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Narayanan R, Sivadas S, Kurien AA. NELL-1-associated membranous nephropathy linked to skin fairness cream use: insights from an Indian case series. Kidney Int 2024; 105:1316-1319. [PMID: 38615743 DOI: 10.1016/j.kint.2024.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/28/2024] [Accepted: 03/19/2024] [Indexed: 04/16/2024]
Affiliation(s)
- Ranjit Narayanan
- Department of Nephrology, Aster MIMS Hospital, Kottakkal, Kerala, India.
| | - Sajeesh Sivadas
- Department of Nephrology, Aster MIMS Hospital, Kottakkal, Kerala, India
| | - Anila Abraham Kurien
- Department of Pathology, Renopath, Center for Renal and Urological Pathology, Chennai, India
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Devaraju PK, Seshadri J, Balasubramanian CM, Kurien AA, Senthilkumaran G, Rajarathinam VD, Jibia VS, Murugesan V, Lamech TM, Thanigachalam D, Ramanathan S, Alavudeen SS, Dakshinamoorthy S, Mookaiah S, Gopalakrishnan N. Complementary and Alternative Medicine Use and Glomerular Disease: A Contemporary Case Series. Kidney Med 2024; 6:100827. [PMID: 38799786 PMCID: PMC11127155 DOI: 10.1016/j.xkme.2024.100827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Rationale & Objective Complementary and alternative medicine (CAM) intake is widely prevalent in many parts of India. Heavy metals are known ingredients in some of these formulations. We studied the spectrum of glomerular diseases in patients using CAM. Study Design Case series. Setting & Participants Patients with proteinuria or unexplained acute kidney injury, who underwent a kidney biopsy between May 2021 and September 2022, and who provided a history of recent CAM intake were included in the study. For patients enrolled prospectively, blood and urine samples were analyzed using mass spectrometry for the presence of mercury, lead, arsenic and cadmium. The CAM formulation, when available, was analyzed using inductively coupled plasma-optical emission spectroscopy. Results Twenty-eight patients were enrolled in the study, with a median duration of CAM intake of 4 months (interquartile range, 2-6 months). Heavy metal screening was performed in 17 patients, of whom 15 had elevated urine mercury levels, 10 had elevated blood mercury levels, and 1 had elevated blood and urine arsenic levels. Of the 6 CAM formulations that were analyzed, all had high levels of mercury. Kidney biopsy findings were membranous nephropathy (n = 19), minimal change disease (n = 8), and mesangial proliferative glomerulonephritis (n = 1). Of the 19 patients with membranous nephropathy, 14 were associated with neural epidermal growth factor-like protein 1 (NELL-1). With conservative management alone, 17 patients achieved complete remission. Limitations Not all patients underwent blood and urine mercury testing, and only 6 patients provided the CAM samples for analysis. Furthermore, occupational and residential exposure to mercury could not be excluded. Conclusions The most common kidney pathology noted in our study was membranous nephropathy, which was predominantly associated with neural epidermal growth factor-like protein 1. A significant proportion of the patients recovered completely after withdrawal of the offending agent and initiation of renin-angiotensin system blockade.
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Affiliation(s)
| | | | | | | | | | | | | | - Vinoj Murugesan
- Institute of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | - Tanuj Moses Lamech
- Institute of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
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Garnier AS, Laubacher H, Briet M. Drug-induced glomerular diseases. Therapie 2024; 79:271-281. [PMID: 37973491 DOI: 10.1016/j.therap.2023.10.010] [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: 06/30/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
Drug-induced kidney diseases represent a wide range of diseases that are responsible for a significant proportion of all acute kidney injuries and chronic kidney diseases. In the present review, we focused on drug-induced glomerular diseases, more precisely podocytopathies - minimal change diseases (MCD), focal segmental glomerulosclerosis (FSGS) - and membranous nephropathies (MN), from a physiological and a pharmacological point of view. The glomerular filtration barrier is composed of podocytes that form foot processes tightly connected and directly in contact with the basal membrane and surrounding capillaries. The common clinical feature of these diseases is represented by the loss of the ability of the filtration barrier to retain large proteins, leading to massive proteinuria and nephrotic syndrome. Drugs such as non-steroidal anti-inflammatory drugs (NSAIDs), D-penicillamine, tiopronin, trace elements, bisphosphonate, and interferons have been historically associated with the occurrence of MCD, FSGS, and MN. In the last ten years, the development of new anti-cancer agents, including tyrosine kinase inhibitors and immune checkpoint inhibitors, and research into their renal adverse effects highlighted these issues and have improved our comprehension of these diseases.
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Affiliation(s)
- Anne-Sophie Garnier
- Service de néphrologie-dialyse-transplantation, CHU d'Angers, 49000 Angers, France; UFR Santé, université d'Angers, 49000 Angers, France; Université d'Angers, UMR CNRS 6015, Inserm U1083, unité MitoVasc, Team Carme, SFR ICAT, 49000 Angers, France; Laboratoire MitoVasc, UMR Inserm 1083 CNRS 6215, 49000 Angers, France
| | - Hélène Laubacher
- UFR Santé, université d'Angers, 49000 Angers, France; Laboratoire MitoVasc, UMR Inserm 1083 CNRS 6215, 49000 Angers, France
| | - Marie Briet
- UFR Santé, université d'Angers, 49000 Angers, France; Université d'Angers, UMR CNRS 6015, Inserm U1083, unité MitoVasc, Team Carme, SFR ICAT, 49000 Angers, France; Laboratoire MitoVasc, UMR Inserm 1083 CNRS 6215, 49000 Angers, France; Service de pharmacologie - toxicologie et pharmacovigilance, CHU d'Angers, 49000 Angers, France.
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Yüzbaşıoğlu Y, Hazar M, Aydın Dilsiz S, Yücel C, Bulut M, Cetinkaya S, Erdem O, Basaran N. Biomonitoring of Oxidative-Stress-Related Genotoxic Damage in Patients with End-Stage Renal Disease. TOXICS 2024; 12:69. [PMID: 38251024 PMCID: PMC10819997 DOI: 10.3390/toxics12010069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/27/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
Chronic kidney disease (CKD), a common progressive renal failure characterized by the permanent loss of functional nephrons can rapidly progress to end-stage renal disease, which is known to be an irreversible renal failure. In the therapy of ESRD, there are controversial suggestions about the use of regular dialysis, since it is claimed to increase oxidative stress, which may increase mortality in patients. In ESRD, oxidative-stress-related DNA damage is expected to occur, along with increased inflammation. Many factors, including heavy metals, have been suggested to exacerbate the damage in kidneys; therefore, it is important to reveal the relationship between these factors in ESRD patients. There are very few studies showing the role of oxidative-stress-related genotoxic events in the progression of ESRD patients. Within the scope of this study, genotoxic damage was evaluated using the comet assay and 8-OHdG measurement in patients with ESRD who were undergoing hemodialysis. The biochemical changes, the levels of heavy metals (aluminum, arsenic, cadmium, lead, and mercury) in the blood, and the oxidative biomarkers, including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels were evaluated, and their relationship with genotoxic damages was revealed. Genotoxicity, oxidative stress, and heavy-metal levels, except mercury, increased significantly in all renal patients. DNA damage, 8OHdG, and MDA significantly increased, and GSH significantly decreased in patients undergoing dialysis, compared with those not having dialysis. The duration and the severity of disease was positively correlated with increased aluminum levels and moderate positively correlated with increased DNA damage and cadmium levels. In conclusion, this study revealed that the oxidative-stress-related DNA damage, and also the levels of Al and Cd, increased in ESRD patients. It is assumed that these changes may play an important role in the progression of renal damage. Approaches for reducing oxidative-stress-related DNA damage and heavy-metal load in ESRD patients are recommended.
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Affiliation(s)
- Yücel Yüzbaşıoğlu
- Department of Emergency Medicine, Ankara Gülhane Training and Research Hospital, Health Sciences University, Ankara 06018, Türkiye
| | - Merve Hazar
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Ağrı İbrahim Cecen University, Ağrı 04100, Türkiye;
| | - Sevtap Aydın Dilsiz
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara 06100, Türkiye;
| | - Ciğdem Yücel
- Department of Clinical Biochemistry, Ankara Gülhane Training and Research Hospital, Health Sciences University, Ankara 06018, Türkiye;
| | - Mesudiye Bulut
- Department of Nephrology, Ankara Gülhane Training and Research Hospital, Health Sciences University, Ankara 06018, Türkiye;
| | - Serdar Cetinkaya
- Department of Pharmaceutical Toxicology, Gülhane Faculty of Pharmacy, Health Sciences University, Ankara 06018, Türkiye; (S.C.); (O.E.)
| | - Onur Erdem
- Department of Pharmaceutical Toxicology, Gülhane Faculty of Pharmacy, Health Sciences University, Ankara 06018, Türkiye; (S.C.); (O.E.)
| | - Nursen Basaran
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Başkent University, Ankara 06790, Türkiye;
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de Almeida EC, Faria VD, Cirinêu FD, Santiago MGA, Miotto B, Vieira JCS, Braga CP, Adamec J, Fernandes AAH, Buzalaf MAR, Padilha PDM. Metalloproteomic Investigation of Hg-Binding Proteins in Renal Tissue of Rats Exposed to Mercury Chloride. Int J Mol Sci 2023; 25:164. [PMID: 38203335 PMCID: PMC10779082 DOI: 10.3390/ijms25010164] [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: 10/25/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
Results obtained from rat studies indicate that, even at low concentrations, mercurial species cause harmful effects on the kidneys, by inducing the nephrotic oxidative stress response. In the present work, Hg-associated proteins were identified as possible mercury-exposure biomarkers in rat kidneys exposed to low mercury chloride concentrations for 30 days (Hg-30) and 60 days (Hg-60), using metalloproteomic strategies. The renal proteomic profile was fractioned by two-dimensional electrophoresis and the mercury determinations in kidney samples, protein pellets and protein spots were performed using graphite furnace atomic absorption spectrometry. The characterization of Hg-associated protein spots and the analysis of differentially expressed proteins were performed by liquid chromatography, coupled with tandem mass spectrometry. Eleven Hg-associated protein spots with a concentration range of 79 ± 1 to 750 ± 9 mg kg-1 in the Hg-60 group were identified. The characterization and expression analyses allowed the identification of 53 proteins that were expressed only in the Hg-60 group, 13 "upregulated" proteins (p > 0.95) and 47 "downregulated" proteins (p < 0.05). Actin isoforms and hemoglobin subunits were identified in protein spots of the Hg-60 group, with mercury concentrations in the range of 138 to 750 mg kg-1, which qualifies these proteins as potential mercury-exposure biomarkers.
