Metals and the skin

Stretchable Sensor Materials Applicable to Radiofrequency Coil Design in Magnetic Resonance Imaging: A Review

Wearable sensors are rapidly gaining influence in the diagnostics, monitoring, and treatment of disease, thereby improving patient outcomes. In this review, we aim to explore how these advances can be applied to magnetic resonance imaging (MRI). We begin by (i) introducing limitations in current flexible/stretchable RF coils and then move to the broader field of flexible sensor technology to identify translatable technologies. To this goal, we discuss (ii) emerging materials currently used for sensor substrates, (iii) stretchable conductive materials, (iv) pairing and matching of conductors with substrates, and (v) implementation of lumped elements such as capacitors. Applicable (vi) fabrication methods are presented, and the review concludes with a brief commentary on (vii) the implementation of the discussed sensor technologies in MRI coil applications. The main takeaway of our research is that a large body of work has led to exciting new sensor innovations allowing for stretchable wearables, but further exploration of materials and manufacturing techniques remains necessary, especially when applied to MRI diagnostics.

Metal(loid) speciation in dermal bioaccessibility extracts from contaminated soils and permeation through synthetic skin

Dermal exposure to metal(loid)s from contaminated soils can contribute to health risk. Metal(loid) speciation will influence their bioaccessibility in sweat and subsequent permeation across the skin. Therefore, the speciation of the bioaccessible fraction of metal(loid)s in two synthetic sweat formulations (sweat A (pH 6.5) and B (pH 4.7)) was assessed using chemical equilibrium modelling (Visual MINTEQ). Permeation through synthetic skin and the influence of sebum in the permeation of As, Cr, Cu, Ni, Pb, and Zn were also investigated using Franz cells. Following dermal bioaccessibility tests for five Chromated Copper Arsenate (CCA)-contaminated soils and one certified soil (SQC001), mean metal(loid) bioaccessibility (%) was higher in sweat B (2.33-18.8) compared to sweat A (0.12-7.53). Arsenic was almost entirely found as As(V) in both sweats. In sweat A, comparable concentrations of Cr(III) and Cr(VI) were found whereas in sweat B, Cr was primarily present as Cr(III). Copper was primarily found as Cu2+. Bioaccessible Cr extracted from nearly all soils permeated through the Strat-M membrane when it was coated with sebum. The Cr permeation coefficient (Kp) ranged between 0.004 and 0.13 cm/h and the Kp for Cu was higher (0.024-0.52 cm/h). As, Ni, Pb, and Zn did not permeate the synthetic skin.

Estimation of indoor soil/dust-skin adherence factors and health risks for adults and children in two typical cities in southern China

Soil/dust (SD) skin adherence is key dermal exposure parameter used for calculating the health risk of dermal exposure to contaminants. However, few studies of this parameter have been conducted in Chinese populations. In this study, forearm SD samples were randomly collected using the wipe method from population in two typical cities in southern China as well as office staff in a fixed indoor environment. SD samples from the corresponding areas were also sampled. The wipes and SD were analyzed for tracer elements (aluminum, barium, manganese, titanium, and vanadium). The SD-skin adherence factors were 14.31 μg/cm² for adults in Changzhou, 7.25 μg/cm² for adults in Shantou, and 9.37 μg/cm² for children in Shantou, respectively. Further, the recommended values for indoor SD-skin adherence factors for adults and children in Southern China were calculated to be 11.50 μg/cm² and 9.37 μg/cm², respectively, which were lower than the U.S. Environmental Protection Agency (USEPA) recommended values. And the SD-skin adherence factor value for the office staff was small (1.79 μg/cm²), but the data were more stable. In addition, PBDEs and PCBs in dust samples from industrial and residential area in Shantou were also determined, and health risks were assessed using the dermal exposure parameters measured in this study. None of the organic pollutants posed a health risk to adults and children via dermal contact. These studies emphasized the importance of localized dermal exposure parameters, and further studies should be conducted in the future.

Potential Carcinogens in Makeup Cosmetics

Facial makeup cosmetics are commonly used products that are applied to the skin, and their ingredients come into contact with it for many years. Consequently, they should only contain substances that are considered safe or used within an allowable range of established concentrations. According to current European laws, all cosmetics approved for use should be entirely safe for their users, and the responsibility for this lies with manufacturers, distributors, and importers. However, the use of cosmetics can be associated with undesirable effects due to the presence of certain chemical substances. An analysis of 50 random facial makeup cosmetics commercially available on the European Union market and manufactured in six European countries was carried out, concerning the presence of substances with potential carcinogenic properties, as described in recent years in the literature. Nine types of facial makeup cosmetics were selected, and their compositions, as declared on the labels, were analyzed. The carcinogens were identified with information present in the European CosIng database and according to the Insecticide Resistance Action Committee's (IRAC) classification. As a result, the following potential carcinogens were identified: parabens (methylparaben, propylparaben, butylparaben, and ethylparaben), ethoxylated compounds (laureth-4, lautreth-7, or ethylene glycol polymers known as PEG), formaldehyde donors (imidazolidinyl urea, quaternium 15, and DMDM hydantoin), and ethanolamine and their derivatives (triethanolamine and diazolidinyl urea), as well as carbon and silica. In conclusion, all of the analyzed face makeup cosmetics contain potential carcinogenic substances. The literature review confirmed the suppositions regarding the potential carcinogenic effects of selected cosmetic ingredients. Therefore, it seems necessary to carry out studies on the long-term exposure of compounds present in cosmetics and perhaps introduce stricter standards and laws regulating the potential presence of carcinogens and their activity in cosmetics.

