1
|
Feiler MO, Kulick ER, Sinclair K, Spiegel N, Habel S, Castello OG. Toxic metals and pediatric clinical immune dysfunction: A systematic review of the epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:172303. [PMID: 38599398 DOI: 10.1016/j.scitotenv.2024.172303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Children are at high risk for exposure to toxic metals and are vulnerable to their effects. Significant research has been conducted evaluating the role of these metals on immune dysfunction, characterized by biologic and clinical outcomes. However, there are inconsistencies in these studies. The objective of the present review is to critically evaluate the existing literature on the association between toxic metals (lead, mercury, arsenic, and cadmium) and pediatric immune dysfunction. METHODS Seven databases (PubMed (NLM), Embase (Elsevier), CINAHL (Ebsco), Web of Science (Clarivate Analytics), ProQuest Public Health Database, and ProQuest Environmental Science Collection) were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in February 2024. Rayaan software identified duplicates and screened by title and abstract in a blinded and independent review process. The remaining full texts were reviewed for content and summarized. Exclusions during the title, abstract, and full-text reviews included: 1) not original research, 2) not epidemiology, 3) did not include toxic metals, 4) did not examine an immune health outcome, or 5) not pediatric (>18 years). This systematic review protocol followed the PRISMA guidelines. Rayaan was used to screen records using title and abstract by two blinded and independent reviewers. This process was repeated for full-text article screening selection. RESULTS The search criteria produced 7906 search results; 2456 duplicate articles were removed across search engines. In the final review, 79 studies were included which evaluated the association between toxic metals and outcomes indicative of pediatric immune dysregulation. CONCLUSIONS The existing literature suggests an association between toxic metals and pediatric immune dysregulation. Given the imminent threat of infectious diseases demonstrated by the recent COVID-19 epidemic in addition to increases in allergic disease, understanding how ubiquitous exposure to these metals in early life can impact immune response, infection risk, and vaccine response is imperative.
Collapse
Affiliation(s)
- Marina Oktapodas Feiler
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, United States of America; Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America.
| | - Erin R Kulick
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Krystin Sinclair
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Nitzana Spiegel
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Sonia Habel
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, United States of America
| | - Olivia Given Castello
- Charles Library, Temple University Libraries, Temple University, United States of America
| |
Collapse
|
2
|
Heydarirad G, Rastegar S, Haji-Abdolvahab H, Fuzimoto A, Hunter J, Zare R, Pasalar M. Efficacy and safety of purslane (Portulaca oleracea) for mild to moderate chronic hand eczema; A randomized, double-blind, placebo-controlled clinical trial. Explore (NY) 2024; 20:401-410. [PMID: 37872023 DOI: 10.1016/j.explore.2023.10.005] [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: 06/28/2023] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION Chronic hand eczema (CHE) is a common skin inflammation with a complex pathophysiology. Due to its anti-inflammatory properties, Portulaca oleracea L. (purslane) is traditionally used in Persian medicine for skin ailments. This study aimed to evaluate the safety and efficacy of a standardized purslane extract (based on traditional Persian medicine) for adults with mild or moderately severe CHE. METHODS A randomized, double-blind, placebo-controlled clinical trial was conducted at Razi Hospital in Iran from January to June 2022. Participants were randomly allocated to receive an oral purslane or placebo syrup plus topical Vaseline for four weeks. Seventy participants were randomly allocated into the intervention (n = 35) and placebo (n = 35) groups. The primary outcomes were the extent and severity of CHE symptoms over the four weeks after adjusting for age, gender and baseline score. Secondary outcomes were quality of life, symptom recurrence, treatment satisfaction, and adverse events. RESULTS After 4 weeks of treatment, compared to the placebo group (n = 31), the purslane group (n = 31) had significantly lower physician-reported fissure scores (adjusted mean difference (adjMD): -0.50, 95 %CI -3.93 to -0.34, p = 0.043), participant-reported itching (adjMD -0.51, 95 %CI -2.32 to -0.31, p = 0.041), dryness (adjMD -1.46, 95 %CI -2.89 to -0.03, p = 0.045), and total itching, dryness and thickness (adjMD -2.36, 95 %CI -6.23 to -1.51, p = 0.023) scores. Fourteen participants (purslane n = 10; placebo n = 4, p = 0.068) experienced adverse events of mild to moderate severity. CONCLUSION Purslane has some promising effects for reducing the extent and severity of CHE symptoms, and no direct comparisons have been made with commonly used treatments. Future multicenter trials and mechanistic studies are warranted to establish the safety and effectiveness of purslane as a potential therapeutic agent for CHE. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT20200707048040N1).
