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Feiler MO, Kulick ER, Sinclair K, Spiegel N, Habel S, Castello OG. Toxic metals and pediatric clinical immune dysfunction: A systematic review of the epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:172303. [PMID: 38599398 DOI: 10.1016/j.scitotenv.2024.172303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Children are at high risk for exposure to toxic metals and are vulnerable to their effects. Significant research has been conducted evaluating the role of these metals on immune dysfunction, characterized by biologic and clinical outcomes. However, there are inconsistencies in these studies. The objective of the present review is to critically evaluate the existing literature on the association between toxic metals (lead, mercury, arsenic, and cadmium) and pediatric immune dysfunction. METHODS Seven databases (PubMed (NLM), Embase (Elsevier), CINAHL (Ebsco), Web of Science (Clarivate Analytics), ProQuest Public Health Database, and ProQuest Environmental Science Collection) were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in February 2024. Rayaan software identified duplicates and screened by title and abstract in a blinded and independent review process. The remaining full texts were reviewed for content and summarized. Exclusions during the title, abstract, and full-text reviews included: 1) not original research, 2) not epidemiology, 3) did not include toxic metals, 4) did not examine an immune health outcome, or 5) not pediatric (>18 years). This systematic review protocol followed the PRISMA guidelines. Rayaan was used to screen records using title and abstract by two blinded and independent reviewers. This process was repeated for full-text article screening selection. RESULTS The search criteria produced 7906 search results; 2456 duplicate articles were removed across search engines. In the final review, 79 studies were included which evaluated the association between toxic metals and outcomes indicative of pediatric immune dysregulation. CONCLUSIONS The existing literature suggests an association between toxic metals and pediatric immune dysregulation. Given the imminent threat of infectious diseases demonstrated by the recent COVID-19 epidemic in addition to increases in allergic disease, understanding how ubiquitous exposure to these metals in early life can impact immune response, infection risk, and vaccine response is imperative.
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Affiliation(s)
- Marina Oktapodas Feiler
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, United States of America; Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America.
| | - Erin R Kulick
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Krystin Sinclair
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Nitzana Spiegel
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Sonia Habel
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Olivia Given Castello
- Charles Library, Temple University Libraries, Temple University, United States of America
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Olarewaju E, Obeng-Gyasi E. Cadmium, Lead, Chronic Physiological Stress and Endometrial Cancer: How Environmental Policy Can Alter the Exposure of At-Risk Women in the United States. Healthcare (Basel) 2023; 11:healthcare11091278. [PMID: 37174820 PMCID: PMC10178079 DOI: 10.3390/healthcare11091278] [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: 03/09/2023] [Revised: 04/04/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
The health and life outcomes of individuals are intertwined with the context in which they grow and live. The totality of exposures one experiences affects health in the short term and throughout the life course. Environmental exposure to multiple contaminants can increase stress levels in individuals and neighborhoods with psychosocial stressors such as crime, drug and alcohol misuse, and violence also taking a toll on individual and neighborhood wellbeing. In addition, the availability, organization, and quality of local institutions and infrastructure all affect health in the short and long term. The role of these factors in endometrial cancer will be explored in this paper. In addition, policy implications regarding lead, chronic physiological stress, and endometrial cancer will be explored to ascertain the impact of these factors on at-risk women.