Ultrathin, all-organic, fabric-based ferroelectret loudspeaker for wearable electronics

All-organic, flexible, and body-compatible loudspeakers have become increasingly attractive for wearable electronics. Due to their remarkable piezoelectric response, ferroelectrets are suitable for loudspeakers. Two distinct kinds of ultrathin ferroelectrets, including cellular polypropylene films and expanded polytetrafluoroethylene (ePTFE) films, were combined with three different types of electrodes ((Poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS))-coated fabrics, PEDOT:PSS direct coating, and sputter-coated Au/Pd) for study regarding their frequency-dependent sound intensity and radiation directivity. Among the loudspeakers investigated, the all-fabric loudspeakers with ePTFE ferroelectret and PEDOT:PSS-coated spandex electrodes have a higher frequency dependency. Loudspeakers equipped with PEDOT:PSS-coated spandex electrodes are less angle dependent compared to other loudspeakers evaluated. Moreover, the soft loudspeaker constituted of an all-organic FEP(fluorinated-ethylene-propylene)-ePTFE-based ferroelectret and PEDOT:PSS-coated fabrics presented in this paper is easy to integrate with clothes and has a higher thermal stability. It is naturally compatible with the human body and a competitive candidate for future developments of all-organic loudspeakers for wearable electronic systems.

A comprehensive summary of disease variants implicated in metal allergy

Allergic disease represents one of the most prominent global public health crises of the 21^st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.

The Toxicological Risk Assessment of Dermal Exposure of Patients Exposed to Nickel and Chromium due to Application of Ointments with Marjoram Herb Extract (Majoranae Herbae Extractum) Available in Polish Pharmacies

For elemental impurities that have been studied for transcutaneous absorption, the available data are rarely suitable for proper toxicological risk assessment - there are multiple factors that can influence this dermal absorption. Hence, in our studies, we applied generic and conservative approach - cutaneous permitted daily exposure (CPDE) described in International Conference on Harmonisation's Q3D Guideline on Elemental Impurities (ICH Q3D). The aim of this article is toxicological risk assessment (TRA) of dermal exposure of patients exposed to nickel and chromium due to application of ointments with Marjoram herb extract (Majoranae herbae extractum) available in Polish pharmacies (n = 5, because only five manufacturers produce this kind of pharmaceutical products in Poland). To make the appropriate TRA approach, we considered (1) raw results (metal per kg of ointment), (2) one-time administration of applied ointments, and (3) daily exposure versus CPDE. Due to the fact the concentrations of Ni generally present in cutaneous products as impurities are not considered sufficient to induce sensitization, the cutaneous and transcutaneous concentration limits (CTCLs) approach was applied for this element assessment. The toxicological analysis was carried out using microwave-assisted wet digestion with concentrated nitric acid and electrothermal atomization atomic absorption spectrometry. Our results show that the ointments with Marjoram herb extract from pharmacies in Poland represent a potential health hazard to patients; however, there may be a requirement for the monitoring of impurities of nickel in future. To the best of our knowledge, this paper is the first study about nickel and chromium content in ointments with Marjoram herb extract (Majoranae herbae extractum).

Rapid Review of Dermal Penetration and Absorption of Inorganic Lead Compounds for Occupational Risk Assessment

Lead (Pb) exposure continues to be a significant public health issue in both occupational and non-occupational settings. The vast majority of exposure and toxicological studies have focused on effects related to inhalation and gastrointestinal exposure routes. Exposure to inorganic Pb compounds through dermal absorption has been less well studied, perhaps due to the assumption that the dermal pathway is a minor contributor to aggregate exposures to Pb compounds. The aim of this rapid review was to identify and evaluate published literature on dermal exposures to support the estimation of key percutaneous absorption parameters (Kp, flux, diffusion rate) for use in occupational risk assessment. Eleven articles were identified containing information from both in vitro and in vivo systems relevant to percutaneous absorption kinetics. These articles provided 24 individual study summaries and information for seven inorganic Pb compounds. The vast majority of study summaries evaluated (n = 22, 92%) reported detectable amounts of dermal absorption of inorganic Pb. Data were identified for four Pb compounds (Pb acetate, Pb nitrate, Pb oxide, and Pb metal) that may be sufficient to use in evaluating physiologically based pharmacokinetic models. Average calculated diffusion rates for the pool of animal and human skin data ranged from 10-7 to 10-4 mg cm-2 h-1, and Kp values ranged from 10-7 to 10-5 cm h-1. Study design and documentation were highly variable, and only one of the studies identified was conducted using standard test guideline-compliant methodologies. Two studies provided quality estimates on the impacts of dermal absorption from water-insoluble Pb compounds on blood Pb levels. These two studies reported that exposures via dermal routes could elevate blood Pb by over 6 µg dl-1. This estimation could represent over 100% of 5 µg dl-1, the blood Pb associated with adverse health effects in adults. The utility of these estimates to occupational dermal exposures is limited, because the confidence in the estimates is not high. The literature, while of limited quality, overall strongly suggests inorganic Pb has the potential for dermal uptake in meaningful amounts associated with negative health outcomes based on upper bound diffusion rate estimates. Future standard test guideline-compliant studies are needed to provide high-confidence estimates of dermal uptake. Such data are needed to allow for improved evaluation of Pb exposures in an occupational risk assessment context.

