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Carretero VJ, Liccardi N, Tejedor MA, de Pascual R, Campano JH, Hernández-Guijo JM. Lead exerts a depression of neurotransmitter release through a blockade of voltage dependent calcium channels in chromaffin cells. Toxicology 2024; 505:153809. [PMID: 38648961 DOI: 10.1016/j.tox.2024.153809] [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: 01/22/2024] [Revised: 04/08/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
The present work, using chromaffin cells of bovine adrenal medullae (BCCs), aims to describe what type of ionic current alterations induced by lead (Pb2+) underlies its effects reported on synaptic transmission. We observed that the acute application of Pb2+ lead to a drastic depression of neurotransmitters release in a concentration-dependent manner when the cells were stimulated with both K+ or acetylcholine, with an IC50 of 119,57 μM and of 5,19 μM, respectively. This effect was fully recovered after washout. Pb2+ also blocked calcium channels of BCCs in a time- and concentration-dependent manner with an IC50 of 6,87 μM. This blockade was partially reversed upon washout. This compound inhibited the calcium current at all test potentials and shows a shift of the I-V curve to more negative values of about 8 mV. The sodium current was not blocked by acute application of high Pb2+ concentrations. Voltage-dependent potassium current was also shortly affected by high Pb2+. Nevertheless, the calcium- and voltage-dependent potassium current was drastically depressed in a dose-dependent manner, with an IC50 of 24,49 μM. This blockade was related to the prevention of Ca2+ influx through voltage-dependent calcium channels coupled to Ca2+-activated K+-channels (BK) instead a direct linking to these channels. Under current-clamp conditions, BCCs exhibit a resting potential of -52.7 mV, firing spontaneous APs (1-2 spikes/s) generated by the opening of Na+ and Ca2+-channels, and terminated by the activation of K+ channels. In spite of the effect on ionic channels exerted by Pb2+, we found that Pb2+ didn't alter cellular excitability, no modification of the membrane potential, and no effect on action potential firing. Taken together, these results point to a neurotoxic action evoked by Pb2+ that is associated with changes in neurotransmitter release by blocking the ionic currents responsible for the calcium influx.
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Affiliation(s)
- Victoria Jiménez Carretero
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Ninfa Liccardi
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Maria Arribas Tejedor
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Ricardo de Pascual
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Jorge Hernández Campano
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Jesús M Hernández-Guijo
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain; Ramón y Cajal Institute for Health Research, IRYCIS, Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9,100, Madrid 28029, Spain.
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Regencia ZJG, Zhao W, Torres-Roja C, Jones BC, Baja ES. Association between lead and circulating markers of inflammation among traffic enforcers in Metro Manila, Philippines: the MMDA traffic enforcer's health study. Int Arch Occup Environ Health 2024; 97:303-311. [PMID: 38351350 DOI: 10.1007/s00420-023-02044-w] [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: 10/23/2023] [Accepted: 12/30/2023] [Indexed: 03/19/2024]
Abstract
PURPOSE Several epidemiological studies have linked lead (Pb) exposure to induced oxidative stress and the promotion of inflammatory response. We performed a within-subjects study (repeated measures study) to evaluate the relationship between the concentration of blood lead (B-Pb) and toenail lead (T-Pb) and circulating markers of inflammation. METHODS We evaluated the associations between B-Pb concentrations and T-Pb concentrations and circulating markers of inflammation, soluble intracellular adhesion molecule-1 (s-ICAM-1), soluble vascular adhesion molecule-1 (s-VCAM-1), and high-sensitivity C-reactive protein (hs-CRP) on 158 traffic enforcers from the Metropolitan Manila Development Authority (MMDA) traffic enforcer's health study. Linear mixed-effects models with random subject-specific intercepts were fitted to estimate the association between B-Pb and T-Pb exposure and circulating markers of inflammation, adjusting for confounding factors. RESULTS Traffic enforcers were middle-aged men (89.4%) with a mean age (± SD) of 37.1 years ± 8.9 years and had a total of 293 valid markers of inflammation measurements. B-Pb concentration was related to increased hs-CRP levels. A 10% increase in B-Pb was associated with a 5.7% increase in hs-CRP level [95% confidence interval (95% CI): 1.3-10.1]. However, B-Pb was not associated with s-ICAM-1 and s-VCAM-1. Furthermore, no associations were observed between T-Pb and all the circulating markers of inflammation. CONCLUSIONS Low-level B-Pb may increase hs-CRP among traffic enforcers. Moreover, the study suggests that Pb via the oxidative and inflammation pathways may have an essential role in the development of cardiovascular disease. Furthermore, MMDA and the Department of Labor and Employment can use our study's findings as evidence to conduct routine screening of blood heavy metals, especially Pb, among MMDA and other traffic enforcers as part of their yearly medical examination.
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Affiliation(s)
- Zypher Jude G Regencia
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Room 103, Paz Mendoza Bldg., 547 Pedro Gil Street, 1000, Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Room 201, NIH Bldg., 623 Pedro Gil Street, Ermita, 1000, Manila, Philippines
| | - Wenyuan Zhao
- Department of Genetics, Genomics and Informatics, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Carolina Torres-Roja
- Department of Genetics, Genomics and Informatics, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Byron C Jones
- Department of Genetics, Genomics and Informatics, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Emmanuel S Baja
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Room 103, Paz Mendoza Bldg., 547 Pedro Gil Street, 1000, Manila, Philippines.
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Room 201, NIH Bldg., 623 Pedro Gil Street, Ermita, 1000, Manila, Philippines.
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Guilarte TR. Invited Perspective: Challenging the Dogma of Lead Neurotoxicity. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:81306. [PMID: 37639478 PMCID: PMC10461787 DOI: 10.1289/ehp13184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Tomás R. Guilarte
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
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SOBIN CHRISTINA, GUTIéRREZ‐VEGA MARISELA, FLORES‐MONTOYA GISEL, RIO MICHELLEDEL, ALVAREZ JUANM, OBENG ALEXANDER, AVILA JALEEN, HETTIARACHCHI GANGA. Improving Equitability and Inclusion for Testing and Detection of Lead Poisoning in US Children. Milbank Q 2023; 101:48-73. [PMID: 36717973 PMCID: PMC10037693 DOI: 10.1111/1468-0009.12596] [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: 06/01/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 02/01/2023] Open
Abstract
Policy Points Child lead poisoning is associated with socioeconomic inequity and perpetuates health inequality. Methods for testing and detection of child lead poisoning are ill suited to the current demographics and characteristics of the problem. A three-pronged revision of current testing approaches is suggested. Employing the suggested revisions can immediately increase our national capacity for equitable, inclusive testing and detection. ABSTRACT: Child lead poisoning, the longest-standing child public health epidemic in US history, is associated with socioeconomic inequity and perpetuates health inequality. Removing lead from children's environments ("primary prevention") is and must remain the definitive solution for ending child lead poisoning. Until that goal can be realized, protecting children's health necessarily depends on the adequacy of our methods for testing and detection. Current methods for testing and detection, however, are no longer suited to the demographics and magnitude of the problem. We discuss the potential deployment and feasibility of a three-pronged revision of current practices including: 1) acceptance of capillary samples for final determination of lead poisoning, with electronic documentation of "clean" collection methods submitted by workers who complete simple Centers for Disease Control and Prevention-endorsed online training and certification for capillary sample collection; 2) new guidance specifying the analysis of capillary samples by inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectrometry with documented limit of detection ≤0.2 μg/dL; and 3) adaptive "census tract-specific" universal testing and monitoring guidance for children from birth to 10 years of age. These testing modifications can bring child blood lead level (BLL) testing into homes and communities, immediately increasing our national capacity for inclusive and equitable detection and monitoring of dangerous lower-range BLLs in US children.
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Affiliation(s)
| | | | | | - MICHELLE DEL RIO
- Environmental and Occupational Health, School of Public HealthIndiana University
| | - JUAN M. ALVAREZ
- School of Public HealthUniversity of Texas Health Science Center at Houston
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Smith DR, Strupp BJ. Animal Models of Childhood Exposure to Lead or Manganese: Evidence for Impaired Attention, Impulse Control, and Affect Regulation and Assessment of Potential Therapies. Neurotherapeutics 2023; 20:3-21. [PMID: 36853434 PMCID: PMC10119373 DOI: 10.1007/s13311-023-01345-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 03/01/2023] Open
Abstract
Behavioral disorders involving attention and impulse control dysfunction, such as ADHD, are among the most prevalent disorders in children and adolescents, with significant impact on their lives. The etiology of these disorders is not well understood, but is recognized to be multifactorial, with studies reporting associations with polygenic and environmental risk factors, including toxicant exposure. Environmental epidemiological studies, while good at establishing associations with a variety of environmental and genetic risk factors, cannot establish causality. Animal models of behavioral disorders, when properly designed, can play an essential role in establishing causal relationships between environmental risk factors and a disorder, as well as provide model systems for elucidating underlying neural mechanisms and testing therapies. Here, we review how animal model studies of developmental lead or manganese exposure have been pivotal in (1) establishing a causal relationship between developmental exposure and lasting dysfunction in the domains of attention, impulse control, and affect regulation, and (2) testing the efficacy of specific therapeutic approaches for alleviating the lasting deficits. The lead and manganese case studies illustrate how animal models can advance knowledge in ways that are not possible in human studies. For example, in contrast to the Treatment of Lead Poisoned Children (TLC) human clinical trial evaluating succimer chelation efficacy to improve cognitive functioning in lead-exposed children, our developmental lead exposure animal model showed that succimer chelation can produce lasting cognitive benefits if chelation sufficiently reduces brain lead levels. In addition, this study revealed that succimer treatment in the absence of lead exposure produces lasting cognitive dysfunction, highlighting potential risks of chelation in off-label uses, such as the treatment of autistic children without a history of lead exposure. Our animal model of developmental manganese exposure has demonstrated that manganese can cause lasting attentional and sensorimotor deficits, akin to an ADHD-inattentive behavioral phenotype, thereby providing insights into the role of environmental exposures as contributors to ADHD. These studies have also shown that oral methylphenidate (Ritalin) can fully alleviate the deficits produced by early developmental Mn exposure. Future work should continue to focus on the development and use of animal models that appropriately recapitulate the complex behavioral phenotypes of behavioral disorders, in order to determine the mechanistic basis for the behavioral deficits caused by developmental exposure to environmental toxicants, and the efficacy of existing and emerging therapies.
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Affiliation(s)
- Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, 95060, USA.
| | - Barbara J Strupp
- Division of Nutritional Sciences and Department of Psychology, Cornell University, Ithaca, NY, 14853, USA
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Kershner EK, Tobarran N, Chambers A, Wills BK, Cumpston KL. Retained bullets and lead toxicity: a systematic review. Clin Toxicol (Phila) 2022; 60:1176-1186. [PMID: 36074021 DOI: 10.1080/15563650.2022.2116336] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Lead toxicity secondary to retained bullet(s) (RB) after a penetrating gunshot wound is a rare but likely underdiagnosed condition, given the substantial number of firearm injuries in the United States. There is currently no consensus on the indications for surveillance, chelation, or surgical intervention. OBJECTIVE The purpose of our review is to summarize the literature on systemic lead toxicity secondary to RBs to help guide clinicians in the management of these patients. METHODOLOGY The primary literature search was conducted in Medline (PubMed), EMBASE, Cochrane, and CENTRAL using the following MESH terms: "chelation" and "lead poisoning" or "lead toxicity" or "lead" and "bullet" or "missile" or "gunshot", or "bullet". RESULTS The search identified 1,082 articles. After exclusions, a total of 142 articles were included in our final review, the majority of which were case reports. Several factors appear to increase the risk of developing lead toxicity including the location of the RB, the presence of a fracture or recent trauma, number of fragments, hypermetabolic states, and bullet retention duration. Particularly, RBs located within a body fluid compartment like an intra-articular space appear to be at a substantially higher risk of developing lead toxicity. Even though patients with lead toxicity from RBs will have similar symptoms to patients with lead toxicity from other sources, the diagnosis of lead poisoning may occur months or years after a gunshot wound. Symptomatic patients with high blood lead levels (BLLs) tended to improve with a combination of chelation and surgical removal of RBs. CONCLUSIONS We suggest surveillance with serial BLLs should be performed. Patients with intra-articular RBs appear to be at increased risk of lead toxicity and if possible, early surgical removal of the RBs is warranted, especially given that signs of toxicity are vague, and patients may not have access to follow-up. Long-term chelation should not be used as a surgical alternative and management should be multidisciplinary.
