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Chen T, Gu Y, Zhang Z, Chen Z, Zhang J, Leng X. Association between copper and Achilles tendon disease: a two-sample Mendelian randomization study. Front Nutr 2024; 11:1505636. [PMID: 39606572 PMCID: PMC11598432 DOI: 10.3389/fnut.2024.1505636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Accepted: 10/28/2024] [Indexed: 11/29/2024] Open
Abstract
Background There is a clear association between micronutrients and Achilles tendon disease (AT). An increase in micronutrients may alleviate AT symptoms and have a therapeutic effect. The aim of this study is to clarify the causal relationship between 15 micronutrients (copper, zinc, magnesium, vitamins A, C, E, D, B6, B12, folic acid, carotene, iron, selenium, calcium, and potassium) and AT. Methods We employed the Mendelian randomization (MR) method to analyze the causal effects of micronutrients on the risk of AT. The SNPs related to micronutrients were obtained from a large-scale genome-wide association study (GWAS) of circulating micronutrients in European populations. Outcome data were obtained from a meta-analysis of AT in European-ancestry participants from the Finnish FINNGEN BIOBANK. The main analysis was conducted using the inverse variance weighting (IVW) method, with additional sensitivity and pleiotropy analyses performed. Results Inverse variance weighting results indicated a causal relationship between copper and AT (P = 0.003, OR = 0.899, 95% CI = 0.839-0.964). Sensitivity analysis validated the robustness and reliability of this finding. Conclusion This study revealed a causal relationship between copper and AT, with copper serving as a protective factor. This provides evidence of the causality between copper and AT, offering new insights for clinical research and therapeutic approaches in AT.
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Affiliation(s)
- TianYang Chen
- Changchun University of Chinese Medicine, Changchun, China
| | | | | | | | | | - Xiangyang Leng
- Changchun University of Chinese Medicine, Changchun, China
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Fontes A, Jauch AT, Sailer J, Engler J, Azul AM, Zischka H. Metabolic Derangement of Essential Transition Metals and Potential Antioxidant Therapies. Int J Mol Sci 2024; 25:7880. [PMID: 39063122 PMCID: PMC11277342 DOI: 10.3390/ijms25147880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/08/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
Essential transition metals have key roles in oxygen transport, neurotransmitter synthesis, nucleic acid repair, cellular structure maintenance and stability, oxidative phosphorylation, and metabolism. The balance between metal deficiency and excess is typically ensured by several extracellular and intracellular mechanisms involved in uptake, distribution, and excretion. However, provoked by either intrinsic or extrinsic factors, excess iron, zinc, copper, or manganese can lead to cellular damage upon chronic or acute exposure, frequently attributed to oxidative stress. Intracellularly, mitochondria are the organelles that require the tightest control concerning reactive oxygen species production, which inevitably leaves them to be one of the most vulnerable targets of metal toxicity. Current therapies to counteract metal overload are focused on chelators, which often cause secondary effects decreasing patients' quality of life. New therapeutic options based on synthetic or natural antioxidants have proven positive effects against metal intoxication. In this review, we briefly address the cellular metabolism of transition metals, consequences of their overload, and current therapies, followed by their potential role in inducing oxidative stress and remedies thereof.