Influence of repeated contacts on the transfer of elemental metallic lead between compartments in an integrated conceptual model for dermal exposure assessment

Transfer of contaminants to and from the skin surface has been postulated to occur through a number of different pathways and compartments including: object(s)-to-skin, skin-to-skin, skin-to-clothing, skin-to-gloves, air-to-skin, skin-to-lips, and skin-to-saliva. However, many identified transfer pathways have been only minimally examined to determine the potential for measurable transfer. The purpose of this study was to quantitatively evaluate repeated transfer between different compartments using elemental metallic lead (Pb) in the solid form using a series of systematic measurements in human subjects. The results demonstrated that some transfer pathways and compartments are significantly more important than others. Transfer of Pb could not be measured from skin to cotton clothing or skin to laminate countertop surfaces. However, transfer was consistently measured for skin-to-skin and between the skin and the surface of nitrile gloves, suggesting the potential for significant transfer to or from these compartments in real-world exposure scenarios, and the importance of these pathways. With repeated contacts, transfer increased non-linearly between 1 and 5 contacts, but appeared to approach a steady state distribution among the compartments within 10 contacts. Consistent with other studies, relative to 100% transfer for a single contact, the quantitative transfer efficiency decreased with repeated contacts to 29% after 5 contacts and 11-12% after 10 contacts; for skin-to-skin transfer measurements, transfer efficiency after either 5 or 10 contacts was approximately 50% of the single contact transfer. These data are likely to be useful for refining current approaches to modeling of repeated contacts for dermal exposure and risk assessment.

Synthesis and Spectroscopic Investigations of Schiff Base Ligand and Its Bimetallic Ag(I) Complex as DNA and BSA Binders

Generation of well-defined potential metallotherapeutics for cancer treatment, one of the most population-threatening diseases, is challenging and an active area of modern research in view of their unique properties and thus multiple possible pathways of action in cells. Specifically, Schiff base ligands were recognized as very promising building blocks for the construction of stable and active complexes of numerous geometries and topologies. Incorporation of Ag(I) ions allows for the formation of flat complexes with potential unoccupied coordination sites, thus giving rise to specific interactions between the metallotherapeutic and biomolecule of interest. Herein, we present the design, synthesis and characterization of new Schiff base ligand L and its Ag(I) bimetallic complex [Ag2L2]2+ with two planar moieties formed around the metal ions and connected through cyclohexane rings, confirmed by X-ray measurements. The compounds were described in context of their potential use as anticancer drugs through DNA and BSA binding pathways by several spectroscopic methods (CD, UV-Vis, fluorescence). We revealed that both, L and [Ag2L2]2+, interact with similar affinity with CT-DNA (Kb~106 M-1), while they differ in the type and strength of interactions with the model albumin-BSA. [Ag2L2]2+ binds BSA in both a dynamic and static manner with the Ksv = 8.8 × 104 M-1 in the Trp-134 and Trp-213 sites, whereas L interacts with BSA only dynamically (KSV = 2.4 × 104 M-1). This found further confirmation in the CD studies which revealed a reduction in α-helix content in the albumin of 16% in presence of [Ag2L2]2+.

All-Organic Flexible Ferroelectret Nanogenerator with Fabric-Based Electrodes for Self-Powered Body Area Networks

Due to their electrically polarized air-filled internal pores, optimized ferroelectrets exhibit a remarkable piezoelectric response, making them suitable for energy harvesting. Expanded polytetrafluoroethylene (ePTFE) ferroelectret films are laminated with two fluorinated-ethylene-propylene (FEP) copolymer films and internally polarized by corona discharge. Poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS)-coated spandex fabric is employed for the electrodes to assemble an all-organic ferroelectret nanogenerator (FENG). The outer electret-plus-electrode double layers form active device layers with deformable electric dipoles that strongly contribute to the overall piezoelectric response in the proposed concept of wearable nanogenerators. Thus, the FENG with spandex electrodes generates a short-circuit current which is twice as high as that with aluminum electrodes. The stacking sequence spandex/FEP/ePTFE/FEP/ePTFE/FEP/spandex with an average pore size of 3 µm in the ePTFE films yields the best overall performance, which is also demonstrated by the displacement-versus-electric-field loop results. The all-organic FENGs are stable up to 90 °C and still perform well 9 months after being polarized. An optimized FENG makes three light emitting diodes (LEDs) blink twice with the energy generated during a single footstep. The new all-organic FENG can thus continuously power wearable electronic devices and is easily integrated, for example, with clothing, other textiles, or shoe insoles.

Comparison of Synthetic Sweat and Influence of Sebum in the Permeation of Bioaccessible Metal(loid)s from Contaminated Soils through a Synthetic Skin Membrane

Dermal exposure to metal(loid)s from contaminated soils has received less attention than oral and inhalation exposure. Still, it can be a relevant pathway for some contaminants. Comparison of synthetic sweats (donor solutions), the influence of sebum, and the characterization of diffusion parameters through a synthetic membrane (acting as skin surrogate) in the permeation of metal(loid)s (As, Cr, Cu, Ni, Pb, and, Zn) from polluted soils is missing. The dermal bioaccessibility tests were performed using two sweat compositions [EN 1811, pH 6.5 (sweat A) and NIHS 96-10, pH 4.7 (sweat B)]. Diffusion parameters of soluble metal(loid)s using the Franz cell methodology were calculated using the Strat-M membrane. The influence of synthetic sebum in the permeation of metal(loid)s was also investigated. The metal(loid) bioaccessibility percentage was higher for sweat B (pH 4.7) compared to sweat A (pH 6.5), attributed to lower pH of sweat B. Among the six elements tested, only chromium and copper permeated the membrane. Permeation coefficient (K_p) was higher for chromium in sweat A (0.05-0.11 cm h^-1) than sweat B (0.0007-0.0037 cm h^-1) likely due to a higher pH and thus more permeable Cr species. The presence of sebum increased lag times for copper permeation. Additional studies regarding speciation of metal(loid)s following extractions in synthetic sweat and comparison of synthetic membrane Strat-M and human skin in the permeation of metal(loid)s are recommended.