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Affiliation(s)
- Elizabeth Olarewaju
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
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Zheng K, Zeng Z, Tian Q, Huang J, Zhong Q, Huo X. Epidemiological evidence for the effect of environmental heavy metal exposure on the immune system in children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 868:161691. [PMID: 36669659 DOI: 10.1016/j.scitotenv.2023.161691] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/28/2022] [Accepted: 01/14/2023] [Indexed: 06/17/2023]
Abstract
Heavy metals exist widely in daily life, and exposure to heavy metals caused by environmental pollution has become a serious public health problem worldwide. Due to children's age-specific behavioral characteristics and imperfect physical function, the adverse health effects of heavy metals on children are much higher than in adults. Studies have found that heavy metal exposure is associated with low immune function in children. Although there are reviews describing the evidence for the adverse effects of heavy metal exposure on the immune system in children, the summary of evidence from epidemiological studies involving the level of immune molecules is not comprehensive. Therefore, this review summarizes the current epidemiological study on the effect of heavy metal exposure on childhood immune function from multiple perspectives, emphasizing its risks to the health of children's immune systems. It focuses on the effects of six heavy metals (lead (Pb), cadmium (Cd), arsenic (As), mercury (Hg), nickel (Ni), and manganese (Mn)) on children's innate immune cells, lymphocytes and their subpopulations, cytokines, total and specific immunoglobulins, and explores the immunotoxicological effects of heavy metals. The review finds that exposure to heavy metals, particularly Pb, Cd, As, and Hg, not only reduced lymphocyte numbers and suppressed adaptive immune responses in children, but also altered the innate immune response to impair the body's ability to fight pathogens. Epidemiological evidence suggests that heavy metal exposure alters cytokine levels and is associated with the development of inflammatory responses in children. Pb, As, and Hg exposure was associated with vaccination failure and decreased antibody titers, and increased risk of immune-related diseases in children by altering specific immunoglobulin levels. Cd, Ni and Mn showed activation effects on the immune response to childhood vaccination. Exposure age, sex, nutritional status, and co-exposure may influence the effects of heavy metals on immune function in children.
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Affiliation(s)
- Keyang Zheng
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Zhijun Zeng
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China
| | - Qianwen Tian
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Jintao Huang
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Qi Zhong
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, School of Environment, Jinan University, 855 East Xingye Avenue, Guangzhou 511443, Guangdong, China.
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Ghosh R, Goyal T, Mitra P, Malavika L, Sharma S, Sharma P. Association Between Circulating Plasmacytoid Dendritic Cell Percentage and Blood Lead Levels in Children. Biol Trace Elem Res 2021; 199:2508-2513. [PMID: 32918715 DOI: 10.1007/s12011-020-02383-6] [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: 08/01/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
Lead (Pb) exposure is known to cause T helper 1 (Th1) to T helper 2 (Th2) shift in the immune response. The mechanism responsible for these effects is unclear. Plasmacytoid dendritic cells (pDCs) are known as the principal secretor of type 1 interferons (IFNs), which have a stimulatory effect on Th1 differentiation. However, no previous study has explored the effect of Pb on pDCs. Thus, the present study was conducted to explore the correlation between circulating pDC count, serum IFNα (pan) levels, and blood lead levels (BLLs) in children environmentally exposed to Pb. A total of 82 school-going children were recruited from government and private schools in Jodhpur. BLL, pDC percentages, and serum IFNα (pan) levels were estimated by atomic absorption spectrometry, flow cytometry, and ELISA, respectively, in 82 samples. The participants were divided as per BLL quartiles into 4 groups: (A) BLL < 3 μg/dL (n = 21), (B) BLL = 3-4.08 μg/dL (n = 20), (C) BLL = 4.08-6.17 μg/dL (n = 20), and (D) BLL > 6.17 μg/dL (n = 21). Only in category D, pDC percentages showed a significant positive correlation with BLL (Spearman's R = 0.5). Therefore, this preliminary data suggests that BLL might modulate pDC levels in a dose-dependent manner.