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Affiliation(s)
- Adriana Fontes
- Institute of Molecular Toxicology and Pharmacology, Helmholtz Center Munich, German Research Center for Environmental Health, D-85764 Neuherberg, Germany;
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- CIBB-Center for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - Adrian T. Jauch
- School of Medicine and Health, Institute of Toxicology and Environmental Hygiene, Technical University Munich, D-80802 Munich, Germany
| | - Judith Sailer
- School of Medicine and Health, Institute of Toxicology and Environmental Hygiene, Technical University Munich, D-80802 Munich, Germany
| | - Jonas Engler
- School of Medicine and Health, Institute of Toxicology and Environmental Hygiene, Technical University Munich, D-80802 Munich, Germany
| | - Anabela Marisa Azul
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal
- CIBB-Center for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- IIIUC-Institute for Interdisciplinary Research, University of Coimbra, 3030-789 Coimbra, Portugal
| | - Hans Zischka
- Institute of Molecular Toxicology and Pharmacology, Helmholtz Center Munich, German Research Center for Environmental Health, D-85764 Neuherberg, Germany;
- School of Medicine and Health, Institute of Toxicology and Environmental Hygiene, Technical University Munich, D-80802 Munich, Germany
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3
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Escobedo-Monge MF, Barrado E, Parodi-Román J, Escobedo-Monge MA, Torres-Hinojal MC, Marugán-Miguelsanz JM. Copper/Zinc Ratio in Childhood and Adolescence: A Review. Metabolites 2023; 13:metabo13010082. [PMID: 36677007 PMCID: PMC9862945 DOI: 10.3390/metabo13010082] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Both copper (Cu) and zinc (Zn) are crucial micronutrients for human growth and development. This literature review covered the last five years of available evidence on the Cu/Zn ratio in children and adolescents. We searched PubMed, Web of Science, Google Scholar, Cochrane Library, and Science Direct for publications between 2017 and 2022, especially in English, although publications in other languages with abstracts in English were included. The main terms used were "copper", "zinc", "copper-zinc", and "zinc-copper" ratios. Cu and Zn determinations made in blood, plasma, or serum were included. This review comprises several cross-sectional and case-control studies with substantial results. The bibliographic search generated a compilation of 19 articles, in which 63.2% of the studies mostly reported a significantly higher Cu/Zn ratio, and 57.9% of them informed significantly lower levels of Zn. We conclude that children and adolescents with acute and chronic conditions are at greater risk of developing elevated Cu/Zn ratios, related to altered nutritional, infectious, and inflammatory status.
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Affiliation(s)
- Marlene Fabiola Escobedo-Monge
- Faculty of Medicine, University of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain
- Correspondence: ; Tel.: +34-639-590-467
| | - Enrique Barrado
- Department of Analytical Chemistry, Science Faculty, Campus Miguel Delibes, University of Valladolid, Calle Paseo de Belén, 7, 47011 Valladolid, Spain
| | - Joaquín Parodi-Román
- Science Faculty, University of Cadiz, Paseo de Carlos III, 28, 11003 Cádiz, Spain
| | | | | | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics, Faculty of Medicine, University of Valladolid, Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain
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Liu Y, Zhu J, Xu L, Wang B, Lin W, Luo Y. Copper regulation of immune response and potential implications for treating orthopedic disorders. Front Mol Biosci 2022; 9:1065265. [PMID: 36545506 PMCID: PMC9762617 DOI: 10.3389/fmolb.2022.1065265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Copper is an indispensable trace metal element in human body, and copper deficiency is rare in clinic. However, diseases associated with serum copper deficiency, such as leukopenia, neutropenia, arthritis, osteoporosis, and bone defects, are well known. Copper ions can also achieve the effect of fighting pathogenic bacteria through the "contact killing" characteristic. Copper ion is also an important cofactor of bone matrix synthase, plays an important role in the pathophysiology of orthopedic diseases. The present review highlights the biological functions of copper in immunity, bone diseases and stem cells, as well as potential drug development targeting copper status for diagnostics and therapeutics of copper-associated bone diseases.
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Affiliation(s)
- Yamei Liu
- College of Basic Medical, Guangzhou University of Chinese Medicine, Guangzhou, China
- Research Center of Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junlang Zhu
- Department of Trauma and Foot-Ankle Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liangliang Xu
- Lingnan Medical Research Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bin Wang
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weiping Lin
- The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yiwen Luo
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Tahir N, Ashraf A, Waqar SHB, Rafae A, Kantamneni L, Sheikh T, Khan R. Copper deficiency, a rare but correctable cause of pancytopenia: a review of literature. Expert Rev Hematol 2022; 15:999-1008. [PMID: 36314081 DOI: 10.1080/17474086.2022.2142113] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Copper is increasingly being recognized as a vital mineral required by both animals and humans. It plays a vital role in many metabolic processes such as cellular respiration, iron oxidation, and hemoglobin synthesis. Copper deficiency, which can be hereditary or acquired, can lead to a wide spectrum of disease processes such as ringed sideroblastic anemia, myelodysplasia, and pancytopenia. Timely identification and management of copper deficiency is necessary to prevent irreversible complications. AREAS COVERED Our study focuses on prevalence, etiology, pathophysiology, complications, and treatment of copper deficiency. EXPERT OPINION Copper deficiency is frequently underrecognized as the cause of anemia, neutropenia, and bone marrow dysplasia. As it is potentially treatable, it should always be kept in the differentials when patients present with neurological and hematological abnormalities.