A moisturizing chitosan-silk fibroin dressing with silver nanoparticles-adsorbed exosomes for repairing infected wounds

Refractory wounds caused by microbial infection impede wound healing, vascular regeneration, nerve system repair and the regeneration of other skin appendages. In addition, large-area infected wounds cause the appearance of multidrug-resistant (MDR) bacterial strains, which pose a major challenge both in clinical and scientific research. Although many stem cell-derived exosomes have been demonstrated to promote skin repair and regeneration, exosomes are seldom applied in the treatment of infective wounds due to the lack of antimicrobial function. In this study, we fabricated an asymmetric wettable dressing with a composite of exosomes and silver nanoparticles (CTS-SF/SA/Ag-Exo dressing) for promoting angiogenesis, nerve repair and infected wound healing. The CTS-SF/SA/Ag-Exo dressing possesses multifunctional properties including broad-spectrum antimicrobial activity, promoting wound healing, retaining moisture and maintaining electrolyte balance. It can effectively inhibit the growth of bacterial and promote the proliferation of human fibroblasts in vitro. Moreover, the in vivo results show that the CTS-SF/SA/Ag-Exo dressing enhanced wound healing by accelerating collagen deposition, angiogenesis and nerve repair in a P. aeruginosa infected mouse skin wound defect model. We hope that this dressing will provide a solution for the repair of infected wounds for treatments in the clinic.

Effects of electrical biostimulation and silver ions on porcine fibroblast cells

The medical applications of electrical biostimulation and silver ions have been evaluated in laboratory experiments and clinical studies for more than two decades. Their effects on preventing infection and promoting wound healing have been described. However, little is known about the role of electrical biostimulation and/or silver ion on changes in cellular transcriptome dynamics. To our knowledge, few studies have been conducted to investigate the potential of electrical biostimulation and silver ions in cell reprogramming. Besides, it is essential to assess any possible adverse effects or potential benefits of the silver ions on mammalian cells to address its safety concerns and to improve silver medical products. In this study, we investigated transcriptomic changes in porcine fibroblast cells in response to electrical biostimulation in the presence of silver ions. Exposed cells presented distinct morphological changes after treatment, which was mainly due to the exposure of silver ions rather than the electrical current itself. Gene expression analyses suggested that electrical biostimulation and silver ions did not increase the expression of pluripotency genes. Interestingly, a set of genes related to cellular metabolic processes were differentially expressed after cells were exposed to electrically generated silver ions for 21 hours. We found that 2.00 mg/L of electrically generated silver ion caused an increase of ATP generation and an increase of the total pool of NAD⁺ and NADH, while ROS production did not change. Aside from toxic effects, the results reported herein demonstrate the alternative effects of silver ions on mammalian cells, especially an oxidative phosphorylation burst. To our knowledge, this response of mammalian cells to silver ions has not been described previously. Although the function of this burst is not understood, it may lead to alterations in cellular activities such as metabolic remodeling and cell reprogramming, and/or serve an as-yet unknown function in neutralization or detoxification of the silver ions within the cells.

Inorganic ions in the skin: Allies or enemies?

Skin constitutes a barrier protecting the organism against physical and chemical factors. Therefore, it is constantly exposed to the xenobiotics, including inorganic ions that are ubiquitous in the environment. Some of them play important roles in homeostasis and regulatory functions of the body, also in the skin, while others can be considered dangerous. Many authors have shown that inorganic ions could penetrate inside the skin and possibly induce local effects. In this review, we give an account of the current knowledge on the effects of skin exposure to inorganic ions. Beneficial effects on skin conditions related to the use of thermal spring waters are discussed together with the application of aluminium in underarm hygiene products and silver salts in treatment of difficult wounds. Finally, the potential consequences of dermal exposure to topical sensitizers and harmful heavy ions including radionuclides are discussed.

Metal nanomaterials: Immune effects and implications of physicochemical properties on sensitization, elicitation, and exacerbation of allergic disease

The recent surge in incorporation of metallic and metal oxide nanomaterials into consumer products and their corresponding use in occupational settings have raised concerns over the potential for metals to induce size-specific adverse toxicological effects. Although nano-metals have been shown to induce greater lung injury and inflammation than their larger metal counterparts, their size-related effects on the immune system and allergic disease remain largely unknown. This knowledge gap is particularly concerning since metals are historically recognized as common inducers of allergic contact dermatitis, occupational asthma, and allergic adjuvancy. The investigation into the potential for adverse immune effects following exposure to metal nanomaterials is becoming an area of scientific interest since these characteristically lightweight materials are easily aerosolized and inhaled, and their small size may allow for penetration of the skin, which may promote unique size-specific immune effects with implications for allergic disease. Additionally, alterations in physicochemical properties of metals in the nano-scale greatly influence their interactions with components of biological systems, potentially leading to implications for inducing or exacerbating allergic disease. Although some research has been directed toward addressing these concerns, many aspects of metal nanomaterial-induced immune effects remain unclear. Overall, more scientific knowledge exists in regards to the potential for metal nanomaterials to exacerbate allergic disease than to their potential to induce allergic disease. Furthermore, effects of metal nanomaterial exposure on respiratory allergy have been more thoroughly-characterized than their potential influence on dermal allergy. Current knowledge regarding metal nanomaterials and their potential to induce/exacerbate dermal and respiratory allergy are summarized in this review. In addition, an examination of several remaining knowledge gaps and considerations for future studies is provided.

