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Issanov A, Adewusi B, Saint-Jacques N, Dummer TJB. Arsenic in drinking water and lung cancer: A systematic review of 35 years of evidence. Toxicol Appl Pharmacol 2024; 483:116808. [PMID: 38218206 DOI: 10.1016/j.taap.2024.116808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/21/2023] [Accepted: 01/08/2024] [Indexed: 01/15/2024]
Abstract
The association between higher arsenic concentrations in drinking water and lung cancer is well-established. However, the risk associated with lower levels of arsenic exposure remains uncertain. This systematic review and meta-analysis summarizes the evidence on the relationship between exposure to arsenic in drinking water and lung cancer outcomes as measured over a broad range of exposures, including lower levels. A total of 51 studies were included in the review and 15 met criteria for inclusion in meta-analysis. Risk estimates for lung cancer incidence and mortality were pooled and analyzed separately using Bayesian hierarchical random-effects models with a Gaussian observation submodel for log(Risk), computed using the "brms" R package. For lung cancer incidence, the predicted posterior mean relative risks (RRs) at arsenic concentrations of 10, 50 and 150 μg/L were 1.11 (0.86-1.43), 1.67 (1.27-2.17) and 2.21 (1.61-3.02), respectively, with posterior probabilities of 79%, 100% and 100%, respectively, for the RRs to be >1. The posterior mean mortality ratios at 20, 50 and 150 μg/L were 1.22 (0.83-1.78), 2.10 (1.62-2.71) and 2.41 (1.88-3.08), respectively, with posterior probabilities being above 80%. In addition to observing the dose-response relationship, these findings demonstrate that individuals exposed to low to moderate levels of arsenic (<150 μg/L) were at an elevated risk of developing or dying from lung cancer. Given the widespread exposure to lower levels of arsenic, there is an urgent need for vigilance and potential revisions to regulatory guidelines to protect people from the cancer risks associated with arsenic exposure.
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Affiliation(s)
- Alpamys Issanov
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Betty Adewusi
- Nova Scotia Health Cancer Care Program, Nova Scotia Health, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada
| | - Nathalie Saint-Jacques
- Nova Scotia Health Cancer Care Program, Nova Scotia Health, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada; Department of Medicine, Dalhousie University, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada
| | - Trevor J B Dummer
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada.
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Linares AM, Thaxton-Wiggins A, Unrine JM. Concentrations of Lead and Arsenic in Mother's Milk and Children's Blood in Peruvian Breastfeeding Dyads. J Hum Lact 2024; 40:69-79. [PMID: 38084709 PMCID: PMC10984648 DOI: 10.1177/08903344231212430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Toxic trace elements could enter human milk through mothers' food consumption, drinking water, air, or incidental soil ingestion, and are of concern to the nursing infant. RESEARCH AIM To determine the concentration of toxic trace elements (lead and arsenic) in Peruvian mothers' milk and their association with blood concentrations in their own infants 3-20 months old. METHOD This exploratory, cross-sectional study, carried out in Peru, included breastfeeding mother/child dyads (N = 40). Following standardized protocols, biospecimens of human milk and child's blood were collected. RESULTS Lead and arsenic concentrations in milk were above the method detection limits in 73% and 100% of samples with median concentrations of 0.26 µg/L (IQR = 0.10, 0.33 µg/L) and 0.73 µg/L (IQR = 0.63, 0.91 µg/L), respectively. Concentrations of lead and arsenic in blood were 2.05 µg/dL (SD = 1.35), and 1.43 µg/dl (geometric mean: SD = 1.39), respectively. Blood lead concentrations in 12.5% (n = 5) of the samples were above the U.S. Center for Disease Control and Prevention reference value (< 3.5 µg/dl), and over half of arsenic concentrations were above the acceptable levels of < 1.3 µg/dl (Mayo Clinic Interpretative Handbook). Our results showed that for every one-month increase in age, lead blood concentrations increased by 0.1 µg/dl (p = 0.023). Additionally, every 1 µg/L increase in the mother's milk arsenic was associated with a 1.40 µg/dl increase in the child's blood arsenic concentration. CONCLUSIONS Implementing effective interventions to decrease the toxic exposure of reproductive-aged women is needed in Peru and worldwide.