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Affiliation(s)
- Raghumoy Ghosh
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Taru Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prasenjit Mitra
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - L Malavika
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Shailja Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
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Folorunso OM, Frazzoli C, Chijioke-Nwauche I, Bocca B, Orisakwe OE. Toxic Metals and Non-Communicable Diseases in HIV Population: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:492. [PMID: 34068196 PMCID: PMC8152992 DOI: 10.3390/medicina57050492] [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] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 12/29/2022]
Abstract
Background and Objectives: HIV has been a serious global health concern since its discovery, with about 37.9 million people living with HIV worldwide as of 2018. Sub-Saharan Africa (SSA) accounts for 68% of the infection and contributed 74% of the 1.5 million deaths in 2013 despite having only 12% of the total world population residing in the region. This systematic review has attempted to determine the association between heavy metal toxicity and the occurrence of non-communicable diseases in the HIV/AIDS population. Materials and Methods: Three databases were systematically searched: PubMed, Scopus, and Google Scholar for studies written in English and published between 1 April 2000 and 12 April 2020. Studies were excluded if the main outcomes were not measured or did not meet the inclusion criteria. Results: All the six included studies are cross-sectional in design, and therefore were evaluated using the STROBE checklist. The data extraction was done using an extraction table; the ratio of female to male participants included in the study was 1.09:1. Qualitative analysis was used due to the heterogeneity in the heavy metal biomarkers and the outcome measured by the included studies. Two studies compared the concentration of heavy metals in HIV-positive and HIV-negative participants while one compared the levels between HAART-naïve and HAART-treated participants, and three determined the association between heavy metal toxicity and non-communicable diseases (liver fibrosis, anaemia, and reproductive parameters, respectively) in HIV-positive patients. Conclusions: Blood lead, cadmium, and mercury levels were higher in HIV-seropositive than -seronegative subjects, whereas serum zinc level was lower in HIV-seropositive than -seronegative subjects, but the causal association between heavy metals and non-communicable diseases in HIV subjects is largely unknown. Interdisciplinary research between nutrition, toxicology, and human health is envisaged for primary and secondary prevention and treatment.
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Affiliation(s)
- Opeyemi M. Folorunso
- African Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, Port Harcourt 5323, Rivers State, Nigeria;
| | - Chiara Frazzoli
- Department for Cardiovascular, Endocrine-Metabolic Diseases, and Aging, Istituto Superiore di Sanità, 00162 Rome, Italy;
| | - Ifeyinwa Chijioke-Nwauche
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Port Harcourt, Port Harcourt 5323, Rivers State, Nigeria;
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Orish E. Orisakwe
- African Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, Port Harcourt 5323, Rivers State, Nigeria;
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port Harcourt, Port Harcourt 5323, Rivers State, Nigeria
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Quinete N, Hauser-Davis RA. Drinking water pollutants may affect the immune system: concerns regarding COVID-19 health effects. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:1235-1246. [PMID: 33156499 PMCID: PMC7644792 DOI: 10.1007/s11356-020-11487-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/30/2020] [Indexed: 05/12/2023]
Abstract
The current coronavirus pandemic is leading to significant impacts on the planet, changing our way of life. Although the COVID-19 virus mechanisms of action and pathogenesis are still under extensive research, immune system effects are evident, leading, in many cases, to respiratory distress. Although apparent pollution reduction has been noticed by the population, environmental and human health impacts due to the increased use of plastic waste and disinfectants is concerning. One of the main routes of human exposure to pollutants is through drinking water. Thus, this point of view discusses some major contaminants in drinking water known to be immunotoxic, exploring sources and drinking water routes and emphasizing the known mechanisms of action that could likely compromise the effective immune response of humans, particularly raising concerns regarding people exposed to the COVID-19 virus. Based on a literature review, metals, plastic components, plasticizers, and per- and polyfluoroalkyl substances may display the potential to exacerbate COVID-19 respiratory symptoms, although epidemiological studies are still required to confirm the synergistic effects between these pollutants and the virus.