Distribution of Arsenic and Risk Assessment of Activities on Soccer Pitches Irrigated with Arsenic-Contaminated Water

The aim of this research was to estimate the risk of human exposure to arsenic due to sporting activities in a private soccer club in Mexico, where arsenic-contaminated water was regularly used for irrigation. For this purpose, the total concentration in the topsoil was considered for risk assessment. This was accomplished through three main objectives: (1) measuring arsenic concentrations in irrigation water and irrigated soils, (2) determining arsenic spatial distribution in shallow soils with Geographical Information Systems (GIS) using geostatistical analysis, and (3) collecting field and survey data to develop a risk assessment calculation for soccer activities in the soccer club. The results showed that the average arsenic concentrations in shallow soils (138.1 mg/kg) were 6.2 times higher than the Mexican threshold for domestic soils (22 mg/kg). Furthermore, dermal contact between exposed users and contaminated soils accounted for a maximum carcinogenic risk value of 1.8 × 10⁻⁵, which is one order of magnitude higher than the recommended risk value, while arsenic concentrations in the irrigation water were higher (6 mg/L) than the WHO’s permissible threshold in drinking water, explaining the contamination of soils after irrigation. To the best of our knowledge, this is the first risk study regarding dermal contact with arsenic following regular grass irrigation with contaminated water in soccer pitches.

A novel in vitro metric predicts in vivo efficacy of inhaled silver-based antimicrobials in a murine Pseudomonas aeruginosa pneumonia model

To address the escalating problem of antimicrobial resistance and the dwindling antimicrobial pipeline, we have developed a library of novel aerosolizable silver-based antimicrobials, particularly for the treatment of pulmonary infections. To rapidly screen this library and identify promising candidates, we have devised a novel in vitro metric, named the “drug efficacy metric” (DEM), which integrates both the antibacterial activity and the on-target, host cell cytotoxicity. DEMs calculated using an on-target human bronchial epithelial cell-line correlates well (R² > 0.99) with in vivo efficacy, as measured by median survival hours in a Pseudomonas aeruginosa pneumonia mouse model following aerosolized antimicrobial treatment. In contrast, DEMs derived using off-target primary human dermal fibroblasts correlate poorly (R² = 0.0595), which confirms our hypothesis. SCC1 and SCC22 have been identified as promising drug candidates through these studies, and SCC22 demonstrates a dose-dependent survival advantage compared to sham treatment. Finally, silver-bearing biodegradable nanoparticles were predicted to exhibit excellent in vivo efficacy based on its in vitro DEM value, which was confirmed in our mouse pneumonia model. Thus, the DEM successfully predicted the efficacy of various silver-based antimicrobials, and may serve as an excellent tool for the rapid screening of potential antimicrobial candidates without the need for extensive animal experimentation.

Safety Assessment of Alumina and Aluminum Hydroxide as Used in Cosmetics

This is a safety assessment of alumina and aluminum hydroxide as used in cosmetics. Alumina functions as an abrasive, absorbent, anticaking agent, bulking agent, and opacifying agent. Aluminum hydroxide functions as a buffering agent, corrosion inhibitor, and pH adjuster. The Food and Drug Administration (FDA) evaluated the safe use of alumina in several medical devices and aluminum hydroxide in over-the-counter drugs, which included a review of human and animal safety data. The Cosmetic Ingredient Review (CIR) Expert Panel considered the FDA evaluations as part of the basis for determining the safety of these ingredients as used in cosmetics. Alumina used in cosmetics is essentially the same as that used in medical devices. This safety assessment does not include metallic or elemental aluminum as a cosmetic ingredient. The CIR Expert Panel concluded that alumina and aluminum hydroxide are safe in the present practices of use and concentration described in this safety assessment.

An asymmetric wettable chitosan–silk fibroin composite dressing with fixed silver nanoparticles for infected wound repair: in vitro and in vivo evaluation

The treatment of large-area infected wounds remains a significant challenge, as there is no effective wound dressing for infected wound healing applicable to clinical applications.

Transdermal iron replenishment therapy

Iron deficiency anemia is one of the major nutritional deficiency disorders. Iron deficiency anemia occurs due to decreased absorption of iron from diet, chronic blood loss and other associated diseases. The importance of iron and deleterious effects of iron deficiency anemia are discussed briefly in this review followed by the transdermal approaches to deliver iron. Transdermal delivery of iron would be able to overcome the side effects associated with conventional oral and parenteral iron therapy and improves the patient compliance. During preliminary investigations, ferric pyrophosphate and iron dextran were selected as iron sources for transdermal delivery. Different biophysical techniques were explored to assess their efficiency in delivering iron across the skin, and in vivo studies were carried out using anemic rat model. Transdermal iron delivery is a promising approach that could make a huge positive impact on patients suffering with iron deficiency.