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Affiliation(s)
- Emerson Carlos de Almeida
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-687, SP, Brazil; (E.C.d.A.); (V.D.F.); (F.D.C.); (M.G.A.S.); (B.M.); (J.C.S.V.); (A.A.H.F.)
| | - Victor Diego Faria
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-687, SP, Brazil; (E.C.d.A.); (V.D.F.); (F.D.C.); (M.G.A.S.); (B.M.); (J.C.S.V.); (A.A.H.F.)
| | - Felipe Dalmazzo Cirinêu
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-687, SP, Brazil; (E.C.d.A.); (V.D.F.); (F.D.C.); (M.G.A.S.); (B.M.); (J.C.S.V.); (A.A.H.F.)
| | - Maria G. A. Santiago
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-687, SP, Brazil; (E.C.d.A.); (V.D.F.); (F.D.C.); (M.G.A.S.); (B.M.); (J.C.S.V.); (A.A.H.F.)
| | - Beatriz Miotto
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-687, SP, Brazil; (E.C.d.A.); (V.D.F.); (F.D.C.); (M.G.A.S.); (B.M.); (J.C.S.V.); (A.A.H.F.)
| | - José C. S. Vieira
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-687, SP, Brazil; (E.C.d.A.); (V.D.F.); (F.D.C.); (M.G.A.S.); (B.M.); (J.C.S.V.); (A.A.H.F.)
| | | | - Jiri Adamec
- School of Medicine, Louisiana State University Health Sciences Center (LSUHSC), New Orleans, LA 70112, USA;
| | - Ana A. H. Fernandes
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-687, SP, Brazil; (E.C.d.A.); (V.D.F.); (F.D.C.); (M.G.A.S.); (B.M.); (J.C.S.V.); (A.A.H.F.)
| | - Marília A. R. Buzalaf
- Faculty of Dentistry of Bauru (FOB), University of Sao Paulo (USP), Bauru 17012-901, SP, Brazil;
| | - Pedro de Magalhães Padilha
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-687, SP, Brazil; (E.C.d.A.); (V.D.F.); (F.D.C.); (M.G.A.S.); (B.M.); (J.C.S.V.); (A.A.H.F.)
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6
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Mattewada NK, Priyamvada P. Can Corticosteroids be Used as a First-Line Agent for Mercury-Related Glomerular Diseases? Kidney Int Rep 2023; 8:1694-1695. [PMID: 37547523 PMCID: PMC10403667 DOI: 10.1016/j.ekir.2023.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/17/2023] [Accepted: 05/29/2023] [Indexed: 08/08/2023] Open
Affiliation(s)
- Naveen Kumar Mattewada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | - P.S. Priyamvada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
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Zhang L, Du M, Tu Y, Liang D, Wu X, Xie H. Clinicopathological features and long-term prognosis of glomerular diseases associated with mercury-containing cosmetics. J Nephrol 2023; 36:1401-1407. [PMID: 37060438 DOI: 10.1007/s40620-023-01606-y] [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: 09/24/2022] [Accepted: 02/15/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVE The pathological types and long-term prognosis of glomerular diseases related to mercury exposure are unclear. This study retrospectively examined 41 cases of glomerulonephropathy caused by mercury-containing cosmetics. METHODOLOGY Forty-one subjects with glomerular diseases presumably caused by mercury-containing cosmetics were selected. Clinical features, kidney biopsy, treatment, and follow-up data were collected. RESULTS All patients were female with an average age of 39.4 ± 6.6 years at diagnosis. Median time of exposure to mercury-containing cosmetics was six months, and average urine mercury level was 66.80 ± 38.55ug/(g·Cr). Most patients presented with nephrotic syndrome. Renal histopathology showed membranous nephropathy in 22 patients (53.65%), minimal change disease in 13 patients (31.71%), IgA nephropathy with minimal change disease in 5 patients (12.20%), and focal segmental glomerulosclerosis in 1 patient. Median time of exposure to mercury was longer and the proportion of patients with autoantibodies (mainly antinuclear antibodies) was higher in patients with membranous nephropathy. Both blood phospholipase A2 receptor -Ab and kidney tissue phospholipase A2 receptor were negative. Thirty-six patients received glucocorticosteroids and/or immunosuppressants. Five patients were treated with an angiotensin receptor blocker, and nine patients were treated with chelation therapy. The median follow-up time was 40 months (range 27-94). All patients achieved complete remission, and the median time to complete remission was one month. They all successfully discontinued the drugs without relapsing; withdrawal time was 26 months. CONCLUSION Membranous nephropathy was the most common pathological type in mercury-induced glomerular disease. Patients were sensitive to glucocorticosteroids and immunosuppressants and achieved complete remission quickly. Contrary to primary glomerulonephritides, patients with mercury-induced glomerular diseases had no relapses after withdrawal of the mercury containing cosmetics.
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Affiliation(s)
- Lihua Zhang
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
| | - Mengru Du
- Naijing Drum Tower Hospital, The Affiliated Hospital of Nanjing University School of Medicine, Nanjing, 210008, China
| | - Yuanmao Tu
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
| | - Dandan Liang
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
| | - Xiaomei Wu
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China
| | - Honglang Xie
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China.
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8
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Cremoni M, Agbekodo S, Teisseyre M, Zorzi K, Brglez V, Benzaken S, Esnault V, Planchard JH, Seitz-Polski B. Toxic Occupational Exposures and Membranous Nephropathy. Clin J Am Soc Nephrol 2022; 17:1609-1619. [PMID: 36283759 PMCID: PMC9718038 DOI: 10.2215/cjn.02930322] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Membranous nephropathy is a rare autoimmune kidney disease whose increasing prevalence in industrialized countries pleads for the involvement of an environmental factor in the development of the disease. In addition, the predominance of men in membranous nephropathy, classically attributed to biologic or genetic differences between men and women, could also be due to different occupational exposures. To support this hypothesis, we sought to describe the toxic occupational exposures of patients with membranous nephropathy. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In this observational epidemiologic study, we compared the occupations and toxic occupational exposures of 100 patients with membranous nephropathy with those of the general population, consisting of two cohorts of 26,734,000 and 26,500 French workers. We then compared the characteristics of patients exposed to an occupational toxic substance with those of unexposed patients. RESULTS Patients with membranous nephropathy worked more frequently in the construction sector than the general population (33% versus 7%, P<0.001). This difference remained significant by age and sex. They were also more frequently exposed to toxic substances, such as asbestos (16% versus 5%, P<0.001), lead (9% versus 1%, P<0.001), or organic solvents (37% versus 15%, P<0.001), than the general population. The predominance of men in the subgroup of patients occupationally exposed to toxic substances was not observed in unexposed individuals (organic solvents: 80% men versus 41%, P<0.001; asbestos: 90% men versus 55%, P=0.004). In addition, patients with phospholipase A2 receptor 1 (PLA2R1) epitope spreading were more frequently exposed to asbestos and organic solvents than patients without epitope spreading (32% versus 7%, P=0.02 and 74% versus 43%, P=0.02, respectively), with a dose-dependent effect. CONCLUSIONS Patients with membranous nephropathy were more frequently exposed to certain occupational toxic substances, such as asbestos and organic solvents, than the general population. This occupational exposure was more frequent in men and in patients with PLA2R1 epitope spreading. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER Immunopathological Analysis in a French National Cohort of Membranous Nephropathy (IHMN), NCT04326218. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2022_10_25_CJN02930322.mp3.
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Affiliation(s)
- Marion Cremoni
- Reference Center for Rare Diseases Idiopathic Nephrotic Syndrome, Nice University Hospital, Nice, France
- Clinical Research Unit Côte d'Azur, University Côte d'Azur, Nice, France
- Department of Nephrology Dialysis and Transplantation, Pasteur 2 Hospital, Nice University Hospital, Nice, France
| | - Sophie Agbekodo
- Department of Occupational Health, Cimiez Hospital, Nice University Hospital, Nice, France
| | - Maxime Teisseyre
- Reference Center for Rare Diseases Idiopathic Nephrotic Syndrome, Nice University Hospital, Nice, France
- Clinical Research Unit Côte d'Azur, University Côte d'Azur, Nice, France
| | - Kevin Zorzi
- Reference Center for Rare Diseases Idiopathic Nephrotic Syndrome, Nice University Hospital, Nice, France
| | - Vesna Brglez
- Reference Center for Rare Diseases Idiopathic Nephrotic Syndrome, Nice University Hospital, Nice, France
- Clinical Research Unit Côte d'Azur, University Côte d'Azur, Nice, France
| | - Sylvia Benzaken
- Immunology Laboratory, Archet 1 Hospital, Nice University Hospital, Nice, France
| | - Vincent Esnault
- Reference Center for Rare Diseases Idiopathic Nephrotic Syndrome, Nice University Hospital, Nice, France
- Department of Nephrology Dialysis and Transplantation, Pasteur 2 Hospital, Nice University Hospital, Nice, France
| | - Jo-Hanna Planchard
- Department of Occupational Health, Cimiez Hospital, Nice University Hospital, Nice, France
| | - Barbara Seitz-Polski
- Reference Center for Rare Diseases Idiopathic Nephrotic Syndrome, Nice University Hospital, Nice, France
- Clinical Research Unit Côte d'Azur, University Côte d'Azur, Nice, France
- Department of Nephrology Dialysis and Transplantation, Pasteur 2 Hospital, Nice University Hospital, Nice, France
- Immunology Laboratory, Archet 1 Hospital, Nice University Hospital, Nice, France
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Abraham Tharakan PK, Seethalekshmy NV. Beautification Gone Awry: Membranous Glomerulonephritis Following Use of Skin Lightening Cream Containing Mercury. Indian J Dermatol 2022; 67:837. [PMID: 36998857 PMCID: PMC10043663 DOI: 10.4103/ijd.ijd_616_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Affiliation(s)
| | - N V Seethalekshmy
- Department of Pathology, Amrita Institute of Medical Sciences, Kochi, Kerala, India E-mail:
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Barregard L, Sallsten G, Lundh T, Mölne J. Low-level exposure to lead, cadmium and mercury, and histopathological findings in kidney biopsies. ENVIRONMENTAL RESEARCH 2022; 211:113119. [PMID: 35288159 DOI: 10.1016/j.envres.2022.113119] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND Lead (Pb), cadmium (Cd) and mercury (Hg) are all nephrotoxic metals, and a large part of the body burden of Cd and Hg is found in the kidneys. There are, however, few studies on associations between exposure to these toxic metals and renal biopsy findings, and none at low-level exposure. AIM To examine the hypothesis that low-level concentration of Pb, Cd or Hg in the kidneys is associated with histopathological changes in the kidneys. METHODS We determined concentrations of Pb, Cd and Hg in kidney, blood and urine in 109 healthy kidney donors, aged 24-70 years. The renal biopsies were scored according to the Banff classification regarding tubular atrophy, interstitial fibrosis, glomerulosclerosis, arteriosclerosis, and arteriolohyalinosis. Kidney function was assessed based on glomerular filtration rate (GFR) as well as urinary excretion of albumin, low molecular weight proteins, kidney injury molecule 1 and N-acetylglucose aminidase. Associations between metal concentrations and histopathological changes, were assessed in models also including age, sex and smoking. RESULTS The median kidney concentrations of Pb, Cd and Hg were 0.08, 13 and 0.21 μg/g, respectively. There were signs of tubular atrophy in 63%, interstitial fibrosis in 21%, glomerulosclerosis in 71%, arteriosclerosis in 47%, and arteriolohyalinosis in 36% of the donors, but, as could be expected, the histopathological findings were limited, mostly Banff grade 1. In models adjusted for age, sex and smoking, kidney Cd was positively associated with tubular atrophy (p = 0.03) and possibly with arteriolohyalinosis (p = 0.06). Kidney Hg was associated with arteriosclerosis (p = 0.004). DISCUSSION AND CONCLUSIONS The results suggest that even low levels of Cd in the kidney can induce a mild degree of tubular atrophy. This is in line with previous findings at high-level Cd exposure. The association between kidney Hg and renal arteriosclerosis was unexpected, and may be a chance finding.