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Affiliation(s)
- Natalia Quinete
- Institute of Environment & Department of Chemistry and Biochemistry, Florida International University, 11200 SW 8th Street, Modesto A. Maidique Campus, Miami, FL, 33199, USA.
| | - Rachel Ann Hauser-Davis
- Laboratório de Avaliação e Promoção da Saúde Ambiental, Instituto Oswaldo Cruz, Fiocruz, Av. Brazil, 4.365, Manguinhos, Rio de Janeiro, RJ, 21040-360, Brazil
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Oktapodas Feiler M, Caserta MT, van Wijngaarden E, Thevenet-Morrison K, Hardy DJ, Zhang YV, Dozier AM, Lawrence BP, Jusko TA. Environmental Lead Exposure and Influenza and Respiratory Syncytial Virus Diagnoses in Young Children: A Test-Negative Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207625. [PMID: 33086756 PMCID: PMC7590174 DOI: 10.3390/ijerph17207625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 01/05/2023]
Abstract
Experimental and epidemiological evidence suggests that environmental toxicants may influence susceptibility to influenza and respiratory syncytial virus (RSV). The objective of the present study was to estimate the association between blood lead concentrations and the odds of child influenza or RSV infection. A test-negative, case-control study was conducted among 617 children, <4 years of age, tested for influenza/RSV from 2012-2017 in Rochester, NY. There were 49 influenza cases (568 controls) and 123 RSV cases (494 controls). Blood lead concentrations reported in children's medical records were linked with influenza/RSV lab test results. Covariables were collected from medical records, birth certificates, and U.S. census data. In this sample, evidence of an association between blood lead levels and RSV or influenza diagnosis was not observed. Children with a lead level ≥1 μg/dL vs. <1 μg/dL had an adjusted odds ratio (aOR) and 95% confidence limit of 0.95 (0.60, 1.49) for RSV and 1.34 (0.65, 2.75) for influenza. In sex-specific analyses, boys with lead concentrations ≥1 μg/dL vs. <1 μg/dL had an aOR = 1.89 (1.25, 2.86) for influenza diagnosis, while the estimates were inconsistent for girls. These results are suggestive of sex-specific associations between blood lead levels and the risk of influenza, although the sample size was small.
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Affiliation(s)
- Marina Oktapodas Feiler
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA; (E.v.W.); (B.P.L.); (T.A.J.)
- Correspondence:
| | - Mary T. Caserta
- Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA;
| | - Edwin van Wijngaarden
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA; (E.v.W.); (B.P.L.); (T.A.J.)
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, 265 Crittenden Blvd, Rochester, NY 14620, USA; (K.T.-M.); (A.M.D.)
| | - Kelly Thevenet-Morrison
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, 265 Crittenden Blvd, Rochester, NY 14620, USA; (K.T.-M.); (A.M.D.)
| | - Dwight J. Hardy
- Department of Microbiology and Immunology, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA;
| | - Yan Victoria Zhang
- Department of Pathology and Laboratory Medicine, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA;
| | - Ann M. Dozier
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, 265 Crittenden Blvd, Rochester, NY 14620, USA; (K.T.-M.); (A.M.D.)
| | - B. Paige Lawrence
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA; (E.v.W.); (B.P.L.); (T.A.J.)
- Department of Microbiology and Immunology, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA;
| | - Todd A. Jusko
- Department of Environmental Medicine, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA; (E.v.W.); (B.P.L.); (T.A.J.)
- Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA;
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, 265 Crittenden Blvd, Rochester, NY 14620, USA; (K.T.-M.); (A.M.D.)