Collapse
Affiliation(s)
- Ghazaleh Heydarirad
- Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh Rastegar
- Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Jennifer Hunter
- Director, Health Research Group, Sydney, New South Wales, Australia
| | - Roghayeh Zare
- Research Center of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehdi Pasalar
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
3
|
Prokopciuk N, Taminskiene V, Vaideliene L, Juskiene I, Svist V, Valiulyte I, Valskys V, Valskiene R, Valiulis A, Aukstikalnis T, Vaidelys L, Butikis M, Norkuniene J, Tarasiuk N, Valiulis A. The incidence of upper respiratory infections in children is related to the concentration of vanadium in indoor dust aggregates. Front Public Health 2024; 12:1339755. [PMID: 38577275 PMCID: PMC10993999 DOI: 10.3389/fpubh.2024.1339755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
Background It has been reported that the disease-initiated and disease-mediated effects of aerosol pollutants can be related to concentration, site of deposition, duration of exposure, as well as the specific chemical composition of pollutants. Objectives To investigate the microelemental composition of dust aggregates in primary schools of Vilnius and determine trace elements related to acute upper respiratory infections among 6-to 11-year-old children. Methods Microelemental analysis of aerosol pollution was performed using dust samples collected in the classrooms of 11 primary schools in Vilnius from 2016 to 2020. Sites included areas of its natural accumulation behind the radiator heaters and from the surface of high cupboards. The concentrations of heavy metals (Pb, W, Sb, Sn, Zr, Zn, Cu, Ni, Mn, Cr, V, and As) in dust samples were analyzed using a SPECTRO XEPOS spectrometer. The annual incidence rates of respiratory diseases in children of each school were calculated based on data from medical records. Results The mean annual incidence of physician-diagnosed acute upper respiratory infections (J00-J06 according to ICD-10A) among younger school-age children was between 25.1 and 71.3% per school. A significant correlation was found between vanadium concentration and the number of episodes of acute upper respiratory infections during each study year from 2016 to 2020. The lowest was r = 0.67 (p = 0.024), and the highest was r = 0.82 (p = 0.002). The concentration of vanadium in the samples of dust aggregates varied from 12.7 to 52.1 parts per million (ppm). No significant correlations between the other trace elements and the incidence of upper respiratory infections were found, which could be caused by a small number of study schools and relatively low concentrations of other heavy metals found in the samples of indoor dust aggregates. Conclusion A significant and replicable correlation was found between the concentration of vanadium in the samples of natural dust aggregates collected in primary schools and the incidence of acute upper respiratory infections in children. Monitoring the concentration of heavy metals in the indoor environment can be an important instrument for the prevention and control of respiratory morbidity in children.
Collapse
Affiliation(s)
- Nina Prokopciuk
- Clinic of Children’s Diseases, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
- Department of Pathology and Forensic Medicine, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
- Human Ecology Multidisciplinary Research Group, Department of Public Health, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | - Vaida Taminskiene
- Human Ecology Multidisciplinary Research Group, Department of Public Health, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | - Laimute Vaideliene
- Clinic of Children’s Diseases, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Izabele Juskiene
- Clinic of Children’s Diseases, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Vitalija Svist
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Indre Valiulyte
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Kantonsspital Münsterlingen, Münsterlingen, Switzerland
| | - Vaidotas Valskys
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Roberta Valskiene
- Laboratory of Ecotoxicology, Nature Research Centre, Vilnius, Lithuania
| | - Algirdas Valiulis
- Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Tomas Aukstikalnis
- Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Lukas Vaidelys
- Clinic of Children’s Diseases, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mindaugas Butikis
- Human Ecology Multidisciplinary Research Group, Department of Public Health, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | - Jolita Norkuniene
- Department of Mathematical Statistics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Nikolaj Tarasiuk
- Human Ecology Multidisciplinary Research Group, Department of Public Health, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | - Arunas Valiulis
- Clinic of Children’s Diseases, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
- Human Ecology Multidisciplinary Research Group, Department of Public Health, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
- Clinic of Asthma, Allergy and Chronic Respiratory Diseases, Vilnius, Lithuania
| |
Collapse
|
4
|
Aubry RL, Innes AM, Haber RM. Syndromic or non-syndromic congenital ichthyosis? A case report of two brothers with ichthyosis but microphthalmia and blindness in only one brother. SAGE Open Med Case Rep 2024; 12:2050313X241231386. [PMID: 38333515 PMCID: PMC10851717 DOI: 10.1177/2050313x241231386] [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] [Received: 10/13/2023] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
We present the cases of two brothers with ichthyosis, born to consanguineous parents, with the eldest having extracutaneous manifestations in the form of microphthalmia and corneal opacities causing complete blindness. Initially, we were faced with the question of whether the phenotype in this family was due to the effects of a single pleiotropic, presumably autosomal recessive gene manifesting as a syndromic form of ichthyosis, or whether there were multiple causal genes, and the ichthyosis was non-syndromic. Ultimately, clinical follow-up of the family, combined with research-based exome sequencing established a diagnosis of NIPAL4 autosomal recessive congenital ichthyosis in both brothers, but the ocular abnormalities causing blindness in the older brother were due to coexisting autosomal recessively inherited loss of function mutations in peroxidasin, the latter finding also seen in a sister unaffected by ichthyosis.