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Affiliation(s)
- Lars Barregard
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Thomas Lundh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University and Skane University Hospital, Lund, Sweden
| | - Johan Mölne
- Department of Clinical Pathology, Sahlgrenska University Hospital and Academy, University of Gothenburg, Gothenburg, Sweden
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Saldaña-Villanueva K, Pérez-Vázquez FJ, Ávila-García IP, Méndez-Rodríguez KB, Carrizalez-Yáñez L, Gavilán-García A, Vargas-Morales JM, Van-Brussel E, Diaz-Barriga F. A preliminary study on health impacts of Mexican mercury mining workers in a context of precarious employment. J Trace Elem Med Biol 2022; 71:126925. [PMID: 35051884 DOI: 10.1016/j.jtemb.2022.126925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/17/2021] [Accepted: 01/04/2022] [Indexed: 11/21/2022]
Abstract
Mercury mining is one of the main sources of mercury (Hg) release into the environment, causing serious impacts on human health and the environment. Workers in these mines are employed informally and precariously and therefore lack labor rights such as social security. The objective of the study is to make visible the exposure to environmental contaminants and the health of workers in mercury mines. An environmental assessment was conducted to determine workers' exposure to contaminants; urine samples were obtained to measure exposure to mercury and arsenic, and blood samples were obtained for lead and cadmium. Clinical parameters were also evaluated. Concentrations of Hg, As and Pb were determined in soil, 279.4 mg/kg (24.4-788.5), 14.7 mg/kg (9.5-20.3) and 1.4 mg/kg (1-2.8), respectively. The exposure results for mercury were 551 μg/g creatinine, for arsenic 50 μg/L and for lead 4.7 μg/dL. Cd-B was not found. In addition, 17.6 % of the workers had diabetes and 17.6 % had renal disorders. Principal Component Regression was performed obtaining an r2 of 0.86 for glomerular filtration rate and 0.54 for albumin creatinine ratio using clinical, occupational, and metal exposure variables. Exposure to Hg in this type of mine is not exclusive, so there is a cumulative risk of chronic exposure to different environmental pollutants directly impacting the health of workers. It is necessary to implement health strategies and different work opportunities for these workers.
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Affiliation(s)
- Kelvin Saldaña-Villanueva
- Coordination for the Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosi, San Luis Potosi, Mexico
| | - Francisco J Pérez-Vázquez
- Coordination for the Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosi, San Luis Potosi, Mexico
| | - Ivette P Ávila-García
- Coordination for the Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosi, San Luis Potosi, Mexico
| | - Karen B Méndez-Rodríguez
- Coordination for the Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosi, San Luis Potosi, Mexico
| | - Leticia Carrizalez-Yáñez
- Coordination for the Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosi, San Luis Potosi, Mexico
| | - Arturo Gavilán-García
- National Institute of Ecology and Climate Change, Secretariat of the Environment and Natural Resources (SEMARNAT) Mexico, Mexico
| | - Juan M Vargas-Morales
- School of Chemistry, Autonomous University of San Luis Potosi, San Luis Potosí, Mexico
| | - Evelyn Van-Brussel
- Department of Pharmacology and Toxicology, School of Medicine, UASLP, Toxicological Care Information Center (CIAT), Hospital Dr. Ignacio Morones Prieto, San Luis Potosí, Mexico
| | - Fernando Diaz-Barriga
- Coordination for the Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosi, San Luis Potosi, Mexico.
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12
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What can mercury teach us about membranous nephropathy and minimal change disease? Kidney Int Rep 2022; 7:1157-1160. [PMID: 35694554 PMCID: PMC9174039 DOI: 10.1016/j.ekir.2022.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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13
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Environmental exposure to lead, mercury, and cadmium is not associated with abnormal kidney function in Korean adolescents. Pediatr Nephrol 2022; 37:625-631. [PMID: 34448022 DOI: 10.1007/s00467-021-05215-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND We aimed to elucidate the relationship between environmental exposure to lead (Pb), mercury (Hg), and cadmium (Cd) which were measured in blood and the kidney function of adolescents. METHODS Cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey from 2010 to 2017. Statistical procedures were performed to analyze the Korean population of adolescents aged 12-17 years. Regression analysis was performed, and covariates included age, sex, body mass index, smoking status, and other heavy metal levels. RESULTS The median blood levels of Pb, Hg, and Cd were 1.165 μg/dL, 1.805 μg/L, and 0.304 μg/L, respectively. Adolescents with Pb levels in the highest quartile (> 1.454 μg/dL) had a 3.35 mL/min/1.73 m2-lower estimated glomerular filtration rate using creatinine (eGFRcr) (95% confidence interval (CI), -6.03 to -0.68 mL/min/1.73 m2) compared to those in the lowest quartile (< 0.856 μg/dL) in the unadjusted model. However, there was no association between the blood Pb level and eGFRcr in the adjusted model. Levels of Hg and Cd were not associated with eGFRcr in either model. High blood levels of all three heavy metals were not associated with the risk of hypertension. CONCLUSIONS There was no association between increased blood levels of Pb, Hg, and Cd; eGFRcr; and increased risk of hypertension in Korean adolescents who were exposed to relatively low levels of heavy metals.
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The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food. PATHOPHYSIOLOGY 2021; 28:513-543. [PMID: 35366249 PMCID: PMC8830458 DOI: 10.3390/pathophysiology28040034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/11/2021] [Accepted: 12/15/2021] [Indexed: 12/12/2022] Open
Abstract
Autoimmune diseases affect 5–9% of the world’s population. It is now known that genetics play a relatively small part in the pathophysiology of autoimmune disorders in general, and that environmental factors have a greater role. In this review, we examine the role of the exposome, an individual’s lifetime exposure to external and internal factors, in the pathophysiology of autoimmune diseases. The most common of these environmental factors are toxic chemicals, food/diet, and infections. Toxic chemicals are in our food, drink, common products, the air, and even the land we walk on. Toxic chemicals can directly damage self-tissue and cause the release of autoantigens, or can bind to human tissue antigens and form neoantigens, which can provoke autoimmune response leading to autoimmunity. Other types of autoimmune responses can also be induced by toxic chemicals through various effects at the cellular and biochemical levels. The food we eat every day commonly has colorants, preservatives, or packaging-related chemical contamination. The food itself may be antigenic for susceptible individuals. The most common mechanism for food-related autoimmunity is molecular mimicry, in which the food’s molecular structure bears a similarity with the structure of one or more self-tissues. The solution is to detect the trigger, remove it from the environment or diet, then repair the damage to the individual’s body and health.
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15
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Huang L, Zhao YJ, Dong QR, Hu GC. Immune-mediated membranous nephropathy: Long term fluconazole usage caused podocyte autophagy. J Biochem Mol Toxicol 2021; 36:e22935. [PMID: 34726812 DOI: 10.1002/jbt.22935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/31/2021] [Accepted: 10/13/2021] [Indexed: 11/09/2022]
Abstract
The primary consequences of membranous nephropathy (MN) are the development of nephrotic syndrome including hypogammaglobulinemia, the increased infectious risk, the loss of protein-bound vitamin D, and, above all, an elevated thromboembolic incidence of up to 50% in severe proteinuria patients. Membrane nephropathy may be either idiopathic or primary, not recognized (70%-80%) or secondary (20%-30%) to pathological sicknesses such as hepatitis B, systemic lupus erythematosus, malignancies, and side-effects of medicines. The immunological responses in MN involve multiple components: immunoglobulin G (IgG), long-escaped antigens, and the membrane attachment complex, formed by the supplement to form C5b-9. In general, IgG4 is the most significant IgG subclass deposited in idiopathic membranous nephropathic disease but fluctuating IgG1 levels also are linked with immunological deposits. In contrast, IgG1, IgG2, and IgG3 deposition are greater than IgG4 deposition in secondary nephropathy. Fluconazole is a synthetic antifungal triazole that is often used. It is well tolerated in general and has never been identified as a cause of nephropathies. We report on the development of MN caused by fluconazole therapy that could potentiate podocyte autophagy.
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Affiliation(s)
- Lan Huang
- Division of Nephrology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Ya-Juan Zhao
- Division of Nephrology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Qiao-Rong Dong
- Division of Nephrology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Gui-Cai Hu
- Division of Nephrology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
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16
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Ran E, Wang M, Yi Y, Feng M, Liu Y. Mercury poisoning complicated by acquired neuromyotonia syndrome: A case report. Medicine (Baltimore) 2021; 100:e26910. [PMID: 34397926 PMCID: PMC8360472 DOI: 10.1097/md.0000000000026910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/26/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Acquired neuromyotonia syndrome is a rare form of peripheral nerve hyperexcitability syndrome. It is characterized by spontaneous and continuous muscle contractions. Acquired neuromyotonia syndrome is mainly observed in patients with autoimmune diseases or tumors, but it is a rare neurological clinical manifestation in patients with mercury poisoning. PATIENT CONCERNS A 56-year-old woman presented with continuous and involuntary muscle twitching in her legs for 2 months; it was accompanied by a burning sensation in the lower limbs, insomnia, fatigue, and night sweats. These symptoms did not disappear during sleep. DIAGNOSES Toxicological blood analysis via atomic fluorescence spectrometry revealed that the level of mercury was 0.07 μmol/L (normal level: <0.05 μmol/L). Her urinary mercury level measured using the cold atomic absorption method was 217.50 μmol/mol creatinine, which was considerably higher than the reference range (0-2.25 μmol/mol creatinine for people not in contact with mercury, 0-20 μmol/mol creatinine following long-term exposure). Upon further testing, a high level of mercury (10,572 mg/kg) was detected in the patient's cream. Accordingly, this patient was diagnosed with mercury poisoning. INTERVENTIONS Treatment with 2,3-dimercapto-1-propanesulfonic acid (DMPS) was initiated. Her urinary mercury level decreased to 9.67 μmol/mol creatinine, and her neuromyotonia syndrome and hyponatremia were relieved, with urine protein completely disappearing after 3 months of treatment. OUTCOMES After DMPS treatment, the clinical manifestations of the nervous system disappeared and electrolyte parameters returned to normal levels. LESSONS Acquired neuromyotonia syndrome is a rare disorder caused by the hyperexcitability of peripheral nerves, resulting in spontaneous and continuous muscle contraction. Mercury poisoning should be considered in patients with neuromyotonia syndrome. Early detection of mercury poisoning can prevent unnecessary examinations and treatments.
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Affiliation(s)
| | | | | | | | - Yuanjun Liu
- Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan Province, China
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Yawei S, Jianhai L, Junxiu Z, Xiaobo P, Zewu Q. Epidemiology, clinical presentation, treatment, and follow-up of chronic mercury poisoning in China: a retrospective analysis. BMC Pharmacol Toxicol 2021; 22:25. [PMID: 33941274 PMCID: PMC8091676 DOI: 10.1186/s40360-021-00493-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 04/20/2021] [Indexed: 01/04/2023] Open
Abstract
Background There are no reports on the incidence of chronic mercury poisoning in a large population in China. This study investigated the epidemiology, clinical manifestations, treatment, and follow-up of Chinese patients with chronic mercury poisoning. Methods Data for 288 mercury poisoning patients were collected at our hospital from July 2014 to September 2019, including sex, age, admission time, blood mercury content, urine mercury content, creatinine, urinary mercury/creatinine ratio, 24-h urinary protein levels, electromyography (EMG) findings, renal biopsy, and follow-up. Patient characteristics were evaluated by statistical and correlation analyses. Results First, mercury poisoning in China mainly occurred through occupational exposure and the inappropriate use of mercury-containing cosmetics and Chinese folk remedies (CFRs). Second, the most common symptoms were nervous system (50.3 %), kidney (16.4 %) and breathing (8.0 %). Mercury poisoning-induced Nephrotic syndrome (NS) and peripheral neuropathy are common long-term complications. The complications of occupational and cosmetics-induced mercury poisoning are consistent with international belief. However, the NS caused by CFRs is mainly membranous nephropathy and the probability of peripheral neuropathy caused by CFRs is higher than other pathogens. Third, follow-up data shows that 13 patients with EMG-confirmed neurological injury, 10 showed full recovery after 38.50 ± 8.03 months. Furthermore, among 18 patients with NS, 15 had normal urine protein and serum albumin levels after 22.67 ± 10.26 months. Conclusions Regulation of skin-lightening cosmetic products, safety surveillance of CFRs, and prevention and control of occupational exposure must be improved to decrease the incidence of mercury poisoning in China.