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Pukanha K, Yimthiang S, Kwanhian W. The Immunotoxicity of Chronic Exposure to High Levels of Lead: An Ex Vivo Investigation. TOXICS 2020; 8:toxics8030056. [PMID: 32823721 PMCID: PMC7560427 DOI: 10.3390/toxics8030056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/08/2020] [Accepted: 08/12/2020] [Indexed: 01/12/2023]
Abstract
Lead (Pb) is a toxic metal known for its wide-ranging adverse health effects. However, a compound of Pb is still used in the caulking process to repair wooden fishing boats. The present study aimed to measure Pb exposure and its immunologic effects in boatyard workers in Nakhon Si Thammarat province, Thailand, in comparison with an age-matched control group of farmers. The age, body mass index, and smoking history in workers (n = 14) and controls (n = 16) did not differ. The median blood Pb concentration was 8.7-fold higher in workers than controls (37.1 versus 4.3 µg/dL, p < 0.001). Workers had 8.4% lower phagocytic active cells than controls (89.9% versus 98.1%, p = 0.019). In response to a mitogen stimulation, the peripheral blood mononuclear cells (PBMCs) from workers produced 2-fold higher ratios of interleukin-4 (IL-4) to interferon-γ than the PBMCs from controls (p = 0.026). Furthermore, Pb-exposed workers had 33.9% lower cytotoxic T (Tc) cells than controls (24.3% versus 36.8%, p = 0.004). In stark contrast, the percentage of regulatory T (Treg) cells in workers was 2.7-fold higher than controls (6.1% versus 2.3%, p < 0.001). In all subjects, blood Pb showed positive correlations with the percentages of Treg cells (r = 0.843, p < 0.001) and IL-4 (r = 0.473, p = 0.041) while showing an inverse correlation with the percentages of Tc cells (r = −0.563, p = 0.015). These findings indicate that chronic high Pb exposure may cause a shift towards humoral immune response, together with a suppression of cellular immunity, thereby suggesting an elevation in cancer risk in Pb-exposed workers.
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Affiliation(s)
- Kawinsaya Pukanha
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80161, Thailand;
| | - Supabhorn Yimthiang
- School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand;
| | - Wiyada Kwanhian
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80161, Thailand;
- Correspondence:
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Di Lenardo TZ, Ward BJ, Pillet S, Mann K, Bornman R, Obida M, Chevrier J. Exposure to lead and vaccine-specific IgG titers in South African children participating in the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE): A longitudinal study. ENVIRONMENTAL RESEARCH 2020; 180:108794. [PMID: 31655331 DOI: 10.1016/j.envres.2019.108794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND While successes have been achieved in reducing global exposure to lead, few studies have investigated the potential health effects of low-level exposure (e.g. blood lead levels [BLLs] below the CDC reference level of 5 μg/dL), particularly among children from low- and middle-income countries. In addition, lead is immunotoxic in animals but human data on immune response to vaccines is limited. Our aim was to determine whether low-level exposure to lead is associated with humoral response to vaccines among rural South African children. METHODS We used data from the Venda Health Examination of Mothers, Babies and their Environment (VHEMBE), a birth cohort study conducted in Limpopo, South Africa. BLLs were measured in whole blood collected at age 1 year and IgG titers for measles, tetanus and Haemophilus influenzae type B (Hib) were determined at age 3.5 years among 425 fully-vaccinated children. RESULTS BLLs were low (median = 1.90 μg/dL) and 94% of children had a BLL below 5 μg/dL. Overall, BLLs were associated with higher risks of having IgG titers below the protective limit for tetanus (RR = 1.88 per 10-fold increase; 95%CI = 1.08, 3.24) but not measles (RR = 1.02; 95%CI = 0.26, 3.95) or Hib (RR = 0.96; 95%CI = 0.54, 1.71). BLLs were also associated with low Hib IgG titers among children exposed to HIV in utero and with low measles IgG titers among females. In contrast, the association with measles IgG titers was positive among males. CONCLUSION Low-level exposure to lead may compromise the humoral response to vaccines. Children exposed to HIV in utero and females may be particularly susceptible.