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Affiliation(s)
| | | | - Jason M. Unrine
- Environmental Toxicology, Department of Plant and Soil Sciences. Agriculture Science Center North, Kentucky Water Resources Research Institute, University of Kentucky, Lexington, KY, USA
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Wang Q, Cui Q, Gao JP, Xing R. Role of iron biomarkers and iron intakes in lung cancer risk: A systematic review and meta-analysis. J Trace Elem Med Biol 2022; 74:127060. [PMID: 35987180 DOI: 10.1016/j.jtemb.2022.127060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND The role of iron biomarkers and iron intake in the susceptibility to lung cancer is unclear. The purpose of this study was to conduct a systematic review and meta-analysis, to assess the relationship between iron levels in the body or iron intake and the risk of lung cancer. METHOD This review is registered with PROSPERO (number CRD 42020199776). PubMed, Web of Science, Scopus, Embase and Cochrane were used to search for studies assessing the relationship between iron and lung cancer, up to July 15, 2021. Qualitative and quantitative analysis was carried out to determine if there was a correlation between iron biomarkers/intakes and the risk of lung cancer. RESULT Twenty articles were included. Pooled analyses demonstrated that serum ferritin concentrations and transferrin saturation (TSAT) were significantly higher in patients with lung cancer than in healthy controls (ferritin: standardized mean differences [SMD], 0.235, 95% confidence interval [CI], 0.129, 0.341, I2 = 32.1 %; TSAT: SMD, 0.07, 95 % CI, 0.018, 0.121, I2 = 0 %). In contrast, serum transferrin concentrations were significantly lower in patients with lung cancer than in healthy controls (SMD, -0.591, 95 % CI, -1.18, -0.003, I2 = 87.7 %). No significant effects of serum iron, lung tissue iron, bronchoalveolar lavage fluid (BALF) ferritin, or iron intake (total iron, dietary iron, heme iron, or non-heme iron) were found on lung cancer incidence. CONCLUSION Among the different iron biomarkers analyzed, a trend in association was only detected with serum ferritin, TSAT and transferrin concentration and no associations were found between iron intakes and the risk of lung cancer. However, more prospective studies are needed to strengthen the current evidence.
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Affiliation(s)
- Qian Wang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi Cui
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jin-Ping Gao
- Department of Oncology, General Hospital of Northern Theater Command, Shenyang, China
| | - Rui Xing
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China.
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Tindula G, Mukherjee SK, Ekramullah SM, Arman DM, Biswas SK, Islam J, Obrycki JF, Christiani DC, Liang L, Warf BC, Mazumdar M. Parental metal exposures as potential risk factors for spina bifida in Bangladesh. ENVIRONMENT INTERNATIONAL 2021; 157:106800. [PMID: 34358915 PMCID: PMC9008873 DOI: 10.1016/j.envint.2021.106800] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/08/2021] [Accepted: 07/26/2021] [Indexed: 06/11/2023]
Abstract
BACKGROUND Neural tube defects are a pressing public health concern despite advances in prevention from folic acid-based strategies. Numerous chemicals, in particular arsenic, have been associated with neural tube defects in animal models and could influence risk in humans. OBJECTIVES We investigated the relationship between parental exposure to arsenic and 17 metals and risk of neural tube defects (myelomeningocele and meningocele) in a case control study in Bangladesh. METHODS Exposure assessment included analysis of maternal and paternal toenail samples using inductively coupled plasma mass spectrometry (ICP-MS). A total of 278 participants (155 cases and 123 controls) with data collected from 2016 to 2020 were included in the analysis. RESULTS In the paternal models, a one-unit increase in the natural logarithm of paternal toenail arsenic was associated with a 74% (odds ratio: 1.74, 95% confidence interval: 1.26-2.42) greater odds of having a child with spina bifida, after adjusting for relevant covariates. Additionally, paternal exposure to aluminum, cobalt, chromium, iron, selenium, and vanadium was associated with increased odds of having a child with spina bifida in the adjusted models. In the maternal models, a one-unit increase in the natural logarithm of maternal toenail selenium and zinc levels was related to a 382% greater (odds ratio: 4.82, 95% confidence interval: 1.32-17.60) and 89% lower (odds ratio: 0.11, 95% confidence interval: 0.03-0.42) odds of having a child with spina bifida in the adjusted models, respectively. Results did not suggest an interaction between parental toenail metals and maternal serum folate. DISCUSSION Parental toenail levels of numerous metals were associated with increased risk of spina bifida in Bangladeshi infants. Paternal arsenic exposure was positively associated with neural tube defects in children and is of particular concern given the widespread arsenic poisoning of groundwater resources in Bangladesh and the lack of nutritional interventions aimed to mitigate paternal arsenic exposure. The findings add to the growing body of literature of the impact of metals, especially paternal environmental factors, on child health.