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Affiliation(s)
- Sun Yawei
- Department of Chemical Poisoning Treatment, Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, No. 8 Dong da Street, Fengtai District, 100071, Beijing, China
| | - Long Jianhai
- Pulmonary and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, 100050, Beijing, China
| | - Zhao Junxiu
- Department of Chemical Poisoning Treatment, Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, No. 8 Dong da Street, Fengtai District, 100071, Beijing, China
| | - Peng Xiaobo
- Department of Chemical Poisoning Treatment, Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, No. 8 Dong da Street, Fengtai District, 100071, Beijing, China.
| | - Qiu Zewu
- Department of Chemical Poisoning Treatment, Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, No. 8 Dong da Street, Fengtai District, 100071, Beijing, China.
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18
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Anvar MI, Iyenger JN, Mehta SS, Jagdeeshkumar B. IGg4-related Disease Presenting as Rapidly Progressive Renal Failure and Inguinal Iymphadenopathy. Indian J Nephrol 2021; 31:286-289. [PMID: 34376945 PMCID: PMC8330657 DOI: 10.4103/ijn.ijn_377_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/14/2020] [Accepted: 04/03/2020] [Indexed: 11/06/2022] Open
Abstract
A 58-year-old man presented with swelling in the left inguinal region and loss of appetite, nausea and azotemia with a serum creatinine of 5.2 mg/dL and urine albumin of 1+ and normal size kidneys with no hematuria. His serum creatinine increased to 9 mg/dL over 1 month, his total proteins were 10.8 and serum albumin was 3.3 g/dL, and lymph node excision biopsy showed fragments of lymphoid tissue with interfollicular areas containing sheets of plasma cells and atretic germinal centers. In view of unexplained renal failure, he underwent renal biopsy, which showed interstitial inflammatory infiltrate composed of lymphocytes and rich in plasma cells with storiform fibrosis and a possibility of IgG4-related renal disease was reported. On further evaluation, serum electrophoresis showed no M band. Serum IgG4 levels were 18.2 g/L (0.03–2 g/L). A diagnosis of IgG4-related renal disease was confirmed.
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Affiliation(s)
- Maniyar Iqbal Anvar
- Associate Professor Department of Nephrology, VIMS, Bellary, Karnataka, India
| | - Jayaram N Iyenger
- Director at Anand Diagnostic Laboratory- A Neuberg Associate, Bengaluru, Karnataka, India
| | - Shweta S Mehta
- Consultant Pathologist at Anand Diagnostic Laboratory- A Neuberg Associate, Bengaluru, Karnataka, India
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Yawei C, Jing S, Wenju S, Yupeng L, Ping Z, Liping H. Mercury as a cause of membranous nephropathy and Guillain-Barre syndrome: case report and literature review. J Int Med Res 2021; 49:300060521999756. [PMID: 33769115 PMCID: PMC8168032 DOI: 10.1177/0300060521999756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Secondary renal involvement in chronic exposure to metallic mercury is well known. Mercury also causes central nervous system damage and demyelinating polyneuropathy. Here, we describe a case of a patient with daily exposure to mercury in skin lightening cream and hair dyes who was diagnosed with Guillain-Barre syndrome and then developed nephrotic syndrome because of membranous neuropathy. By reviewing the literature describing mercury-associated diseases, we found that mercury components have an immunomodulatory activity, which is also involved in both peripheral neuropathy and glomerulonephritis.
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Affiliation(s)
| | - Sun Jing
- The People's Hospital of QianNan, Duyun, China
| | | | - Li Yupeng
- Chu Hsien-I Memorial Hospital, Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | | | - Han Liping
- Chu Hsien-I Memorial Hospital, Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
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20
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Zeng HL, Zhang B, Wang X, Yang Q, Cheng L. Urinary trace elements in association with disease severity and outcome in patients with COVID-19. ENVIRONMENTAL RESEARCH 2021; 194:110670. [PMID: 33387537 PMCID: PMC7772999 DOI: 10.1016/j.envres.2020.110670] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 12/06/2020] [Accepted: 12/21/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND The dynamics of urinary trace elements in patients with COVID-19 still remains to be investigated. METHODS A retrospective study was performed on a cohort of 138 confirmed COVID-19 patients for their urinary levels of essential and/or toxic metals including chromium, manganese, copper, arsenic, selenium, cadmium, mercury, thallium and lead according to the different disease severity (severe or non-severe) and outcome (recovered or deceased). RESULTS Urinary concentrations of chromium, manganese, copper, selenium, cadmium, mercury and lead after creatinine adjustment were found to be higher in severe patients than the non-severe cases with COVID-19. And among the severe cases, these elements were also higher in the deceased group than the recovered group. When the weeks of the post-symptom onset were taken in account, the changes of these urinary elements were existed across the clinical course since the disease onset. These urinary elements were found to be mostly positively inter-correlated, and further positively correlated with other laboratory inflammatory parameters including serum cytokines (IL-1B, IL2R, IL6, IL8, IL10, TNFα), ferritin, and neutrophil count and white blood cell count. As a independently predictive factor, urinary creatinine-adjusted copper of ≥25.57 μg/g and ≥99.32 μg/g were associated with significantly increased risk of severe illness and fatal outcome in COVID-19, respectively. CONCLUSIONS These results suggest abnormities in urinary levels of the trace metals were tightly associated with the severe illness and fatal outcome of COVID-19.
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Affiliation(s)
- Hao-Long Zeng
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Zhang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Yang
- Institute of Food Science and Engineering, Wuhan Polytechnic University, Wuhan, China.
| | - Liming Cheng
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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21
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Köker L, Aydın F, Gaygusuz Ö, Akçaalan R, Çamur D, İlter H, Ayoğlu FN, Altın A, Topbaş M, Albay M. Heavy Metal Concentrations in Trachurus Mediterraneus and Merlangius Merlangus Captured from Marmara Sea, Turkey and Associated Health Risks. ENVIRONMENTAL MANAGEMENT 2021; 67:522-531. [PMID: 32892259 DOI: 10.1007/s00267-020-01352-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/21/2020] [Indexed: 05/09/2023]
Abstract
Rapid industrialization and excessive human population growth may cause deterioration in marine water quality and biodiversity. Heavy metals are one of the most common pollutants in the seas and marine organisms, including demersal and pelagic fish, can accumulate them from the environment. Assessment of the ecological risk of heavy metals from fish has an important role in public health. In this study, some heavy metal (Pb, Cd, As, Cr, Hg, Cu, Zn, and Fe) concentrations were determined in the muscle tissues of two commonly consumed fish species, Trachurus mediterraneus (Mediterranean horse mackerel) and Merlangius merlangus (Whiting), which are the fifth (14,222 tons/year) and sixth (6814 tons/year) highest commercial catches of marine fish species in Turkey, respectively. Heavy metal concentrations of samples collected from four sites (Adalar, İzmit Bay, Yalova, and Tekirdağ) in the Marmara Sea were determined using ICP-MS. Fish samples caught at Yalova station were found to have the highest heavy metal concentrations. According to the World Health Organization (WHO), in terms of the mean values, only As, and Cr were higher than permissible limits in T. mediterraneus, while Pb, Cd, As, and Cr were higher in M. merlangus. Arsenic concentrations were higher than maximum limits in both T. mediterraneus and M. merlangus. The estimated weekly intake (EWI) was calculated to assess the potential health impact. The EWI for arsenic, cadmium, lead, and mercury for some sites was above the provisional tolerable weekly intake.
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Affiliation(s)
- Latife Köker
- Department of Marine and Freshwater Resources Management, Faculty of Aquatic Sciences, Istanbul University, Istanbul, 34130, Turkey.
| | - Fatih Aydın
- Department of Marine and Freshwater Resources Management, Faculty of Aquatic Sciences, Istanbul University, Istanbul, 34130, Turkey
| | - Özcan Gaygusuz
- Department of Marine and Freshwater Resources Management, Faculty of Aquatic Sciences, Istanbul University, Istanbul, 34130, Turkey
| | - Reyhan Akçaalan
- Department of Marine and Freshwater Resources Management, Faculty of Aquatic Sciences, Istanbul University, Istanbul, 34130, Turkey
| | - Derya Çamur
- Department of Public Health, Faculty of Gülhane Medicine, University of Health Sciences, Ankara, Turkey
| | - Hüseyin İlter
- Provincial Health Directorate, Ministry of Health, Ankara, Turkey
| | - Ferruh Niyazi Ayoğlu
- Department of Public Health, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Ahmet Altın
- Department of Environmental Engineering, Bülent Ecevit University, Zonguldak, 67100, Turkey
| | - Murat Topbaş
- Department of Public Health, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Meriç Albay
- Department of Marine and Freshwater Resources Management, Faculty of Aquatic Sciences, Istanbul University, Istanbul, 34130, Turkey
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22
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Vieira JVDA, Marques VB, Vieira LV, Crajoinas RDO, Shimizu MHM, Seguro AC, Carneiro MTWD, Girardi ACC, Vassallo DV, Dos Santos L. Changes in the renal function after acute mercuric chloride exposure in the rat are associated with renal vascular endothelial dysfunction and proximal tubule NHE3 inhibition. Toxicol Lett 2021; 341:23-32. [PMID: 33476711 DOI: 10.1016/j.toxlet.2021.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 10/22/2022]
Abstract
Mercury is an environmental pollutant and a threat to human health. Mercuric chloride (HgCl2)-induced acute renal failure has been described by several reports, but the mechanisms of renal dysfunction remain elusive. This study tested the hypothesis that HgCl2 directly impairs renal vascular reactivity. Additionally, due to the mercury toxicity on the proximal tubule, we investigated whether the HgCl2-induced natriuresis is accompanied by inhibition of Na+/H+ exchanger isoform-3 (NHE3). We found that 90-min HgCl2 infusion (6.5 μg/kg i.v.) remarkably increased urinary output, reduced GFR and renal blood flow, and increased vascular resistance in rats. "In vitro" experiments of HgCl2 infusion in isolated renal vascular bed demonstrated an elevation of perfusion pressure in a concentration- and time-dependent manner, associated with changes on the endothelium-dependent vasodilatation and the flow-pressure relationship. Moreover, by employing "in vivo" stationary microperfusion of the proximal tubule, we found that HgCl2 inhibits NHE3 activity and increases the phosphorylation of NHE3 at serine 552 in the renal cortex, in line with the HgCl2-induced diuresis. Changes in renal proximal tubular function induced by HgCl2 were parallel to increased urinary markers of proximal tubular injury. Besides, atomic spectrometry showed that mercury accumulated in the renal cortex. We conclude that acute HgCl2 exposure causes renal vasoconstriction that is associated with reduced endothelial vasodilator agonist- and flow-mediated responses and inhibition of NHE3-mediated sodium reabsorption. Thus, our data suggest that HgCl2-induced acute renal failure may be attributable at least in part by its direct effects on renal hemodynamics and NHE3 activity.
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Affiliation(s)
| | | | - Luiza Valli Vieira
- Department of Chemistry, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | | | | | - Antonio Carlos Seguro
- Department of Nephrology (LIM-12), University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
| | | | | | | | - Leonardo Dos Santos
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil.
