jin T. Renal function after reduction in cadmium exposure: an 8-year follow-up of residents in cadmium-polluted areas. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:223-8. [PMID: 22027495 PMCID: PMC3279438 DOI: 10.1289/ehp.1103699] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 10/25/2011] [Indexed: 05/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Long-term exposure to cadmium (Cd) causes renal dysfunction, but the change in renal function with exposure is unknown. We assessed the evolution of Cd-induced renal effects after a reduction in dietary exposure to Cd in rice. METHODS Four hundred twelve residents in previously Cd-polluted and nonpolluted areas were examined twice, in 1998 and in 2006. Changes in blood Cd, urinary Cd, and kidney function [N-acetyl-β-d-glucosaminidase (NAG), β2-microglobulin, and albumin in urine] were measured. RESULTS In the most polluted area, mean blood Cd was 8.9 μg/L and 3.3 μg/L in 1998 and in 2006, respectively, and urinary Cd was 11.6 and 9.0 μg/g creatinine. Urinary albumin in 1998 increased with urinary Cd, but no such exposure-response relation appeared for 2006 albumin versus urinary Cd 1998, indicating recovery. Other biomarkers of kidney function were also elevated in 1998. Partial recovery was observed for NAG among women and was suggested for β2-microglobulin among young individuals. The probability of having β2-microglobulin levels above the 95th percentile in 2006 was high in those with elevated β2-microglobulin in 1998 [odds ratio (OR) = 24.8; 95% confidence interval (CI): 11.2, 55.3] compared with albumin (OR = 3.0; 95% CI: 1.2, 7.5) and NAG (OR = 2.6; 95% CI: 1.6, 4.4). CONCLUSIONS Results suggest that a Cd-mediated increase in urinary albumin excretion is reversible upon substantial reduction of exposure. For markers of tubular effects, we observed a tendency toward improvement but not complete recovery. Data from repeated observations suggest that β2-microglobulin may be more informative than NAG as an indicator for an individual's future tubular function.
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Affiliation(s)
- Yihuai Liang
- Department of Occupational Health and Toxicology (Key Laboratory of Public Health Safety, Ministry of Education of China), School of Public Health, Fudan University, Shanghai, People's Republic of China
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Weaver VM, Kim NS, Jaar BG, Schwartz BS, Parsons PJ, Steuerwald AJ, Todd AC, Simon D, Lee BK. Associations of low-level urine cadmium with kidney function in lead workers. Occup Environ Med 2010; 68:250-6. [PMID: 20974743 DOI: 10.1136/oem.2010.056077] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Low-level cadmium exposure, resulting in, for example, urinary cadmium <2.0 μg/g creatinine, is widespread; recent data suggest nephrotoxicity even at these low levels. Few studies have examined the impact of low-level cadmium exposure in workers who are occupationally exposed to other nephrotoxicants such as lead. METHODS We evaluated associations of urine cadmium, a measure of cumulative dose, with four glomerular filtration measures and N-acetyl-β-D-glucosaminidase (NAG) in lead workers. Recent and cumulative lead doses were assessed via blood and tibia lead, respectively. RESULTS In 712 lead workers, mean (SD) blood and tibia lead values, urine cadmium values and estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation were 23.1 (14.1) μg/dl, 26.6 (28.9) μg Pb/g bone mineral, 1.15 (0.66) μg/g creatinine and 97.4 (19.2) ml/min/1.73 m(2), respectively. After adjustment for age, sex, body mass index, urine creatinine, smoking, alcohol, education, annual income, diastolic blood pressure, current or former lead worker job status, new or returning study participant, and blood and tibia lead, higher ln-urine cadmium was associated with higher calculated creatinine clearance, eGFR (β = 8.7 ml/min/1.73 m(2); 95% CI 5.4 to 12.1) and ln-NAG but lower serum creatinine. CONCLUSIONS Potential explanations for these results include a normal physiological response in which urine cadmium levels reflect renal filtration, the impact of adjustment for urine dilution with creatinine in models of kidney outcomes, and cadmium-related hyperfiltration.
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Affiliation(s)
- Virginia M Weaver
- Division of Occupational and Environmental Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Rm 7041, Baltimore, MD 21205, USA.
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Trzcinka-Ochocka M, Jakubowski M, Szymczak W, Janasik B, Brodzka R. The effects of low environmental cadmium exposure on bone density. ENVIRONMENTAL RESEARCH 2010; 110:286-293. [PMID: 20106473 DOI: 10.1016/j.envres.2009.12.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 11/27/2009] [Accepted: 12/09/2009] [Indexed: 05/28/2023]
Abstract
Recent epidemiological data indicate that low environmental exposure to cadmium, as shown by cadmium body burden (Cd-U), is associated with renal dysfunction as well as an increased risk of cadmium-induced bone disorders. The present study was designed to assess the effects of low environmental cadmium exposure, at the level sufficient to induce kidney damage, on bone metabolism and mineral density (BMD). The project was conducted in the area contaminated with cadmium, nearby a zinc smelter located in the region of Poland where heavy industry prevails. The study population comprised 170 women (mean age=39.7; 18-70 years) and 100 men (mean age=31.9; 18-76 years). Urinary and blood cadmium and the markers of renal tubular dysfunction (beta(2)M-U RBP, NAG), glomerular dysfunction (Alb-U and beta(2)M-S) and bone metabolism markers (BAP-S, CTX-S) as well as forearm BMD, were measured. The results of this study based on simple dose-effect analysis showed the relationship between increasing cadmium concentrations and an increased excretion of renal dysfunction markers and decreasing bone density. However, the results of the multivariate analysis did not indicate the association between exposure to cadmium and decrease in bone density. They showed that the most important factors that have impact on bone density are body weight and age in the female subjects and body weight and calcium excretion in males. Our investigation revealed that the excretion of low molecular weight proteins occurred at a lower level of cadmium exposure than the possible loss of bone mass. It seems that renal tubular markers are the most sensitive and significant indicators of early health effects of cadmium intoxication in the general population. The correlation of urinary cadmium concentration with markers of kidney dysfunction was observed in the absence of significant correlations with bone effects. Our findings did not indicate any effects of environmental cadmium exposure on bone density.
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Affiliation(s)
- M Trzcinka-Ochocka
- Department of Chemical Hazards, Laboratory of Biomonitoring, Nofer Institute of Occupational Medicine, Lodz, Poland.