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Affiliation(s)
- Emily K Kershner
- Department of Emergency Medicine, Division of Clinical Toxicology, Virginia Commonwealth University Health System, Richmond, VA, USA.,Virginia Poison Center, Richmond, VA, USA
| | - Natasha Tobarran
- Department of Emergency Medicine, Division of Clinical Toxicology, Virginia Commonwealth University Health System, Richmond, VA, USA.,Virginia Poison Center, Richmond, VA, USA
| | - Andrew Chambers
- Department of Emergency Medicine, Division of Clinical Toxicology, Virginia Commonwealth University Health System, Richmond, VA, USA.,Virginia Poison Center, Richmond, VA, USA
| | - Brandon K Wills
- Department of Emergency Medicine, Division of Clinical Toxicology, Virginia Commonwealth University Health System, Richmond, VA, USA.,Virginia Poison Center, Richmond, VA, USA
| | - Kirk L Cumpston
- Department of Emergency Medicine, Division of Clinical Toxicology, Virginia Commonwealth University Health System, Richmond, VA, USA.,Virginia Poison Center, Richmond, VA, USA
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7
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Kamai EM, Daniels JL, Delamater PL, Lanphear BP, MacDonald Gibson J, Richardson DB. Patterns of Children's Blood Lead Screening and Blood Lead Levels in North Carolina, 2011-2018-Who Is Tested, Who Is Missed? ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:67002. [PMID: 35647633 PMCID: PMC9158533 DOI: 10.1289/ehp10335] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND No safe level of lead in blood has been identified. Blood lead testing is required for children on Medicaid, but it is at the discretion of providers and parents for others. Elevated blood lead levels (EBLLs) cannot be identified in children who are not tested. OBJECTIVES The aims of this research were to identify determinants of lead testing and EBLLs among North Carolina children and estimate the number of additional children with EBLLs among those not tested. METHODS We linked geocoded North Carolina birth certificates from 2011-2016 to 2010 U.S. Census data and North Carolina blood lead test results from 2011-2018. We estimated the probability of being screened for lead and created inverse probability (IP) of testing weights. We evaluated the risk of an EBLL of ≥3μg/dL at <30 months of age, conditional on characteristics at birth, using generalized linear models and then applied IP weights to account for missing blood lead results among unscreened children. We estimated the number of additional children with EBLLs of all North Carolina children using the IP-weighted population and bootstrapping to produce 95% credible intervals (CrI). RESULTS Mothers of the 63.5% of children (402,002 of 633,159) linked to a blood lead test result were disproportionately young, Hispanic, Black, American Indian, or on Medicaid. In full models, maternal age ≤20y [risk ratio (RR)=1.10; 95% confidence interval (CI): 1.13, 1.20] or smoking (RR=1.14; 95% CI: 1.12, 1.17); proximity to a major roadway (RR=1.10; 95% CI: 1.05, 1.15); proximity to a lead-releasing Toxics Release Inventory site (RR=1.08; 95% CI: 1.03, 1.14) or a National Emissions Inventory site (RR=1.11; 95% CI: 1.07, 1.14); and living in neighborhoods with more housing built before 1950 (RR=1.10; 95% CI: 1.05, 1.14) or before 1940 (RR=1.18; 95% CI: 1.11, 1.25) or more vacant housing (RR=1.14; 95% CI: 1.11, 1.17) were associated with an increased risk of EBLL, whereas overlap with a public water service system was associated with a decreased risk of EBLL (RR=0.85; 95% CI: 0.83, 0.87). Children of Black mothers were no more likely than children of White mothers to have EBLLs (RR=0.98; 95% CI: 0.96, 1.01). Complete blood lead screening in 2011-2018 may have identified an additional 17,543 (95% CrI: 17,462, 17,650) children with EBLLs ≥3μg/dL. DISCUSSION Our results indicate that current North Carolina lead screening strategies fail to identify over 30% (17,543 of 57,398) of children with subclinical lead poisoning and that accounting for characteristics at birth alters the conclusions about racial disparities in children's EBLLs. https://doi.org/10.1289/EHP10335.
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Affiliation(s)
- Elizabeth M. Kamai
- Department of Epidemiology, University of North Carolina at Chapel Hill (UNC-Chapel Hill), Chapel Hill, North Carolina, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Julie L. Daniels
- Department of Epidemiology, University of North Carolina at Chapel Hill (UNC-Chapel Hill), Chapel Hill, North Carolina, USA
- Department of Maternal and Child Health, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul L. Delamater
- Department of Geography, UNC-Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, UNC-Chapel Hill, North Carolina, USA
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | | | - David B. Richardson
- Department of Environmental and Occupational Health, University of California, Irvine, California, USA
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Cruz GB, Vasquez MA, Cabañas E, Joseph JN, Skeen JC, Lynch KP, Ahmed I, Khairi EB, Bonitto JR, Clarke EG, Rubi S, Hameed N, Kaur S, Mathew N, Dacius TF, Jose TJ, Handford G, Wolfe S, Feher A, Tidwell K, Tobin J, Ugalde E, Fee S, Choe A, Gillenwater K, Hindi B, Pilout S, Natale NR, Domahoski N, Kent MH, Jacob JC, Lambert KG, Neuwirth LS. Developmental Lead Exposure in Rats Causes Sex-Dependent Changes in Neurobiological and Anxiety-Like Behaviors that Are Improved by Taurine Co-treatment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1370:461-479. [DOI: 10.1007/978-3-030-93337-1_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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9
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Neuwirth LS, Emenike BU, Cruz GB, Cabañas E, Vasquez MA, Joseph JN, Ayaz Z, Mian M, Ali MM, Clarke EG, Barrera ED, Hameed N, Rubi S, Dacius TF, Skeen JC, Bonitto JR, Khairi EB, Iqbal A, Ahmed I, Jose TJ, Lynch KP, Alivira A, Mathew N, Kaur S, Masood S, Tranquilee B, Thiruverkadu V. Taurine-Derived Compounds Produce Anxiolytic Effects in Rats Following Developmental Lead Exposure. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1370:445-460. [PMID: 35882818 DOI: 10.1007/978-3-030-93337-1_42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Lead (Pb2+) is a developmental neurotoxicant that disrupts the GABA-shift and subsequently causes alterations in the brain's excitation-to-inhibition (E/I) balance. Taurine is a well-established neuroprotective and inhibitory compound for regulating brain excitability. Since mechanistically taurine can facilitate neuronal inhibition through the GABA-AR, the present study examined the anxiolytic potential of taurine derivatives. Treatment groups consisted of the following developmental Pb2+-exposures: Control (0 ppm) and Perinatal (150 ppm or 1,000 ppm lead acetate in the drinking water). Rats were scheduled for behavioral tests between postnatal days (PND) 36-45 with random drug assignments to either saline, taurine, or taurine-derived compound (TD-101, TD-102, or TD-103) to assess the rats' responsivity to each drug in mitigating the developmental Pb2+-exposure and anxiety-like behaviors through the GABAergic system. Long-Evans hooded rats were assessed using an open field (OF) test for preliminary locomotor assessment. Twenty-four hours later, the same rats were exposed to the elevated plus maze (EPM) and were given an i.p. injection of 43 mg/Kg of the saline, taurine, or TD drugs 15 min prior to testing. Each rat was tested using the triple-blind random assignment method for each drug condition. The OF data revealed that Control female rats had increased locomotor activity over Control male rats, and the Pb2+-exposed males and females had increased locomotor activity when compared to the Control male and female rats. However, in the EPM, the Control female rats exhibited more anxiety-like behaviors over Control male rats, and the Pb2+-exposed male and female rats showed selective responsivity to TD drugs when compared to taurine. For Pb2+-exposed males, TD-101 showed consistent recovery of anxiety-like behaviors similar to that of taurine regardless of Pb2+ dose, whereas in Pb2+-exposed females TD-101 and TD-103 showed greater anxiolytic responses in the EPM. The results from the present psychopharmacological study suggests that taurine and its derivatives are interesting drug candidates to explore sex-specific mechanisms and actions of taurine and the associated GABAergic receptor properties by which these compounds alleviate anxiety as a potential behavioral pharmacotherapy for neurodevelopmental Pb2+ exposure.
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Affiliation(s)
- Lorenz S Neuwirth
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.
| | - Bright U Emenike
- Department of Chemistry and Physics, SUNY Old Westbury, Old Westbury, NY, USA
| | - George B Cruz
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Ericka Cabañas
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Michelle A Vasquez
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Chemistry and Physics, SUNY Old Westbury, Old Westbury, NY, USA
| | - Jewel N Joseph
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Zaid Ayaz
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Mohammed Mian
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Mohamed M Ali
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Evan G Clarke
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Eddy D Barrera
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Nimra Hameed
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Samantha Rubi
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Teddy F Dacius
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Jourvonn C Skeen
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Jalen R Bonitto
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Eric B Khairi
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Asma Iqbal
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Isra Ahmed
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Tokunbo J Jose
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Kirsten P Lynch
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Amber Alivira
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Neena Mathew
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Sukhpreet Kaur
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Sidrah Masood
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Bettina Tranquilee
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Veni Thiruverkadu
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
- Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
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Albores-Garcia D, McGlothan JL, Guilarte TR. Early-life lead exposure and neurodevelopmental disorders. CURRENT OPINION IN TOXICOLOGY 2021; 26:22-27. [PMID: 34013137 DOI: 10.1016/j.cotox.2021.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Lead (Pb2+) exposure is a global public health problem of major proportion with an alarming number of children with blood Pb2+ levels > 10 >g/dL, twice the current CDC reference level for Pb2+ exposure. Mounting evidence from population-based studies suggests an association between chronic early life Pb2+ exposure (CELLE) and psychiatric disorders, specifically schizophrenia (SZ). Preclinical studies suggest a common mechanism in the pathophysiology of CELLE and SZ, NMDA receptor hypofunction. Here we describe human and experimental animal studies providing the evidence for such an association. Further, recent preclinical studies indicate that Pb2+-induced changes in neurotransmitter receptors that mediate the action(s) of drugs of abuse are increased in brain regions associated with addiction circuits in adolescence, a period of increased susceptibility to drug use and abuse and expression of psychiatric disease in humans. In summary, the relationship between the global burden of childhood Pb2+ exposure and the latent onset of psychiatric disorders and predisposition to drug use requires further investigations in human populations.
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Affiliation(s)
- D Albores-Garcia
- Brain, Behavior & the Environment Program Department of Environmental Health Sciences Robert Stempel College of Public Health & Social Work Florida International University Miami, FL 33199, United States
| | - J L McGlothan
- Brain, Behavior & the Environment Program Department of Environmental Health Sciences Robert Stempel College of Public Health & Social Work Florida International University Miami, FL 33199, United States
| | - T R Guilarte
- Brain, Behavior & the Environment Program Department of Environmental Health Sciences Robert Stempel College of Public Health & Social Work Florida International University Miami, FL 33199, United States
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11
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Spiller HA, Hays HL, Casavant MJ. Rethinking treatment of mercury poisoning: the roles of selenium, acetylcysteine, and thiol chelators in the treatment of mercury poisoning: a narrative review. TOXICOLOGY COMMUNICATIONS 2021. [DOI: 10.1080/24734306.2020.1870077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Henry A. Spiller
- Central Ohio Poison Center, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Hannah L. Hays
- Central Ohio Poison Center, Nationwide Children’s Hospital, Columbus, OH, USA
- Departments of Emergency Medicine and Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Marcel J. Casavant
- Central Ohio Poison Center, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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12
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(Ascorb)ing Pb Neurotoxicity in the Developing Brain. Antioxidants (Basel) 2020; 9:antiox9121311. [PMID: 33371438 PMCID: PMC7767447 DOI: 10.3390/antiox9121311] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/21/2022] Open
Abstract
Lead (Pb) neurotoxicity is a major concern, particularly in children. Developmental exposure to Pb can alter neurodevelopmental trajectory and has permanent neuropathological consequences, including an increased vulnerability to further stressors. Ascorbic acid is among most researched antioxidant nutrients and has a special role in maintaining redox homeostasis in physiological and physio-pathological brain states. Furthermore, because of its capacity to chelate metal ions, ascorbic acid may particularly serve as a potent therapeutic agent in Pb poisoning. The present review first discusses the major consequences of Pb exposure in children and then proceeds to present evidence from human and animal studies for ascorbic acid as an efficient ameliorative supplemental nutrient in Pb poisoning, with a particular focus on developmental Pb neurotoxicity. In doing so, it is hoped that there is a revitalization for further research on understanding the brain functions of this essential, safe, and readily available vitamin in physiological states, as well to justify and establish it as an effective neuroprotective and modulatory factor in the pathologies of the nervous system, including developmental neuropathologies.