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Affiliation(s)
- Nayha Tahir
- Department of Hematology and Oncology, Kaiser Permanente, San Francisco, CA, USA
| | - Aqsa Ashraf
- Department of Internal Medicine, Zucker School of Medicine, Hofstra/Northwell, Mather Hospital, Port Jefferson, NY, USA
| | - Syed Hamza Bin Waqar
- Department of Internal Medicine, State University of New York, Downstate Medical Center Brooklyn, Brooklyn, NY, USA
| | - Abdul Rafae
- Department of Hematology and Oncology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Leela Kantamneni
- Department of Internal Medicine, Huntsville Regional Medical Campus, University of Alabama, Birmingham, AL, USA
| | - Taha Sheikh
- Department of Hematology and Oncology, University of Toledo, Toledo, OH, USA
| | - Rafiullah Khan
- Division of Hematology Oncology, The Christ Hospital Network Physicians, Cincinnati, OH, USA
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6
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Penny H, Flores R, Pennington E, Pedersen A, Tran S. The role of macronutrients and micronutrients in wound healing: a narrative review. J Wound Care 2022; 31:S14-S22. [PMID: 35576197 DOI: 10.12968/jowc.2022.31.sup5.s14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There is an extensive amount of research and literature discussing the role of various nutrients throughout the wound healing process. Despite the importance of nutrition in wound healing, dietary protocols often remain absent from wound care standards. This may be due to a lack of comprehensive literature that summarises the complexities and considerations associated with nutrient deficiency and supplementation into an easily accessible and inclusive reference tool. The purpose of this review is to assess the nutrients with key roles in the wound healing process, and subsequently provide information that enables optimisation of nutrition in wound healing. The goal is to consolidate the complexities associated with this topic into a simple, easy-to-use reference tool. We have identified the most important nutrients required for optimal wound healing and condensed the findings into an inclusive chart to be utilised in a clinical setting. This reference tool will include patient populations at risk of deficiency, the stage of wound healing in which each nutrient is required, delivery method and recommended daily intake, outpatient recommendations for rich food sources of each nutrient, and considerations associated with each nutrient.
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Affiliation(s)
- Harry Penny
- UPMC Altoona, 1414 9th Ave, Altoona, PA 16602, US
| | | | | | | | - Son Tran
- Temple University, School of Pediatric Medicine 148 N. 8th Street, Philadelphia, PA 19107, US
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Lizaola-Mayo BC, Dickson RC, Lam-Himlin DM, Chascsa DM. Exogenous copper exposure causing clinical wilson disease in a patient with copper deficiency. BMC Gastroenterol 2021; 21:278. [PMID: 34238237 PMCID: PMC8265109 DOI: 10.1186/s12876-021-01859-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 06/28/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Human Swayback is a disease characterized by acquired copper deficiency which primarily manifests as myeloneuropathy. Common causes include malabsorptive disorders, gastric surgery, total parenteral nutrition and excessive zinc intake. In contrast, copper supplementation should be closely monitored as excessive doses can lead to acute intoxication and in chronic cases, cirrhosis. Copper derangements are rare, however it is important to consider them due to potential severe complications. CASE PRESENTATION We present a middle-aged man who had been previously diagnosed with Human Swayback after presenting with various neurological symptoms. The patient was subsequently placed on copper supplementation. A decade later, he was referred to our hospital for liver transplant evaluation due to new diagnosis of decompensated end-stage liver disease after an abdominal surgery. His initial workup was suggestive of Wilson disease-subsequent ATP7B gene was negative. Ultimately, the patient underwent liver transplantation; liver explant was significant for a copper dry weight concentration of 5436 mcg/g. CONCLUSIONS Human Swayback is a very rare copper-related disease which deserves awareness due to its potential irreversible health effects in the human body. Additionally, in patients who require copper supplementation, serial levels should be monitored to ensure adequate copper levels.