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Johri N, Jacquillet G, Unwin R. Heavy metal poisoning: the effects of cadmium on the kidney. Biometals 2010; 23:783-92. [PMID: 20354761 DOI: 10.1007/s10534-010-9328-y] [Citation(s) in RCA: 379] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 03/16/2010] [Indexed: 01/18/2023]
Abstract
The heavy metal cadmium (Cd) is known to be a widespread environmental contaminant and a potential toxin that may adversely affect human health. Exposure is largely via the respiratory or gastrointestinal tracts; important non-industrial sources of exposure are cigarette smoke and food (from contaminated soil and water). The kidney is the main organ affected by chronic Cd exposure and toxicity. Cd accumulates in the kidney as a result of its preferential uptake by receptor-mediated endocytosis of freely filtered and metallothionein bound Cd (Cd-MT) in the renal proximal tubule. Internalised Cd-MT is degraded in endosomes and lysosomes, releasing free Cd(2+) into the cytosol, where it can generate reactive oxygen species (ROS) and activate cell death pathways. An early and sensitive manifestation of chronic Cd renal toxicity, which can be useful in individual and population screening, is impaired reabsorption of low molecular weight proteins (LMWP) (also a receptor-mediated process in the proximal tubule) such as retinol binding protein (RBP). This so-called 'tubular proteinuria' is a good index of proximal tubular damage, but it is not usually detected by routine clinical dipstick testing for proteinuria. Continued and heavy Cd exposure can progress to the clinical renal Fanconi syndrome, and ultimately to renal failure. Environmental Cd exposure may be a significant contributory factor to the development of chronic kidney disease, especially in the presence of other co-morbidities such as diabetes or hypertension; therefore, the sources and environmental impact of Cd, and efforts to limit Cd exposure, justify more attention.
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Affiliation(s)
- Nikhil Johri
- Centre for Nephrology, University College London Medical School, Royal Free Campus, Rowland Hill Street, London, UK.
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Abstract
Histopathology is the gold standard for defining renal injury, but it is invasive, time-consuming and expensive, plus it is seldom used in subjects with mild renal injury. Using biomarkers linked to distinct, defined cell types and tissues provides a direct link to histopathology without its drawbacks, plus it provides increased sensitivity, and specificity. The nephron consists of several sections, each with its own specific biomarkers; therefore, by the use of a battery of tests injuries can be localised to distinct areas of it. Using urine samples simplifies repeated sampling from the same subject or animal leading to better defined toxicokinetics and disease monitoring.Serum creatinine is the most widely used renal biomarker in spite of its known shortcomings. Cell-specific biomarkers are more specific and sensitive and have been known for over 40 years, but they are still underused in renal medicine and research. In particular, while many studies have shown cell-specific biomarkers to be valuable in diagnosis, there are few studies where they have been used to guide therapy or linked to quantitative changes in the kidney. Furthermore, the great majority of cell-specific biomarkers are from the proximal tubule, which may have hindered research into the study of conditions where the distal tubules are affected. Recently, the range of biomarkers and their applications has been expanded by the introduction of indicators of cellular regeneration.This chapter will discuss how using biomarkers with a known cellular origin, renal effects may be found earlier and at lower levels of injury. Their use in both renal medicine and drug research will be presented. Knowledge of these existing markers lays the foundation for evaluation, comparison, and characterisation of new markers that will be identified in the future.
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Kobayashi E, Suwazono Y, Dochi M, Honda R, Kido T. Association of lifetime cadmium intake or drinking Jinzu River water with the occurrence of renal tubular dysfunction. ENVIRONMENTAL TOXICOLOGY 2009; 24:421-428. [PMID: 18937307 DOI: 10.1002/tox.20444] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study was performed to clarify whether lifetime cadmium (Cd) intake (LCd) calculated from consumption of Cd-polluted rice and other foods, or drinking and/or cooking with Jinzu River water is associated with the occurrence of renal tubular dysfunction and to estimate the threshold level of LCd using a benchmark dose procedure. From participants in the 1967 and 1968 health examinations, the 2607 subjects (1430 men and 1177 women) who were aged 50 years or more, and who had either resided in the current hamlet since birth or moved there from a nonpolluted area and resided for a total of 30 years or longer were chosen as the target population. Based on a multiple logistic regression analysis performed for abnormal urinary findings (proteinuria, glucosuria, or proteinuria with glucosuria) using LCd as the explanatory variable with or without consideration of use of the river water for drinking and/or cooking, it was inferred that both factors of LCd and use of the river water influenced the occurrence of renal tubular dysfunction, with LCd appearing to exert a greater impact compared to drinking/cooking with the river water. Moreover, the threshold values of LCd for proteinuria with glucosuria were estimated to be 2.91 g in men and 1.79 g in women, without adjustment for use of the river water. After adjustment for its use, the values of proteinuria were calculated to be 0.93 g in women. When assuming user/nonuser status of the river water, the threshold level was calculated as 0.75/0.93 g in women. The difference of 0.18 g was interpreted as representing the influence of drinking/cooking with the river water.
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Affiliation(s)
- Etsuko Kobayashi
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuohku, Chiba 260-8670, Japan.
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Kobayashi E, Suwazono Y, Dochi M, Honda R, Nishijo M, Kido T, Nakagawa H. Estimation of benchmark doses as threshold levels of urinary cadmium, based on excretion of β2-microglobulin in cadmium-polluted and non-polluted regions in Japan. Toxicol Lett 2008; 179:108-12. [DOI: 10.1016/j.toxlet.2008.04.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 04/24/2008] [Accepted: 04/24/2008] [Indexed: 11/24/2022]
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Kalahasthi RB, Rajmohan HR, Rajan BK, Kumar M K. Urinary N-acetyl-beta -D-glucosaminidase and its isoenzymes A & B in workers exposed to cadmium at cadmium plating. J Occup Med Toxicol 2007; 2:5. [PMID: 17659077 PMCID: PMC1971251 DOI: 10.1186/1745-6673-2-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Accepted: 07/20/2007] [Indexed: 11/18/2022] Open
Abstract
Objective The present study was carried out to determine the effect of cadmium exposure on Urinary N-acetyl-beta -D-glucosaminidase and its isoenzymes A and B in workers exposed at cadmium plating. Methods 50 subjects using cadmium during cadmium plating formed the study group. An equal number of age-sex matched subjects working in administrative section formed the control group. Urinary cadmium levels were determined by using a flameless atomic absorption spectrophotometer. Urinary N-acetyl-beta -D-glucosaminidase and its isoenzymes A and B were determined by using spectrophotmetric method. Results A significant increase of urinary total N-acetyl-beta -D-glucosaminidase and its isoenzymes A and B profiles were noted in study as compared to controls. The levels of urinary N-acetyl-beta -D-glucosaminidase and its isoenzymes A and B profiles were positively and significantly correlated with cadmium levels in urine. Multiple regression analysis was used to assess the effect of urinary cadmium or life style confounding factors (age, BMI, smoking and alcohol consumption) on urinary N-acetyl-beta -D-glucosaminidase and its isoenzymes A and B. The analysis showed that the study subjects who had urine cadmium levels greater than 5 μg/g of creatinine, work duration >15 years, smoking and body mass index variables were significantly associated with urinary total N-acetyl-beta -D-glucosaminidase but not on isoenzymes A&B. Conclusion The results presented in this study shows that the increased levels of urinary N-acetyl-beta -D-glucosaminidase observed in cadmium-exposed workers could be used as biomarkers for suggesting preventive measure.