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13
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Nussbaumer-Streit B, Mayr V, Dobrescu AI, Wagner G, Chapman A, Pfadenhauer LM, Lohner S, Lhachimi SK, Busert LK, Gartlehner G. Household interventions for secondary prevention of domestic lead exposure in children. Cochrane Database Syst Rev 2020; 10:CD006047. [PMID: 33022752 PMCID: PMC8094406 DOI: 10.1002/14651858.cd006047.pub6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Lead exposure is a serious health hazard, especially for children. It is associated with physical, cognitive and neurobehavioural impairment in children. There are many potential sources of lead in the environment, therefore trials have tested many household interventions to prevent or reduce lead exposure. This is an update of a previously published review. OBJECTIVES To assess the effects of household interventions intended to prevent or reduce further lead exposure in children on improvements in cognitive and neurobehavioural development, reductions in blood lead levels and reductions in household dust lead levels. SEARCH METHODS In March 2020, we updated our searches of CENTRAL, MEDLINE, Embase, 10 other databases and ClinicalTrials.gov. We also searched Google Scholar, checked the reference lists of relevant studies and contacted experts to identify unpublished studies. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs of household educational or environmental interventions, or combinations of interventions to prevent lead exposure in children (from birth to 18 years of age), where investigators reported at least one standardised outcome measure. DATA COLLECTION AND ANALYSIS Two authors independently reviewed all eligible studies for inclusion, assessed risk of bias and extracted data. We contacted trialists to obtain missing information. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included 17 studies (three new to this update), involving 3282 children: 16 RCTs (involving 3204 children) and one quasi-RCT (involving 78 children). Children in all studies were under six years of age. Fifteen studies took place in urban areas of North America, one in Australia and one in China. Most studies were in areas with low socioeconomic status. Girls and boys were equally represented in those studies reporting this information. The duration of the intervention ranged from three months to 24 months in 15 studies, while two studies performed interventions on a single occasion. Follow-up periods ranged from three months to eight years. Three RCTs were at low risk of bias in all assessed domains. The other 14 studies were at unclear or high risk of bias; for example, we considered two RCTs and one quasi-RCT at high risk of selection bias and six RCTs at high risk of attrition bias. National or international research grants or governments funded 15 studies, while the other two did not report their funding sources. Education interventions versus no intervention None of the included studies in this comparison assessed effects on cognitive or neurobehavioural outcomes, or adverse events. All studies reported data on blood lead level outcomes. Educational interventions showed there was probably no evidence of a difference in reducing blood lead levels (continuous: mean difference (MD) -0.03, 95% confidence interval (CI) -0.13 to 0.07; I² = 0%; 5 studies, 815 participants; moderate-certainty evidence; log-transformed data), or in reducing floor dust levels (MD -0.07, 95% CI -0.37 to 0.24; I² = 0%; 2 studies, 318 participants; moderate-certainty evidence). Environmental interventions versus no intervention Dust control: one study in this comparison reported data on cognitive and neurobehavioural outcomes, and on adverse events in children. The study showed numerically there may be better neurobehavioural outcomes in children of the intervention group. However, differences were small and the CI included both a beneficial and non-beneficial effect of the environmental intervention (e.g. mental development (Bayley Scales of Infant Development-II): MD 0.1, 95% CI -2.1 to 2.4; 1 study, 302 participants; low-certainty evidence). The same study did not observe any adverse events related to the intervention during the eight-year follow-up, but observed two children with adverse events in the control group (1 study, 355 participants; very low-certainty evidence). Meta-analysis also found no evidence of effectiveness on blood lead levels (continuous: MD -0.02, 95% CI -0.09 to 0.06; I² = 0%; 4 studies, 565 participants; moderate-certainty evidence; log-transformed data). We could not pool the data regarding floor dust levels, but studies reported that there may be no evidence of a difference between the groups (very low-certainty evidence). Soil abatement: the two studies assessing this environmental intervention only reported on the outcome of 'blood lead level'. One study showed a small effect on blood lead level reduction, while the other study showed no effect. Therefore, we deem the current evidence insufficient to draw conclusions about the effectiveness of soil abatement (very low-certainty evidence). Combination of educational and environmental interventions versus standard education Studies in this comparison only reported on blood lead levels and dust lead levels. We could not pool the studies in a meta-analysis due to substantial differences between the studies. Since the studies reported inconsistent results, the evidence is currently insufficient to clarify whether a combination of interventions reduces blood lead levels and floor dust levels (very low-certainty evidence). AUTHORS' CONCLUSIONS Based on available evidence, household educational interventions and environmental interventions (namely dust control measures) show no evidence of a difference in reducing blood lead levels in children as a population health measure. The evidence of the effects of environmental interventions on cognitive and neurobehavioural outcomes and adverse events is uncertain too. Further trials are required to establish the most effective intervention for reducing or even preventing further lead exposure. Key elements of these trials should include strategies to reduce multiple sources of lead exposure simultaneously using empirical dust clearance levels. It is also necessary for trials to be carried out in low- and middle-income countries and in differing socioeconomic groups in high-income countries.
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Affiliation(s)
- Barbara Nussbaumer-Streit
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Verena Mayr
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Andreea Iulia Dobrescu
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Gernot Wagner
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Andrea Chapman
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, IBE, LMU Munich, Munich, Germany
| | - Szimonetta Lohner
- Cochrane Hungary, Clinical Center of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary
| | - Stefan K Lhachimi
- Research Group for Evidence-Based Public Health, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
- Department for Health Services Research, Institute for Public Health and Nursing Research, Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Laura K Busert
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Gerald Gartlehner
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
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Potash E, Ghani R, Walsh J, Jorgensen E, Lohff C, Prachand N, Mansour R. Validation of a Machine Learning Model to Predict Childhood Lead Poisoning. JAMA Netw Open 2020; 3:e2012734. [PMID: 32936296 PMCID: PMC7495240 DOI: 10.1001/jamanetworkopen.2020.12734] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Childhood lead poisoning causes irreversible neurobehavioral deficits, but current practice is secondary prevention. OBJECTIVE To validate a machine learning (random forest) prediction model of elevated blood lead levels (EBLLs) by comparison with a parsimonious logistic regression. DESIGN, SETTING, AND PARTICIPANTS This prognostic study for temporal validation of multivariable prediction models used data from the Women, Infants, and Children (WIC) program of the Chicago Department of Public Health. Participants included a development cohort of children born from January 1, 2007, to December 31, 2012, and a validation WIC cohort born from January 1 to December 31, 2013. Blood lead levels were measured until December 31, 2018. Data were analyzed from January 1 to October 31, 2019. EXPOSURES Blood lead level test results; lead investigation findings; housing characteristics, permits, and violations; and demographic variables. MAIN OUTCOMES AND MEASURES Incident EBLL (≥6 μg/dL). Models were assessed using the area under the receiver operating characteristic curve (AUC) and confusion matrix metrics (positive predictive value, sensitivity, and specificity) at various thresholds. RESULTS Among 6812 children in the WIC validation cohort, 3451 (50.7%) were female, 3057 (44.9%) were Hispanic, 2804 (41.2%) were non-Hispanic Black, 458 (6.7%) were non-Hispanic White, and 442 (6.5%) were Asian (mean [SD] age, 5.5 [0.3] years). The median year of housing construction was 1919 (interquartile range, 1903-1948). Random forest AUC was 0.69 compared with 0.64 for logistic regression (difference, 0.05; 95% CI, 0.02-0.08). When predicting the 5% of children at highest risk to have EBLLs, random forest and logistic regression models had positive predictive values of 15.5% and 7.8%, respectively (difference, 7.7%; 95% CI, 3.7%-11.3%), sensitivity of 16.2% and 8.1%, respectively (difference, 8.1%; 95% CI, 3.9%-11.7%), and specificity of 95.5% and 95.1% (difference, 0.4%; 95% CI, 0.0%-0.7%). CONCLUSIONS AND RELEVANCE The machine learning model outperformed regression in predicting childhood lead poisoning, especially in identifying children at highest risk. Such a model could be used to target the allocation of lead poisoning prevention resources to these children.
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Affiliation(s)
- Eric Potash
- Harris School of Public Policy, University of Chicago, Chicago, Illinois
| | - Rayid Ghani
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Joe Walsh
- Harris School of Public Policy, University of Chicago, Chicago, Illinois
| | | | | | - Nik Prachand
- Chicago Department of Public Health, Chicago, Illinois
| | - Raed Mansour
- Chicago Department of Public Health, Chicago, Illinois
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15
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Eisenberg A, Seymour E, Hill AB, Akers J. Toxic structures: Speculation and lead exposure in Detroit's single-family rental market. Health Place 2020; 64:102390. [PMID: 32838900 DOI: 10.1016/j.healthplace.2020.102390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/06/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022]
Abstract
Foreclosure sales permitted investors to purchase large volumes of low-cost residential properties after the last financial crisis, reshaping patterns of property ownership in low-income housing markets across the US. This study links post-foreclosure property acquisitions by investor landlords to subsequent lead poisoning cases among children under age six living in Detroit, Michigan. We find that the odds of exhibiting elevated blood lead levels (≥5 μg/dL) are higher for children living in investor-owned homes purchased through tax foreclosure sale. These findings highlight the potential for property speculation in post-foreclosure housing markets to exacerbate severe and racialized burdens of excess lead toxicity in low-income communities.
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Affiliation(s)
- Alexa Eisenberg
- School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Eric Seymour
- Urban Planning, Edward J. Bloustein School of Planning and Public Policy, Rutgers University, 33 Livingston Ave, New Brunswick, NJ 08901, USA.
| | - Alex B Hill
- Chronic Disease and Injury Prevention Manager, Detroit Health Department, 3246 E Jefferson, Detroit, MI, 48207, USA.
| | - Joshua Akers
- Geography and Urban and Regional Studies, University of Michigan-Dearborn, 4901 Evergreen Rd, Dearborn, MI, 48128, USA.
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16
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Wang T, Zhang J, Xu Y. Epigenetic Basis of Lead-Induced Neurological Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134878. [PMID: 32645824 PMCID: PMC7370007 DOI: 10.3390/ijerph17134878] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023]
Abstract
Environmental lead (Pb) exposure is closely associated with pathogenesis of a range of neurological disorders, including Alzheimer’s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), attention deficit/hyperactivity disorder (ADHD), etc. Epigenetic machinery modulates neural development and activities, while faulty epigenetic regulation contributes to the diverse forms of CNS (central nervous system) abnormalities and diseases. As a potent epigenetic modifier, lead is thought to cause neurological disorders through modulating epigenetic mechanisms. Specifically, increasing evidence linked aberrant DNA methylations, histone modifications as well as ncRNAs (non-coding RNAs) with AD cases, among which circRNA (circular RNA) stands out as a new and promising field for association studies. In 23-year-old primates with developmental lead treatment, Zawia group discovered a variety of epigenetic changes relating to AD pathogenesis. This is a direct evidence implicating epigenetic basis in lead-induced AD animals with an entire lifespan. Additionally, some epigenetic molecules associated with AD etiology were also known to respond to chronic lead exposure in comparable disease models, indicating potentially interlaced mechanisms with respect to the studied neurotoxic and pathological events. Of note, epigenetic molecules acted via globally or selectively influencing the expression of disease-related genes. Compared to AD, the association of lead exposure with other neurological disorders were primarily supported by epidemiological survey, with fewer reports connecting epigenetic regulators with lead-induced pathogenesis. Some pharmaceuticals, such as HDAC (histone deacetylase) inhibitors and DNA methylation inhibitors, were developed to deal with CNS disease by targeting epigenetic components. Still, understandings are insufficient regarding the cause–consequence relations of epigenetic factors and neurological illness. Therefore, clear evidence should be provided in future investigations to address detailed roles of novel epigenetic factors in lead-induced neurological disorders, and efforts of developing specific epigenetic therapeutics should be appraised.
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Affiliation(s)
| | | | - Yi Xu
- Correspondence: ; Tel.: +86-183-2613-5046
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17
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Moghadam AT, Bahreini M, Anzali BC. Opium-Related Lead Toxicity: An Integrative Review and Case Series. J Emerg Med 2020; 59:33-45. [PMID: 32414545 DOI: 10.1016/j.jemermed.2020.04.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 03/31/2020] [Accepted: 04/08/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Restrictive regulations and the increased price of opioids have resulted in the addition of impurities to illicit opioids by drug dealers. Among the adulterants, lead salts are optimal agents to make packages heavier. Consequently, lead toxicity has emerged in the opioid-user population. OBJECTIVES Our goal was to review the related literature and describe patients with common presentations of opioid-related lead poisoning to provide a basis to prepare optimal management. METHODS A narrative review was performed aiming to study opioid lead poisoning. PubMed and Google Scholar databases were explored with two Medical Subject Heading terms, lead poisoning and substance-related disorders to find a broad but relevant spectrum of articles. Then, the reference lists within those articles were checked to upgrade our literature pool on this issue. RESULTS Ultimately, among English-language articles, 16 were case series and case reports of patients with lead intoxication after opioid consumption. Data pertaining to disease characteristics, diagnosis, and treatment protocols were extracted. CONCLUSIONS The clinical presentation of opioid lead intoxication can vary from rather asymptomatic to severely debilitating gastrointestinal or neurologic symptoms. The diagnosis is made by checking lead blood levels after obviating other critical diagnoses and should be considered in each drug user in endemic regions of opioid addiction, such as the Middle East. Management protocols are suggested to cover both features of opioid-related complications and lead toxicity.