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Affiliation(s)
- Thomas Z Di Lenardo
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Brian J Ward
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Division of Experimental Medicine, Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Stéphane Pillet
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Koren Mann
- Division of Experimental Medicine, Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Gerald Bronfman Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Riana Bornman
- University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Muvhulawa Obida
- University of Pretoria Institute for Sustainable Malaria Control and School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Jonathan Chevrier
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
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Jusko TA, Singh K, Greener EA, Oktapodas Feiler M, Thevenet-Morrison K, Lawrence BP, Wright RO, Thurston SW. Blood Lead Concentrations and Antibody Levels to Measles, Mumps, and Rubella among U.S. Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173035. [PMID: 31443341 PMCID: PMC6747326 DOI: 10.3390/ijerph16173035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/10/2019] [Accepted: 08/13/2019] [Indexed: 11/16/2022]
Abstract
Child blood lead concentrations have been associated with measures of immune dysregulation in nationally representative study samples. However, response to vaccination-often considered the gold standard in immunotoxicity testing-has not been examined in relation to typical background lead concentrations common among U.S. children. The present study estimated the association between blood lead concentrations and antigen-specific antibody levels to measles, mumps, and rubella in a nationally representative sample of 7005 U.S. children aged 6-17 years. Data from the 1999-2004 cycles of the National Health and Nutrition Examination Survey (NHANES) were used. In the adjusted models, children with blood lead concentrations between 1 and 5 µg/dL had an 11% lower anti-measles (95% CI: -16, -5) and a 6% lower anti-mumps antibody level (95% CI: -11, -2) compared to children with blood lead concentrations <1 µg/dL. The odds of a seronegative anti-measles antibody level was approximately two-fold greater for children with blood lead concentrations between 1 and 5 µg/dL compared to children with blood lead concentrations <1 µg/dL (OR = 2.0, 95% CI: 1.4, 3.1). The adverse associations observed in the present study provide further evidence of potential immunosuppression at blood lead concentrations <5 µg/dL, the present Centers for Disease Control and Prevention action level.
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Affiliation(s)
- Todd A Jusko
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
| | - Kyra Singh
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Elizabeth A Greener
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Marina Oktapodas Feiler
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Kelly Thevenet-Morrison
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - B Paige Lawrence
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
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Mitra P, Sharma S, Purohit P, Sharma P. Clinical and molecular aspects of lead toxicity: An update. Crit Rev Clin Lab Sci 2017; 54:506-528. [DOI: 10.1080/10408363.2017.1408562] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Prasenjit Mitra
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Shailja Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Purvi Purohit
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
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12
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Zeng X, Xu X, Boezen HM, Huo X. Children with health impairments by heavy metals in an e-waste recycling area. CHEMOSPHERE 2016; 148:408-15. [PMID: 26829309 DOI: 10.1016/j.chemosphere.2015.10.078] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 10/10/2015] [Accepted: 10/19/2015] [Indexed: 02/05/2023]
Abstract
E-waste recycling has become a global environmental health issue. Pernicious chemicals escape into the environment due to informal and nonstandard e-waste recycling activities involving manual dismantling, open burning to recover heavy metals and open dumping of residual fractions. Heavy metals derived from electronic waste (e-waste), such as, lead (Pb), cadmium (Cd), chromium (Cr), manganese (Mn), nickel (Ni), mercury (Hg), arsenic (As), copper (Cu), zinc (Zn), aluminum (Al) and cobalt (Co), differ in their chemical composition, reaction properties, distribution, metabolism, excretion and biological transmission. Our previous studies showed that heavy metal exposure have adverse effects on children's health including lower birth weight, lower anogenital distance, lower Apgar scores, lower current weight, lower lung function, lower hepatitis B surface antibody levels, higher prevalence of attention-deficit/hyperactivity disorder, and higher DNA and chromosome damage. Heavy metals influence a number of diverse systems and organs, resulting in both acute and chronic effects on children's health, ranging from minor upper respiratory irritation to chronic respiratory, cardiovascular, nervous, urinary and reproductive disease, as well as aggravation of pre-existing symptoms and disease. These effects of heavy metals on children's health are briefly discussed.