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Affiliation(s)
- Ravi Babu Kalahasthi
- Regional Occupational Health Centre (Southern), Indian Council of Medical Research, Bangalore Medical College Campus, Bangalore-560 002, India
| | - HR Rajmohan
- Regional Occupational Health Centre (Southern), Indian Council of Medical Research, Bangalore Medical College Campus, Bangalore-560 002, India
| | - BK Rajan
- Regional Occupational Health Centre (Southern), Indian Council of Medical Research, Bangalore Medical College Campus, Bangalore-560 002, India
| | - Karuna Kumar M
- Department of studies in Biochemistry, University of Mysore, Mysore, India
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Morales AI, Vicente-Sánchez C, Sandoval JMS, Egido J, Mayoral P, Arévalo MA, Fernández-Tagarro M, López-Novoa JM, Pérez-Barriocanal F. Protective effect of quercetin on experimental chronic cadmium nephrotoxicity in rats is based on its antioxidant properties. Food Chem Toxicol 2006; 44:2092-100. [PMID: 16962696 DOI: 10.1016/j.fct.2006.07.012] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Revised: 07/06/2006] [Accepted: 07/10/2006] [Indexed: 11/29/2022]
Abstract
Oxidative stress can play a key role in Cd-induced dysfunctions. Quercetin is a potent oxygen free radicals scavenger and a metal chelator. Our aim was to study the effect of quercetin on Cd-induced kidney damage and oxidative stress as well as its mechanism of action. Wistar rats were distributed in four experimental groups: control rats; Cd; quercetin and Cd+quercetin. Renal toxicity was evaluated by measuring urinary excretion of proteins, albumin, glucose and enzymes markers of tubular necrosis, as well as plasma concentration of creatinine. Plasma TBARS concentration and activity of antioxidant enzymes in kidney were also measured. Renal cell damage was assessed by electron microscopy. Animals that received both Cd and quercetin showed a better renal function than those receiving Cd alone. Cd-induced tubular lesions were markedly reduced in rats that also received quercetin. Cd-induced increase in plasma TBARS was prevented by the administration of quercetin. Total plasma antioxidants and renal superoxide dismutase and glutathione-reductase activities were higher in the group that received Cd and quercetin than in rats that received Cd alone. Quercetin administration does not modify the renal content or the urinary excretion of Cd. In conclusion, quercetin treatment prevents renal tubular damage and increased oxidative stress induced by chronic Cd administration, most probably throughout its antioxidant properties.
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Affiliation(s)
- A I Morales
- Instituto Reina Sofía de Investigación Nefrológica, Departamento de Fisiología y Farmacología, Edificio Departamental, Campus Miguel de Unamuno, Universidad de Salamanca, 37007 Salamanca, Spain
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Ekong EB, Jaar BG, Weaver VM. Lead-related nephrotoxicity: a review of the epidemiologic evidence. Kidney Int 2006; 70:2074-84. [PMID: 17063179 DOI: 10.1038/sj.ki.5001809] [Citation(s) in RCA: 209] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Chronic kidney disease (CKD) represents a major global public health concern. Efforts to prevent and/or slow progression of CKD are essential. Lead nephropathy, characterized by chronic tubulointerstitial nephritis, is a well-known risk of chronic, high-level lead exposure. However, in recent years, lead exposure has declined sharply, particularly in developed countries. We reviewed epidemiologic research in general, occupational, and patient populations to assess whether lead, at current exposure levels, still contributes to nephrotoxicity. Other pertinent topics, such as risk in children, genetic susceptibility, and co-exposure to cadmium, are also considered. The data reviewed indicate that lead contributes to nephrotoxicity, even at blood lead levels below 5 microg/dl. This is particularly true in susceptible populations, such as those with hypertension (HTN), diabetes, and/or CKD. Low socioeconomic status is a risk factor for both lead exposure and diseases that increase susceptibility. Future public health risk for lead-related nephrotoxicity may be most significant in those rapidly developing countries where risk factors for CKD, including obesity and secondary HTN and diabetes mellitus, are increasing more rapidly than lead exposure is declining. Global efforts to reduce lead exposure remain important. Research is also needed to determine whether specific therapies, such as chelation, are beneficial in susceptible populations.
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Affiliation(s)
- E B Ekong
- Division of Occupational and Environmental Health, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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Shimizu A, Kobayashi E, Suwazono Y, Uetani M, Oishi M, Inaba T, Kido T, Nogawa K. Estimation of benchmark doses for urinary cadmium based on beta2-microglobulin excretion in cadmium-polluted regions of the Kakehashi River basin, Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2006; 16:329-37. [PMID: 16990174 DOI: 10.1080/09603120600869174] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
A benchmark dose low (BMDL) is used as a replacement for the no observed adverse effect level. The threshold levels of urinary cadmium (Cd) as BMDL were estimated using data from the Kakehashi River basin. The target population (>or=50 years) comprised 3178 and 294 participants inhabiting Cd-polluted and non-polluted areas, respectively. Cut-off values for beta2-MG-uria were defined as the 84 and 95% upper limit values calculated from control subjects, and 1000 microg/l or microg/g cr of beta2-MG. Using these cut-off values, the BMDL at which the excess risk is 0.05 was determined to be 2.9 - 4.0 microg/g cr (males) and 1.5 - 3.6 microg/g cr (females). The present study demonstrated that a BMD approach is useful to estimate the threshold level of urinary Cd in Cd-exposed subjects and people living in general environment without any known Cd-pollution since a BMD approach does not need abnormality rates of urinary findings in the controls.
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Affiliation(s)
- Akane Shimizu
- Department of Occupational and Environmental Medicine, Graduate School of Medicine (A2), Chiba University, Chiba, Japan.