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Affiliation(s)
- Ali Tafazoli Moghadam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Bahreini
- Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran
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18
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Gaitens JM, Potter BK, D'Alleyrand JG, Overmann AL, Gochfeld M, Smith DR, Breyer R, McDiarmid MA. The management of embedded metal fragment patients and the role of chelation Therapy: A workshop of the Department of Veterans Affairs-Walter Reed National Medical Center. Am J Ind Med 2020; 63:381-393. [PMID: 32144801 DOI: 10.1002/ajim.23098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/10/2020] [Accepted: 02/21/2020] [Indexed: 01/12/2023]
Abstract
Exposure to retained metal fragments from war-related injuries can result in increased systemic metal concentrations, thereby posing potential health risks to target organs far from the site of injury. Given the large number of veterans who have retained fragments and the lack of clear guidance on how to medically manage these individuals, the Department of Veterans Affairs (VA) convened a meeting of chelation experts and clinicians who care for embedded fragment patients to discuss current practices and provide medical management guidance. Based on this group's clinical expertise and review of published literature, the evidence presented suggests that, at least in the case of lead fragments, short-term chelation therapy may be beneficial for embedded fragment patients experiencing acute symptoms associated with metal toxicity; however, in the absence of clinical symptoms or significantly elevated blood lead concentrations (greater than 80 µg/dL), chelation therapy may offer little to no benefit for individuals with retained fragments and pose greater risks due to remobilization of metals stored in bone and other soft tissues. The combination of periodic biomonitoring to assess metal body burden, longitudinal fragment imaging, and selective fragment removal when metal concentrations approach critical injury thresholds offers a more conservative management approach to caring for patients with embedded fragments.
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Affiliation(s)
- Joanna M. Gaitens
- Department of Veterans Affairs Medical Center Baltimore and Department of MedicineUniversity of Maryland School of MedicineBaltimore Maryland
| | - Benjamin K. Potter
- Department of OrthopaedicsWalter Reed National Military Medical CenterBethesda Maryland
| | | | - Archie L. Overmann
- Department of OrthopaedicsWalter Reed National Military Medical CenterBethesda Maryland
| | - Michael Gochfeld
- Department of Environmental and Occupational Health, Environmental and Occupational Health Sciences InstituteRutgers Robert Wood Johnson Medical SchoolPiscataway New Jersey
| | - Donald R. Smith
- Department of Microbiology and Environmental ToxicologyUniversity of CaliforniaSanta Cruz California
| | - Richard Breyer
- Department of RadiologyBaltimore Veterans Affairs Medical CenterBaltimore Maryland
| | - Melissa A. McDiarmid
- Department of Veterans Affairs Medical Center Baltimore and Department of MedicineUniversity of Maryland School of MedicineBaltimore Maryland
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19
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Neuwirth LS, Emenike BU, Barrera ED, Hameed N, Rubi S, Dacius TF, Skeen JC, Bonitto JR, Khairi E, Iqbal A, Ahmed I, Jose TJ, Lynch K, Khan M, Alvira AL, Mathew N, Kaur S, Masood S, Tranquilee B, Thiruverkadu V. Assessing the Anxiolytic Properties of Taurine-Derived Compounds in Rats Following Developmental Lead Exposure: A Neurodevelopmental and Behavioral Pharmacological Pilot Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1155:801-819. [PMID: 31468449 DOI: 10.1007/978-981-13-8023-5_69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Lead (Pb2+) is a developmental neurotoxicant that causes alterations in the brain's excitation-to-inhibition (E/I) balance. By increasing chloride concentration through GABA-ARs, taurine serves as an effective inhibitory compound for maintaining appropriate levels of brain excitability. Considering this pharmacological mechanism of taurine facilitated inhibition through the GABA-AR, the present pilot study sought to explore the anxiolytic potential of taurine derivatives. Treatment groups consisted of the following developmental Pb2+-exposures: Control (0 ppm) and Perinatal (150 ppm or 1000 ppm lead acetate in the drinking water). Rats were scheduled for behavioral tests between postnatal days (PND) 36-45 with random assignments to either solutions of Saline, Taurine, or Taurine Derived compounds (i.e., TD-101, TD-102, or TD-103) to assess the rats' responsiveness to each drug in mitigating the developmental Pb2+-exposure through the GABAergic system. Long Evans Hooded rats were assessed using an Open Field (OF) test for preliminary locomotor assessment. Approximately 24-h after the OF, the same rats were exposed to the Elevated Plus Maze (EPM) and were given an i.p. injection of 43 mg/Kg of the Saline, Taurine, or TD drugs 15-min prior to testing. Each rat was tested using the random assignment method for each pharmacological condition, which was conducted using a triple-blind procedure. The OF data revealed that locomotor activity was unaffected by Pb2+-exposure with no gender differences observed. However, Pb2+-exposure induced an anxiogenic response in the EPM, which interestingly, was ameliorated in a gender-specific manner in response to taurine and TD drugs. Female rats exhibited more anxiogenic behavior than the male rats; and as such, exhibited a greater degree of anxiety that were recovered in response to Taurine and its derivatives as a drug therapy. The results from the present psychopharmacological pilot study suggests that Taurine and its derivatives could provide useful data for further exploring the pharmacological mechanisms and actions of Taurine and the associated GABAergic receptor properties by which these compounds alleviate anxiety as a potential behavioral pharmacotherapy for treating anxiety and other associated mood disorders.
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Affiliation(s)
- Lorenz S Neuwirth
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA. .,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.
| | - Bright U Emenike
- Department of Chemistry & Physics, SUNY Old Westbury, Old Westbury, NY, USA
| | - Eddy D Barrera
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Nimra Hameed
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.,Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Samantha Rubi
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.,Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Teddy F Dacius
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Jourvonn C Skeen
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.,Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Jalen R Bonitto
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.,Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Eric Khairi
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.,Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Asma Iqbal
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Isra Ahmed
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Tokunbo J Jose
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Kirsten Lynch
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Maheen Khan
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.,Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA
| | - Amber L Alvira
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Neena Mathew
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Sukhpreet Kaur
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Sidrah Masood
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA.,SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA
| | - Bettina Tranquilee
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.,Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
| | - Veni Thiruverkadu
- SUNY Neuroscience Research Institute, SUNY Old Westbury, Old Westbury, NY, USA.,Department of Biology, SUNY Old Westbury, Old Westbury, NY, USA
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20
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Cantor AG, Hendrickson R, Blazina I, Griffin J, Grusing S, McDonagh MS. Screening for Elevated Blood Lead Levels in Childhood and Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2019; 321:1510-1526. [PMID: 30990555 DOI: 10.1001/jama.2019.1004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Elevated blood lead level is associated with serious, often irreversible, health consequences. OBJECTIVE To synthesize evidence on the effects of screening, testing, and treatment for elevated blood lead level in pregnant women and children aged 5 years and younger in the primary care setting to inform the US Preventive Services Task Force. DATA SOURCES Cochrane CENTRAL and Cochrane Database of Systematic Reviews (through June 2018) and Ovid MEDLINE (1946 to June 2018); surveillance through December 5, 2018. STUDY SELECTION English-language trials and observational studies of screening for and treating elevated lead levels in asymptomatic children and pregnant women. DATA EXTRACTION AND SYNTHESIS Independent critical appraisal and data abstraction by 2 reviewers using predefined criteria. MAIN OUTCOMES AND MEASURES Elevated blood lead level, morbidity, mortality, clinical prediction tools, test accuracy, adverse events. RESULTS A total of 24 studies (N = 11 433) were included in this review. No studies evaluated the benefits or harms of screening vs no screening in children. More than 1 positive answer on the 5-item 1991 Centers for Disease Control and Prevention (CDC) screening questionnaire was associated with a pooled sensitivity of 48% (95% CI, 31.4% to 65.6%) and specificity of 58% (95% CI, 39.9% to 74.0%) for identifying children with a venous blood lead level greater than 10 μg/dL (5 studies [n = 2265]). Adapted versions of the CDC questionnaire did not demonstrate improved accuracy. Capillary blood lead testing demonstrated sensitivity of 87% to 91% and specificity greater than 90%, compared with venous measurement (4 studies [n = 1431]). Counseling and nutritional interventions or residential lead hazard control techniques did not reduce blood lead concentrations in asymptomatic children, but studies were few and had methodological limitations (7 studies [n = 1419]). One trial (n = 780) of dimercaptosuccinic acid (DMSA) chelation therapy found reduced blood lead levels in children at 1 week to 1 year but not at 4.5 to 6 years, while another trial (n = 39) found no effect at 1 and 6 months. Seven-year follow-up assessments showed no effect on neuropsychological development, a small deficit in linear growth (height difference, 1.17 cm [95% CI, 0.41 to 1.93]), and poorer cognitive outcomes reported as the Attention and Executive Functions subscore of the Developmental Neuropsychological Assessment (unadjusted difference, -1.8 [95% CI, -4.5 to 1.0]; adjusted P = .045) in children treated with DMSA chelation. Evidence was too limited to determine the accuracy of screening questionnaires or benefits and harms of treatment in pregnant women. CONCLUSIONS AND RELEVANCE Screening questionnaires were not accurate for identifying children with elevated blood lead levels. Chelating agents in children were not significantly associated with sustained effects on blood level levels but were associated with harms.
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Affiliation(s)
- Amy G Cantor
- Pacific Northwest Evidence-based Practice Center, Departments of Medical Informatics and Clinical Epidemiology, Family Medicine, and Obstetrics and Gynecology, Oregon Health & Science University, Portland
| | - Rob Hendrickson
- Department of Emergency Medicine, Oregon Health & Science University, Portland
| | - Ian Blazina
- Pacific Northwest Evidence-based Practice Center, Portland, Oregon
| | - Jessica Griffin
- Pacific Northwest Evidence-based Practice Center, Portland, Oregon
| | - Sara Grusing
- Pacific Northwest Evidence-based Practice Center, Portland, Oregon
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Mansel C, Fross S, Rose J, Dema E, Mann A, Hart H, Klawinski P, Vohra BPS. Lead exposure reduces survival, neuronal determination, and differentiation of P19 stem cells. Neurotoxicol Teratol 2019; 72:58-70. [PMID: 30776472 DOI: 10.1016/j.ntt.2019.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/12/2019] [Accepted: 01/29/2019] [Indexed: 01/09/2023]
Abstract
Lead (Pb) is a teratogen that poses health risks after acute and chronic exposure. Lead is deposited in the bones of adults and is continuously leached into the blood for decades. While this chronic lead exposure can have detrimental effects on adults such as high blood pressure and kidney damage, developing fetuses and young children are particularly vulnerable. During pregnancy, bone-deposited lead is released into the blood at increased rates and can cross the placental barrier, exposing the embryo to the toxin. Embryos exposed to lead display serious developmental and cognitive defects throughout life. Although studies have investigated lead's effect on late-stage embryos, few studies have examined how lead affects stem cell determination and differentiation. For example, it is unknown whether lead is more detrimental to neuronal determination or differentiation of stem cells. We sought to determine the effect of lead on the determination and differentiation of pluripotent embryonic testicular carcinoma (P19) cells into neurons. Our data indicate that lead exposure significantly inhibits the determination of P19 cells to the neuronal lineage by alteration of N-cadherin and Sox2 expression. We also observed that lead significantly alters subsequent neuronal and glial differentiation. Consequently, this research emphasizes the need to reduce public exposure to lead.
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Affiliation(s)
- Clayton Mansel
- William Jewell College, Department of Biology, Liberty, MO, United States of America
| | - Shaneann Fross
- William Jewell College, Department of Biology, Liberty, MO, United States of America
| | - Jesse Rose
- William Jewell College, Department of Biology, Liberty, MO, United States of America
| | - Emily Dema
- William Jewell College, Department of Biology, Liberty, MO, United States of America
| | - Alexis Mann
- William Jewell College, Department of Biology, Liberty, MO, United States of America
| | - Haley Hart
- William Jewell College, Department of Biology, Liberty, MO, United States of America
| | - Paul Klawinski
- William Jewell College, Department of Biology, Liberty, MO, United States of America
| | - Bhupinder P S Vohra
- William Jewell College, Department of Biology, Liberty, MO, United States of America.