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Affiliation(s)
- Gwen Tindula
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Department of Neurology, Harvard Medical School, 25 Shattuck St, Boston, MA, United States
| | - Sudipta Kumer Mukherjee
- Department of Paediatric Neurosurgery, National Institute of Neurosciences and Hospital (NINS), Sher-e-Bangla Nagar, Agargoan, Dhaka 1207, Bangladesh
| | - Sheikh Muhammad Ekramullah
- Department of Paediatric Neurosurgery, National Institute of Neurosciences and Hospital (NINS), Sher-e-Bangla Nagar, Agargoan, Dhaka 1207, Bangladesh
| | - D M Arman
- Department of Paediatric Neurosurgery, National Institute of Neurosciences and Hospital (NINS), Sher-e-Bangla Nagar, Agargoan, Dhaka 1207, Bangladesh
| | - Subrata Kumar Biswas
- Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh
| | - Joynul Islam
- Department of Clinical Neurosurgery, National Institute of Neurosciences and Hospital (NINS), Sher-e-Bangla Nagar, Agargoan, Dhaka 1207, Bangladesh
| | - John F Obrycki
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Department of Neurology, Harvard Medical School, 25 Shattuck St, Boston, MA, United States
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, United States
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, United States
| | - Benjamin C Warf
- Department of Neurosurgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, United States; Department of Neurology, Harvard Medical School, 25 Shattuck St, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, United States.
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Maung MT, Carlson A, Olea-Flores M, Elkhadragy L, Schachtschneider KM, Navarro-Tito N, Padilla-Benavides T. The molecular and cellular basis of copper dysregulation and its relationship with human pathologies. FASEB J 2021; 35:e21810. [PMID: 34390520 DOI: 10.1096/fj.202100273rr] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/23/2021] [Accepted: 07/07/2021] [Indexed: 12/16/2022]
Abstract
Copper (Cu) is an essential micronutrient required for the activity of redox-active enzymes involved in critical metabolic reactions, signaling pathways, and biological functions. Transporters and chaperones control Cu ion levels and bioavailability to ensure proper subcellular and systemic Cu distribution. Intensive research has focused on understanding how mammalian cells maintain Cu homeostasis, and how molecular signals coordinate Cu acquisition and storage within organs. In humans, mutations of genes that regulate Cu homeostasis or facilitate interactions with Cu ions lead to numerous pathologic conditions. Malfunctions of the Cu+ -transporting ATPases ATP7A and ATP7B cause Menkes disease and Wilson disease, respectively. Additionally, defects in the mitochondrial and cellular distributions and homeostasis of Cu lead to severe neurodegenerative conditions, mitochondrial myopathies, and metabolic diseases. Cu has a dual nature in carcinogenesis as a promotor of tumor growth and an inducer of redox stress in cancer cells. Cu also plays role in cancer treatment as a component of drugs and a regulator of drug sensitivity and uptake. In this review, we provide an overview of the current knowledge of Cu metabolism and transport and its relation to various human pathologies.