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Morales AI, Vicente-Sánchez C, Jerkic M, Santiago JM, Sánchez-González PD, Pérez-Barriocanal F, López-Novoa JM. Effect of quercetin on metallothionein, nitric oxide synthases and cyclooxygenase-2 expression on experimental chronic cadmium nephrotoxicity in rats. Toxicol Appl Pharmacol 2006; 210:128-35. [PMID: 16226777 DOI: 10.1016/j.taap.2005.09.006] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Revised: 09/06/2005] [Accepted: 09/07/2005] [Indexed: 11/19/2022]
Abstract
Inflammation can play a key role in Cd-induced dysfunctions. Quercetin is a potent oxygen free radical scavenger and a metal chelator. Our aim was to study the effect of quercetin on Cd-induced kidney damage and metallothionein expression. The study was performed in Wistar rats that were administered during 9 weeks with either cadmium (1.2 mg Cd/kg/day, s.c.), quercetin (50 mg/kg/day, i.p.) or cadmium + quercetin. Renal toxicity was evaluated by measuring blood urea nitrogen concentration and urinary excretion of enzymes marker of tubular damage. Endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) renal expression were assessed by Western blot. Renal expression of metallothionein 1 and 2 (MT-1, MT-2) and eNOS mRNA was assessed by Northern blot. Our data demonstrated that Cd-induced renal toxicity was markedly reduced in rats that also received quercetin. MT-1 and MT-2 mRNA levels in kidney were substantially increased during treatment with Cd, being even higher when the animals received Cd and quercetin. Renal eNOS expression was significantly higher in rats receiving Cd and quercetin than in animals receiving Cd alone or in control rats. In the group that received Cd, COX-2 and iNOS expression was markedly higher than in control rats. In the group Cd+quercetin, no changes in COX-2 and iNOS expression were observed compared with the control group. Our results demonstrate that quercetin treatment prevents Cd-induced overexpression of iNOS and COX-2, and increases MT expression. These effects can explain the protection by quercetin of Cd-induced nephrotoxicity.
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Affiliation(s)
- Ana I Morales
- Instituto Reina Sofía de Investigación Nefrológica, Departamento de Fisiología y Farmacología, Edificio Departamental, Campus Miguel de Unamuno, 37007 Salamanca, Spain
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Trzcinka-Ochocka M, Jakubowski M, Razniewska G, Halatek T, Gazewski A. The effects of environmental cadmium exposure on kidney function: the possible influence of age. ENVIRONMENTAL RESEARCH 2004; 95:143-150. [PMID: 15147919 DOI: 10.1016/j.envres.2003.10.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2003] [Revised: 10/21/2003] [Accepted: 10/23/2003] [Indexed: 05/24/2023]
Abstract
The study aimed to assess the possible influence of long-term environmental exposure to cadmium and age at the time of exposure on renal function. The study was a follow-up of the 1991-1994 project concerning 2000 inhabitants of a cadmium-contaminated area in the vicinity of a zinc smelter. Since the smelter was built in the late 1950s but was not operated until 1968, some of the inhabitants were not exposed to cadmium during childhood. For the follow-up, 308 persons who in 1993 presented with Cd-U levels > or = 0.5 microg/L adjusted for specific gravity (1.020) were selected in 2000. The study population included 136 people who were exposed to cadmium in childhood (former children) and 172 adults (unexposed adults) with no such exposure. These two groups were divided into subgroups according to Cd-U levels: < or =1 (group 1), 1-2 (group 2), and > or =2 microg/g creatinine (group 3). Urinary and blood cadmium and the markers of renal tubular dysfunction (beta2 M-U, RBP-U, NAG, NAG-A, NAG-B) and glomerular dysfunction (Alb-U and beta2 M-S) were measured. Persons with a history of occupational exposure to cadmium were excluded from this project. In group 3 of the unexposed adults, concentrations of RPB-U, NAG, NAG-B, and Alb-U were significantly higher than those in group 1. In former children, this could be observed only for RPB-U and Alb-U. Urine concentrations of these markers were higher in all of the subgroups of former children than in the groups of unexposed adults (except for NAG and its two forms). However, these differences were significant only for RBP-U in group 3. The findings indicate that early renal effects in the general population may occur at Cd-U concentrations above 2 microg/g creatinine and at lower levels for NAG-B. Moreover, cadmium exposure in childhood may have a stronger impact the renal function, particularly tubular reabsorption, than the exposure of a mature organism.
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Affiliation(s)
- M Trzcinka-Ochocka
- Nofer Institute of Occupational Medicine, 8 Sw. Teresy Street, P.O. Box 199, 90-950 Lodz, Poland.
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Mandic L, Radmila M, Jelena A, Dubravka D. Change in the iso-enzyme profiles of urinary N-acetyl-beta-D-glucosoaminidase in workers exposed to mercury. Toxicol Ind Health 2003; 18:207-14. [PMID: 14653309 DOI: 10.1191/0748233702th144oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The iso-enzyme profiles of urinary N-acetyl-beta-D-glucosoaminidase (NAG) were studied in the workers from a chloro-alkaline electrolysis plant that had been continuously exposed to elemental mercury. The same workers then had a work break of four months and were later re-exposed to mercury for another five months. The activities of urinary NAG in workers exposed to mercury before and after the work break and in the control group were 2.09 +/- 1.03 IU/L; 0.90 +/- 0.52 IU/L and 1.13 +/- 0.35 IU/L, respectively. The fraction of the dominant A form activity in the total activity, in the workers exposed to mercury after a work break (85.31 +/- 5.32%), was almost equal to the fraction of A in the control group (84.64 +/- 2.75%). The percent fraction of A forms (A and A2) during continuous exposure was almost equal to the sum of the fractions A and A2 in the control group and for exposure after the work break. The fraction of the B form activity in the total activity during exposure to elemental mercury for five months after the work break (7.41 +/- 3.45%) was lower (P < 0.1) than the fraction of the B form in the control group (8.62 +/- 2.19%). The decrease in the fraction of the B form compared with the control group was more significant (P < 0.001) in the case of continuously exposed workers (5.25 +/- 2.55%). Beside the major A and B iso-enzymes of NAG, the A2 form was also isolated, and its fraction in the control group (6.73 +/- 2.15%) was not negligible. For workers exposed to mercury for five months, it was 7.28 +/- 3.52%. It is concluded that mercury affected the increased exocytosis of iso-enzyme A and the inhibition of B iso-enzyme of NAG. The increase in activity of urinary NAG in subjects exposed to mercury was a consequence of the increased excretion of A form. It was established also that the four months work break was sufficient for the repair of renal damages that occurred during continuous exposure, and which were monitored by the activity of NAG. Thus, the effects of mercury seem to have been reversible.
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Affiliation(s)
- Ljuba Mandic
- Faculty of Chemistry, University of Belgrade, P.O. Box 158, Studentski trg 16, 11001 Belgrade, Yugoslavia.