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22
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Braun JM, Hornung R, Chen A, Dietrich KN, Jacobs DE, Jones R, Khoury JC, Liddy-Hicks S, Morgan S, Vanderbeek SB, Xu Y, Yolton K, Lanphear BP. Effect of Residential Lead-Hazard Interventions on Childhood Blood Lead Concentrations and Neurobehavioral Outcomes: A Randomized Clinical Trial. JAMA Pediatr 2018; 172:934-942. [PMID: 30178064 PMCID: PMC6233767 DOI: 10.1001/jamapediatrics.2018.2382] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Childhood lead exposure is associated with neurobehavioral deficits. The effect of a residential lead hazard intervention on blood lead concentrations and neurobehavioral development remains unknown. OBJECTIVE To determine whether a comprehensive residential lead-exposure reduction intervention completed during pregnancy could decrease residential dust lead loadings, prevent elevated blood lead concentrations, and improve childhood neurobehavioral outcomes. DESIGN, SETTING, AND PARTICIPANTS This longitudinal, community-based randomized clinical trial of pregnant women and their children, the Health Outcomes and Measures of the Environment (HOME) Study, was conducted between March 1, 2003, and January 31, 2006. Pregnant women attending 1 of 9 prenatal care clinics affiliated with 3 hospitals in the Cincinnati, Ohio, metropolitan area were recruited. Of the 1263 eligible women, 468 (37.0%) agreed to participate and 355 women (75.8%) were randomized in this intention-to-treat analysis. Participants were randomly assigned to receive 1 of 2 interventions designed to reduce residential lead or injury hazards. Follow-up on children took place at 1, 2, 3, 4, 5, and 8 years of age. Data analysis was performed from September 2, 2017, to May 6, 2018. MAIN OUTCOMES AND MEASURES Residential dust lead loadings were measured at baseline and when children were 1 and 2 years of age. At 1, 2, 3, 4, 5, and 8 years of age, the children's blood lead concentrations as well as behavior, cognition, and executive functions were assessed. RESULTS Of the 355 women randomized, 174 (49.0%) were assigned to the intervention group (mean [SD] age at delivery, 30.1 (5.5) years; 119 [68.3%] self-identified as non-Hispanic white) and 181 (50.9%) to the control group (mean [SD] age at delivery, 29.2 [5.7] years; 123 [67.9%] self-identified as non-Hispanic white). The intervention reduced the dust lead loadings for the floor (24%; 95% CI, -43% to 1%), windowsill (40%; 95% CI, -60% to -11%), and window trough (47%; 95% CI, -68% to -10%) surfaces. The intervention did not statistically significantly reduce childhood blood lead concentrations (-6%; 95% CI, -17% to 6%; P = .29). Neurobehavioral test scores were not statistically different between children in the intervention group than those in the control group except for a reduction in anxiety scores in the intervention group (β = -1.6; 95% CI, -3.2 to -0.1; P = .04). CONCLUSIONS AND RELEVANCE Residential lead exposures, as well as blood lead concentrations in non-Hispanic black children, were reduced through a comprehensive lead-hazard intervention without elevating the lead body burden. However, this decrease did not result in substantive neurobehavioral improvements in children. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00129324.
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Affiliation(s)
- Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, Rhode Island
| | - Richard Hornung
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Aimin Chen
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kim N. Dietrich
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - David E. Jacobs
- National Center for Healthy Housing, Chicago, Illinois,Department of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago
| | - Robert Jones
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jane C. Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio,Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Stacey Liddy-Hicks
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Samantha Morgan
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | | - Yingying Xu
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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23
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Maloney B, Bayon BL, Zawia NH, Lahiri DK. Latent consequences of early-life lead (Pb) exposure and the future: Addressing the Pb crisis. Neurotoxicology 2018; 68:126-132. [PMID: 29981765 PMCID: PMC9873145 DOI: 10.1016/j.neuro.2018.06.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND The lead (Pb) exposure crisis in Flint, Michigan has passed from well-publicized event to a footnote, while its biological and social impact will linger for lifetimes. Interest in the "water crisis" has dropped to pre-event levels, which is neither appropriate nor safe. Flint's exposure was severe, but it was not unique. Problematic Pb levels have also been found in schools and daycares in 42 states in the USA. The enormity of Pb exposure via municipal water systems requires multiple responses. Herein, we focus on addressing a possible answer to long-term sequelae of Pb exposure. We propose "4R's" (remediation, renovation, reallocation, and research) against the Pb crisis that goes beyond a short-term fix. Remediation for affected individuals must continue to provide clean water and deal with both short and long-term effects of Pb exposure. Renovation of current water delivery systems, at both system-wide and individual site levels, is necessary. Reallocation of resources is needed to ensure these two responses occur and to get communities ready for potential sequelae of Pb exposure. Finally, properly focused research can track exposed individuals and illuminate latent (presumably epigenetic) results of Pb exposure and inform further resource reallocation. CONCLUSION Motivation to act by not only the general public but also by scientific and medical leaders must be maintained beyond initial news cycle spikes and an annual follow-up story. Environmental impact of Pb contamination of drinking water goes beyond one exposure incident in an impoverished and forgotten Michigan city. Population effects must be addressed long-term and nationwide.
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Affiliation(s)
- Bryan Maloney
- Department of Psychiatry, USA,Indiana Alzheimer Disesae Center, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Baindu L. Bayon
- Medical & Molecular Genetics, USA,Indiana Alzheimer Disesae Center, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nasser H. Zawia
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, USA
| | - Debomoy K. Lahiri
- Department of Psychiatry, USA,Medical & Molecular Genetics, USA,Indiana Alzheimer Disesae Center, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA,Corresponding author at: Department of Psychiatry, Neuroscience Research Building, Indiana University School of Medicine, 320 West 15th St., Indianapolis IN 46202, USA. (D.K. Lahiri)
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24
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Yan J, Gao Z, Wang J, Ma W, Ying X, Zhou C, Yan C. Family environmental and dietary implications for low-level prenatal lead exposure in Wujiang City, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:12780-12787. [PMID: 29473138 DOI: 10.1007/s11356-017-1102-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/19/2017] [Indexed: 06/08/2023]
Abstract
To explore the potential environmental and dietary factors during pregnancy affecting low-level prenatal lead exposure, we conducted a longitudinal study in Wujiang City, China. A total of 1976 mother-infant pairs were included from 2009 to 2010. An interviewed questionnaire was conducted and cord blood samples were collected. The geometric means of cord blood lead level was 30.3 μg/L (95% CI, 29.8-30.8) with 99.24% below 100 μg/L. Maternal age, passive smoking, and living in the countryside were significantly associated with cord blood lead concentrations. Multiple logistic models showed that some family environmental factors including using firewood and electricity as kitchen fuel were positively correlated with increased cord blood lead levels. Among dietary sources recorded in this study, meat consumption (> 3 times/week), fish consumption (1-3 times/week), vegetables consumption (> 1 times/day), and fruit intake (> 1 times/day) had inverse relationship with cord blood lead levels. In general, our findings may have important implications for family environmental and dietary direction during pregnancy to decrease prenatal lead exposure.
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Affiliation(s)
- Jin Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Zhenyan Gao
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Ju Wang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Wenjuan Ma
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Xiaolan Ying
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Cancan Zhou
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Chonghuai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
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25
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Weitzman M. American pediatric society's 2017 John Howland award acceptance lecture: a tale of two toxicants: childhood exposure to lead and tobacco. Pediatr Res 2018; 83:23-30. [PMID: 28945701 DOI: 10.1038/pr.2017.240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/18/2017] [Indexed: 11/09/2022]
Abstract
This article summarizes the presentation of the 2017 Howland Award to Michael Weitzman, MD, at the Annual Pediatric Academic Society Meetings. It summarizes the remarkable advances in understanding the effects and pathways of exposure of the two most common and pernicious of our nation's child environmental exposures, namely lead and tobacco. It also summarizes the profound effect of the translation of these findings into prudent and effective clinical and public health policies such that exposure to both has dramatically decreased over the past 40 years due to the tenacious activities of pediatricians, other child-related professionals, government agencies at all levels, and the American Academy of Pediatrics. Research and clinical activities, although essential, were not sufficient to produce these successes, but required extensive mentoring to produce a generation of academic pediatricians capable of conducting the requisite research, and extensive advocacy by pediatricians and others to overcome the formidable inertia and outright opposition to efforts to protect our children from these exposures. Moreover, the article highlights that both of these environmental exposures have roots in social and environmental injustice and neither is solved, and that there is no safe level of exposure to either of these toxicants.
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Affiliation(s)
- Michael Weitzman
- Department of Pediatrics, New York University School of Medicine, New York City, New York
- Department of Environmental Medicine, New York University School of Medicine, New York City, New York
- College of Global Public Health, New York University, New York City, New York
- NYU/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE
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26
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Jonasson ME, Afshari R. Historical documentation of lead toxicity prior to the 20th century in English literature. Hum Exp Toxicol 2017; 37:775-788. [PMID: 29076389 DOI: 10.1177/0960327117737146] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Lead is a heavy metal that remains a persistent environmental toxin. Although there have been a substantial number of reviews published on the health effects of lead, these reviews have predominantly focused on recent publications and rarely look at older, more historical articles. Old documents on lead can provide useful insight in establishing the historical context of lead usage and its modes of toxicity. The objective of this review is to explore historical understandings and uses of lead prior to the 20th century. One hundred eighty-eight English language articles that were published before the year 1900 were included in this review. Major themes in historical documentation of lead toxicology include lead's use in medical treatments, symptoms of lead poisoning, treatments for lead poisoning, occupational lead poisonings, and lead contamination in food and drinking water. The results of this review indicate that lead's usage was widespread throughout the 19th century, and its toxic properties were well-known. Common symptoms of lead poisoning and suggested treatments were identified during this time period. This review provides important insight into the knowledge and uses of lead before the 20th century and can serve as a resource for researchers looking at the history of lead.
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Affiliation(s)
| | - R Afshari
- 2 BC Centre for Disease Control, Vancouver, Canada.,3 Occupational and Environmental Health Division, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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27
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Bjørklund G, Mutter J, Aaseth J. Metal chelators and neurotoxicity: lead, mercury, and arsenic. Arch Toxicol 2017; 91:3787-3797. [DOI: 10.1007/s00204-017-2100-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/19/2017] [Indexed: 01/07/2023]
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28
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Hauptman M, Bruccoleri R, Woolf AD. An Update on Childhood Lead Poisoning. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2017; 18:181-192. [PMID: 29056870 PMCID: PMC5645046 DOI: 10.1016/j.cpem.2017.07.010] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Childhood lead poisoning is a multi-faceted, complex condition, which affects not only the child's health and well-being, but also the family's housing security, economic status, job security, and stress level. This review updates the emergency department clinician on the management of childhood lead poisoning. Infants and children are at higher risk than adults for lead exposure due to their smaller size and proportionately larger dose of ingested toxins, their proximity to ground dirt and indoor dust, their energy and curiosity, their oral exploratory and pica behaviors, their proportionately larger daily water and milk intake, and dietary preferences that differ markedly from those of adults. Pediatric health care providers working in the emergency department can provide medical management, as well as preventive counseling and guidance, to parents of children presenting with evidence of acute or chronic lead poisoning.
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Affiliation(s)
- Marissa Hauptman
- Pediatric Environmental Health Center, Division of General Pediatrics, Department of Medicine, Boston Children's Hospital
- Department of Pediatrics, Harvard Medical School
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA
| | - Rebecca Bruccoleri
- Pediatric Environmental Health Center, Division of General Pediatrics, Department of Medicine, Boston Children's Hospital
- Department of Pediatrics, Harvard Medical School
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA
- Program in Medical Toxicology, Boston Children's Hospital
| | - Alan D Woolf
- Pediatric Environmental Health Center, Division of General Pediatrics, Department of Medicine, Boston Children's Hospital
- Department of Pediatrics, Harvard Medical School
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA
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29
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ACMT Recommends Against Use of Post-Chelator Challenge Urinary Metal Testing. J Med Toxicol 2017; 13:352-354. [PMID: 28726084 DOI: 10.1007/s13181-017-0624-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 11/29/2022] Open
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30
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Weiss D, Lee D, Feldman R, Smith KE. Severe lead toxicity attributed to bullet fragments retained in soft tissue. BMJ Case Rep 2017; 2017:bcr-2016-217351. [PMID: 28275014 DOI: 10.1136/bcr-2016-217351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
A man aged 30 years presented to an emergency department with a 1 month history of severe abdominal pain, jaundice, constipation, lower extremity weakness and weight loss. A peripheral blood smear was performed that showed basophilic stippling of erythrocytes prompting a blood lead level (BLL) evaluation. The patient had a BLL of >200 µg/dL. Retained bullet fragments were identified in the left lower extremity from a previous gunshot wound 10 years prior. Lead from the excised bullet fragment was consistent with the patient's blood lead by isotope ratio analysis. This case is a rare example of a severely elevated BLL attributed to bullet fragments in soft tissue. Bullets retained in soft tissue are not often considered a risk factor for a markedly elevated BLL because they become encapsulated within the tissue over time.