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Affiliation(s)
- May T Maung
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, USA
| | - Alyssa Carlson
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, USA
| | - Monserrat Olea-Flores
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, Mexico
| | - Lobna Elkhadragy
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA
| | - Kyle M Schachtschneider
- Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA.,Department of Biochemistry & Molecular Genetics, University of Illinois at Chicago, Chicago, IL, USA.,National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Napoleon Navarro-Tito
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, Mexico
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Brainson CF, Huang B, Chen Q, McLouth LE, He C, Hao Z, Arnold SM, Zinner RG, Mullett TW, Bocklage TJ, Orren DK, Villano JL, Durbin EB. Description of a Lung Cancer Hotspot: Disparities in Lung Cancer Histology, Incidence, and Survival in Kentucky and Appalachian Kentucky. Clin Lung Cancer 2021; 22:e911-e920. [PMID: 33958300 DOI: 10.1016/j.cllc.2021.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/14/2021] [Accepted: 03/18/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Kentucky is recognized as the state with the highest lung cancer burden for more than 2 decades, but how lung cancer differs in Kentucky relative to other US populations is not fully understood. PATIENTS AND METHODS We examined lung cancer reported to the Surveillance, Epidemiology, and End Results (SEER) Program by Kentucky and the other SEER regions for patients diagnosed between 2012 and 2016. Our analyses included histologic types, incidence rates, stage at diagnosis, and survival in Kentucky and Appalachian Kentucky relative to other SEER regions. RESULTS We found that both squamous cell carcinomas and small-cell lung cancers represent larger proportions of lung cancer diagnoses in Kentucky and Appalachian Kentucky than they do in the SEER registries. Furthermore, age-adjusted cancer incidence rates were higher in Kentucky for every subtype of lung cancer examined. Most notably, for Appalachian women the rate of small-cell carcinomas was 3.5-fold higher, and for Appalachian men the rate of squamous cell carcinoma was 3.1-fold higher, than the SEER rates. In Kentucky, lung cancers were diagnosed at later stages and lung cancer survival was lower for adenocarcinoma and neuroendocrine carcinomas than in SEER registries. Squamous cell carcinomas and small-cell carcinomas were most lethal in Appalachian Kentucky. CONCLUSION Together, these data highlight the considerable disparities among lung cancer cases in the United States and demonstrate the continuing high burden and poor survival of lung cancer in Kentucky and Appalachian Kentucky. Strategies to identify and rectify causes of these disparities are discussed.
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Affiliation(s)
- Christine F Brainson
- Department of Toxicology and Cancer Biology, College of Medicine, University of Kentucky, Lexington, KY; Markey Cancer Center, University of Kentucky, Lexington, KY.
| | - Bin Huang
- Markey Cancer Center, University of Kentucky, Lexington, KY; Division of Cancer Biostatistics, College of Medicine, University of Kentucky, Lexington, KY; Kentucky Cancer Registry, Markey Cancer Center, University of Kentucky, Lexington, KY
| | - Quan Chen
- Markey Cancer Center, University of Kentucky, Lexington, KY; Kentucky Cancer Registry, Markey Cancer Center, University of Kentucky, Lexington, KY
| | - Laurie E McLouth
- Markey Cancer Center, University of Kentucky, Lexington, KY; Department of Behavioral Science, Center for Health Equity Transformation, College of Medicine, University of Kentucky, Lexington, KY
| | - Chunyan He
- Markey Cancer Center, University of Kentucky, Lexington, KY; Department of Medicine, Division of Medical Oncology, College of Medicine, University of Kentucky, Lexington, KY
| | - Zhonglin Hao
- Markey Cancer Center, University of Kentucky, Lexington, KY; Department of Medicine, Division of Medical Oncology, College of Medicine, University of Kentucky, Lexington, KY
| | - Susanne M Arnold
- Markey Cancer Center, University of Kentucky, Lexington, KY; Department of Medicine, Division of Medical Oncology, College of Medicine, University of Kentucky, Lexington, KY
| | - Ralph G Zinner
- Markey Cancer Center, University of Kentucky, Lexington, KY; Department of Medicine, Division of Medical Oncology, College of Medicine, University of Kentucky, Lexington, KY
| | - Timothy W Mullett
- Department of Surgery, Division of Cardiothoracic Surgery, College of Medicine, University of Kentucky, Lexington, KY
| | - Therese J Bocklage
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Kentucky, Lexington, KY
| | - David K Orren
- Department of Toxicology and Cancer Biology, College of Medicine, University of Kentucky, Lexington, KY; Markey Cancer Center, University of Kentucky, Lexington, KY
| | - John L Villano
- Markey Cancer Center, University of Kentucky, Lexington, KY; Department of Medicine, Division of Medical Oncology, College of Medicine, University of Kentucky, Lexington, KY
| | - Eric B Durbin
- Markey Cancer Center, University of Kentucky, Lexington, KY; Kentucky Cancer Registry, Markey Cancer Center, University of Kentucky, Lexington, KY; Division of Biomedical Informatics, Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY
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Liu N, Guan Y, Li B, Yao S. Biomonitorization of concentrations of 28 elements in serum and urine among workers exposed to indium compounds. PLoS One 2021; 16:e0246943. [PMID: 33617552 PMCID: PMC7899351 DOI: 10.1371/journal.pone.0246943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022] Open
Abstract
Many studies have documented the abnormal concentrations of metals/metalloids in serum or urine of occupational workers, but no works systematically analysed the concentrations of elements in serum or urine of indium-exposed workers. This study was aimed to assess 28 elements in serum and urine from 57 individuals with occupational exposure to indium and its compounds. Control subjects were 63 workers without metal exposure. We collected information on occupation and lifestyle habits by questionnaire. Biological samples were collected to quantify elements by inductive coupled plasma-mass spectrometer. Air in the breathing zones was drawn at flow rates of 1.5-3 L/min for a sampling period of 6 to 8 h, using a Model BFC-35 pump. The average ambient indium level was 0.078 mg/m3. Serum/urine Indium levels were significantly higher in indium-exposed workers than in controls (P < 0.01). Moreover, serum/urine indium concentrations in the group with 6-14 years and ≥15 years of employment were significantly higher than those with ≤5 employment years(P < 0.05). Ten of the other 27 elements/metals measured were higher in serum/urine in indium-exposed workers compared to the controls (aluminum, beryllium, cadmium, cesium, chromium, lithium, manganese, magnesium, molybdenum and vanadium). Zinc levels in serum/urine were significantly decreased in the indium-exposed workers. Additionally, other elements/metals were higher in one specimen (serum or urine) but lower in the other (Selenium was lower in serum but higher in urine in the indium-exposed workers compared with the controls; likewise Thallium and Rubidium were higher in serum but lower in urine). Linear regression analyses, revealed significant correlations between serum and urine for indium, aluminum, arsenic, barium, cadmium, cesium, cobalt, selenium, silver, and zinc (P < 0.05). These data suggest that occupational exposure to indium and its compounds may disturb the homeostasis of trace elements in systemic circulation, indium concentrations in serum or urine appear reflective of workers' exposure to ambient indium and their years of working, respectively. The serum/urine levels of essential metals are modified by exposure to indium in occupationally exposed workers. Further studies including larger sample size and more kinds of biological sample are needed to validate our findings.
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Affiliation(s)
- Nan Liu
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yi Guan
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Bin Li
- Institute for Occupational Health and Poison Control in China Center for Disease Prevention and Control, Beijing, China
| | - Sanqiao Yao
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
- Xinxiang Medical University, Xinxiang, China
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Zabłocka-Słowińska K, Prescha A, Płaczkowska S, Porębska I, Kosacka M, Pawełczyk K. Serum and Whole Blood Cu and Zn Status in Predicting Mortality in Lung Cancer Patients. Nutrients 2020; 13:nu13010060. [PMID: 33375477 PMCID: PMC7824662 DOI: 10.3390/nu13010060] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 12/16/2022] Open
Abstract
Alterations in circulating Cu and Zn are negative predictors of survival in neoplastic patients and are known during lung cancer. However, no data on predicting mortality of lung cancer patients based on the level of these elements in the blood have been presented to date. The aims of this prospective cohort study were as follows: (i) To evaluate the disturbances in serum and whole blood Cu and Zn, (ii) to assess the relationships between serum and whole blood Cu and Zn status and clinical, sociodemographic, and nutritional data, and (iii) to investigate the association of Cu and Zn status with all-cause mortality in lung cancer. Naïve-treatment lung cancer patients (n = 167) were characterized in terms of sociodemographic, clinical, and anthropometric data and dietary intake and compared with sex-matched control subjects (n = 48). Whole blood and serum Cu and Zn status was determined by atomic absorption spectrometry. Cox proportional hazards models adjusted for multiple confounders/mediators were used to estimate the association between all-cause death and Cu and Zn status. Sex, cardiovascular disease, chronic obstructive pulmonary disease, clinical stage, and hemoglobin, platelet, and glucose concentrations significantly differentiated Cu and Zn status. All-cause mortality in lung cancer patients was positively associated with serum Cu levels, Cu:Zn ratio, and whole blood Zn levels. However, an advanced clinical stage of disease was the strongest predictor of all-cause mortality. Circulatory status of Cu and Zn might be included in routine clinical characteristics of patients with lung cancer patients as additional prognostic variables, but only after further more detail studies.