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Moriguchi J, Ezaki T, Tsukahara T, Furuki K, Fukui Y, Okamoto S, Ukai H, Sakurai H, Shimbo S, Ikeda M. Comparative evaluation of four urinary tubular dysfunction markers, with special references to the effects of aging and correction for creatinine concentration. Toxicol Lett 2003; 143:279-90. [PMID: 12849688 DOI: 10.1016/s0378-4274(03)00181-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Comparative evaluation was made on alpha(1)-microglobulin (alpha(1)-MG), beta(2)-microglobulin (beta(2)-MG), retinol binding protein (RBP) and N-acetyl-beta-D-glucosaminidase (NAG), as a marker of renal tubular dysfunction after environmental exposure to cadmium (Cd), with special references to the effects of aging and correction for creatinine concentration. For this purpose, a previously established database of 817 never-smoking Japanese women (at the ages of 20 to 74 years) on hematological [hemoglobin, serum ferritin (FE), etc.] and urinary parameters [alpha(1)-MG, beta(2)-MG, creatinine (cr), and a specific gravity] was revisited. For the present analysis, the database was supplemented by the data on RBP and NAG in urine. The exposure of the women to Cd was such that the geometric mean Cd in urine was 1.3 microg/g cr. Among the four tubular dysfunction markers, NAG showed the closest correlation with Cd, followed by alpha(1)-MG and then beta(2)-MG, and RBP was least so although the correlations were all statistically significant. The observed values of the markers gave the best results, whereas correction for a urine specific gravity gave poorer correlation, and it was the worst when correction for creatinine concentration was applied. Age was the most influential confounding factor. The effect of age appeared to be attributable at least in part to the fact that both creatinine and, to a lesser extent, the specific gravity decreased as a function of age. Iron deficiency anemia of sub-clinical degree as observed among the women did not affect any of the four tubular dysfunction markers. In conclusion, NAG and alpha(1)-MG, rather beta(2)-MG or RBP, are more sensitive to detect Cd-induced tubular dysfunction in mass screening. The use of uncorrected observed values of the markers rather than traditional creatinine-corrected values is recommended when comparison covers people of a wide range of ages.
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Affiliation(s)
- J Moriguchi
- Kyoto Industrial Health Association, 67 Nishinokyo-Kitatsuboicho, Nakagyo-ku, Kyoto, Japan
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Weaver VM, Lee BK, Ahn KD, Lee GS, Todd AC, Stewart WF, Wen J, Simon DJ, Parsons PJ, Schwartz BS. Associations of lead biomarkers with renal function in Korean lead workers. Occup Environ Med 2003; 60:551-62. [PMID: 12883015 PMCID: PMC1740600 DOI: 10.1136/oem.60.8.551] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
AIMS To compare associations of lead biomarkers with renal function in current and former lead workers. METHODS Cross sectional analysis of first year results from a longitudinal study of 803 lead workers and 135 controls in South Korea. Clinical renal function was assessed by blood urea nitrogen (BUN), serum creatinine, and measured and calculated creatinine clearance. Urinary N-acetyl-beta-D-glucosaminidase (NAG) and retinol-binding protein were also measured. RESULTS Mean (SD) tibia lead, blood lead, and DMSA chelatable lead levels in lead workers were 37.2 (40.4) micro g/g bone mineral, 32.0 (15.0) micro g/dl, and 767.8 (862.1) micro g/g creatinine, respectively. Higher lead measures were associated with worse renal function in 16/42 models. When influential outliers were removed, higher lead measures remained associated with worse renal function in nine models. An additional five associations were in the opposite direction. Effect modification by age was observed. In 3/16 models, associations between higher lead measures and worse clinical renal function in participants in the oldest age tertile were significantly different from associations in those in the youngest age tertile which were in the opposite direction. Mean urinary cadmium (CdU) was 1.1 micro g/g creatinine (n = 191). Higher CdU levels were associated with higher NAG. CONCLUSIONS These data suggest that lead has an adverse effect on renal function in the moderate dose range, particularly in older workers. Associations between higher lead measures and lower BUN and serum creatinine and higher creatinine clearances may represent lead induced hyperfiltration. Environmental cadmium may also have an adverse renal impact, at least on NAG.
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Affiliation(s)
- V M Weaver
- Division of Occupational and Environmental Health, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Brzóska MM, Kamiński M, Supernak-Bobko D, Zwierz K, Moniuszko-Jakoniuk J. Changes in the structure and function of the kidney of rats chronically exposed to cadmium. I. Biochemical and histopathological studies. Arch Toxicol 2003; 77:344-52. [PMID: 12799774 DOI: 10.1007/s00204-003-0451-1] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2002] [Accepted: 01/09/2003] [Indexed: 10/20/2022]
Abstract
The aim of this study was to assess the effects of chronic exposure to cadmium (Cd) on the structure and function of kidneys, as well as to establish the body burden of Cd at which the changes occur. For this purpose we have created an experimental model using rats intoxicated with Cd administered in drinking water at the concentration of 5 or 50 mg Cd/l for 6, 12 and 24 weeks. The degree of kidney damage was evaluated biochemically and histopathologically. Sensitive biomarkers of Cd-induced proximal tubular injury such as urinary total N-acetyl-beta- d-glucosaminidase (NAG-T) and its isoenzyme B (NAG-B), and alkaline phosphatase (ALP) were used. Cd content in the kidney increased with the level and duration of exposure leading to dose- and time-dependent structural and functional renal failure. In rats exposed to 5 mg Cd/l, first symptoms of injury of the main tubules of long and short nephrons (structural damage to epithelial cells, increased urinary activities of NAG-T and NAG-B) were noted after 12 weeks of the experiment. The damage occurred at a low kidney Cd concentration amounting to 4.08+/-0.33 micro g/g wet weight (mean +/-SE) and a urinary concentration of 4.31+/-0.28 micro g/g creatinine. On exposure to 50 mg Cd/l, damage to the main tubules (blurred structure of tubular epithelium, atrophy of brush border, partial fragmentation of cells with release of nuclei into tubular lumen as well as increased urinary activities of NAG-T, NAG-B and ALP) was already evident after 6 weeks with the kidney Cd concentration of 24.09+/-1.72 micro g/g wet weight. In rats exposed to 50 mg Cd/l, a lack of regular contour of glomeruli was noted after 12 weeks, whereas after 24 weeks thickening of capillary vessels and widening of filtering space were evident. After 24 weeks of exposure to Cd, increased urea concentration in the serum with simultaneous decrease in its level in the urine, indicating decreased clearance of urea, and increased excretion of total protein were observed, but endogenous creatinine clearance remained unaffected. At the lower exposure, symptoms of structural, but not functional, damage to the glomeruli were also evident after 24 weeks of the experiment. Our results provide evidence that chronic exposure to Cd dose-dependently damages (structurally and functionally) the whole kidney. The injury affects the main resorptive part (proximal convoluted tubules and straight tubules) and the filtering part (glomeruli) of the nephron. But the target site for Cd action is the main tubule. We hypothesize that the threshold for Cd effects on the kidney is less than 4.08+/-0.33 micro g/g wet kidney weight and greater than 2.40+/-0.15 micro g/g (at this Cd concentration no symptoms of kidney damage were noted), and it may be close to the latter value. A very important finding of this study is that Cd acts on the whole kidney, especially on the main tubules, even at relatively low accumulation in this organ. It confirms the hypothesis that humans environmentally exposed to Cd, especially smokers, are at risk of tubular dysfunction.