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Moroni G, Ponticelli C. Secondary Membranous Nephropathy. A Narrative Review. Front Med (Lausanne) 2020; 7:611317. [PMID: 33344486 PMCID: PMC7744820 DOI: 10.3389/fmed.2020.611317] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/13/2020] [Indexed: 12/16/2022] Open
Abstract
Membranous nephropathy (MN) is a common cause of proteinuria and nephrotic syndrome all over the world. It can be subdivided into primary and secondary forms. Primary form is an autoimmune disease clinically characterized by nephrotic syndrome and slow progression. It accounts for ~70% cases of MN. In the remaining cases MN may be secondary to well-defined causes, including infections, drugs, cancer, or autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), urticarial vasculitis, sarcoidosis, thyroiditis, Sjogren syndrome, systemic sclerosis, or ankylosing spondylitis. The clinical presentation is similar in primary and secondary MN. However, the outcome may be different, being often related to that of the original disease in secondary MN. Also, the treatment may be different, being targeted to the etiologic cause in secondary MN. Thus, the differential diagnosis between primary and secondary MN is critical and should be based not only on history and clinical features of the patient but also on immunofluorescence and electron microscopy analysis of renal biopsy as well as on the research of circulating antibodies. The identification of the pathologic events underlying a secondary MN is of paramount importance, since the eradication of the etiologic factors may be followed by remission or definitive cure of MN. In this review we report the main diseases and drugs responsible of secondary MN, the outcome and the pathogenesis of renal disease in different settings and the possible treatments.
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Affiliation(s)
- Gabriella Moroni
- Nephrology Unit Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore, Milan, Italy
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Kain T, Weinstein J, Thompson A, Boggild AK. The “wing-heeled” traveler. Trop Dis Travel Med Vaccines 2020; 6:2. [PMID: 32099658 PMCID: PMC7029559 DOI: 10.1186/s40794-020-0103-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/10/2020] [Indexed: 11/10/2022] Open
Abstract
AbstractIntoxication syndromes may be travel acquired, and are related to intentional or accidental inhalational or percutaneous exposures or ingestions. Due to their myriad clinical presentations, initial differential diagnosis of such intoxications in returned travelers is broad, and typically requires detailed history and laboratory investigations to disentangle. We herein use a case-based clinical problem solving approach to illumination of a mercury intoxication syndrome, which presented in a 48-year-old VFR traveler to Guyana. Common clinical presentations, differential diagnoses, laboratory investigations, and therapeutic interventions are discussed.
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Qin AB, Lin ZS, Wang SX, Wang H, Cui Z, Zhou FD, Zhao MH. Comparison of Ultrastructural Features Between Patients with Mercury-associated Membranous Nephropathy and Idiopathic Membranous Nephropathy. Am J Med Sci 2020; 361:327-335. [PMID: 33632518 DOI: 10.1016/j.amjms.2020.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 10/09/2020] [Accepted: 11/23/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prolonged exposure to mercury can cause membranous nephropathy. Mercury-associated membranous nephropathy (M-MN) and idiopathic membranous nephropathy (I-MN) have similar clinical manifestations, making misdiagnoses likely. We compared the clinicopathological and ultrastructural features of M-MN and I-MN. METHODS We retrospectively analyzed the clinicopathological data of 13 M-MN patients and 13 I-MN patients. Electron micrographs of glomerular capillaries were taken, and foot process width (FPW) and the number of foot processes per 10 μm glomerular basement membrane (GBM) were calculated. The presence and location of electron-dense deposits were recorded. RESULTS Compared with I-MN patients, M-MN patients were younger (38.7 ± 8.5 versus 45.8 ± 5.7 years, P = 0.020), achieved complete remission more quickly (9.0 ± 6.1 versus 20.3 ± 9.8 months, P = 0.004), and had a lower relapse rate (0 versus 45.5%, P = 0.014). Patients with M-MN also had lower FPW (974.3 [interquartile range or IQR, 791.2-1504.4] nm versus 2370.6 [IQR, 2219.4-2559.1] nm, P = 0.001), more foot processes per 10 μm GBM (8.1 [IQR, 5.2-10.0] versus 3.3 [IQR, 3.1-3.5], P = 0.001), and a higher rate of mesangial electron-dense deposits (41.7% versus 0, P = 0.015). A cut-off FPW of <1654 nm differentiated M-MN from I-MN with high sensitivity (92.3%) and specificity (83.3%). CONCLUSIONS Foot process effacement was less severe in M-MN than in I-MN. In patients with mercury toxic exposure, MN with less severe foot processes effacement suggested mercury could be the cause. Better prognosis in patients with M-MN may be associated with minor podocyte damage.
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Affiliation(s)
- Ai-Bo Qin
- Renal Division, Department of Medicine, Peking University First Hospital, Renal Pathology Center, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Zi-Shan Lin
- Renal Division, Department of Medicine, Peking University First Hospital, Renal Pathology Center, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Su-Xia Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Renal Pathology Center, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China; Electron Microscopy Laboratory, Peking University First Hospital Beijing, China
| | - Hui Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Renal Pathology Center, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China; Electron Microscopy Laboratory, Peking University First Hospital Beijing, China
| | - Zhao Cui
- Renal Division, Department of Medicine, Peking University First Hospital, Renal Pathology Center, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Fu-de Zhou
- Renal Division, Department of Medicine, Peking University First Hospital, Renal Pathology Center, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Renal Pathology Center, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China; Peking-Tsinghua Center for Life Sciences, Beijing, China
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Qin AB, Yu XJ, Wang SX, Zhou FD, Zhao MH. Unveiling the Features of Mercury-Associated Minimal Change Disease: Comparison with Primary Minimal Change Disease. KIDNEY DISEASES 2020; 7:156-165. [PMID: 33824871 DOI: 10.1159/000510877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/10/2020] [Indexed: 11/19/2022]
Abstract
Introduction Long-term exposure to mercury can cause minimal change disease. However, the current understanding of mercury-associated minimal change disease (M-MCD) is inadequate. To improve the understanding of M-MCD, this study retrospectively analyzed the clinicopathological, ultrastructural, and prognostic features of M-MCD, in comparison with primary minimal change disease (P-MCD). Methods We retrospectively analyzed the clinicopathological data of 21 M-MCD patients and 21 P-MCD patients. Electron micrographs of glomerular capillaries were taken, and the foot process width (FPW) was measured. A receiver operating characteristics (ROC) curve analysis was performed to determine the optimum cutoff value of FPW that can differentiate the M-MCD from P-MCD. Results M-MCD patients presented similar clinical and routine pathological characteristics with P-MCD patients but had lower levels of FPW (935.0 [interquartile range (IQR) 853.7-1,176.7] nm vs. 1,403.2 [IQR 1,089.2-1,841.8] nm, p = 0.002). ROC curve analysis showed that FPW value below 1,385 nm might help to differentiate M-MCD from P-MCD (area under the curve of 0.787, sensitivity of 94.7%, and specificity of 52.4%). For patients with M-MCD, 77.8% achieved complete remission after mercury detoxification monotherapy. Patients with M-MCD had a lower relapse rate than patients with P-MCD (0 vs. 47.1%, p = 0.003). In addition, there was no significant difference in remission time between M-MCD patients treated with mercury detoxification monotherapy and those initially treated with immunosuppressive therapy (2.0 [IQR 1.0-6.0] months vs. 2.0 [IQR 1.5-2.5] months, p = 0.606). Conclusions M-MCD patients showed similar clinicopathological features with P-MCD patients, but with less severe foot process effacement, suggesting different pathogenesis of these 2 disease entities. The treatment of mercury detoxification was highly effective for patients with M-MCD and can be considered as a primary choice in clinical practice.
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Affiliation(s)
- Ai-Bo Qin
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao-Juan Yu
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Su-Xia Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.,Electron Microscopy Laboratory, Pathological Center, Peking University First Hospital, Beijing, China
| | - Fu-de Zhou
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.,Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
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27
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Bjørklund G, Dadar M, Chirumbolo S, Aaseth J, Peana M. Metals, autoimmunity, and neuroendocrinology: Is there a connection? ENVIRONMENTAL RESEARCH 2020; 187:109541. [PMID: 32445945 DOI: 10.1016/j.envres.2020.109541] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/04/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
It has been demonstrated that metals can induce autoimmunity. However, few studies have attempted to assess and elucidate the underlying mechanisms of action. Recent research has tried to evaluate the possible interactions of the immune system with metal ions, particularly with heavy metals. Research indicates that metals have the potential to induce or promote the development of autoimmunity in humans. Metal-induced inflammation may dysregulate the hypothalamic-pituitary-adrenal (HPA) axis and thus contribute to fatigue and other non-specific symptoms characterizing disorders related to autoimmune diseases. The toxic effects of several metals are also mediated through free radical formation, cell membrane disturbance, or enzyme inhibition. There are worldwide increases in environmental metal pollution. It is therefore critical that studies on the role of metals in autoimmunity, and neuroendocrine disorders, including effects on the developing immune system and brain and the genetic susceptibility are performed. These studies can lead to efficient preventive strategies and improved therapeutic approaches. In this review, we have retrieved and commented on studies that evaluated the effects of metal toxicity on immune and endocrine-related pathways. This review aims to increase awareness of metals as factors in the onset and progression of autoimmune and neuroendocrine disorders.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; CONEM Scientific Secretary, Verona, Italy
| | - Jan Aaseth
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway; IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Massimiliano Peana
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
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28
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Bao Y, Shen H. An unusual cause of nephrotic syndrome in a 10-year-old girl: Answers. Pediatr Nephrol 2020; 35:1219-1221. [PMID: 31953753 DOI: 10.1007/s00467-019-04466-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 11/27/2019] [Accepted: 12/17/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Yu Bao
- Department Of Nephrology, The Children's Hospital, National Clinical Research Center For Child Health, Zhejiang University School Of Medicine, Hangzhou, China
| | - Huijun Shen
- Department Of Nephrology, The Children's Hospital, National Clinical Research Center For Child Health, Zhejiang University School Of Medicine, Hangzhou, China.
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29
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Kumar MN, Priyamvada PS, Chellappan A, Sunooj KV, Srinivas BH, Nachiappa Ganesh R, Sampath E, Parameswaran S. Membranous Nephropathy Associated With Indigenous Indian Medications Containing Heavy Metals. Kidney Int Rep 2020; 5:1510-1514. [PMID: 32954075 PMCID: PMC7486185 DOI: 10.1016/j.ekir.2020.06.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/04/2020] [Accepted: 06/17/2020] [Indexed: 10/28/2022] Open
Affiliation(s)
- M Naveen Kumar
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P S Priyamvada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Anand Chellappan
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | | | - Rajesh Nachiappa Ganesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ezhilnilavan Sampath
- Department of Nephrology, Sri Narayani Hospital & Research Centre, Vellore, Tamilnadu, India
| | - Sreejith Parameswaran
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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30
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Takizawa K, Miura K, Kaneko N, Yabuuchi T, Ishizuka K, Kanda S, Harita Y, Akioka Y, Horita S, Taneda S, Honda K, Hattori M. Renal hypoplasia can be the cause of membranous nephropathy-like lesions. Clin Exp Nephrol 2020; 24:813-820. [PMID: 32424448 DOI: 10.1007/s10157-020-01902-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/09/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Renal hypoplasia (RH) is the most common cause of chronic kidney disease in children. In cases of RH, proteinuria is often induced by glomerular hypertrophy and hyperfiltration that is commonly associated with focal segmental glomerulosclerosis. This study reports the first case series of a possible association between RH and membranous nephropathy (MN). METHODS Of the 168 children with RH who visited our department between 1999 and 2017, five with overt proteinuria (≥ 1 g/gCr) underwent renal biopsy. We retrospectively reviewed the medical charts and analyzed biopsy specimens using light microscopy (LM), immunofluorescence (IF), and electron microscopy. RESULTS The five children (four boys and one girl) had a median age of 5.5 years at the time of renal biopsy. The median proteinuria was 4.23 g/gCr (range 1.46-14.25), median serum albumin, 2.9 g/dL (range 2.3-3.7), and median estimated glomerular filtration rate, 59.7 mL/min/1.73 m2 (range 36.7-103.6). LM showed segmental spike formation and mesangial hypercellularity and IF study showed segmental granular immunoglobulin G (IgG) staining (IgG1 and IgG3 dominant) along the capillary loops in all five patients. Electron-dense deposits were observed in the subepithelial and mesangial areas. Thus, the pathological studies showed MN-like lesions in all patients. CONCLUSION Our study suggests that RH can be the cause of MN-like lesions.