Collapse
Affiliation(s)
- Rachel L Aubry
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - A. Micheil Innes
- Department of Medical Genetics, Alberta Children’s Hospital, Calgary, AB, Canada
| | - Richard M Haber
- Richmond Road Diagnostic and Treatment Centre (RRDTC), Calgary, AB, Canada
| |
Collapse
|
5
|
Lee S, Ryu SH, Sul WJ, Kim S, Kim D, Seo S. Association of exposure to indoor molds and dampness with allergic diseases at water-damaged dwellings in Korea. Sci Rep 2024; 14:135. [PMID: 38167981 PMCID: PMC10762174 DOI: 10.1038/s41598-023-50226-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
This study aims to characterize levels of molds, bacteria, and environmental pollutants, identify the associations between indoor mold and dampness exposures and childhood allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, using three different exposure assessment tools. A total of 50 children with their parents who registered in Seoul and Gyeonggi-do in Korea participated in this study. We collated the information on demographic and housing characteristics, environmental conditions, and lifestyle factors using the Korean version of the International Study of Asthma and Allergies in Childhood questionnaire. We also collected environmental monitoring samples of airborne molds and bacteria, total volatile organic compounds, formaldehyde, and particulate matter less than 10 µm. We evaluated and determined water damage, hidden dampness, and mold growth in dwellings using an infrared (IR) thermal camera and field inspection. Univariate and multivariate regression analyses were performed to evaluate the associations between prevalent allergic diseases and exposure to indoor mold and dampness. Indoor mold and bacterial levels were related to the presence of water damage in dwellings, and the mean levels of indoor molds (93.4 ± 73.5 CFU/m3) and bacteria (221.5 ± 124.2 CFU/m3) in water-damaged homes were significantly higher than those for molds (82.0 ± 58.7 CFU/m3) and for bacteria (152.7 ± 82.1 CFU/m3) in non-damaged dwellings (p < 0.05). The crude odds ratios (ORs) of atopic dermatitis were associated with < 6th floor (OR = 3.80), and higher indoor mold (OR = 6.42) and bacterial levels (OR = 6.00). The crude ORs of allergic diseases, defined as a group of cases who ever suffered from two out of three allergic diseases, e.g., asthma and allergic rhinitis, and allergic rhinitis were also increased by 3.8 and 9.3 times as large, respectively, with water damage (+) determined by IR camera (p < 0.05). The adjusted OR of allergic rhinitis was significantly elevated by 10.4 times in the water-damaged dwellings after adjusting age, sex, and secondhand smoke. Therefore, a longitudinal study is needed to characterize dominant mold species using DNA/RNA-based sequencing techniques and identify a causal relationship between mold exposure and allergic diseases in the future.
Collapse
Affiliation(s)
- Seokwon Lee
- Environmental Health Research Department, National Institute of Environmental Research, Incheon, 22689, Republic of Korea
| | - Seung-Hun Ryu
- Environmental Health Research Department, National Institute of Environmental Research, Incheon, 22689, Republic of Korea
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Woo Jun Sul
- Department of Systems Biotechnology, College of Biotechnology and Natural Resources, Chung-Ang University, Anseong, Gyeonggi-do, 17546, Republic of Korea
| | - Seunghyun Kim
- Allergy Immunology Center, College of Medicine, Korea University, Seoul, 02841, Republic of Korea
| | - Dohyeong Kim
- School of Economic, Political and Policy Sciences, University of Texas at Dallas, Richardson, TX, 75080-3021, USA
| | - SungChul Seo
- Department of Nano, Chemical and Biological Engineering, College of Engineering, Seokyeong University, Seoul, 02173, Republic of Korea.