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Affiliation(s)
- Xiang Zeng
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou University, 22 Xinling Road, Shantou 515041, China; Department of Epidemiology, University Medical Center Groningen, University of Groningen, 1 Hanzeplein, Groningen 9700RB, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, 1 Hanzeplein, Groningen 9700RB, The Netherlands
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou University, 22 Xinling Road, Shantou 515041, China; Department of Cell Biology and Genetics, Shantou University Medical College, Shantou University, 22 Xinling Road, Shantou 515041, China
| | - H Marike Boezen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 1 Hanzeplein, Groningen 9700RB, The Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, 1 Hanzeplein, Groningen 9700RB, The Netherlands
| | - Xia Huo
- School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, China.
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13
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Cao J, Xu X, Hylkema MN, Zeng EY, Sly PD, Suk WA, Bergman Å, Huo X. Early-life Exposure to Widespread Environmental Toxicants and Health Risk: A Focus on the Immune and Respiratory Systems. Ann Glob Health 2016; 82:119-31. [PMID: 27325070 DOI: 10.1016/j.aogh.2016.01.023] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Evidence has accumulated that exposure to widespread environmental toxicants, such as heavy metals, persistent organic pollutants, and tobacco smoke adversely affect fetal development and organ maturation, even after birth. The developing immune and respiratory systems are more sensitive to environmental toxicants due to their long-term physical development, starting from the early embryonic stage and persisting into early postnatal life, which requires complex signaling pathways that control proliferation and differentiation of highly heterogeneous cell types. In this review, we summarize the effect of early-life exposure to several widespread environmental toxicants on immune and lung development before and after birth, including the effects on immune cell counts, baseline characteristics of cell-mediated and humoral immunity, and alteration of lung structure and function in offspring. We also review evidence supporting the association between early-life exposure to environmental toxicants and risk for immune-related diseases and lung dysfunction in offspring in later life.
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Affiliation(s)
- Junjun Cao
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, China; Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, China.
| | - Machteld N Hylkema
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Eddy Y Zeng
- School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, China
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Queensland, Australia
| | - William A Suk
- Hazardous Substances Research Branch, Superfund Research Program, National Institute for Environmental Health Sciences, National Institutes of Health, Bethesda, MD
| | - Åke Bergman
- Swedish Toxicology Sciences Research Center (Swetox), Södertälje, Sweden
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, China; School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, China
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Dietert RR. Developmental Immunotoxicity, Perinatal Programming, and Noncommunicable Diseases: Focus on Human Studies. Adv Med 2014; 2014:867805. [PMID: 26556429 PMCID: PMC4590951 DOI: 10.1155/2014/867805] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/17/2013] [Accepted: 10/30/2013] [Indexed: 12/20/2022] Open
Abstract
Developmental immunotoxicity (DIT) is a term given to encompass the environmentally induced disruption of normal immune development resulting in adverse outcomes. A myriad of chemical, physical, and psychological factors can all contribute to DIT. As a core component of the developmental origins of adult disease, DIT is interlinked with three important concepts surrounding health risks across a lifetime: (1) the Barker Hypothesis, which connects prenatal development to later-life diseases, (2) the hygiene hypothesis, which connects newborns and infants to risk of later-life diseases and, (3) fetal programming and epigenetic alterations, which may exert effects both in later life and across future generations. This review of DIT considers: (1) the history and context of DIT research, (2) the fundamental features of DIT, (3) the emerging role of DIT in risk of noncommunicable diseases (NCDs) and (4) the range of risk factors that have been investigated through human research. The emphasis on the human DIT-related literature is significant since most prior reviews of DIT have largely focused on animal research and considerations of specific categories of risk factors (e.g., heavy metals). Risk factors considered in this review include air pollution, aluminum, antibiotics, arsenic, bisphenol A, ethanol, lead (Pb), maternal smoking and environmental tobacco smoke, paracetamol (acetaminophen), pesticides, polychlorinated biphenyls, and polyfluorinated compounds.