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Affiliation(s)
- Keiichi Takizawa
- Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.,Department of Pediatrics, The University of Tokyo, Tokyo, Japan
| | - Kenichiro Miura
- Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Naoto Kaneko
- Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Tomoo Yabuuchi
- Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Kiyonobu Ishizuka
- Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Shoichiro Kanda
- Department of Pediatrics, The University of Tokyo, Tokyo, Japan
| | - Yutaka Harita
- Department of Pediatrics, The University of Tokyo, Tokyo, Japan
| | - Yuko Akioka
- Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.,Department of Pediatrics, Saitama Medical University, Saitama, Japan
| | - Shigeru Horita
- Department of Pathology, Kidney Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Sekiko Taneda
- Department of Pathology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazuho Honda
- Department of Anatomy, Showa University School of Medicine, Tokyo, Japan
| | - Motoshi Hattori
- Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
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Lu YT, Qi WZ, Wang S, Song XN, Yang DY, Song M, Hang TJ. Toxicity and risk assessment of mercury exposures from cinnabar and Baizi Yangxin Pills based on pharmacokinetic and tissue distribution studies. JOURNAL OF ETHNOPHARMACOLOGY 2020; 250:112489. [PMID: 31866510 DOI: 10.1016/j.jep.2019.112489] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/14/2019] [Accepted: 12/16/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Baizi Yangxin Pills (BZYXP), a popular cinnabar (α-HgS) contained Traditional Chinese Medicines (TCMs) is widely used in clinical trials. However, mercury is one of the most toxic elements. The adverse effects of cinnabar-containing TCMs have been occasionally reported in recent years, leading to the growing concerns about their toxicity and safety. AIM OF THE STUDY The health risks of BZYXP and cinnabar related to the mercury exposures were evaluated through blood pharmacokinetic and tissue distribution studies in rats. MATERIALS AND METHODS The distribution of absorbed mercury in rats' blood and tissues were measured by the developed cold-vapor atomic fluorescence spectrometric method. And the tissue damages were determined through the histopathological examinations. For single dose study, the low and high oral doses were equivalent to 1 and 10-fold therapeutic dose, respectively. The multiple doses study was conducted at low and high dose levels every 12 h for 30 consecutive days. RESULTS Significant differences of mercury blood pharmacokinetic and tissue distribution characteristics were observed between the corresponding BZYXP and cinnabar groups. The herbal ingredients in BZYXP promoted the absorption of bio-accessible mercury of cinnabar and prolonged the elimination process, posing potential health risks. Although mercury was found easily accumulated in kidney, liver and brain tissues, kidney and liver didn't show obvious damages even after 30 days consecutive administration of BZYXP or cinnabar at 10-fold clinically equivalent doses. But brain did show some histopathological changes, and autonomic activities of rats decreased, pointing the potential neurotoxicity. CONCLUSIONS Mercury tend to be accumulated especially when over-dose or prolonged medication with cinnabar-containing TCMs are given. The mercury exposures even at therapeutic doses of BZYXP or cinnabar do pose health risks from the neurotoxicity point of view.
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Affiliation(s)
- Yu-Ting Lu
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 210009, China
| | - Wen-Zhu Qi
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 210009, China
| | - Sheng Wang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 210009, China
| | - Xiao-Ni Song
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 210009, China
| | - Dan-Yi Yang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 210009, China
| | - Min Song
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 210009, China
| | - Tai-Jun Hang
- Key Laboratory of Drug Quality Control and Pharmacovigilance (China Pharmaceutical University), Ministry of Education, Nanjing, 210009, China; Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing, 210009, China.
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Tanner S, Sharma V, Jebakumar D, Narayanan M, Rao A. Mercury in natural health products as a cause of membranous nephropathy. Proc (Bayl Univ Med Cent) 2020; 33:243-245. [PMID: 32313474 DOI: 10.1080/08998280.2020.1719782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 10/25/2022] Open
Abstract
Membranous nephropathy is a glomerular disease characterized by diffuse subepithelial immune complex deposition along the glomerular basement membrane. It can be both primary and secondary to malignancy and various drugs. An emerging area of concern is heavy metal exposure from use of largely unregulated natural health products. Here we present a case of biopsy-proven membranous nephropathy due to natural health products contaminated with mercury.
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Affiliation(s)
- Stephen Tanner
- Department of Nephrology, Baylor Scott & WhiteTempleTexas
| | - Vivek Sharma
- Department of Nephrology, Baylor Scott & WhiteTempleTexas
| | | | | | - Arundhati Rao
- Department of Pathology, Baylor Scott & WhiteTempleTexas
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33
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Parker ML, Stefan C, Reich HN, Kulasingam V. What Is Really in This Weight Loss Supplement? J Appl Lab Med 2019; 4:270-273. [PMID: 31639674 DOI: 10.1373/jalm.2018.027169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/28/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Michelle L Parker
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Cristiana Stefan
- Clinical Laboratory and Diagnostic Services, Centre for Addiction and Mental Health, Toronto, Canada
| | - Heather N Reich
- Division of Nephrology, Toronto Glomerulonephritis Registry, University Health Network, Toronto, Canada
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada; .,Department of Clinical Biochemistry, University Health Network, Toronto, Canada
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34
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Chan TYK, Chan APL, Tang HL. Nephrotic syndrome caused by exposures to skin-lightening cosmetic products containing inorganic mercury. Clin Toxicol (Phila) 2019; 58:9-15. [PMID: 31314603 DOI: 10.1080/15563650.2019.1639724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Thomas Y. K. Chan
- Division of Clinical Pharmacology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Prince of Wales Hospital Poison Treatment Centre, Hong Kong, China
| | - Alan P. L. Chan
- Division of Clinical Pharmacology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - H. L. Tang
- Division of Nephrology, Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
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35
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Zhu XJ, Wang JJ, Mao JH, Shu Q, Du LZ. Relationships of Cadmium, Lead, and Mercury Levels With Albuminuria in US Adults: Results From the National Health and Nutrition Examination Survey Database, 2009-2012. Am J Epidemiol 2019; 188:1281-1287. [PMID: 30874715 DOI: 10.1093/aje/kwz070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 12/17/2022] Open
Abstract
In this cross-sectional study, we evaluated associations between cadmium, lead, and mercury levels and the presence of albuminuria in US adults who participated in the National Health and Nutrition Examination Survey during the period 2009-2012. A total of 2,926 adults aged ≥20 years were included, representing a population-based sample of 18,264,307 persons. Data on blood and urinary levels of cadmium, lead, and mercury and urinary albumin concentration (albuminuria, measured as albumin:creatinine ratio (ACR) ≥30 mg/g) were obtained. Multivariate linear regression was used to analyze associations between log-transformed cadmium, lead, and mercury levels and the presence of albuminuria. Urinary ACR was significantly higher among participants with a blood cadmium level of 0.349-0.692 μg/L (quartile 3) than in those with a blood cadmium level less than or equal to 0.243 μg/L (quartile 1) (crude β = 0.15, 95% confidence interval (CI): 0.01, 0.28). Participants with a urinary cadmium level greater than or equal to 0.220 μg/L had a significantly higher ACR (0.220-0.403 μg/L (quartile 3): crude β = 0.12 (95% CI: 0.03, 0.21); ≥0.404 μg/L (quartile 4): crude β = 0.29 (95% CI: 0.18, 0.39)) than those with a urinary cadmium level less than or equal to 0.126 μg/L (quartile 1). In conclusion, only blood and urinary cadmium levels, not mercury or lead levels, were associated with albuminuria among adults in this population.
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Affiliation(s)
- Xiu-Juan Zhu
- Department of Nephrology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Jing-Jing Wang
- Department of Nephrology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Jian-Hua Mao
- Department of Nephrology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Qiang Shu
- Department of Thoracic and Cardiovascular Surgery, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
| | - Li-Zhong Du
- Department of Neonatology, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, People’s Republic of China
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Qin AB, Su T, Wang SX, Zhang F, Zhou FD, Zhao MH. Mercury-associated glomerulonephritis: a retrospective study of 35 cases in a single Chinese center. BMC Nephrol 2019; 20:228. [PMID: 31221121 PMCID: PMC6587289 DOI: 10.1186/s12882-019-1413-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 06/06/2019] [Indexed: 01/23/2023] Open
Abstract
Background Long-term exposure of mercury may induce glomerulonephritis. Clinical and pathological features of mercury-associated glomerulonephritis are not fully clear. This study retrospectively analyzed 35 cases of mercury-associated glomerulonephritis in a single Chinese center. Methods Thirty-five patients of mercury-associated glomerulonephritis were enrolled. Clinical data on diagnosis and during follow-up were collected. Plasma anti-phospholipase A2 receptor (PLA2R) antibody, glomerular PLA2R and glomerular IgG subclasses deposition were detected in the cases with membranous nephropathy (MN). Results Mercury exposure was caused by skin lighting cream (20 patients), mercury-containing pills (9 patients), hair-dyeing agents (4 patients), and unidentified reasons (2 patients). All patients presented with proteinuria and normal renal function. The median of urinary protein was 4.6 (range 1.6~19.7) g/24 h. Twenty-two patients (62.9%) had nephrotic syndrome. Renal histopathology showed minimal change disease (MCD) in 21 patients (60.0%), MN in 13 (37.1%) and focal segmental glomerular sclerosis (FSGS) in 1 patient (2.9%). The proportion of MCD increased along with urinary mercury concentration (P = 0.024). In 13 cases of MN, all patients were negative for plasma anti-PLA2R antibody and glomerular PLA2R antigen. IgG1 (61.5%) and IgG4 (46.2%) deposits were noted along the glomerular capillary loops. Among the 16 patients received mercury detoxification monotherapy, 14 patients received 4.5 ± 2.8 (range 1~12) rounds of regimen and achieved complete remission in 4.5 (range 0.3~23.0) months, 2 patients stayed no remission. Conclusions MCD was the most common pathological type of mercury-associated glomerulonephritis, followed by MN. The proportion of MCD increased along with the increase of urinary mercury concentration. Most patients could achieve complete remission after mercury detoxification.
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Affiliation(s)
- Ai-Bo Qin
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, 100034, China
| | - Tao Su
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, 100034, China
| | - Su-Xia Wang
- Electron Microscopy Laboratory, Peking University First Hospital, Beijing, China
| | - Fan Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, 100034, China
| | - Fu-de Zhou
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, 100034, China.