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Affiliation(s)
- Małgorzata M Brzóska
- Department of Toxicology, Medical University of Białystok, Mickiewicza 2c str., 15-222, Białystok, Poland.
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de Burbure C, Buchet JP, Bernard A, Leroyer A, Nisse C, Haguenoer JM, Bergamaschi E, Mutti A. Biomarkers of renal effects in children and adults with low environmental exposure to heavy metals. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2003; 66:783-798. [PMID: 12746126 DOI: 10.1080/15287390306384] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The health effects of chronic exposure to heavy metals such as lead, cadmium, and mercury are widely documented, yet few data exist about the renal impact of low environmental exposure to these metals, particularly in children. The aim of this study was to assess renal parameters in children and adults living in an environment known for its past heavy metal contamination around two nonferrous smelters in northern France (Noyelles-Godault and Auby) and to compare their results with age and gender-matched controls living in neighboring municipalities with unpolluted soil (total: 400 children, 600 adults, sex ratio = 1). The integrity of renal function was assessed by measuring the urinary excretion levels of total protein, albumin, transferrin, beta(2)-microglobulin, retinol-binding protein, brush border antigen, and the enzyme N-acetyl-beta-D-glucosaminidase (NAG). The mean blood concentrations of lead (Pb-B, children </=42.2 micro/L, adults </=71.3. micro/L) and of cadmium (Cd-B, children </=0.52 microg/L, adults 0.86 microg/L) were all relatively low, indicating a low uptake of these heavy metals from the environment despite relatively high levels in soil (between 100 and 1700 ppm for lead and 0.7 to 233 ppm for cadmium). Pb-B levels were, however, significantly increased in boys, girls, and women--but not men--living in the polluted area. Boys, men, and women living in the polluted area had also on average higher Cd-B levels. The concentrations of mercury in urine (Hg-U) were by contrast similar in control and exposed groups. None of the renal parameters studied showed a significant difference between control and exposed groups. The influence of heavy metals on renal parameters was further assessed by stepwise multiple regression, testing Pb-B, Cd-B, Hg-U, age, gender, body mass index (BMI), urinary creatinine levels, and area of residence as predictors in both children and adults, including first-order metal interaction terms, smoking habits, and alcohol consumption in adults. The only positive correlation was found between the urinary excretion of NAG activity (standardized for BMI and urinary creatinine) and Cd-B levels when taking the whole children population, indicating that even low cadmium burdens may produce subtle effects on the proximal tubule in children, although deleterious consequences are unlikely should exposure not increase. However, in the absence of other positive findings even after studying the smaller subgroups with higher levels of heavy metals, these results are clearly indicative of the minimal renal impact of living around nonferrous smelters that are currently complying with pollution regulations, even when soil contamination is still high.
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Affiliation(s)
- Claire de Burbure
- Unit of Industrial Toxicology and Occupational Medicine, Faculty of Medicine, Université Catholique de Louvain, Brussels, Belgium
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Honda R, Tsuritani I, Noborisaka Y, Suzuki H, Ishizaki M, Yamada Y. Urinary cadmium excretion is correlated with calcaneal bone mass in Japanese women living in an urban area. ENVIRONMENTAL RESEARCH 2003; 91:63-70. [PMID: 12584006 DOI: 10.1016/s0013-9351(02)00035-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Nine hundred eight women aged 40-88 years living in a non-Cd-polluted area in Japan were analyzed for urinary cadmium (Cd), N-acetyl-beta-D-glucosaminidase (NAG) activity, beta(2)-microglobulin (B2MG) concentration, and for the stiffness index (STIFF) of calcaneal bone using an ultrasound method. The urinary Cd in the subjects, with a mean and range of 2.87 and 0.25-11.4 microg/g creatinine, respectively, showed a significant correlation with NAG but not with B2MG. STIFF was significantly inversely correlated with urinary Cd, and the association remained significant after adjusting for age, body weight, and menstrual status, suggesting a significant effect of Cd on the bone loss in these subjects without signs of Cd-induced kidney damage. A two-fold increase in urinary Cd was accompanied by a decrease in STIFF corresponding to a 1.7-year rise in age. These results emphasize the need for reassessment of the significance of Cd exposure in the general Japanese population.
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Affiliation(s)
- Ryumon Honda
- Department of Hygiene, Kanazawa Medical University, Uchinada, Ishikawa 920-0293, Japan.
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Noonan CW, Sarasua SM, Campagna D, Kathman SJ, Lybarger JA, Mueller PW. Effects of exposure to low levels of environmental cadmium on renal biomarkers. ENVIRONMENTAL HEALTH PERSPECTIVES 2002; 110:151-5. [PMID: 11836143 PMCID: PMC1240729 DOI: 10.1289/ehp.02110151] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
We conducted a study among residents of a small community contaminated with heavy metals from a defunct zinc smelter and residents from a comparison community to determine whether biologic measures of cadmium exposure were associated with biomarkers of early kidney damage. Creatinine-adjusted urinary cadmium levels did not differ between the smelter and comparison communities; thus we combined individuals from both communities (n = 361) for further analyses. The overall mean urinary cadmium level was low, 0.26 microg/g creatinine, similar to reference values observed in the U.S. general population. For children ages 6-17 years, urinary concentration of N-acetyl-beta-D-glucosaminidase (NAG), alanine aminopeptidase (AAP), and albumin were positively associated with urinary cadmium, but these associations did not remain statistically significant after adjusting for urinary creatinine and other potential confounders. For adults ages 18 or older, urinary concentration of NAG, AAP, and albumin were positively associated with urinary cadmium. The associations with NAG and AAP but not with albumin remained statistically significant after adjusting for creatinine and other potential confounders. We found a positive dose-effect relationship between levels of creatinine-adjusted urinary cadmium and NAG and AAP activity, and statistically significant differences in mean activity for these two enzymes between the highest (> or =1.0 microg cadmium/g creatinine) and the lowest (< or =0.25 microg cadmium/g creatinine) exposure groups. The findings of this study indicate that biologic measures of cadmium exposure at levels below 2.0 microg/g creatinine may produce measurable changes in kidney biomarkers.