Silver acetate exposure: Effects on reproduction and post natal development

Effects of oral silver acetate exposure were assessed in P generation and F generation post-natal day 26 rats. Male and female Sprague Dawley rats (n = 20 each) were exposed to silver acetate at 0.4, 4.0 or 40.0 mg/kg bw in their drinking water for 10 weeks prior to and during mating. Females were exposed to silver acetate throughout gestation and lactation. Clinical signs, body weight, feed and fluid consumption were recorded regularly. Decreased mean daily fluid consumption was observed in male and female animals during the 10 week pre mating period and during gestation in the 40 mg/kg bw dose group. Decreased fertility was observed in the 40 mg/kg bw dose group. Decreased feed consumption was observed across all dose groups and decreased mean daily fluid consumption was observed in the 4.0 mg/kg dose group during lactation. Decreased implant numbers, mean numbers of pups born/litter and numbers of live pups born/litter was observed in the 40 mg/kg bw dose group. Pup weight was reduced on lactation days 0, 4 and 7 (males) and 4, 7 and 21 (females) in the 4.0 mg/kg bw dose group and in males at lactation day 21 (40 mg/kg bw dose group). Runting was observed in males (Lactation Day; LD 4) and female (LD 4 and 7) animals in the 4.0 mg/kg bw dose group. Reduced postnatal-day 26 pup weight was observed in male pups in the 40 mg/kg bw dose group and female pups in the 4.0 mg/kg bw dose group.

Biomedical implications of heavy metals induced imbalances in redox systems

Several workers have extensively worked out the metal induced toxicity and have reported the toxic and carcinogenic effects of metals in human and animals. It is well known that these metals play a crucial role in facilitating normal biological functions of cells as well. One of the major mechanisms associated with heavy metal toxicity has been attributed to generation of reactive oxygen and nitrogen species, which develops imbalance between the prooxidant elements and the antioxidants (reducing elements) in the body. In this process, a shift to the former is termed as oxidative stress. The oxidative stress mediated toxicity of heavy metals involves damage primarily to liver (hepatotoxicity), central nervous system (neurotoxicity), DNA (genotoxicity), and kidney (nephrotoxicity) in animals and humans. Heavy metals are reported to impact signaling cascade and associated factors leading to apoptosis. The present review illustrates an account of the current knowledge about the effects of heavy metals (mainly arsenic, lead, mercury, and cadmium) induced oxidative stress as well as the possible remedies of metal(s) toxicity through natural/synthetic antioxidants, which may render their effects by reducing the concentration of toxic metal(s). This paper primarily concerns the clinicopathological and biomedical implications of heavy metals induced oxidative stress and their toxicity management in mammals.

Effects of magnesium deficiency--more than skin deep

Dead Sea and magnesium salt therapy are two of the oldest forms of treatment for skin disease and several other disorders, supported by a body of largely anecdotal evidence. In this paper we review possible pathways for penetration of magnesium ions through the epidermis to reach the circulation, in turn replenishing cellular magnesium levels. We also discuss mechanisms for intercellular movement of magnesium ions and possible mechanisms for the interaction between magnesium ions and inflammatory mediators. Upon addition of magnesium ions in vitro, the expression of inflammatory mediators such as tumour necrosis factor α (TNFα) and nuclear factor κβ (NFκβ) is down regulated. Dysregulation of these and other inflammatory mediators has been linked to several inflammatory disorders, including asthma, arthritis, atherosclerosis and neuroinflammation.

A multifunctional composite of an antibacterial higher-valent silver metallopharmaceutical and a potent wound healing polypeptide: a combined killing and healing approach to wound care

A histatin-1 and silver(ii) polydiguanide complex composite demonstrated both antibacterial and wound healing promoting activity.

Metal allergy in patients with total hip replacement: a review

Metal-on-metal prostheses are increasingly and widely used in total hip arthroplasty, and offer particular benefit to patients with osteoarthritis. Adverse effects related to the release of metal ions (such as cytotoxicity, genotoxicity, carcinogenicity and metal allergy) are common, however. The aims of this review article were to explore the relationship between corrosion products and implant-related hypersensitivity, define normal and toxic metal ion concentrations, and differentiate between allergy and infection in painful total hip replacement. The simultaneous presence of corrosion products and hypersensitivity-related tissue reactions indicates a relationship between the development of corrosion and implant-related hypersensitivity. There are no clear boundaries between normal and toxic metal ion concentrations. Several methods exist for the differential diagnosis of metal allergy and infection, including ultrasound-guided aspiration, patch testing and arthroscopic biopsy. More research is required to elucidate fully the relationship between metal articulations and allergy, and to determine the concentrations of metal ions that lead to harmful effects.

Anticancer Activity of Ag(I) N-Heterocyclic Carbene Complexes Derived from 4,5-Dichloro-1H-Imidazole

A class of Ag(I) N-heterocyclic carbene silver complexes, 1-3, derived from 4,5-dichloro-1H-imidazole has been evaluated for their anticancer activity against the human cancer cell lines OVCAR-3 (ovarian), MB157 (breast), and Hela (cervical). Silver complexes 1-3 are active against the ovarian and breast cancer cell lines. A preliminary in vivo study shows 1 to be active against ovarian cancer in mice. The results obtained in these studies warrant further investigation of these compounds in vivo.

A cultural practice of drinking realgar wine leading to elevated urinary arsenic and its potential health risk

Toasting friends and family with realgar wines and painting children's foreheads and limbs with the leftover realgar/alcohol slurries is an important customary ritual during the Dragon Boat Festival (DBF); a Chinese national holiday and ancient feast day celebrated throughout Asia. Realgar is an arsenic sulfide mineral, and source of highly toxic inorganic arsenic. Despite the long history of realgar use during the DBF, associated risk to human health by arsenic ingestion or percutaneous adsorption is unknown. To address this urine samples were collected from a cohort of volunteers who were partaking in the DBF festivities. The total concentration of arsenic in the wine consumed was 70 mg L⁻¹ with all the arsenic found to be inorganic. Total arsenic concentrations in adult urine reached a maximum of ca. 550 μg L⁻¹ (mean 220.2 μg L⁻¹) after 16 h post-ingestion of realgar wine, while face painting caused arsenic levels in children's urine to soar to 100 μg L⁻¹ (mean 85.3 μg L⁻¹) 40 h after the initial paint application. The average concentration of inorganic arsenic in the urine of realgar wine drinkers on average doubled 16 h after drinking, although this was not permanent and levels subsided after 28 h. As would be expected in young children, the proportions of organic arsenic in the urine remained high throughout the 88-h monitoring period. However, even when arsenic concentrations in the urine peaked at 40 h after paint application, concentrations in the urine only declined slightly thereafter, suggesting pronounced longer term dermal accumulation and penetration of arsenic. Drinking wines blended with realgar or using realgar based paints on children does result in the significant absorption of arsenic and therefore presents a potentially serious and currently unquantified health risk.