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Affiliation(s)
- Rodney R. Dietert
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, North Tower Road, Ithaca, NY 14853, USA
- *Rodney R. Dietert:
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Khan SY, Arshad M, Arshad N, Shafaat S, Tahir HM. A probable role of blood lead levels on some haematological parameters in traffic police, Lahore, Pakistan. Toxicol Ind Health 2013; 32:795-800. [DOI: 10.1177/0748233713511510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The impact of elevated blood lead level on some haematological parameters was studied in the field force of Lahore traffic police, in Pakistan. The blood samples were tested for total leucocytes count (TLC) and differential leucocytes count in the persons with high and low blood lead levels. The TLC and percentage of neutrophils and eosinophils were observed as being significantly elevated in the policemen. No significant change was observed in the percentage of lymphocytes, while the percentage of monocytes was observed as being significantly less in the field force of traffic police.
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Affiliation(s)
- Shafaat Yar Khan
- Department of Biological Sciences, University of Sargodha, Sargodha, Pakistan
| | - Muhammad Arshad
- Department of Biological Sciences, University of Sargodha, Sargodha, Pakistan
| | - Najma Arshad
- Department of Zoology, University of The Punjab, Lahore, Pakistan
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Gillis BS, Arbieva Z, Gavin IM. Analysis of lead toxicity in human cells. BMC Genomics 2012; 13:344. [PMID: 22839698 PMCID: PMC3424832 DOI: 10.1186/1471-2164-13-344] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 07/27/2012] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Lead is a metal with many recognized adverse health side effects, and yet the molecular processes underlying lead toxicity are still poorly understood. Quantifying the injurious effects of lead is also difficult because of the diagnostic limitations that exist when analyzing human blood and urine specimens for lead toxicity. RESULTS We analyzed the deleterious impact of lead on human cells by measuring its effects on cytokine production and gene expression in peripheral blood mononuclear cells. Lead activates the secretion of the chemokine IL-8 and impacts mitogen-dependent activation by increasing the secretion of the proinflammatory cytokines IL-6 and TNF-α and of the chemokines IL-8 and MIP1-α in the presence of phytohemagglutinin. The recorded changes in gene expression affected major cellular functions, including metallothionein expression, and the expression of cellular metabolic enzymes and protein kinase activity. The expression of 31 genes remained elevated after the removal of lead from the testing medium thereby allowing for the measurement of adverse health effects of lead poisoning. These included thirteen metallothionein transcripts, three endothelial receptor B transcripts and a number of transcripts which encode cellular metabolic enzymes. Cellular responses to lead correlated with blood lead levels and were significantly altered in individuals with higher lead content resultantly affecting the nervous system, the negative regulation of transcription and the induction of apoptosis. In addition, we identified changes in gene expression in individuals with elevated zinc protoporphyrin blood levels and found that genes regulating the transmission of nerve impulses were affected in these individuals. The affected pathways were G-protein mediated signaling, gap junction signaling, synaptic long-term potentiation, neuropathic pain signaling as well as CREB signaling in neurons. Cellular responses to lead were altered in subjects with high zinc protoporphyrin blood levels. CONCLUSIONS The results of our study defined specific changes in gene and protein expression in response to lead challenges and determined the injurious effects of exposures to lead on a cellular level. This information can be used for documenting the health effects of exposures to lead which will facilitate identifying and monitoring efficacious treatments for lead-related maladies.
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Affiliation(s)
- Bruce S Gillis
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Zarema Arbieva
- Research Resources Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Igor M Gavin
- Research Resources Center, University of Illinois at Chicago, Chicago, IL, USA
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17
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Mishra K. Lead exposure and its impact on immune system: A review. Toxicol In Vitro 2009; 23:969-72. [DOI: 10.1016/j.tiv.2009.06.014] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2009] [Revised: 05/21/2009] [Accepted: 06/16/2009] [Indexed: 02/05/2023]
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