| |
Collapse
|
6
|
Senanayake J, Haji Rahman R, Safwat F, Riar S, Ampalloor G. Asymptomatic Lead Poisoning in a Pediatric Patient. Cureus 2023; 15:e34940. [PMID: 36938268 PMCID: PMC10017113 DOI: 10.7759/cureus.34940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 02/16/2023] Open
Abstract
Lead poisoning is a harmful condition, potentially resulting in irreversible impairments in neurocognition and behavioral development in the pediatric population. Rarely, life-threatening complications may ensue. We report a case of an asymptomatic four-year-old patient presenting with elevated lead levels (74.7 µg/dL) detected on routine blood lead screening at a well-child examination. The patient has a history significant for atopic disease, namely atopic dermatitis, seasonal allergic rhinitis, and food allergies. Overall, the asymptomatic nature of lead poisoning warrants judicious screening in the pediatric population due to the potential for neurologic complications.
Collapse
Affiliation(s)
| | | | - Fady Safwat
- Research, Washington University School of Medicine, San Pedro, BLZ
| | - Suman Riar
- Medicine, John F. Kennedy University of Medicine, Willemstad, CUW
| | | |
Collapse
|
7
|
Wijayawardena MAA, Yan K, Liu Y, Naidu R. Can the mouse model successfully predict mixed metal(loid)s bioavailability in humans from contaminated soils? CHEMOSPHERE 2023; 311:137113. [PMID: 36356801 DOI: 10.1016/j.chemosphere.2022.137113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/20/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Mouse models have been employed by many scientific research groups worldwide to predict the bioavailability of metal (loid)s and other chemicals in humans. Their suitability for predicting mixed metal (loid) bioavailability has been questioned and debated for decades by many research teams. In this study soils contaminated by lead (Pb) and arsenic (As), either in the field or by spiking in the laboratory, were used in bioavailability and bioaccessibility tests. The spiked soils were aged for more than a year prior to testing to achieve steady state and eliminate soil ageing effects, as reported in previous research. The bioavailability of, firstly, Pb in the presence of As and secondly, As in the presence of Pb was determined using mice. Furthermore, bioaccessibility was determined using a range of in vitro methods: relative bioaccessibility leaching procedure (RBALP), the Unified Bioaccessibility Research Group Europe (BARGE) method (UBM) gastric and intestinal phases, and the National Institute for Public Health and the Environment (RIVM) gastric and intestinal phases. The correlations between Pb and As bioavailability and their in vitro bioaccessibility when they were present in mixtures were analysed. The results indicated that the bioavailability of Pb in mice kidney tissues significantly correlated with bioaccessibility of Pb in RBALP (p < 0.01), UBM gastric (p < 0.01) and intestinal phases (p < 0.01) and RIVM gastric phases when Pb is present in metal (loid) mixtures. Results of the current study reveal that the RBALP, and UBM gastric and intestinal phase were by far the best methods for predicting the RB of Pb when it is present in metal (loid) mixtures. Consequently, the mouse model can successfully explain the in vivo in vitro correlation (IVIVC) of Pb when it is present in metal (loid) mixtures. However, we did find that a mouse model may not be the best one to explain the IVIVC of As when it is present in metal (loid) mixtures.
Collapse
Affiliation(s)
- M A A Wijayawardena
- Global Centre for Environmental Remediation (GCER), University of Newcastle, Australia; CRC for Contamination Assessment and Remediation of the Environment (CRC CARE), ATC Building University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - K Yan
- Global Centre for Environmental Remediation (GCER), University of Newcastle, Australia; CRC for Contamination Assessment and Remediation of the Environment (CRC CARE), ATC Building University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Y Liu
- Global Centre for Environmental Remediation (GCER), University of Newcastle, Australia; CRC for Contamination Assessment and Remediation of the Environment (CRC CARE), ATC Building University of Newcastle, Callaghan, NSW, 2308, Australia
| | - R Naidu
- Global Centre for Environmental Remediation (GCER), University of Newcastle, Australia; CRC for Contamination Assessment and Remediation of the Environment (CRC CARE), ATC Building University of Newcastle, Callaghan, NSW, 2308, Australia.
| |
Collapse
|
8
|
Atopic Dermatitis is More than Skin Deep: A Commentary on Atopic Dermatitis and Review of Pertinent Publications from Children 2019–2021. CHILDREN 2022; 9:children9060850. [PMID: 35740787 PMCID: PMC9221729 DOI: 10.3390/children9060850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022]
|