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Vázquez Cervantes GI, González Esquivel DF, Ramírez Ortega D, Blanco Ayala T, Ramos Chávez LA, López-López HE, Salazar A, Flores I, Pineda B, Gómez-Manzo S, Pérez de la Cruz V. Mechanisms Associated with Cognitive and Behavioral Impairment Induced by Arsenic Exposure. Cells 2023; 12:2537. [PMID: 37947615 PMCID: PMC10649068 DOI: 10.3390/cells12212537] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
Arsenic (As) is a metalloid naturally present in the environment, in food, water, soil, and air; however, its chronic exposure, even with low doses, represents a public health concern. For a long time, As was used as a pigment, pesticide, wood preservative, and for medical applications; its industrial use has recently decreased or has been discontinued due to its toxicity. Due to its versatile applications and distribution, there is a wide spectrum of human As exposure sources, mainly contaminated drinking water. The fact that As is present in drinking water implies chronic human exposure to this metalloid; it has become a worldwide health problem, since over 200 million people live where As levels exceed safe ranges. Many health problems have been associated with As chronic exposure including cancer, cardiovascular diseases, gastrointestinal disturbances, and brain dysfunctions. Because As can cross the blood-brain barrier (BBB), the brain represents a target organ where this metalloid can exert its long-term toxic effects. Many mechanisms of As neurotoxicity have been described: oxidative stress, inflammation, DNA damage, and mitochondrial dysfunction; all of them can converge, thus leading to impaired cellular functions, cell death, and in consequence, long-term detrimental effects. Here, we provide a current overview of As toxicity and integrated the global mechanisms involved in cognitive and behavioral impairment induced by As exposure show experimental strategies against its neurotoxicity.
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Affiliation(s)
- Gustavo Ignacio Vázquez Cervantes
- Neurobiochemistry and Behavior Laboratory, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (G.I.V.C.); (D.F.G.E.); (T.B.A.); (H.E.L.-L.)
| | - Dinora Fabiola González Esquivel
- Neurobiochemistry and Behavior Laboratory, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (G.I.V.C.); (D.F.G.E.); (T.B.A.); (H.E.L.-L.)
| | - Daniela Ramírez Ortega
- Neuroimmunology Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (D.R.O.); (A.S.); (I.F.); (B.P.)
| | - Tonali Blanco Ayala
- Neurobiochemistry and Behavior Laboratory, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (G.I.V.C.); (D.F.G.E.); (T.B.A.); (H.E.L.-L.)
| | - Lucio Antonio Ramos Chávez
- Departamento de Neuromorfología Funcional, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico;
| | - Humberto Emanuel López-López
- Neurobiochemistry and Behavior Laboratory, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (G.I.V.C.); (D.F.G.E.); (T.B.A.); (H.E.L.-L.)
| | - Alelí Salazar
- Neuroimmunology Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (D.R.O.); (A.S.); (I.F.); (B.P.)
| | - Itamar Flores
- Neuroimmunology Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (D.R.O.); (A.S.); (I.F.); (B.P.)
| | - Benjamín Pineda
- Neuroimmunology Department, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (D.R.O.); (A.S.); (I.F.); (B.P.)
| | - Saúl Gómez-Manzo
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Secretaría de Salud, México City 04530, Mexico;
| | - Verónica Pérez de la Cruz
- Neurobiochemistry and Behavior Laboratory, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico; (G.I.V.C.); (D.F.G.E.); (T.B.A.); (H.E.L.-L.)
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Singh A, Ramalingam P, Dhingra S, Ravichandiran V, Murti K. Arsenic: a Culpable Element and a Possible Menace for HIV/AIDS Patients. Biol Trace Elem Res 2022; 200:4955-4966. [PMID: 35128593 DOI: 10.1007/s12011-022-03097-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/02/2022] [Indexed: 11/02/2022]
Abstract
Arsenic contamination has long been recognized as one of the most harmful environmental pollutants resulting from anthropogenic activity. Apart from being an environmental toxicant or pollutant, this culpable heavy metal also has detrimental effects on human health. People throughout the world are exposed to arsenic (As) mostly through polluted drinking water. Acute inorganic arsenic (iAs) poisoning causes nausea, vomiting, stomach discomfort, and severe diarrhea. As on long-term exposure is a potent carcinogen, characterized by IARC (International Agency for Research on Cancer). As levels are high mainly in Gangetic regions due to which the people living around are suffering the consequences. The carcinogenicity of As is well established but the immunotoxicity caused by it is still unknown. Some animal model supports the toxicity of As in the immune system as well, but in humans, mainly suffering from human immunodeficiency virus (HIV), it is not well established. iAs suppresses the immune system by acting on different targets and exacerbating infections. Although animal studies have demonstrated that arsenic trioxide (As2O3) reduces viral rebound and restores CD4 + count in vivo when coupled with antiretroviral medications, elemental AS may have devastating effects on the immune system of HIV patients, making them more prone to opportunistic infections (OIs). It is well known that in later stages of HIV infection, neurological problems also complicate the conditions such as cognitive impairment and AIDS dementia complex (ADC). Along with immunotoxicity, As has the potential to damage HIV patients' brains. This article addresses the immunotoxicity of arsenic and exacerbations caused by it, along with the neurotoxicity, particularly in HIV patients residing near the Gangetic belt.