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Affiliation(s)
- Katarzyna Zabłocka-Słowińska
- Department of Food Science and Dietetics, Wroclaw Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland;
- Correspondence:
| | - Anna Prescha
- Department of Food Science and Dietetics, Wroclaw Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland;
| | - Sylwia Płaczkowska
- Diagnostics Laboratory for Teaching and Research, Department of Laboratory Diagnostics Wroclaw Medical University, ul. Borowska 211a, 50-556 Wroclaw, Poland;
| | - Irena Porębska
- Department and Clinic of Pulmonology and Lung Cancers, Wroclaw Medical University, ul. Grabiszynska 105, 53-439 Wroclaw, Poland; (I.P.); (M.K.)
| | - Monika Kosacka
- Department and Clinic of Pulmonology and Lung Cancers, Wroclaw Medical University, ul. Grabiszynska 105, 53-439 Wroclaw, Poland; (I.P.); (M.K.)
| | - Konrad Pawełczyk
- Department and Clinic of Thoracic Surgery, Wroclaw Medical University, ul. Grabiszynska 105, 53-439 Wroclaw, Poland;
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Fischer RSB, Unrine JM, Vangala C, Sanderson WT, Mandayam S, Murray KO. Evidence of nickel and other trace elements and their relationship to clinical findings in acute Mesoamerican Nephropathy: A case-control analysis. PLoS One 2020; 15:e0240988. [PMID: 33170853 PMCID: PMC7654766 DOI: 10.1371/journal.pone.0240988] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
Background Although there are several hypothesized etiologies of Mesoamerican Nephropathy (MeN), evidence has not yet pointed to the underlying cause. Exposure to various trace elements can cause the clinical features observed in MeN. Methods and findings We measured 15 trace elements, including heavy metals, in renal case-patients (n = 18) and healthy controls (n = 36) in a MeN high-risk region of Nicaragua. Toenails clippings from study participants were analyzed using inductively coupled plasma mass spectrometry. A case-control analysis was performed, and concentrations were also analyzed over participant characteristics and clinical parameters. Nickel (Ni) concentrations were significantly higher in toenails from cases (1.554 mg/kg [0.176–42.647]) than controls (0.208 mg/kg [0.055–51.235]; p<0.001). Ni concentrations correlated positively with serum creatinine levels (p = 0.001) and negatively with eGFR (p = 0.001). Greater Ni exposure was also associated with higher leukocyte (p = 0.001) and neutrophil (p = 0.003) counts, fewer lymphocytes (p = 0.003), and lower hemoglobin (p = 0.004) and hematocrit (p = 0.011). Conclusions Low-dose, chronic environmental exposure to Ni is a possible health risk in this setting. Ni intoxication and resulting systemic and renal effects could explain the clinical signs observed during early MeN. This study provides compelling evidence for a role of Ni in the acute renal impairment observed in this MeN high-risk population. Additional work to assess exposure levels in a larger and heterogeneous population, identify environmental sources of Ni and exposure pathways, and evaluate the link between Ni and MeN pathogenesis are urgently needed.