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Affiliation(s)
- Blanca C Lizaola-Mayo
- Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA.
- Transplant Center, Mayo Clinic, Phoenix, AZ, USA.
| | - Rolland C Dickson
- Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA
- Transplant Center, Mayo Clinic, Phoenix, AZ, USA
| | | | - David M Chascsa
- Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA
- Transplant Center, Mayo Clinic, Phoenix, AZ, USA
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8
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Escobedo-Monge MF, Barrado E, Alonso Vicente C, Escobedo-Monge MA, Torres-Hinojal MC, Marugán-Miguelsanz JM, Redondo del Río MP. Copper and Copper/Zinc Ratio in a Series of Cystic Fibrosis Patients. Nutrients 2020; 12:E3344. [PMID: 33143143 PMCID: PMC7692365 DOI: 10.3390/nu12113344] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Cystic fibrosis (CF) patients require a stable and sufficient supply of micronutrients. Since copper is an essential micronutrient for human development, a cross-sectional study was carried out to investigate the serum copper levels, serum copper/zinc (Cu/Zn) ratios, and their relationship with nutritional indicators in a group of CF patients. Anthropometric, biochemical, and dietary measurements, an abdominal ultrasound, and respiratory and pancreatic tests were conducted. Seventeen CF patients were studied (10 females, 59%), 76.5% of whom were ∆F580. Their mean serum copper (113 ± 23 μg/dL) was normal, and there was only one teenager with hypocupremia (6%) and two children with hypercupremia (18%). A significant association between serum copper and zinc levels was discovered. The Cu/Zn ratio was higher than 1.00 for 94% of patients, which is an indicator of an inflammation status. There was no significant correlation between the serum copper concentrations and respiratory and pancreatic function, respiratory colonization, and the results of the abdominal ultrasound. Linear regression analysis showed that serum copper had a positive association with both the Z-score body mass index (BMI) and mean bone conduction speed (BCS). Therefore, since 94% of CF patients had a Cu/Zn ratio > 1.00, this factor must alert us to consider the risk of zinc deficiency and high inflammatory response. The measurement of serum zinc alone does not show one's zinc status. However, the Cu/Zn ratio may be an indicator of zinc deficiency and the inflammatory status of CF patients.
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Affiliation(s)
- Marlene Fabiola Escobedo-Monge
- Faculty of Medicine, Valladolid University, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (M.C.T.-H.); (M.P.R.d.R.)
| | - Enrique Barrado
- Department of Analytical Chemistry, Science Faculty, Campus Miguel Delibes, University of Valladolid, Calle Paseo de Belén, 7, 47011 Valladolid, Spain;
| | - Carmen Alonso Vicente
- Department of Pediatrics of the Faculty of Medicine, Valladolid University, Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (C.A.V.); (J.M.M.-M.)
| | | | - María Carmen Torres-Hinojal
- Faculty of Medicine, Valladolid University, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (M.C.T.-H.); (M.P.R.d.R.)
| | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics of the Faculty of Medicine, Valladolid University, Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (C.A.V.); (J.M.M.-M.)
| | - María Paz Redondo del Río
- Faculty of Medicine, Valladolid University, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (M.C.T.-H.); (M.P.R.d.R.)