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Affiliation(s)
- Akanksha Singh
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India
| | - P Ramalingam
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India
| | - Sameer Dhingra
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India
| | - V Ravichandiran
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India
- Department of Natural Products, National Institute of Pharmaceutical Education and Research (NIPER), West Bengal, Kolkata, India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Bihar, Hajipur, India.
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Feng J, Qin W, Wang Z, Zhai Z, Ma R, Lv H, Jiang Y. The effects of 2-aminoethoxydiphenyl borate and dantrolene on rat bones treated with NaAsO2. Acta Biochim Biophys Sin (Shanghai) 2021; 53:1247-1249. [PMID: 34117862 DOI: 10.1093/abbs/gmab075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jia Feng
- The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832000, China
| | - Wenjuan Qin
- The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832000, China
| | - Zhen Wang
- The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832000, China
| | - Zijing Zhai
- The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832000, China
| | - Rongji Ma
- The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832000, China
| | - Hailong Lv
- Section for Hepatopancreatobiliary Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China
| | - Yufeng Jiang
- School of Preclinical Medicine, Chengdu Medical College, Chengdu 610500, China
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Kumar A, Ali M, Kumar R, Kumar M, Sagar P, Pandey RK, Akhouri V, Kumar V, Anand G, Niraj PK, Rani R, Kumar S, Kumar D, Bishwapriya A, Ghosh AK. Arsenic exposure in Indo Gangetic plains of Bihar causing increased cancer risk. Sci Rep 2021; 11:2376. [PMID: 33504854 PMCID: PMC7841152 DOI: 10.1038/s41598-021-81579-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/21/2020] [Indexed: 01/30/2023] Open
Abstract
Reportedly, 300 million people worldwide are affected by the consumption of arsenic contaminated groundwater. India prominently figures amongst them and the state of Bihar has shown an upsurge in cases affected by arsenic poisoning. Escalated arsenic content in blood, leaves 1 in every 100 human being highly vulnerable to being affected by the disease. Uncontrolled intake may lead to skin, kidney, liver, bladder, or lung related cancer but even indirect forms of cancer are showing up on a regular basis with abnormal arsenic levels as the probable cause. But despite the apparent relation, the etiology has not been understood clearly. Blood samples of 2000 confirmed cancer patients were collected from pathology department of our institute. For cross-sectional design, 200 blood samples of subjects free from cancer from arsenic free pockets of Patna urban agglomeration, were collected. Blood arsenic levels in carcinoma patients as compared to sarcomas, lymphomas and leukemia were found to be higher. The geospatial map correlates the blood arsenic with cancer types and the demographic area of Gangetic plains. Most of the cancer patients with high blood arsenic concentration were from the districts near the river Ganges. The raised blood arsenic concentration in the 2000 cancer patients strongly correlates the relationship of arsenic with cancer especially the carcinoma type which is more vulnerable. The average arsenic concentration in blood of the cancer patients in the Gangetic plains denotes the significant role of arsenic which is present in endemic proportions. Thus, the study significantly correlates and advocates a strong relation of the deleterious element with the disease. It also underlines the need to address the problem by deciphering the root cause of the elevated cancer incidences in the Gangetic basin of Bihar and its association with arsenic poisoning.
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Affiliation(s)
- Arun Kumar
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India.