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Affiliation(s)
- Rebecca S. B. Fischer
- Section of Tropical Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, United States of America
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, United States of America
| | - Jason M. Unrine
- Department of Plant and Soil Sciences, College of Agriculture, Food, and Environment, University of Kentucky, Lexington, KY, United States of America
| | - Chandan Vangala
- Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Wayne T. Sanderson
- Departments of Epidemiology and Preventive Medicine and Environmental Health, Southeast Center for Agricultural Health and Injury Prevention, College of Public Health, University of Kentucky, Lexington, KY, United States of America
| | - Sreedhar Mandayam
- Section of Nephrology, Department of Medicine, MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Kristy O. Murray
- Section of Tropical Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, United States of America
- William T. Shearer Center for Human Immunobiology, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas, United States of America
- * E-mail:
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Christian WJ, Walker CJ, Huang B, Levy JE, Durbin E, Arnold S. Using residential histories in case-control analysis of lung cancer and mountaintop removal coal mining in Central Appalachia. Spat Spatiotemporal Epidemiol 2020; 35:100364. [PMID: 33138948 DOI: 10.1016/j.sste.2020.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/19/2020] [Accepted: 07/20/2020] [Indexed: 01/09/2023]
Abstract
Population-based ecological and cross-sectional studies have observed high risk for several cancers in areas of Central Appalachia where mountaintop removal coal mines operate. Case-control studies could provide stronger evidence of such relationships, but misclassification of exposure is likely when based on current residence, since individuals could have inhabited several residences with varying environmental exposures over many years. To address this, we used residential histories for individuals enrolled in a previous case-control study of lung cancer to assess residential proximity to mountaintop removal coal mining over a 30-year period, using both survey data and proprietary data from LexisNexis, Inc. Supplementing the survey data with LexisNexis data improved precision and completeness of geographic coordinates. Final logistic regression models revealed higher odds of high exposure among cases. These findings suggest that living in close proximity to mountaintop removal coal mining sites could increase risk for lung cancer, after adjusting for other relevant factors.
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Affiliation(s)
- W J Christian
- Dept. of Epidemiology College of Public Health, University of Kentucky, Lexington, Kentucky, USA.
| | - C J Walker
- Dept. of Epidemiology College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - B Huang
- Kentucky Cancer Registry, Lexington, Kentucky, USA
| | - J E Levy
- Dept. of Geography College of Arts & Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - E Durbin
- Kentucky Cancer Registry, Lexington, Kentucky, USA
| | - S Arnold
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
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Dantzer J, Ryan P, Yolton K, Parsons PJ, Palmer CD, Cecil K, Unrine JM. A comparison of blood and toenails as biomarkers of children's exposure to lead and their correlation with cognitive function. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 700:134519. [PMID: 31698272 PMCID: PMC6939637 DOI: 10.1016/j.scitotenv.2019.134519] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 05/25/2023]
Abstract
This study sought to compare lead (Pb) concentrations in toenails and blood and to investigate the association of each biomarker with children's cognitive function. Toenails and whole blood samples were collected from 224 twelve-year-old children, and their full-scale intelligence quotient (FSIQ) was assessed using the Wechsler Intelligence Scale for Children-4th edition. Inductively coupled plasma-mass spectrometry was used to determine blood (BPb) and toenail (TPb) Pb concentrations. Log BPb and Log TPb were significantly correlated (r2 = 0.49, p < 0.001). In unadjusted analyses, both log-transformed BPb and TPb were significantly associated with decreased FSIQ, but BPb accounted for approximately quadruple the FSIQ scores' variability than log-transformed TPb (model R2 = 0.12 and R2 = 0.03, respectively). After adjusting for neighborhood deprivation, caregiver intelligence (assessed with the Wechsler Abbreviated Scale of Intelligence-2nd edition), and child BMI, BPb remained significantly associated with decreased FSIQ, while TPb did not (p = 0.16). These results suggest that while concentrations of Pb in blood and toenails are correlated, TPb does not predict cognitive outcomes at these exposure levels. With caution and in conjunction with BPb, TPb may be used as a population-based biomarker of Pb exposure.
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Affiliation(s)
- Julianna Dantzer
- Department of Plant and Soil Sciences, University of Kentucky, Lexington, KY, USA
| | - Patrick Ryan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kimberly Yolton
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Patrick J Parsons
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, School of Public Health, The University of Albany, Rennselaer, NY, USA
| | - Christopher D Palmer
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, School of Public Health, The University of Albany, Rennselaer, NY, USA
| | - Kim Cecil
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jason M Unrine
- Department of Plant and Soil Sciences, University of Kentucky, Lexington, KY, USA; Department of Toxicology and Cancer Biology, University of Kentucky, Lexington, KY, USA.
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