Can the mouse model successfully predict mixed metal(loid)s bioavailability in humans from contaminated soils?

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.

Dietary heavy metal(loid)s exposure and prevalence of chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka

Intake of heavy metals and metalloids through the diet is posing a big research challenge in Sri Lanka due to the increasing occurrence of chronic kidney disease of unknown aetiology (CKDu) among the farming communities pursuing their livelihoods in the North Central Province (NCP). Duplicated diet studies were conducted on a sample of 62 individuals comprising adult males, adult females, boys, and girls who were selected following a demographic survey in an area of the NCP where there was a high incidence of CKDu. A health risk assessment was made by analysing the heavy metal(loid)s content in the diet samples, by means of inductively coupled plasma mass spectrometry. Rice and vegetables constituted the main diet in the CKDu prevalent areas, with all gender and age categories adhering to similar daily diet patterns. Results of the heavy metal(loid) analysis of duplicated food intake samples indicated that the amounts of Pb in rice, As and Pb in vegetables, and Cd in fish exceeded the recommended daily limits. Because consumption of rice was much higher than the other food items, the estimated daily intake of Pb exceeded the permissible daily intake of 3.5 µg/kg_BW/day. There were no significant differences between the age and gender categories in respect of estimated daily intake of Pb, which suggested that the entire population of the study area faced the risk of a high level of Pb exposure. Further, the hazard quotient of Pb was greater than 1. Influence of heavy metal(loid)s on the prevalence of CKDu cannot be understated, and as such interventions are required as a matter of urgency to reduce the local population's dietary exposure to heavy metal(loid)s.

Association between body mass index and estimated glomerular filtration rate in patients with chronic kidney disease of unknown aetiology in Sri Lanka

Chronic kidney disease of unknown aetiology (CKDu), which is widespread in the North Central Province (NCP) of Sri Lanka, is not associated with commonly known factors such as diabetes, hypertension, and glomerulonephritis. The pathogenicity of CKDu is not well understood, but people with a low body mass index (BMI) and mineral and nutrient deficiencies are more vulnerable to develop CKDu. To understand this situation, the relationship between BMI and the estimated glomerular filtration rate (eGFR) was investigated in people with CKDu in comparison with unaffected age-matched control groups in disease-endemic areas of the NCP. This community-based cross-sectional study was performed in Medirigiriya in the Polonnaruwa district of Sri Lanka, which has one of the highest densities of patients with CKDu. The data for identifying demographic factors and the relationship between CKDu and BMI were investigated by using a validated survey questionnaire. Findings indicated that the group with the highest number of people affected with CKDu (i.e. eGFR of less than 60 mL/min/1.73 m²) had the lowest BMI compared to those with normal eGFR. The majority affected were male farmers. The severity of the disease was inversely associated with BMI values and had a higher prevalence of smoking and alcohol consumption. In addition, those who consume water from household dug wells had significantly lower eGFR (p < 0.0001). A linear regression analysis revealed a significant positive association between lower eGFR and lower BMI (p < 0.001). We hypothesised that the low BMI in those with CKDu may have increased susceptibility to develop CKDu, in the presence of exposure to multiple nephrotoxins and adverse conditions.