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Affiliation(s)
- Curtis W Noonan
- Division of Health Studies, Agency for Toxic Substances and Disease Registry, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
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42
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Reeves PG, Nielsen EJ, O'Brien-Nimens C, Vanderpool RA. Cadmium bioavailability from edible sunflower kernels: a long-term study with men and women volunteers. ENVIRONMENTAL RESEARCH 2001; 87:81-91. [PMID: 11683591 DOI: 10.1006/enrs.2001.4289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Sunflower kernels (SFK) contain natural Cd in somewhat higher amounts than most other foods. This study was designed to determine if a change in the body burden of Cd could be measured in volunteers who consumed a controlled amount of SFK for 48 weeks. Healthy men and women between 23 and 59 years of age were divided into three groups each by age, sex, and weight. For 48 weeks, one group consumed 255 g (9 oz) of SFK/week, a second group consumed 113 g SFK and 142 g peanuts/week, and a third group consumed 255 g peanuts/week. SFK contained 0.52 microg Cd/g and peanuts contained 0.11 microg Cd/g. The consumption of 255 g SFK/week increased the average estimated intake of Cd from approximately 65 to approximately 175 microg/week. Although the consumption of Cd-containing SFK significantly increased the estimated Cd intake, there were no significant changes in Cd concentration in red blood cells, Cd excretion in the urine, or Cd concentrations in new hair growth. However, fecal Cd excretion significantly increased as the amount of SFK consumption increased. N-Acetyl-beta-D-glucosaminidase, a marker for kidney dysfunctions, was not significantly changed by consuming SFK-Cd. Overall, the results suggest that the consumption of Cd in the form of SFK at 9 oz (255 g)/week for 48 week had no adverse effect on the body burden of Cd.
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Affiliation(s)
- P G Reeves
- U.S. Department of Agriculture, Grand Forks Human Nutrition Research Center, Agricultural Research Service, 2420 Second Avenue North, Grand Forks, North Dakota, 58203, USA.
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Abstract
The presence of a xenobiotic in the environment always represents a risk for living organisms. However, to talk about impregnation there is a need to detect toxicity in the organism, and the concept of intoxication is related to specific organ alterations and clinical symptoms. Moreover, the relationship between the toxic levels within the organism and the toxic response is rather complex and has a difficult forecast because it depends on several factors, namely toxicokinetic and genetic factors. One of the methods to quantify the interaction with xenobiotics and its potential impact on living organisms, including the human being, is monitoring by the use of the so-called biomarkers. They can provide measures of the exposure, toxic effect and individual susceptibility to environmental chemical compounds and may be very useful to assess and control the risk of long-term outcomes associated with exposure to xenobiotic (i.e. heavy metals, halogenated hydrocarbons, pesticides).
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Affiliation(s)
- F Gil
- Department of Legal Medicine and Toxicology, University of Granada, Madrid, Spain.
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Lu J, Jin T, Nordberg G, Nordberg M. Metallothionein gene expression in peripheral lymphocytes from cadmium-exposed workers. Cell Stress Chaperones 2001; 6:97-104. [PMID: 11599580 PMCID: PMC434396 DOI: 10.1379/1466-1268(2001)006<0097:mgeipl>2.0.co;2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Metallothionein (MT) plays an important role in the detoxification of cadmium. To investigate the usefulness of MT gene expression in peripheral blood lymphocytes (PBLs) as a biomarker of cadmium exposure and susceptibility, reverse transcriptase-polymerase chain reaction was used to measure the MT gene expression in PBLs from cadmium-exposed workers. Both basal and induced MT expressions were found to increase with increased blood cadmium (BCd) and urinary cadmium (UCd) levels. Both basal and induced MT expression levels were significantly correlated with the logarithm of BCd and the logarithm of UCd levels. The dose-response relationship between internal dose of cadmium and MT expression suggested the validity of MT expression in PBLs as a biomarker of cadmium exposure. In vitro induced MT expression level in PBLs was found to be inversely related to the level of renal dysfunction indicator, urinary N-acetyl-beta-D-glucosaminidase (UNAG). The latter finding indicates that MT expression in PBLs may be a useful biomarker of susceptibility to renal toxicity of cadmium.
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Affiliation(s)
- J Lu
- Department of Occupational Health, Shanghai Medical University, People's Republic of China
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45
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Tassi C, Abbritti G, Mancuso F, Morucci P, Feligioni L, Muzi G. Activity and isoenzyme profile of N-acetyl-beta-D-glucosaminidase in urine from workers exposed to cadmium. Clin Chim Acta 2000; 299:55-64. [PMID: 10900292 DOI: 10.1016/s0009-8981(00)00276-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The urinary excretion of N-acetyl-beta-D-glucosaminidase (U-NAG) and urinary Cadmium (U-Cd) concentration, a measure of the metal load in the body, were evaluated in 28 workers exposed to Cd, to determine the relation between the two parameters. In urine from 22 exposed workers with U-Cd<2 microg/g creatinine (Cr) there was no significant difference in U-NAG value (0.98+/-0.59 U/gCr) compared to non-exposed (0.73+/-0.48 U/gCr). In the six workers with 2 microg/gCr < or =U-Cd<10 microg/gCr the U-NAG (2.32+/-0.61 U/gCr) was statistically (P<0.05) higher than in other workers. In both the U-Cd intervals examined there were no altered values of beta2-microglobulin from urine of exposed workers compared to non-exposed (<0.30 mg/l). The U-NAG isoenzymes were separated by DEAE-cellulose chromatography from urine of non-exposed subjects and exposed workers. The U-NAG isoenzyme profile in urine of non-exposed subjects showed a high percentage (about 95%) of the A (acid) form, a much lower percentage (about 4.5%) of B (basic) form and a negligible percentage (about 0.5%) of I (intermediate) form. In the urine of 22 exposed workers with U-Cd<2 microg/gCr, the percentages of U-NAG isoenzymes were not different from non-exposed. In the urine of six workers with 2 microg/gCr< or =U-Cd<10 microg/gCr the percentage (8.34+/-0.91) of isoenzyme B (U-NAG-B), a marker of lesional enzymuria, was statistically increased (P<0.05) compared to non-exposed (4.42+/-0.56). These results suggest that adopting a biological limit for U-Cd equal to 10 microg/gCr might not be sufficiently protective. The increase in U-NAG-B content at 2 microg/gCr<U-Cd</=10 microg/gCr is probably due to a lesion of the proximal tubule caused by the metal which might follow an induction of the apoptotic process.