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Affiliation(s)
- Debora Weiss
- Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA.,Wisconsin Department of Health Services, Bureau of Environmental and Occupational Health, Madison, Wisconsin, USA
| | - Don Lee
- Ascension Columbia St. Mary's, Milwaukee, Wisconsin, USA
| | - Ryan Feldman
- Wisconsin Poison Center, Childrens Hospital of Wisconsin, Froedert & the Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kate E Smith
- University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, Trace Element Research Laboratory, Madison, Wisconsin, USA
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31
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Jones AL. Emerging aspects of assessing lead poisoning in childhood. EMERGING HEALTH THREATS JOURNAL 2017. [DOI: 10.3402/ehtj.v2i0.7080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- AL Jones
- Discipline of Clinical Pharmacology and Clinical Toxicology, School of Medicine and Public Health and Calvary Mater Hospital, University of Newcastle, Callaghan, Australia
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32
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Abstract
Obesity is a complex and multifactorial disease, which likely comprises multiple subtypes. Emerging data have linked chemical exposures to obesity. As organismal response to environmental exposures includes altered gene expression, identifying the regulatory epigenetic changes involved would be key to understanding the path from exposure to phenotype and provide new tools for exposure detection and risk assessment. In this report, we summarize published data linking early-life exposure to the heavy metals, cadmium and lead, to obesity. We also discuss potential mechanisms, as well as the need for complete coverage in epigenetic screening to fully identify alterations. The keys to understanding how metal exposure contributes to obesity are improved assessment of exposure and comprehensive establishment of epigenetic profiles that may serve as markers for exposures.
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Affiliation(s)
- Sarah S Park
- Department of Biological Sciences, Center for Human Health & the Environment, North Carolina State University, Raleigh, NC 27695 USA
| | - David A Skaar
- Department of Biological Sciences, Center for Human Health & the Environment, North Carolina State University, Raleigh, NC 27695 USA
| | - Randy L Jirtle
- Department of Biological Sciences, Center for Human Health & the Environment, North Carolina State University, Raleigh, NC 27695 USA.,Department of Oncology, McArdle Laboratory for Cancer Research, University of Wisconsin-Madison, Madison, WI 53705, USA.,Department of Sport & Exercise Sciences, Institute of Sport & Physical Activity Research, University of Bedfordshire, Bedford, Bedfordshire, UK
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health & the Environment, North Carolina State University, Raleigh, NC 27695 USA
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Nussbaumer‐Streit B, Yeoh B, Griebler U, Pfadenhauer LM, Busert LK, Lhachimi SK, Lohner S, Gartlehner G. Household interventions for preventing domestic lead exposure in children. Cochrane Database Syst Rev 2016; 10:CD006047. [PMID: 27744650 PMCID: PMC6461195 DOI: 10.1002/14651858.cd006047.pub5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Lead poisoning is associated with physical, cognitive and neurobehavioural impairment in children, and trials have tested many household interventions to prevent lead exposure. This is an update of the original review, first published in 2008. OBJECTIVES To assess the effects of household interventions for preventing or reducing lead exposure in children, as measured by improvements in cognitive and neurobehavioural development, reductions in blood lead levels and reductions in household dust lead levels. SEARCH METHODS In May 2016 we searched CENTRAL, Ovid MEDLINE, Embase, nine other databases and two trials registers: the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov. We also checked the reference lists of relevant studies and contacted experts to find unpublished studies. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs of household educational or environmental interventions, or combinations of interventions to prevent lead exposure in children (from birth to 18 years of age), where investigators reported at least one standardised outcome measure. DATA COLLECTION AND ANALYSIS Two authors independently reviewed all eligible studies for inclusion, assessed risk of bias and extracted data. We contacted trialists to obtain missing information. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS We included 14 studies involving 2643 children: 13 RCTs (involving 2565 children) and one quasi-RCT (involving 78 children). Children in all studies were under six years of age. Thirteen studies took place in urban areas of North America, and one was in Australia. Most studies were in areas with low socioeconomic status. Girls and boys were equally represented in all studies. The duration of the intervention ranged from 3 months to 24 months in 12 studies, while 2 studies performed interventions on a single occasion. Follow-up periods ranged from 6 months to 48 months. Three RCTs were at low risk of bias in all assessed domains. We rated two RCTs and one quasi-RCT as being at high risk of selection bias and six RCTs as being at high risk of attrition bias. For educational interventions, we rated the quality of evidence to be high for continuous blood lead levels and moderate for all other outcomes. For environmental interventions, we assessed the quality of evidence as moderate to low. National or international research grants or governments funded 12 studies, while the other 2 did not report their funding sources.No studies reported on cognitive or neurobehavioural outcomes. No studies reported on adverse events in children. All studies reported blood lead level outcomes.We put studies into subgroups according to their intervention type. We performed meta-analyses of both continuous and dichotomous data for subgroups where appropriate. Educational interventions were not effective in reducing blood lead levels (continuous: mean difference (MD) 0.02, 95% confidence interval (CI) -0.09 to 0.12, I² = 0%; 5 studies; N = 815; high quality evidence (log transformed); dichotomous ≥ 10.0 µg/dL (≥ 0.48 µmol/L): risk ratio (RR) 1.02, 95% CI 0.79 to 1.30; I² = 0%; 4 studies; N = 520; moderate quality evidence; dichotomous ≥ 15.0 µg/dL (≥ 0.72 µmol/L): RR 0.60, 95% CI 0.33 to 1.09; I² = 0%; 4 studies; N = 520; moderate quality evidence). Meta-analysis for the dust control subgroup also found no evidence of effectiveness on blood lead levels (continuous: MD -0.15, 95% CI -0.42 to 0.11; I² = 90%; 3 studies; N = 298; low quality evidence (log transformed); dichotomous ≥ 10.0 µg/dL (≥ 0.48 µmol/L): RR 0.93, 95% CI 0.73 to 1.18; I² = 0; 2 studies; N = 210; moderate quality evidence; dichotomous ≥ 15.0 µg/dL (≥ 0.72 µmol/L): RR 0.86, 95% CI 0.35 to 2.07; I² = 56%; 2 studies; N = 210; low quality evidence). After adjusting the dust control subgroup for clustering in meta-analysis, we found no evidence of effectiveness. We could not pool the studies using soil abatement (removal and replacement) and combination intervention groups in a meta-analysis due to substantial differences between studies, and generalisability or reproducibility of the results from these studies is unknown. Therefore, there is currently insufficient evidence to clarify whether soil abatement or a combination of interventions reduces blood lead levels. AUTHORS' CONCLUSIONS Based on current knowledge, household educational interventions are ineffective in reducing blood lead levels in children as a population health measure. Dust control interventions may lead to little or no difference in blood lead levels (the quality of evidence was moderate to low, meaning that future research is likely to change these results). There is currently insufficient evidence to draw conclusions about the effectiveness of soil abatement or combination interventions. No study reported on cognitive or neurobehavioural outcomes or adverse events. These patient-relevant outcomes would have been of great interest to draw conclusions for practice.Further trials are required to establish the most effective intervention for preventing lead exposure. Key elements of these trials should include strategies to reduce multiple sources of lead exposure simultaneously using empirical dust clearance levels. It is also necessary for trials to be carried out in low- and middle-income countries and in differing socioeconomic groups in high-income countries.
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Affiliation(s)
- Barbara Nussbaumer‐Streit
- Danube University KremsDepartment for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
- Danube University KremsCochrane AustriaDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
| | | | - Ursula Griebler
- Danube University KremsDepartment for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
- Danube University KremsCochrane AustriaDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
| | - Lisa M Pfadenhauer
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and EpidemiologyMarchioninistr 13MunichBavariaGermany
| | - Laura K Busert
- Ludwig‐Maximilians‐University MunichInstitute for Medical Informatics, Biometry and EpidemiologyMarchioninistr 13MunichBavariaGermany
| | - Stefan K Lhachimi
- Leibniz Institute for Prevention Research and EpidemiologyResearch Group for Evidence‐Based Public HealthAchterstr. 30BremenGermany28359
- University of BremenInstitute for Public Health and Nursing Research, Health Sciences BremenBibliotheksstr. 1BremenGermany28359
| | | | - Gerald Gartlehner
- Danube University KremsDepartment for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
- Danube University KremsCochrane AustriaDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
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Ebrahimzadeh-Bideskan AR, Hami J, Alipour F, Haghir H, Fazel AR, Sadeghi A. Protective effects of ascorbic acid and garlic extract against lead-induced apoptosis in developing rat hippocampus. Metab Brain Dis 2016; 31:1123-32. [PMID: 27311610 DOI: 10.1007/s11011-016-9837-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 05/16/2016] [Indexed: 12/12/2022]
Abstract
Lead exposure has negative effects on developing nervous system and induces apoptosis in newly generated neurons. Natural antioxidants (i.e. Ascorbic acid and Garlic) might protect against lead-induced neuronal cell damage. The aim of the present study was to investigate the protective effects of Ascorbic acid and Garlic administration during pregnancy and lactation on lead-induced apoptosis in rat developing hippocampus. Timed pregnant Wistar rats were administrated with Lead (1500 ppm) via drinking water (Pb group) or lead plus Ascorbic acid (Pb + AA Group, 500 mg/kg, IP), or lead plus Garlic Extract (Pb + G Group, 1 ml garlic juice/100 g BW, via Gavage) from early gestation (GD 0) until postnatal day 50 (PN 50). At the end of experiments, the pups' brains were carefully dissected. To identify neuronal death, the brain sections were stained with TUNEL assay. Mean of blood and brain lead levels increased significantly in Pb group comparing to other studied groups (P < 0.01). There was significant reduction in blood and brain lead level in Pb + AA and Pb + G groups when compared to those of Pb group (P < 0.01). The mean number of TUNEL positive cells in the CA1, CA3, and DG was significantly lower in the groups treated by either Ascorbic acid or Garlic (P < 0.05). Administration of Ascorbic acid and Garlic during pregnancy and lactation protect against lead-induced neuronal cell apoptosis in the hippocampus of rat pups partially via the reduction of Pb concentration in the blood and in the brain.
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Affiliation(s)
| | - Javad Hami
- Department of Anatomical Sciences, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Alipour
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Haghir
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali-Reza Fazel
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Akram Sadeghi
- Department of Anatomy and Cell Biology, School of Medicine, Isfahan University of Medical Sciences, Hezar jarib St, Isfahan, Iran.
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Abstract
Blood lead concentrations have decreased dramatically in US children over the past 4 decades, but too many children still live in housing with deteriorated lead-based paint and are at risk for lead exposure with resulting lead-associated cognitive impairment and behavioral problems. Evidence continues to accrue that commonly encountered blood lead concentrations, even those below 5 µg/dL (50 ppb), impair cognition; there is no identified threshold or safe level of lead in blood. From 2007 to 2010, approximately 2.6% of preschool children in the United States had a blood lead concentration ≥5 µg/dL (≥50 ppb), which represents about 535 000 US children 1 to 5 years of age. Evidence-based guidance is available for managing increased lead exposure in children, and reducing sources of lead in the environment, including lead in housing, soil, water, and consumer products, has been shown to be cost-beneficial. Primary prevention should be the focus of policy on childhood lead toxicity.