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, 100034, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
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Afrifa J, Opoku YK, Gyamerah EO, Ashiagbor G, Sorkpor RD. The Clinical Importance of the Mercury Problem in Artisanal Small-Scale Gold Mining. Front Public Health 2019; 7:131. [PMID: 31192183 PMCID: PMC6549531 DOI: 10.3389/fpubh.2019.00131] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/08/2019] [Indexed: 11/17/2022] Open
Abstract
Artisanal small-scale mining is widely operated in various countries serving as a livelihood to many rural communities. However, it is a significant source of environmental mercury contamination which affects human health. Amalgamation and amalgam smelting, two significant steps in the artisanal small-scale mining operations generate lots of mercury vapors, leading to chronic exposure among miners. Thus, this article seeks to provide a topical review of recent findings on organ damage and metabolic disorders among mercury-exposed artisanal small-scale miners with emphasis on the contributing factors such as personal protective equipment usage and artisanal small-scale gold mining-specific occupational activities. Also, insights into the effect of mercury intoxication and mechanisms of action on organ and metabolic systems among exposed individuals are provided.
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Affiliation(s)
- Justice Afrifa
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.,Scientific Research Center, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yeboah Kwaku Opoku
- Department of Biomedical Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.,Biopharmaceutical Laboratory, College of Life Sciences, Northeast Agricultural University, Harbin, China
| | - Eric Ofori Gyamerah
- Department of Biochemistry, School of Biological Sciences, University of Cape Coast, Cape Coast, Ghana
| | - George Ashiagbor
- Department of Wildlife and Range Management, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Doshi M, Annigeri RA, Kowdle PC, Subba Rao B, Varman M. Membranous nephropathy due to chronic mercury poisoning from traditional Indian medicines: report of five cases. Clin Kidney J 2019; 12:239-244. [PMID: 30976402 PMCID: PMC6452196 DOI: 10.1093/ckj/sfy031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Indexed: 11/13/2022] Open
Abstract
Mercury contained in traditional medicines can cause chronic poisoning, which can cause membranous nephropathy (MN). We report five cases of nephrotic syndrome caused by MN with evidence of chronic mercury poisoning due to consumption of traditional Indian medicines such as Siddha and Ayurveda, which to our knowledge are the first such reports. All patients were seronegative for antibodies against phospholipase A2 receptor (PLA2R). Two patients, who had severe nephrotic syndrome, had received Siddha medicine for prolonged period and oral chelation with dimercaptopropane-1-sulfonic acid was successful in eliminating mercury, resulting in an improvement in nephrotic state in these patients. We suggest that mercury poisoning should be entertained in patients with anti-PLA2R antibody-negative MN, with history of consumption of traditional Indian medicines.
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Affiliation(s)
- Manan Doshi
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Rajeev A Annigeri
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Prakash C Kowdle
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Budithi Subba Rao
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Mahendran Varman
- Department of Nephrology, Apollo Hospitals, Chennai, Tamil Nadu, India
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Pollard KM, Cauvi DM, Toomey CB, Hultman P, Kono DH. Mercury-induced inflammation and autoimmunity. Biochim Biophys Acta Gen Subj 2019; 1863:129299. [PMID: 30742953 DOI: 10.1016/j.bbagen.2019.02.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 01/12/2019] [Accepted: 02/01/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Human exposure to mercury leads to a variety of pathologies involving numerous organ systems including the immune system. A paucity of epidemiological studies and suitable diagnostic criteria, however, has hampered collection of sufficient data to support a causative role for mercury in autoimmune diseases. Nevertheless, there is evidence that mercury exposure in humans is linked to markers of inflammation and autoimmunity. This is supported by experimental animal model studies, which convincingly demonstrate the biological plausibility of mercury as a factor in the pathogenesis of autoimmune disease. SCOPE OF THE REVIEW In this review, we focus on ability of mercury to elicit inflammatory and autoimmune responses in both humans and experimental animal models. MAJOR CONCLUSIONS Although subtle differences exist, the inflammatory and autoimmune responses elicited by mercury exposure in humans and experimental animal models show many similarities. Proinflammatory cytokine expression, lymphoproliferation, autoantibody production, and nephropathy are common outcomes. Animal studies have revealed significant strain dependent differences in inflammation and autoimmunity suggesting genetic regulation. This has been confirmed by the requirement for individual genes as well as genome wide association studies. Importantly, many of the genes required for mercury-induced inflammation and autoimmunity are also required for idiopathic systemic autoimmunity. A notable difference is that mercury-induced autoimmunity does not require type I IFN. This observation suggests that mercury-induced autoimmunity may arise by both common and specific pathways, thereby raising the possibility of devising criteria for environmentally associated autoimmunity. GENERAL SIGNIFICANCE Mercury exposure likely contributes to the pathogenesis of autoimmunity.
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Affiliation(s)
- K Michael Pollard
- Department of Molecular Medicine, Scripps Research, 10550 North Torrey Pines Road, La Jolla, CA, 92037, United States of America.
| | - David M Cauvi
- Department of Surgery and Center for Investigations of Health and Education Disparities, School of Medicine, University of California, San Diego, 9500 Gilman Drive #0739, La Jolla, CA 92093, United States of America.
| | - Christopher B Toomey
- Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, 9500 Gilman Drive #0946, La Jolla, CA 92093.
| | - Per Hultman
- Department of Experimental and Clinical Medicine, Linköping University, Linköping, Sweden.
| | - Dwight H Kono
- Department of Immunology and Microbiology, Scripps Research, 10550 North Torrey Pines Road, La Jolla, CA, 92037, United States of America.
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40
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Onwuzuligbo O, Hendricks AR, Hassler J, Domanski K, Goto C, Wolf MT. Mercury Intoxication as a Rare Cause of Membranous Nephropathy in a Child. Am J Kidney Dis 2018; 72:601-605. [DOI: 10.1053/j.ajkd.2018.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 05/08/2018] [Indexed: 11/11/2022]
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Hameed ERA, Sherif LS, Samie OMA, Ahmed HH, Ahmed A, Atta H, Waheed H, Fahmy RF. Mercury Materno-fetal Burden and Its Nutritional Impact. Open Access Maced J Med Sci 2018; 6:1652-1658. [PMID: 30337982 PMCID: PMC6182524 DOI: 10.3889/oamjms.2018.364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/09/2018] [Accepted: 08/18/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Mercury exists worldwide in food, water and air throwing its health hazards on all body systems. AIM: To show the influence of the presence of mercury in pregnant mothers’ blood on its level in the umbilical cord blood; and to display the relationship between the different foodstuff on the mercury levels in pregnant mothers’ and umbilical cord blood. PATIENTS AND METHODS: This cross-sectional study was conducted on randomly chosen 113 pregnant mothers at the time of labour and on their newborns. Full history, sociodemographic data and food frequency questionnaire for dietary assessment were recorded. The Maternal and neonatal anthropometric measurements together with the Apgar scoring were also measured. Serum mercury levels in both mothers’ and umbilical cord blood were measured using the Inductively Coupled Plasma Mass Spectrometry (ICP-MS). RESULTS: A high percentage of mothers (82.3%) were exposed to passive smoking. There was a statistically significant positive correlation between the maternal and fetal umbilical cord blood mercury levels (p = 0.002). There was an insignificant negative correlation between the maternal blood and fetal umbilical cord blood mercury levels on one side and each of the different foodstuff on the other side (fish, vegetables, fruits and proteins, for example, meat and legumes). An insignificant positive correlation was found between dairy products and of the maternal blood and umbilical cord blood mercury levels. CONCLUSION: The fetal umbilical cord blood mercury levels correlate positively with the maternal blood mercury. The different foodstuff can influence the maternal and umbilical cord blood mercury levels whether by increase or decrease. Strict measures should be taken to decrease environmental mercury contamination with attention to pregnant mothers.
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Affiliation(s)
- Enas R Abdel Hameed
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
| | - Lobna S Sherif
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
| | - Ola M Abdel Samie
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
| | - Hanaa H Ahmed
- Hormones Department, Medical Research Division, National Research Center, Cairo, Egypt
| | | | - Hala Atta
- El-Galaa Teaching Hospital, Cairo, Egypt
| | - Hisham Waheed
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
| | - Reham F Fahmy
- Child Health Department, Medical Research Division, National Research Center, Cairo, Egypt
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Lima LADO, Bittencourt LO, Puty B, Fernandes RM, Nascimento PC, Silva MCF, Alves-Junior SM, Pinheiro JDJV, Lima RR. Methylmercury Intoxication Promotes Metallothionein Response and Cell Damage in Salivary Glands of Rats. Biol Trace Elem Res 2018; 185:135-142. [PMID: 29332268 DOI: 10.1007/s12011-017-1230-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/20/2017] [Indexed: 12/20/2022]
Abstract
Environmental and occupational mercury exposure is considered a major public health issue. Despite being well known that MeHg exposure causes adverse effects in several physiologic functions, MeHg effects on salivary glands still not completely elucidated. Here, we investigated the cellular MeHg-induced damage in the three major salivary glands (parotid, submandibular, and sublingual) of adult rats after chronic, systemic and low doses of MeHg exposure. Rats were exposed by 0.04 mg/kg/day over 60 days. After that, animals were euthanized and all three glands were collected. We evaluated total Hg accumulation, metallothionein I/II (MT I/II), α-smooth muscle actin (α-SMA), and cytokeratin 18 (CK18) immune expression. Our results have showed that MeHg is able to disrupt gland tissue and to induce a protective mechanism by MT I/II expression. We also showed that cell MT production is not enough to protect gland tissue against cellular structural damage seen by reducing marking of cytoskeletal proteins as CK18 and α-SMA. Our data suggest that chronic MeHg exposure in low-daily doses is able to induce cellular damage in rat salivary glands.
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Affiliation(s)
- Leidiane Alencar de Oliveira Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Para, Street Augusto Correa N. 01, Guamá, Belém, Para, 66075-900, Brazil
| | - Leonardo Oliveira Bittencourt
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Para, Street Augusto Correa N. 01, Guamá, Belém, Para, 66075-900, Brazil
| | - Bruna Puty
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Para, Street Augusto Correa N. 01, Guamá, Belém, Para, 66075-900, Brazil
| | - Rafael Monteiro Fernandes
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Para, Street Augusto Correa N. 01, Guamá, Belém, Para, 66075-900, Brazil
| | - Priscila Cunha Nascimento
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Para, Street Augusto Correa N. 01, Guamá, Belém, Para, 66075-900, Brazil
| | - Marcia Cristina Freitas Silva
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Para, Street Augusto Correa N. 01, Guamá, Belém, Para, 66075-900, Brazil
| | | | | | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Para, Street Augusto Correa N. 01, Guamá, Belém, Para, 66075-900, Brazil.
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43
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Vega CM, Orellana JDY, Oliveira MW, Hacon SS, Basta PC. Human Mercury Exposure in Yanomami Indigenous Villages from the Brazilian Amazon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1051. [PMID: 29789499 PMCID: PMC6028914 DOI: 10.3390/ijerph15061051] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 12/16/2022]
Abstract
In the Brazilian Amazon, where the majority of Yanomami villages are settled, mercury (Hg) exposure due to artisanal small-scale gold mining (ASGM) has been reported since the 1980s. This study assessed mercury exposure in the Yanomami reserve and whether the level of contamination was related to the ASGM geographical location. It was conducted using a cross-sectional study of 19 villages. Direct interviews were performed and hair samples were used as a bioindicator of Hg exposure. The Prevalence-Ratio (PR) was estimated as an indicator of association between ASGM geographical locations and human exposure to mercury. Mercury levels (239 hair samples) ranged between 0.4 and 22.1 μg·g-1 and presented substantial differences amongst the villages. In the Waikas-Aracaça region, where current ASGM was reported, we observed the highest Hg concentrations (median = 15.5 μg·g-1). Almost all participants presented with hair-Hg levels >6 μg·g-1 (prevalence = 92.3%). In the Paapiu region, we observed the lowest concentrations (median = 3.2 μg·g-1; prevalence = 6.7%). Our findings showed that the Waikas Ye'kuana and Waikas Aracaca villages presented with 4.4 (PR = 4.4; Confidence Interval (CI) 95% = 2.2⁻9.0) and 14.0 (PR = 14.0; CI 95% = 7.9⁻24.9) times higher prevalence of hair-Hg concentration, respectively, compared with Paapiu. Considering seasonal variation of Hg-exposure, the lowest concentrations were observed during the wet season (June⁻September) and the highest in the dry season (December⁻April). Our study suggests that there is an association between mercury exposure and ASGM geographical locations.