A pharmacological and toxicological profile of silver as an antimicrobial agent in medical devices

Silver is used widely in wound dressings and medical devices as a broad-spectrum antibiotic. Metallic silver and most inorganic silver compounds ionise in moisture, body fluids, and secretions to release biologically active Ag(+). The ion is absorbed into the systemic circulation from the diet and drinking water, by inhalation and through intraparenteral administration. Percutaneous absorption of Ag(+) through intact or damaged skin is low. Ag(+) binds strongly to metallothionein, albumins, and macroglobulins and is metabolised to all tissues other than the brain and the central nervous system. Silver sulphide or silver selenide precipitates, bound lysosomally in soft tissues, are inert and not associated with an irreversible toxic change. Argyria and argyrosis are the principle effects associated with heavy deposition of insoluble silver precipitates in the dermis and cornea/conjunctiva. Whilst these changes may be profoundly disfiguring and persistent, they are not associated with pathological damage in any tissue. The present paper discusses the mechanisms of absorption and metabolism of silver in the human body, presumed mechanisms of argyria and argyrosis, and the elimination of silver-protein complexes in the bile and urine. Minimum blood silver levels consistent with early signs of argyria or argyrosis are not known. Silver allergy does occur but the extent of the problem is not known. Reference values for silver exposure are discussed.

Recovering Ga(III) from coordination complexes using pyridine 2,6-dicarboxylic acid chelation ion chromatography

Ion exchange chelation chromatography is an effective means to extract metals from coordination complexes and biological samples; however there is a lack of data to verify the nature of metal complexes that can be successfully analysed using such a procedure. The aim of this study was to assess the capability of pyridine 2,6-dicarboxylic acid (PDCA) to extract and quantify Ga(III) from a range of environments using standard liquid chromatography apparatus. The PDCA chelation method generated a single Ga(III) peak with a retention time of 2.55 +/- 0.02 min, a precision of <2% and a limit of detection of 110 microM. Ga(III) hydroxide complexes (highest stability constant 15.66) were used to successfully cross-validate the chelation method with inductively coupled plasma mass spectrometry. The PDCA assay extracted 96.9 +/- 1.2% of the spiked Ga(III) from porcine mucus and 100.7 +/- 2.7% from a citrate complex (stability constant 10.02), but only ca 50% from an EDTA complex (stability constant 22.01). These data suggest that PDCA chelation can be considered a suitable alternative to inductively coupled plasma mass spectrometry for Ga(III) quantification from all but the most strongly bound coordinated complexes i.e. a stability constant of <15.

Contaminated soils (II): in vitro dermal absorption of nickel (Ni-63) and mercury (Hg-203) in human skin

Dermal absorption of heavy metal soil contaminants was tested in vitro with chloride salts of radioactive nickel (Ni-63) and mercury (Hg-203). Aqueous soil suspensions, spiked with either Ni-63 or Hg-203, were applied to fresh viable human breast skin tissue in Bronaugh diffusion cells perfused with Hanks HEPES buffered (pH 7.4) receptor containing 4% bovine serum albumin (BSA). Receptor fractions were collected every 6 h for 24 h when skin was soap washed. Tests were conducted concurrently in triplicate with and without soil for each skin specimen. Mean percent dermal absorption including the skin depot for Ni-63 was 1 and 22.8% with and without soil, respectively, while for Hg-203, values of 46.6 and 78.3% were obtained. Excluding the skin depot and considering only absorption in receptor, there was 0.5 and 1.8% absorption of Ni-63 with and without soil, respectively, and 1.5 and 1.4% for Hg-203. The potential bioavailability of the skin depot is discussed in relation to dermal exposure to these metals in contaminated soil.

Immunotoxicity Following Pre- and Post-natal Aluminum Exposure in Rats

The present study was designed to explore the immunotoxic effects of orally administered aluminum (AI) on pregnant rats (n = 60) and their growing fetuses and consequently on the animal wealth. The animals were randomly allocated into three equal groups of 20 rats each. The first group has no treatment and kept as a control (G1). The second and third groups of pregnant rats were treated orally with aluminum chloride at 345 mg/Kg b.wt. The second group (G2) received the tested compound from the 6^th day of gestation to the end of weaning, whereas the third group (G3) received the tested compound from the 15^th day of gestation to the end of weaning. Control and treated animals (dams and offspring) were immunized ip with (0.5 ml) 20% sheep red blood cell (SRBC) suspension seven days before the end of experiments. At the end of exposure, ten dams and ten offspring from each group were used for assessment of cell-mediated immunity and a similar number of animals were sacrificed for evaluating the humoral immune response and serum protein profile. Aluminum chloride exposure of dams (G₂ & G₃) caused significant suppression of both cell mediated and humoral immune responses in the obtained offsprings compared to the control group (G₁) without any significant effect on the immune responses of these dams. Moreover, the serum total globulins, albumin/ globulin (A/G) ratio and gamma globulin fraction were significantly decreased in the treated dam’s offsprings compared to the corresponding controls while the serum total protein and all serum protein fractions showed non significant difference between the control and treated dams and between the two treated dam groups themselves. There were no histopatho-logical changes observed in thymus, spleen and liver of the control and treated dams. Thymus of treated dam’s offsprings (G2) showed lymphoid depletion in both cortex and medulla. Their spleens showed lymphoid depletion in the white pulps and congestion with hemosiderosis in the red pulps. Liver of treated dam’s offsprings showed dilation and congestion of its central vein with degenerative changes in the hepatocytes. These histopathological changes were more severe in G2 than in G3 offsprings. It can be concluded that gestational and/ or lactation exposure of pregnant dams to AI chloride caused suppression of both cellular and humoral immune responses of their offsprings.