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Hubbs-Tait L, Nation JR, Krebs NF, Bellinger DC. Neurotoxicants, Micronutrients, and Social Environments. Psychol Sci Public Interest 2016; 6:57-121. [DOI: 10.1111/j.1529-1006.2005.00024.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
SUMMARY—Systematic research evaluating the separate and interacting impacts of neurotoxicants, micronutrients, and social environments on children's cognition and behavior has only recently been initiated. Years of extensive human epidemiologic and animal experimental research document the deleterious impact of lead and other metals on the nervous system. However, discrepancies among human studies and between animal and human studies underscore the importance of variations in child nutrition as well as social and behavioral aspects of children's environments that mitigate or exacerbate the effects of neurotoxicants. In this monograph, we review existing research on the impact of neurotoxic metals, nutrients, and social environments and interactions across the three domains. We examine the literature on lead, mercury, manganese, and cadmium in terms of dispersal, epidemiology, experimental animal studies, effects of social environments, and effects of nutrition. Research documenting the negative impact of lead on cognition and behavior influenced reductions by the Center for Disease Control in child lead-screening guidelines from 30 micrograms per deciliter (μg/dL) in 1975 to 25 μg/dL in 1985 and to 10 μg/dL in 1991. A further reduction is currently being considered. Experimental animal research documents lead's alteration of glutamate-neurotransmitter (particularly N-methyl-D-aspartate) activity vital to learning and memory. In addition, lead induces changes in cholinergic and dopaminergic activity. Elevated lead concentrations in the blood are more common among children living in poverty and there is some evidence that socioeconomic status influences associations between lead and child outcomes. Micronutrients that influence the effects of lead include iron and zinc. Research documenting the negative impact of mercury on children (as well as adults) has resulted in a reference dose (RfD) of 0.1 microgram per kilogram of body weight per day (μg/kg/day). In animal studies, mercury interferes with glutamatergic, cholinergic, and dopaminergic activity. Although evidence for interactions of mercury with children's social contexts is minimal, researchers are examining interactions of mercury with several nutrients. Research on the effects of cadmium and manganese on child cognition and behavior is just beginning. Experimental animal research links cadmium to learning deficits, manganese to behaviors characteristic of Parkinson's disease, and both to altered dopaminergic functioning. We close our review with a discussion of policy implications, and we recommend interdisciplinary research that will enable us to bridge gaps within and across domains.
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Affiliation(s)
- Laura Hubbs-Tait
- Department of Human Development and Family Science, Oklahoma State University
| | | | - Nancy F. Krebs
- Department of Pediatrics, University of Colorado School of Medicine
| | - David C. Bellinger
- Department of Neurology, Harvard Medical School; Department of Environmental Health, Harvard School of Public Health; and Children's Hospital Boston
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Prevention of gastrointestinal lead poisoning using recombinant Lactococcus lactis expressing human metallothionein-I fusion protein. Sci Rep 2016; 6:23716. [PMID: 27045906 PMCID: PMC4820694 DOI: 10.1038/srep23716] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 03/11/2016] [Indexed: 12/15/2022] Open
Abstract
Low-level lead poisoning is an insidious disease that affects millions of children worldwide, leading to biochemical and neurological dysfunctions. Blocking lead uptake via the gastrointestinal tract is an important prevention strategy. With this in mind, we constructed the recombinant Lactococcus lactis strain pGSMT/MG1363, which constitutively expressed the fusion protein glutathione S-transferase (GST)–small molecule ubiquitin-like modifier protein (SUMO)–metallothionein-I (GST-SUMO-MT). The thermodynamic data indicated that the average number of lead bound to a GST-SUMO-MT molecule was 3.655 and this binding reaction was a spontaneous, exothermic and entropy-increasing process. The total lead-binding capacity of pGSMT/MG1363 was 4.11 ± 0.15 mg/g dry mass. Oral administration of pGSMT/MG1363 (1 × 1010 Colony-Forming Units) to pubertal male rats that were also treated with 5 mg/kg of lead acetate daily significantly inhibited the increase of blood lead levels, the impairment of hepatic function and the decrease of testosterone concentration in the serum, which were all impaired in rats treated by lead acetate alone. Moreover, the administration of pGSMT/MG1363 for 6 weeks did not affect the serum concentration of calcium, magnesium, potassium or sodium ions. This study provides a convenient and economical biomaterial for preventing lead poisoning via the digestive tract.
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Sisombath NS, Jalilehvand F. Similarities between N-Acetylcysteine and Glutathione in Binding to Lead(II) Ions. Chem Res Toxicol 2015; 28:2313-24. [PMID: 26624959 DOI: 10.1021/acs.chemrestox.5b00323] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
N-Acetylcysteine is a natural thiol-containing antioxidant, a precursor for cysteine and glutathione, and a potential detoxifying agent for heavy metal ions. However, previous accounts of the efficiency of N-acetylcysteine (H2NAC) in excretion of lead are few and contradicting. Here, we report results on the nature of lead(II) complexes formed with N-acetylcysteine in aqueous solution, which were obtained by combining information from several spectroscopic methods, including (207)Pb, (13)C, and (1)H NMR, Pb LIII-edge X-ray absorption, ultraviolet-visible (UV-vis) spectroscopy, and electro-spray ionization mass spectrometry (ESI-MS). Two series of solutions were used containing CPb(II) = 10 and 100 mM, respectively, varying the H2NAC/Pb(II) mole ratios from 2.1 to 10.0 at pH 9.1-9.4. The coordination environments obtained resemble those previously found for the Pb(II) glutathione system: at a ligand-to-lead mole ratio of 2.1, dimeric or oligomeric Pb(II) N-acetylcysteine complexes are formed, while a trithiolate [Pb(NAC)3](4-) complex dominates in solutions with H2NAC/Pb(II) mole ratios >3.0.
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Affiliation(s)
- Natalie S Sisombath
- Department of Chemistry, University of Calgary , 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada
| | - Farideh Jalilehvand
- Department of Chemistry, University of Calgary , 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada
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Ferulic Acid Protects Against Lead Acetate-Induced Inhibition of Neurite Outgrowth by Upregulating HO-1 in PC12 Cells: Involvement of ERK1/2-Nrf2 Pathway. Mol Neurobiol 2015; 53:6489-6500. [DOI: 10.1007/s12035-015-9555-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 11/19/2015] [Indexed: 12/28/2022]
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Cao Y, Skaug MA, Andersen O, Aaseth J. Chelation therapy in intoxications with mercury, lead and copper. J Trace Elem Med Biol 2015; 31:188-92. [PMID: 24894443 DOI: 10.1016/j.jtemb.2014.04.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 11/15/2022]
Abstract
In the present review we provide an update of the appropriate use of chelating agents in the treatment of intoxications with compounds of mercury, lead and copper. The relatively new chelators meso-2,3-dimercaptosuccinic acid (DMSA) and 2,3-dimercapto-propanesulphonate (DMPS) can effectively mobilize deposits of mercury as well as of lead into the urine. These drugs can be administered orally and have relatively low toxicity compared to the classical antidote dimercaptopropanol (BAL). d-Penicillamine has been widely used in copper overload, although 2,3-dimercaptosuccinic acid or tetrathiomolybdate may be more suitable alternatives today. In copper-toxicity, a free radical scavenger might be recommended as adjuvant to the chelator therapy.
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Affiliation(s)
- Yang Cao
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marit Aralt Skaug
- Faculty of Public Health, Hedmark University College, Elverum, Norway.
| | - Ole Andersen
- Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark
| | - Jan Aaseth
- Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger, Norway
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Aaseth J, Skaug MA, Cao Y, Andersen O. Chelation in metal intoxication--Principles and paradigms. J Trace Elem Med Biol 2015; 31:260-6. [PMID: 25457281 DOI: 10.1016/j.jtemb.2014.10.001] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 08/14/2014] [Accepted: 10/06/2014] [Indexed: 01/19/2023]
Abstract
The present review provides an update of the general principles for the investigation and use of chelating agents in the treatment of intoxications by metals. The clinical use of the old chelators EDTA (ethylenediamine tetraacetate) and BAL (2,3-dimercaptopropanol) is now limited due to the inconvenience of parenteral administration, their own toxicity and tendency to increase the neurotoxicity of several metals. The hydrophilic dithiol chelators DMSA (meso-2,3-dimercaptosuccinic acid) and DMPS (2,3-dimercapto-propanesulphonate) are less toxic and more efficient than BAL in the clinical treatment of heavy metal poisoning, and available as capsules for oral use. In copper overload, DMSA appears to be a potent antidote, although d-penicillamine is still widely used. In the chelation of iron, the thiols are inefficient, since iron has higher affinity for ligands with nitrogen and oxygen, but the new oral iron antidotes deferiprone and desferasirox have entered into the clinical arena. Comparisons of these agents and deferoxamine infusions are in progress. General principles for research and development of new chelators are briefly outlined in this review.
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Affiliation(s)
- Jan Aaseth
- Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger, Norway
| | - Marit Aralt Skaug
- Faculty of Public Health, Hedmark University College, 2418 Elverum, Norway.
| | - Yang Cao
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ole Andersen
- Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark
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Yeoh B, Woolfenden S, Lanphear B, Ridley GF, Livingstone N, Jorgensen E. Household interventions for preventing domestic lead exposure in children. Cochrane Database Syst Rev 2014:CD006047. [PMID: 25506680 DOI: 10.1002/14651858.cd006047.pub4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Lead poisoning is associated with physical, cognitive and neurobehavioural impairment in children and trials have tested many household interventions to prevent lead exposure. This is an update of the original review by the same authors first published in 2008. OBJECTIVES To determine the effectiveness of household interventions in preventing or reducing lead exposure in children as measured by reductions in blood lead levels and/or improvements in cognitive development. SEARCH METHODS We identified trials through electronic searches of CENTRAL (2012, Issue 1), MEDLINE (1948 to January Week 1 2012), EMBASE (1980 to Week 2 2012), CINAHL (1937 to January 2012), PsycINFO (1887 to January Week 2 2012), ERIC (1966 to January 2012), Sociological Abstracts (1952 to January 2012), Science Citation Index (1970 to 20 January 2012), ZETOC (20 January 2012), LILACS (20 January 2012), Dissertation Abstracts (late 1960s to January 2012), ClinicalTrials.gov (19 January 2012), Current Controlled Trials (19 January 2012), Australian New Zealand Clinical Trials Registry (19 January 2012) and the National Research Register Archive. We also contacted experts to find unpublished studies. SELECTION CRITERIA Randomised and quasi-randomised controlled trials of household educational or environmental interventions to prevent lead exposure in children where at least one standardised outcome measure was reported. DATA COLLECTION AND ANALYSIS Two authors independently reviewed all eligible studies for inclusion, assessed risk of bias and extracted data. We contacted trialists to obtain missing information. MAIN RESULTS We included 14 studies (involving 2656 children). All studies reported blood lead level outcomes and none reported on cognitive or neurobehavioural outcomes. We put studies into subgroups according to their intervention type. We performed meta-analysis of both continuous and dichotomous data for subgroups where appropriate. Educational interventions were not effective in reducing blood lead levels (continuous: mean difference (MD) 0.02, 95% confidence interval (CI) -0.09 to 0.12, I(2) = 0 (log transformed); dichotomous ≥ 10µg/dL (≥ 0.48 µmol/L): relative risk (RR) 1.02, 95% CI 0.79 to 1.30, I(2)=0; dichotomous ≥ 15µg/dL (≥ 0.72 µmol/L): RR 0.60, 95% CI 0.33 to 1.09, I(2) = 0). Meta-analysis for the dust control subgroup also found no evidence of effectiveness (continuous: MD -0.15, 95% CI -0.42 to 0.11, I(2) = 0.9 (log transformed); dichotomous ≥ 10µg/dL (≥ 0.48 µmol/L): RR 0.93, 95% CI 0.73 to 1.18, I(2) =0; dichotomous ≥ 15µg/dL (≥ 0.72 µmol/L): RR 0.86, 95% CI 0.35 to 2.07, I(2) = 0.56). When meta-analysis for the dust control subgroup was adjusted for clustering, no statistical significant benefit was incurred. The studies using soil abatement (removal and replacement) and combination intervention groups were not able to be meta-analysed due to substantial differences between studies. AUTHORS' CONCLUSIONS Based on current knowledge, household educational or dust control interventions are ineffective in reducing blood lead levels in children as a population health measure. There is currently insufficient evidence to draw conclusions about the effectiveness of soil abatement or combination interventions.Further trials are required to establish the most effective intervention for prevention of lead exposure. Key elements of these trials should include strategies to reduce multiple sources of lead exposure simultaneously using empirical dust clearance levels. It is also necessary for trials to be carried out in developing countries and in differing socioeconomic groups in developed countries.
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Affiliation(s)
- Berlinda Yeoh
- Royal Far West, PO Box 52, Manly, NSW, 1655, Australia.
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McKay CA. Role of chelation in the treatment of lead poisoning: discussion of the Treatment of Lead-Exposed Children Trial (TLC). J Med Toxicol 2014; 9:339-43. [PMID: 24178899 DOI: 10.1007/s13181-013-0341-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Lead exposure in children is one component leading to cognitive impairment. The Treatment of Lead-Exposed Children Trial (1994-2004) studied the effect of succimer in treating low levels of lead exposure (20-44 mcg/dL) in children 12 to 33 months old. While succimer was effective in reducing blood lead concentrations in the short term, treatment of blood lead levels did not result in any detectable improvement in a wide variety of measurements of cognitive or behavioral function. Furthermore, blood lead concentrations were not distinguishable between chelated and non-chelated individuals at 1 year. The most important treatment strategy is identification and termination of major sources of lead exposure.