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Affiliation(s)
- Claudia M Vega
- Center for Amazonian Scientific Innovation, Wake Forest University, 1834 Wake Forest Road P.O. Box 7306, Winston-Salem, NC 27106, USA.
| | - Jesem D Y Orellana
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Rua Teresina, 476, Adrianópolis, Manaus CEP: 69057-070, Brazil.
| | - Marcos W Oliveira
- Instituto Socioambiental-ISA, Av. Higienópolis, 901, Higienópolis, São Paulo CEP: 01238-001, Brazil.
| | - Sandra S Hacon
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro CEP: 21041-210, Brazil.
| | - Paulo C Basta
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro CEP: 21041-210, Brazil.
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Abstract
The burden of disease and death attributable to environmental pollution is becoming a public health challenge worldwide, especially in developing countries. The kidney is vulnerable to environmental pollutants because most environmental toxins are concentrated by the kidney during filtration. Given the high mortality and morbidity of kidney disease, environmental risk factors and their effect on kidney disease need to be identified. In this Review, we highlight epidemiological evidence for the association between kidney disease and environmental pollutants, including air pollution, heavy metal pollution and other environmental risk factors. We discuss the potential biological mechanisms that link exposure to environmental pollutants to kidney damage and emphasize the contribution of environmental pollution to kidney disease. Regulatory efforts should be made to control environmental pollution and limit individual exposure to preventable or avoidable environmental risk. Population studies with accurate quantification of environmental exposure in polluted regions, particularly in developing countries, might aid our understanding of the dose-response relationship between pollutants and kidney diseases.
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Affiliation(s)
- Xin Xu
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China
| | - Sheng Nie
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China
| | - Hanying Ding
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China
| | - Fan Fan Hou
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China
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46
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Lu Y, Yang D, Song X, Wang S, Song M, Hang T. Bioaccessibility and health risk assessment of mercury in cinnabar containing Traditional Chinese Medicines. J Trace Elem Med Biol 2017; 44:17-25. [PMID: 28965573 DOI: 10.1016/j.jtemb.2017.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/25/2017] [Accepted: 05/19/2017] [Indexed: 11/19/2022]
Abstract
Cinnabar (α-HgS), has been formulated in Traditional Chinese Medicines (TCMs) for thousands of years. Since the total Hg content was accepted widely as the toxicity criteria, the safety alerts have been issued about the cinnabar containing TCMs for exceeding Hg limits. However, cinnabar is almost insoluble in water, the oral absorption is extremely low. Hence, it is not suitable to use the total Hg content alone to evaluate the toxicity of cinnabar containing TCMs. In instead, the bioaccessible Hg is a much reasonable safety indicator. In this study, bioaccessible Hg contents of 29 cinnabar containing TCMs were determined by cold vapor-atomic fluorescence spectrometry after in vitro extractions with the simulated gastrointestinal fluids, while the total Hg contents were determined after acid digestion. According to the daily dosages, the bioaccessible Hg exposures of these TCMs were evaluated, and most of them were within the permitted daily exposure set by the International Council for Harmonisation, demonstrating that these TCMs are safe when administrated following the instructions. However, the obtained results also suggested that the Hg exposure could also be influenced by the herbal ingredients in TCMs and the bioactivities in gastrointestinal tract, indicating the possible health risks after excessive or long-term medication of cinnabar containing TCMs. Considering the influencing factors of the Hg intakes after oral administration of cinnabar containing TCMs, the bioaccessible Hg exposure should be considered as a more rational criterion for evaluating the health risks than the total Hg content. Furthermore, precautions should also be taken to ensure safe usages of cinnabar containing TCMs from both the cinnabar contents and the processing procedures points of view, as well as the daily dosage regimen, for all of them are directly related with the bioaccessible Hg exposures.
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Affiliation(s)
- Yuting Lu
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing 210009, China
| | - Danyi Yang
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing 210009, China
| | - Xiaoni Song
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing 210009, China
| | - Sheng Wang
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing 210009, China
| | - Min Song
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing 210009, China
| | - Taijun Hang
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, Department of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing 210009, China.
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Pollard KM, Escalante GM, Huang H, Haraldsson KM, Hultman P, Christy JM, Pawar RD, Mayeux JM, Gonzalez-Quintial R, Baccala R, Beutler B, Theofilopoulos AN, Kono DH. Induction of Systemic Autoimmunity by a Xenobiotic Requires Endosomal TLR Trafficking and Signaling from the Late Endosome and Endolysosome but Not Type I IFN. THE JOURNAL OF IMMUNOLOGY 2017; 199:3739-3747. [PMID: 29055005 DOI: 10.4049/jimmunol.1700332] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 09/25/2017] [Indexed: 12/17/2022]
Abstract
Type I IFN and nucleic acid-sensing TLRs are both strongly implicated in the pathogenesis of lupus, with most patients expressing IFN-induced genes in peripheral blood cells and with TLRs promoting type I IFNs and autoreactive B cells. About a third of systemic lupus erythematosus patients, however, lack the IFN signature, suggesting the possibility of type I IFN-independent mechanisms. In this study, we examined the role of type I IFN and TLR trafficking and signaling in xenobiotic systemic mercury-induced autoimmunity (HgIA). Strikingly, autoantibody production in HgIA was not dependent on the type I IFN receptor even in NZB mice that require type I IFN signaling for spontaneous disease, but was dependent on the endosomal TLR transporter UNC93B1 and the endosomal proton transporter, solute carrier family 15, member 4. HgIA also required the adaptor protein-3 complex, which transports TLRs from the early endosome to the late endolysosomal compartments. Examination of TLR signaling pathways implicated the canonical NF-κB pathway and the proinflammatory cytokine IL-6 in autoantibody production, but not IFN regulatory factor 7. These findings identify HgIA as a novel type I IFN-independent model of systemic autoimmunity and implicate TLR-mediated NF-κB proinflammatory signaling from the late endocytic pathway compartments in autoantibody generation.
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Affiliation(s)
- K Michael Pollard
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037;
| | - Gabriela M Escalante
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037
| | - Hua Huang
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037
| | - Katarina M Haraldsson
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037
| | - Per Hultman
- Department of Experimental and Clinical Medicine, Linköping University, Linköping 58183, Sweden; and
| | - Joseph M Christy
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037
| | - Rahul D Pawar
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037
| | - Jessica M Mayeux
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA 92037
| | | | - Roberto Baccala
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037
| | - Bruce Beutler
- Center for the Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, TX 75390
| | | | - Dwight H Kono
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037
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48
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Macedo-Júnior SJ, Luiz-Cerutti M, Nascimento DB, Farina M, Soares Santos AR, de Azevedo Maia AH. Methylmercury exposure for 14 days (short-term) produces behavioral and biochemical changes in mouse cerebellum, liver, and serum. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2017; 80:1145-1155. [PMID: 28850017 DOI: 10.1080/15287394.2017.1357324] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Various studies on methylmercury (MeHg)-induced toxicity focused on the central nervous system (CNS) as a primary target. However, MeHg-mediated toxicity is related to metallic interaction with electrophilic groups, which are not solely restricted to the CNS, but these reactive groups are present ubiquitously in several systems/organs. The aim of this study was thus to examine MeHg-induced systemic toxicity in mice using a standardized neurotoxicology testing exposure model to measure cerebellar neurotoxicity by determining biochemical and behavioral parameters in the cerebellum. After 2 weeks exposure to MeHg (40 µg/ml; diluted in drinking water; ad libitum), adult male Swiss mice showed a marked motor impairment characteristic of cerebellar toxicity as noted in the following tests: rotarod, beam walking, pole, and hind limb clasping. MeHg treatment resulted in Hg deposition in the cerebellum as well as reduction in cerebellar weight, glutathione peroxidase (GPx) activity, and interleukin (IL)-6 levels. MeHg ingestion increased cerebellar glutathione reductase (GR) activity and brain-derived neurotrophic factor (BDNF) levels. In addition to cerebellar toxicity, MeHg treatment also elevated total and non-high density lipoprotein (non-HDL) cholesterol levels, as well as serum aspartate transaminase (AST) and alanine transaminase (ALT) enzymatic activities, systemic parameters. Increased liver weight and reduced serum urea levels were also noted in MeHg-exposed mice. Taken together, our findings demonstrated that a well-standardized exposure protocol to examine MeHg-induced neurotoxicity also produced systemic toxicity in mice, which was characterized by changes in markers of hepatic function as well as serum lipid homeostasis.
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Affiliation(s)
- Sérgio José Macedo-Júnior
- a Programa de Pós-Graduação em Farmacologia, Departamento de Farmacologia , Centro de Ciências Biológicas, Universidade Federal de Santa Catarina , Florianópolis , SC , Brazil
| | - Murilo Luiz-Cerutti
- b Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas , Universidade Federal de Santa Catarina , Florianópolis , SC , Brazil
| | - Denise B Nascimento
- c Departamento de Química, Centro de Ciências Naturais e Exatas , Universidade Federal de Santa Maria , Santa Maria , RS , Brazil
| | - Marcelo Farina
- d Departamento de Bioquímica, Centro de Ciências Biológicas , Universidade Federal de Santa Catarina , Florianópolis , SC , Brazil
| | - Adair Roberto Soares Santos
- b Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas , Universidade Federal de Santa Catarina , Florianópolis , SC , Brazil
| | - Alcíbia Helena de Azevedo Maia
- e Departamento de Patologia, Centro de Ciências da Saúde , Universidade Federal de Santa Catarina , Florianópolis , SC , Brazil
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Bridges CC, Zalups RK. The aging kidney and the nephrotoxic effects of mercury. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2017; 20:55-80. [PMID: 28339347 PMCID: PMC6088787 DOI: 10.1080/10937404.2016.1243501] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Owing to advances in modern medicine, life expectancies are lengthening and leading to an increase in the population of older individuals. The aging process leads to significant alterations in many organ systems, with the kidney being particularly susceptible to age-related changes. Within the kidney, aging leads to ultrastructural changes such as glomerular and tubular hypertrophy, glomerulosclerosis, and tubulointerstitial fibrosis, which may compromise renal plasma flow (RPF) and glomerular filtration rate (GFR). These alterations may reduce the functional reserve of the kidneys, making them more susceptible to pathological events when challenged or stressed, such as following exposure to nephrotoxicants. An important and prevalent environmental toxicant that induces nephrotoxic effects is mercury (Hg). Since exposure of normal kidneys to mercuric ions might induce glomerular and tubular injury, aged kidneys, which may not be functioning at full capacity, may be more sensitive to the effects of Hg than normal kidneys. Age-related renal changes and the effects of Hg in the kidney have been characterized separately. However, little is known regarding the influence of nephrotoxicants, such as Hg, on aged kidneys. The purpose of this review was to summarize known findings related to exposure of aged and diseased kidneys to the environmentally relevant nephrotoxicant Hg.
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Affiliation(s)
- Christy C Bridges
- a Mercer University School of Medicine , Division of Basic Medical Sciences , Macon , Georgia , USA
| | - Rudolfs K Zalups
- a Mercer University School of Medicine , Division of Basic Medical Sciences , Macon , Georgia , USA
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