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9
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[Severe hypocupremia and familial amyloid polyneuropathy]. NUTR HOSP 2020; 37:223-227. [PMID: 31793325 DOI: 10.20960/nh.02771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: we report a patient with transthyretin familial amyloid polyneuropathy (TTR-FAP) and severe hypocupremia. Case report: a 79-year-old male with TTR-FAP and severe malnutrition. Laboratory tests showed low serum copper (Cu) and ceruloplasmin levels, as well as low urinary Cu levels. The patient reported neither digestive symptoms nor previous gastrointestinal surgery. Liver function tests, iron metabolism, hemoglobin, leukocytes and zinc were normal. Discussion: Cu is a trace element. It is part of the cuproenzymes involved in several physiological functions. Hypocupremia can be related to genetic or acquired etiologies, including low intake, bariatric surgery, increased losses, etc. Primary clinical manifestations include hematological (anemia and leukopenia) and neurological (myelopathy, peripheral neuropathy) features. Treatment is empirical. In severe cases it may be initiated with endovenose administration, followed by oral supplementation.
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Altarelli M, Ben-Hamouda N, Schneider A, Berger MM. Copper Deficiency: Causes, Manifestations, and Treatment. Nutr Clin Pract 2019; 34:504-513. [PMID: 31209935 DOI: 10.1002/ncp.10328] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The metabolism of the essential trace element copper remains incompletely understood and, until recently, nearly ignored in acute medicine. Menkes disease was for long the only known copper deficiency condition, but several case reports and investigations conducted over the last 2 decades have shown that deficiency is more frequent than previously suspected, with devastating individual consequences and potential public health consequences. The copper needs in healthy individuals are 0.9 mg/d, which translates to 0.3 mg/d intravenously in parenteral nutrition; the present review aims at gathering actual knowledge. METHOD AND RESULTS A review of literature was conducted in PubMed and Cochrane systematic reviews to identify the most recent information about copper deficiency and generate a narrative review. Copper deficiency has hereditary and acquired origins, the latter being the most frequent. Clinical manifestations are nonspecific but affect all organs and systems, particularly the hematologic (anemia) and the neurologic (myeloneuropathy) systems. Deficiency also affects the cardiovascular, cutaneous, and immune systems. Severe copper deficiency due to reduced absorption after bariatric bypass surgery has become frequent. CONCLUSION Deficiency is more frequent than previously recognized, probably because of changing nutrition patterns but also because of some treatments that have become very common such as bypass bariatric surgery and, in acute medicine, prolonged continuous renal replacement therapy. The patients may present with severe hematologic and neurologic complications that go untreated because copper deficiency was not considered in the differential diagnosis: These complications often need active intravenous repletion with doses 4-8 times the usual nutrition recommendations.
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Affiliation(s)
- Marco Altarelli
- Adult Intensive Care and Burn Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Nawfel Ben-Hamouda
- Adult Intensive Care and Burn Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Antoine Schneider
- Adult Intensive Care and Burn Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Mette M Berger
- Adult Intensive Care and Burn Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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Jakubek M, Kejík Z, Kaplánek R, Veselá H, Sýkora D, Martásek P, Král V. Perimidine-based synthetic receptors for determination of copper(II) in water solution. Supramol Chem 2017. [DOI: 10.1080/10610278.2017.1414216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Milan Jakubek
- First Faculty of Medicine, Charles University , Prague, Czech Republic
- Faculty of Chemical Engineering, Department of Analytical Chemistry, University of Chemistry and Technology , Prague, Czech Republic
| | - Zdeněk Kejík
- First Faculty of Medicine, Charles University , Prague, Czech Republic
| | - Robert Kaplánek
- First Faculty of Medicine, Charles University , Prague, Czech Republic
- Faculty of Chemical Engineering, Department of Analytical Chemistry, University of Chemistry and Technology , Prague, Czech Republic
| | - Hana Veselá
- Faculty of Chemical Engineering, Department of Analytical Chemistry, University of Chemistry and Technology , Prague, Czech Republic
| | - David Sýkora
- Faculty of Chemical Engineering, Department of Analytical Chemistry, University of Chemistry and Technology , Prague, Czech Republic
| | - Pavel Martásek
- First Faculty of Medicine, Charles University , Prague, Czech Republic
| | - Vladimír Král
- First Faculty of Medicine, Charles University , Prague, Czech Republic
- Faculty of Chemical Engineering, Department of Analytical Chemistry, University of Chemistry and Technology , Prague, Czech Republic
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