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MESH Headings
- Age Factors
- Biomarkers/blood
- Chelating Agents/therapeutic use
- Chelation Therapy
- Child
- Child, Preschool
- Cognition/drug effects
- Environmental Exposure/adverse effects
- Female
- Humans
- Infant
- Infant Behavior/drug effects
- Lead/adverse effects
- Lead/blood
- Lead Poisoning, Nervous System, Childhood/blood
- Lead Poisoning, Nervous System, Childhood/diagnosis
- Lead Poisoning, Nervous System, Childhood/drug therapy
- Lead Poisoning, Nervous System, Childhood/etiology
- Lead Poisoning, Nervous System, Childhood/psychology
- Male
- Randomized Controlled Trials as Topic
- Succimer/therapeutic use
- Time Factors
- Treatment Outcome
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Affiliation(s)
- Charles A McKay
- Division of Medical Toxicology, Department of Emergency Medicine, Hartford Hospital/University of Connecticut School of Medicine, American College of Medical Toxicology, 10645 N. Tatum Blvd. Suite 200-111, Phoenix, AZ, 85028, USA,
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Smith D, Strupp BJ. The scientific basis for chelation: animal studies and lead chelation. J Med Toxicol 2014; 9:326-38. [PMID: 24113857 DOI: 10.1007/s13181-013-0339-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This presentation summarizes several of the rodent and non-human studies that we have conducted to help inform the efficacy and clinical utility of succimer (meso-2,3-dimercaptosuccincinic acid) chelation treatment. We address the following questions: (1) What is the extent of body lead, and in particular brain lead reduction with chelation, and do reductions in blood lead accurately reflect reductions in brain lead? (2) Can succimer treatment alleviate the neurobehavioral impacts of lead poisoning? And (3) does succimer treatment, in the absence of lead poisoning, produce neurobehavioral deficits? Results from our studies in juvenile primates show that succimer treatment is effective at accelerating the elimination of lead from the body, but chelation was only marginally better than the complete cessation of lead exposure alone. Studies in lead-exposed adult primates treated with a single 19-day course of succimer showed that chelation did not measurably reduce brain lead levels compared to vehicle-treated controls. A follow-up study in rodents that underwent one or two 21-day courses of succimer treatment showed that chelation significantly reduced brain lead levels, and that two courses of succimer were significantly more efficacious at reducing brain lead levels than one. In both the primate and rodent studies, reductions in blood lead levels were a relatively poor predictor of reductions in brain lead levels. Our studies in rodents demonstrated that it is possible for succimer chelation therapy to alleviate certain types of lead-induced behavioral/cognitive dysfunction, suggesting that if a succimer treatment protocol that produced a substantial reduction of brain lead levels could be identified for humans, a functional benefit might be derived. Finally, we also found that succimer treatment produced lasting adverse neurobehavioral effects when administered to non-lead-exposed rodents, highlighting the potential risks of administering succimer or other metal-chelating agents to children who do not have elevated tissue lead levels. It is of significant concern that this type of therapy has been advocated for treating autism.
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Affiliation(s)
- Donald Smith
- Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, CA, USA,
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Lee YJ, Oh SH, Park C, Hong M, Lee AR, Yoo HJ, Shin CY, Cheon KA, Bahn GH. Advanced pharmacotherapy evidenced by pathogenesis of autism spectrum disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2014; 12:19-30. [PMID: 24851117 PMCID: PMC4022762 DOI: 10.9758/cpn.2014.12.1.19] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/17/2014] [Accepted: 03/20/2014] [Indexed: 01/08/2023]
Abstract
In clinical practice, pharmacological treatment is mostly focused on behavioral symptoms in everyday life. Nevertheless, persistent effort continues to develop medication for causal treatment. Recent changes in diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) to DSM-5 would affect not only diagnosing approaches, but also therapeutic approaches. Because previous pervasive developmental disorders have been integrated into a single entity, the autism spectrum disorder (ASD), we have to prepare for what medications are valuable for the ASD. In this article, we reviewed the following etiological treatment: acetylcholine and glutamate related medicine; amino acid medicine such as secretin, endogenous opioid, and oxytocin; complementary and alternative medicine such as chelating agents, vitamins, and omega-3; promising drugs related to the scope of pharmacogenetics currently under study.
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Affiliation(s)
- Yeon Jung Lee
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
| | - Soo Hyun Oh
- Department of Life Sciences, Ewha Womans University, Seoul, Korea
| | - Chanmin Park
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
| | - Minha Hong
- Department of Psychiatry, Dankook University Medical College, Chungnam, Korea
| | - Ah Rah Lee
- Kyung Hee University School of Medicine, Seoul, Korea
| | - Hee Jeong Yoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chan Young Shin
- Department of Pharmacology, Konkuk University School of Medicine, Seoul, Korea
| | - Keun-Ah Cheon
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Geon Ho Bahn
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
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Mason LH, Harp JP, Han DY. Pb neurotoxicity: neuropsychological effects of lead toxicity. BIOMED RESEARCH INTERNATIONAL 2014; 2014:840547. [PMID: 24516855 PMCID: PMC3909981 DOI: 10.1155/2014/840547] [Citation(s) in RCA: 310] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 10/09/2013] [Accepted: 10/14/2013] [Indexed: 11/18/2022]
Abstract
Neurotoxicity is a term used to describe neurophysiological changes caused by exposure to toxic agents. Such exposure can result in neurocognitive symptoms and/or psychiatric disturbances. Common toxic agents include heavy metals, drugs, organophosphates, bacterial, and animal neurotoxins. Among heavy metal exposures, lead exposure is one of the most common exposures that can lead to significant neuropsychological and functional decline in humans. In this review, neurotoxic lead exposure's pathophysiology, etiology, and epidemiology are explored. In addition, commonly associated neuropsychological difficulties in intelligence, memory, executive functioning, attention, processing speed, language, visuospatial skills, motor skills, and affect/mood are explored.
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Affiliation(s)
- Lisa H. Mason
- Department of Neurology, University of Kentucky College of Medicine, 740 S. Limestone, Lexington, KY 40536, USA
- Department of Psychology, University of Kentucky College of Arts and Sciences, 106b Kastle Hall, Lexington, KY 40506, USA
| | - Jordan P. Harp
- Department of Neurology, University of Kentucky College of Medicine, 740 S. Limestone, Lexington, KY 40536, USA
- Department of Psychology, University of Kentucky College of Arts and Sciences, 106b Kastle Hall, Lexington, KY 40506, USA
| | - Dong Y. Han
- Department of Neurology, University of Kentucky College of Medicine, 740 S. Limestone, Lexington, KY 40536, USA
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Spanier AJ, Wilson S, Ho M, Hornung R, Lanphear BP. The contribution of housing renovation to children's blood lead levels: a cohort study. Environ Health 2013; 12:72. [PMID: 23981571 PMCID: PMC3765489 DOI: 10.1186/1476-069x-12-72] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 08/24/2013] [Indexed: 05/30/2023]
Abstract
BACKGROUND Routine renovation of older housing is a risk factor for childhood lead poisoning, but the contribution to children's blood lead levels is poorly defined for children with lower exposure levels. METHODS We examined a prospective cohort of 276 children followed from 6 to 24 months of age. We conducted surveys of renovation activities and residential lead hazards and obtained blood lead level (B-Pb) every six months. We analyzed B-Pb in a repeated measures design using a mixed effects linear model. RESULTS Parent reported interior renovation ranged from 11 to 25% of housing units at the four, 6-month periods. In multivariable analysis, children whose housing underwent interior renovation had a 12% higher mean B-Pb by two years of age compared with children whose housing units were not renovated (p < 0.01). The time between renovation and the child blood lead sample was associated with higher B-Pb (p-value for trend <0.01); compared to children in non-renovated housing, children whose housing units underwent renovation in the prior month had a 17% higher mean B-Pb at two years of age, whereas children whose housing renovation occurred in the prior 2-6 months had an 8% higher mean B-Pb. We also found an association between higher paint lead loading, measured using an X-ray fluorescence (XRF) based paint lead index, and child B-Pb (p = 0.02); for every 10 mg/cm2 increase in paint lead loading index there was a 7.5% higher mean childhood B-Pb. CONCLUSIONS In an analysis of data collected before the recent changes to Environmental Protection Agency's Lead, Renovation, Repair and Painting Rule, routine interior housing renovation was associated with a modest increase in children's B-Pb. These results are important for the provision of clinical advice, for housing and public health professionals, and for policymakers.
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Affiliation(s)
- Adam J Spanier
- Department of Pediatrics, Penn State University Hershey Medical Center, HS83, 500 University Drive, P. O. Box 850, Hershey, PA 17033-0850, USA
| | - Stephen Wilson
- Department of Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0535, USA
| | - Mona Ho
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229-3026, USA
| | - Richard Hornung
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229-3026, USA
| | - Bruce P Lanphear
- Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229-3026, USA
- Child and Family Research Institute, British Columbia Children’s Hospital, 950 West 28th Ave., Vancouver, BC, Canada V5Z 4H4
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, B.C., Canada V5A 1S6
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Wang Y, Chen A, Dietrich KN, Radcliffe J, Caldwell KL, Rogan WJ. Postnatal exposure to methyl mercury and neuropsychological development in 7-year-old urban inner-city children exposed to lead in the United States. Child Neuropsychol 2013; 20:527-38. [PMID: 23971942 DOI: 10.1080/09297049.2013.824955] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The most common route for general population exposure to methyl mercury (MeHg) is fish consumption. Recommendations to pregnant women about consuming fish contaminated with MeHg are also applied to children, but there are few studies available about the effects of low-level postnatal MeHg exposure in them. OBJECTIVES To investigate the association between postnatal methyl mercury exposure and neuropsychological development in a study of children also exposed to lead, both measured at 7 years. METHODS We measured MeHg concentrations in blood samples from the Treatment of Lead-Exposed Children (TLC) trial in which 780 children with elevated concentrations of lead in blood were followed with neuropsychological tests from ages 12-33 months through 7 years. Here we examine blood MeHg concentration and neuropsychological test scores, both measured at age 7 years. We used a maximum likelihood method to estimate geometric mean MeHg concentration and generalized linear regression models to analyze MeHg and neuropsychological test scores. RESULTS Geometric mean MeHg concentration was 0.56 (95% confidence interval: 0.52, 0.59) μ g/L. A 1 μ g/L increase in MeHg was associated with a 2.1 (95% confidence interval: 0.4, 3.8) point increase in Full-Scale IQ and 0.2 (95% confidence interval: 0.02, 0.4) point increase in Learning Slopeindex T-score on a test of verbal memory. CONCLUSIONS Our results suggest that the relatively low MeHg exposure in US school-aged children from this population has no detectable adverse effect on neuropsychological development. The positive associations observed between MeHg and neurodevelopment may indirectly reflect consumption of beneficial polyunsaturated fatty acids from seafood.
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Affiliation(s)
- Yan Wang
- a Epidemiology Branch , National Institute of Environmental Health Sciences , Research Triangle Park , North Carolina , USA
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Zhang Y, Li Q, Liu X, Zhu H, Song A, Jiao J. Antioxidant and micronutrient-rich milk formula reduces lead poisoning and related oxidative damage in lead-exposed mice. Food Chem Toxicol 2013; 57:201-8. [DOI: 10.1016/j.fct.2013.03.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 03/04/2013] [Accepted: 03/12/2013] [Indexed: 11/25/2022]
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Arnold LE, Hurt E, Lofthouse N. Attention-deficit/hyperactivity disorder: dietary and nutritional treatments. Child Adolesc Psychiatr Clin N Am 2013; 22:381-402, v. [PMID: 23806311 DOI: 10.1016/j.chc.2013.03.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Dozens of complementary and alternative treatments have been advocated for attention-deficit/hyperactivity disorder. Some verge into standard treatment of specific cases. Most do not have conclusive evidence of effectiveness or safety for attention-deficit/hyperactivity disorder, but some have enough evidence and are safe, easy, cheap, and sensible enough that individual patient trials can be justified. There is a need to flesh out the evidence base, which could be done cost effectively for supplements or off-label agents that are amenable to placebo control.
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Affiliation(s)
- L Eugene Arnold
- Nisonger Center, Ohio State University, McCampbell 395E, 1581 Dodd Drive, Columbus, OH 43210, USA.
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