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Affiliation(s)
- C Tassi
- Dipartimento di Medicina Sperimentale e Scienze Biochimiche, Sezione di Medicina di Laboratorio, Università di Perugia, Via, 06100, del Giochetto, Peru
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Jin T, Nordberg G, Sehlin J, Wallin H, Sandberg S. The susceptibility to nephrotoxicity of streptozotocin-induced diabetic rats subchronically exposed to cadmium chloride in drinking water. Toxicology 1999; 142:69-75. [PMID: 10647919 DOI: 10.1016/s0300-483x(99)00135-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Streptozotocin-induced diabetic rats and normal non-diabetic (ND) rats were exposed to cadmium chloride in drinking water in doses of 0, 50 and 100 ppm for 90 days. There was a dose-related increase in urinary protein and enzymes in the diabetic group, but an increase in proteinuria only in the high exposure subgroup of the ND group. It is suggested that diabetic rats induced by streptozotocin are more susceptible to cadmium nephrotoxicity than normal (ND) rats. Metallothionein synthesis in liver was estimated to be similar in both the diabetic and non-diabetic groups after exposure to cadmium. Less excretion of cadmium in urine and greater accumulation of cadmium in kidney were observed in the diabetic group, and this may be one of the mechanisms underlying the susceptibility of diabetic animals to the effects of cadmium. Further biochemical and histological studies are required in order to explain the detailed events involved in inducing such changes in the toxicokinetics of cadmium.
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Affiliation(s)
- T Jin
- Department of Environmental Medicine, Umeå University, Sweden
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Bomhard EM, Maruhn D, Rinke M. Time course of chronic oral cadmium nephrotoxicity in Wistar rats: excretion of urinary enzymes. Drug Chem Toxicol 1999; 22:679-703. [PMID: 10536756 DOI: 10.3109/01480549908993175] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Twelve male and female Wistar rats each received cadmium (as CdCl2) in their diet at concentrations of 0, 10, 50, and 250 ppm for 72 weeks. After 1, 4, 8, 13, 18, 26, 32, 45, 57, and 68 weeks a total of 8 enzymes from different cellular compartments of the nephron were measured. At the end of the study period, the kidneys were examined histopathologically. Concentrations up to and including 50 ppm did not induce any adverse effect. At 250 ppm, growth of male and female animals was markedly retarded. Significantly increased activities of the cytosolic phosphohexose isomerase were excreted by males and females receiving 250 ppm at all timepoints from week 13. The values of the mitochondrial glutamate dehydrogenase were mostly elevated from week 1 to 57, however, due to a wide scatter range, were only occasionally significantly different from control values. The brush border enzymes (gamma-glutamyl transferase, alkaline phosphatase and leucine arylamidase) were not changed in a relevant manner in female rats, while in 250 ppm males the excreted activity of ALP and LAP from week 1 to week 18, and that of GGT during the entire study period were significantly lower than the control values. Excretion of the lysosomal enzymes aryl sulfatase A, beta-galactosidase, and beta-N-acetyl-D-glucosaminidase was at no time influenced in a noteworthy manner. Histopathology after 72 weeks revealed chronic but also acute degenerative changes in the kidneys of 250 ppm males and females. A comparison of published data on persons having undergone high cadmium exposure with the results presented here shows remarkable differences.
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Affiliation(s)
- E M Bomhard
- Institute of Toxicology, BAYER AG, Wuppertal, Germany.
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Jin T, Nordberg G, Wu X, Ye T, Kong Q, Wang Z, Zhuang F, Cai S. Urinary N-acetyl-beta-D-glucosaminidase isoenzymes as biomarker of renal dysfunction caused by cadmium in a general population. ENVIRONMENTAL RESEARCH 1999; 81:167-173. [PMID: 10433849 DOI: 10.1006/enrs.1999.3959] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
N-Acetyl-beta-D-glucosaminidase (NAG) and its isoenzymes in urine have been studied in a population group residing in a polluted area in China. The area studied was contaminated by industrial wastewater from a nearby smelter that discharged cadmium-polluted wastewater into a river used for the irrigation of rice fields. Cadmium concentrations in rice were 3.70, 0.51, and 0.07 mg/kg for the highly and moderately polluted areas and the control area, respectively. Cadmium concentrations in urine exceeded 5 microgram/liter in the majority of subjects in the most highly polluted area. There was a marked dose-dependent increase in NAG and NAG B content of urine related both to urinary cadmium and to the calculated cadmium uptake. It is concluded that urinary NAG and its isoenzymes could serve as a sensitive biomarker of renal dysfunction in cadmium-exposed populations. The mechanisms underlying the increase in NAG and its isoenzymes after cadmium exposure need to be studied further.
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Affiliation(s)
- T Jin
- Department of Environmental Medicine, Umeâ University, Umeâ, 901 87, Sweden.
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49
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Abstract
Cadmium as an environmental or occupational toxin has been well studied. Exposure can fairly easily be detected by analysis of cadmium in biological material. Different routes of cadmium uptake, such as via airborne particles, cigarette smoke or contaminated food, have been identified. Urinary concentrations associated with renal effects vary, depending on urinary marker of effect, and are as low as 2 micrograms cadmium/g creatinine. Different segments of the nephron are affected by cadmium. Urinary enzymes and serum derived proteins, mainly low-molecular weight proteins, as well as eicosanoids or glycosaminoglycans are among the tubular or glomerular markers of effect. Predisposing factors, such as smoking, dietary habits and low body iron stores have been described. It is concluded that even for low level cadmium exposure effects can be detected with sensitive diagnostic tools.
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Affiliation(s)
- L M Fels
- Department of Nephrology, Hannover Medical School, Germany.
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50
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Novelli EL, Vieira EP, Rodrigues NL, Ribas BO. Risk assessment of cadmium toxicity on hepatic and renal tissues of rats. ENVIRONMENTAL RESEARCH 1998; 79:102-105. [PMID: 9841808 DOI: 10.1006/enrs.1998.3865] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Pollution and industrial practices result in concentrations of metals and other environmental agents that are related to environmental toxicity. A rat bioassay was utilized for the identification of toxic effects of cadmium intake. This demonstrated increased total urinary proteins and increased kidney weights in rats exposed to CdCl2 for 7 days, in drinking water (100 mg/L). Serum creatinine, total and direct bilirubin concentrations and alanine transaminase activity were increased in Cd-exposed rats, indicating renal and hepatic toxicity. It was also observed that lipoperoxide concentrations were increased, while Cu-Zn superoxide dismutase activity was decreased in rats treated with cadmium. This indicated that the renal and hepatic toxicity induced by cadmium involved superoxide radicals.
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Affiliation(s)
- E L Novelli
- Department of Chemistry, University Estadual Paulista, UNESP, Botucatu, São Paulo, 18618-000, Brazil
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