Slow recovery from severe inorganic arsenic poisoning despite treatment with DMSA (2.3-dimercaptosuccinic acid)

A 39-year-old woman was hospitalized for nausea, diarrhea, vomiting, and weakness of unknown etiology. Her condition progressively deteriorated and she developed multiple organ failure and tetraplegia. The diagnosis of inorganic arsenic poisoning was established by measurements of arsenic in urine and serum, showing 2,000 microg/L (normal < 10 microg/L) and 290 mug/Kg (normal < 2 microg/Kg), respectively. Hair arsenic was 57 mg/kg (normal < 0.2 mg/kg). Chelating therapy with 2.3-dimercaptosuccinic acid (DMSA) 600 mg three times daily was given for a period of 45 days with three abruption periods during a total of 13 days. The clinical manifestations of arsenic toxicosis disappeared very slowly and five years after the hospitalization she still suffers from peripheral neuropathy. Although the use of DMSA was associated with increased urinary elimination of arsenic and a decrease in blood arsenic concentrations, DMSA treatment probably had no significant effect on the total body clearance in our patient. The source of the poisoning was never detected, nor the motivation behind it. Criminal intent was suspected, but no verdict was given.

Bactericidal silver ion delivery into hydrophobic coatings with surfactants

A much studied oil-soluble surfactant, bis[2-ethylhexyl]sulfosuccinate, sodium salt, was ion exchanged into the silver ion form and dissolved into microemulsions of immiscible polyurethane step monomers. Coating and curing of these microemulsions produced polyurethane coatings that exhibit bactericidal activity against representative Gram negative bacteria. After 24 h exposure, 0.006-0.012% weight Ag relative to coating weight (0.0013-0.0025 micromol Ag/cm2) results in the three-log reduction in Escherichia coli. A slightly higher level of 0.031% weight Ag relative to coating weight (0.006 micromol Ag/cm2) killed all of the E. coli after 12 h exposure. Similar results were obtained for Pseudomonas aeruginosa. Since the double-tail surfactant anion promotes reverse micelle formation in many different kinds of oils and solvents, it appears an excellent vector for incorporating low and effective amounts of silver ion into many industrial, hospital, and household coating formulations.

Zinc in wound healing: theoretical, experimental, and clinical aspects

Zinc is an essential trace element in the human body and its importance in health and disease is appreciated. It serves as a cofactor in numerous transcription factors and enzyme systems including zinc-dependent matrix metalloproteinases that augment autodebridement and keratinocyte migration during wound repair. Zinc confers resistance to epithelial apoptosis through cytoprotection against reactive oxygen species and bacterial toxins possibly through antioxidant activity of the cysteine-rich metallothioneins. Zinc deficiency of hereditary or dietary cause can lead to pathological changes and delayed wound healing. Oral zinc supplementation may be beneficial in treating zinc-deficient leg ulcer patients, but its therapeutic place in surgical patients needs further clarification. Topical administration of zinc appears to be superior to oral therapy due to its action in reducing superinfections and necrotic material via enhanced local defense systems and collagenolytic activity, and the sustained release of zinc ions that stimulates epithelialization of wounds in normozincemic individuals. Zinc oxide in paste bandages (Unna boot) protects and soothes inflamed peri-ulcer skin. Zinc is transported through the skin from these formulations, although the systemic effects seem insignificant. We present here the first comprehensive account of zinc in wound management in relation to current concepts of wound bed preparation and the wound-healing cascade. This review article suggests that topical zinc therapy is underappreciated even though clinical evidence emphasizes its importance in autodebridement, anti-infective action, and promotion of epithelialization.

Synthesis from caffeine of a mixed N-heterocyclic carbene-silver acetate complex active against resistant respiratory pathogens

The bis(N-heterocyclic carbene) (NHC) silver complex, 3, with a methyl carbonate anion was formed from the reaction of the iodide salt of methylated caffeine, 1, with silver (I) oxide in methanol. Attempts to crystallize this complex from a mixture of common alcohols and ethyl acetate led to the formation of an NHC-silver acetate complex, 4. The more direct synthesis of 4 was accomplished by the in-situ deprotonation of 1 by silver acetate in methanol. Complex 4 demonstrated antimicrobial activity against numerous resistant respiratory pathogens from the lungs of cystic fibrosis (CF) patients including members of the Burkholderia cepacia complex that cause a high rate of mortality in patients with cystic fibrosis (CF). Application of this NHC silver complex to primary cultures of murine respiratory epithelial cells followed by microarray analysis showed minimal gene expression changes at the concentrations effective against respiratory pathogens. Furthermore, methylated caffeine without silver showed some antibacterial and antifungal activity.