| | - Mohammad Ali
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Ranjit Kumar
- Department of Animal Sciences, Central University of Himachal Pradesh, Kangra, Himachal Pradesh, India
| | - Mukesh Kumar
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Prity Sagar
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Ritu Kumari Pandey
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Vivek Akhouri
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Vikas Kumar
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Gautam Anand
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Pintoo Kumar Niraj
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Rita Rani
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
| | - Santosh Kumar
- Department of Applied Geoscience and Engineering, Delft University of Technology, Delft, The Netherlands
| | - Dhruv Kumar
- Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida, India
| | | | - Ashok Kumar Ghosh
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar, 801505, India
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Wei Y, Jia C, Lan Y, Hou X, Zuo J, Li J, Wang T, Mao G. The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case-control study. BMJ Open 2019; 9:e025336. [PMID: 31666259 PMCID: PMC6830718 DOI: 10.1136/bmjopen-2018-025336] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES We investigated the association of specific serum amino acids (AAs) with the odds of arsenic-induced skin lesions (AISL) and their ability to distinguish patients with AISL from people chronically exposed to arsenic. DESIGN Case-control study. SETTING Three arsenic-exposed villages in Wuyuan County, Hetao Plain, Inner Mongolia, China were evaluated. PARTICIPANTS Among the 450 residents aged 18-79 years, who were chronically exposed to arsenic via drinking water, 56 were diagnosed as having AISL (defined as cases). Another 56 participants without AISL, matched by gender and age (±1 year) from the same population, were examined as controls. MAIN OUTCOME MEASURES AND METHODS AA levels were determined by ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry-based metabolomics analysis. Potential confounding variables were identified via a standardised questionnaire and clinical examination. Multivariable conditional logistic regression model and receiver operating characteristic curve analyses were performed to investigate the relationship between specific AAs and AISL. RESULTS Tryptophan and phenylalanine levels were negatively associated with AISL (p<0.05). Compared with that in the first quartile, the adjusted OR of AISL in the second, third and fourth quartiles were decreased by 44%, 88% and 79% for tryptophan and 30%, 80% and 80% for phenylalanine, respectively. The combination of these two higher-level AAs showed the lowest OR for AISL (OR=0.08; 95% CI 0.02 to 0.25; p<0.001). Furthermore, both AAs showed a moderate ability to distinguish patients with AISL from the control, with the area under the curve (AUC; 95% CI) as 0.67 (0.57 to 0.77) for tryptophan and 0.70 (0.60 to 0.80) for phenylalanine (p<0.05). The combined pattern with AUC (95% CI) was 0.72 (0.62 to 0.81), showing a sensitivity of 76.79% and specificity of 58.93% (p<0.001). CONCLUSIONS Specific AAs may be linked to AISL and play important roles in early AISL identification. TRIAL REGISTRATION NUMBER NCT02235948.
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Affiliation(s)
- Yaping Wei
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Center on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, Beijing, China
| | - Chaonan Jia
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Center on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Yuan Lan
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, China
| | - Xiangqing Hou
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Center on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Jingjing Zuo
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jushuang Li
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Center on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Tao Wang
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Center on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Guangyun Mao
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Center on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Center on Clinical Research, the Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, China
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Paul SK, Islam MS, Hasibuzzaman MM, Hossain F, Anjum A, Saud ZA, Haque MM, Sultana P, Haque A, Andric KB, Rahman A, Karim MR, Siddique AE, Karim Y, Rahman M, Miyataka H, Xin L, Himeno S, Hossain K. Higher risk of hyperglycemia with greater susceptibility in females in chronic arsenic-exposed individuals in Bangladesh. Sci Total Environ 2019; 668:1004-1012. [PMID: 31018442 PMCID: PMC6560360 DOI: 10.1016/j.scitotenv.2019.03.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 03/01/2019] [Accepted: 03/03/2019] [Indexed: 04/15/2023]
Abstract
Arsenic (As) toxicity and diabetes mellitus (DM) are emerging public health concerns worldwide. Although exposure to high levels of As has been associated with DM, whether there is also an association between low and moderate As exposure and DM remains unclear. We explored the dose-dependent association between As exposure levels and hyperglycemia, with special consideration of the impact of demographic variables, in 641 subjects from rural Bangladesh. The total study participants were divided into three groups depending on their levels of exposure to As in drinking water (low, moderate and high exposure groups). Prevalence of hyperglycemia, including impaired glucose tolerance (IGT) and DM was significantly associated with the subjects' drinking water arsenic levels. Almost all exposure metrics (As levels in the subjects' drinking water, hair and nails) showed dose-dependent associations with the risk of hyperglycemia, IGT and DM. Among the variables considered, sex, age, and BMI were found to be associated with higher risk of hyperglycemia, IGT and DM. In sex-stratified analyses, As exposure showed a clearer pattern of dose-dependent risk for hyperglycemia in females than males. Finally, drinking water containing low-to-moderate levels of As (50.01-150 μg/L) was found to confer a greater risk of hyperglycemia than safe drinking water (As ≤10 μg/L). Thus the results suggested that As exposure was dose-dependently associated with hyperglycemia, especially in females.
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Affiliation(s)
- Sudip Kumar Paul
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh; Department of Applied Nutrition and Food Technology, Islamic University, Kushtia 7003, Bangladesh
| | - Md Shofikul Islam
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia 7003, Bangladesh
| | - M M Hasibuzzaman
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Faruk Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Adiba Anjum
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Zahangir Alam Saud
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Md Mominul Haque
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Papia Sultana
- Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Azizul Haque
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA
| | | | - Aminur Rahman
- The Life Science Center, School of Science and Technology, Örebro University, SE 701 82, Örebro, Sweden
| | - Md Rezaul Karim
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia 7003, Bangladesh
| | - Abu Eabrahim Siddique
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Yeasir Karim
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Mizanur Rahman
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Hideki Miyataka
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Lian Xin
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Seiichiro Himeno
- Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Khaled Hossain
- Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi 6205, Bangladesh.
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Abstract
Arsenic is a potent human carcinogen affecting the rate of cancer deaths worldwide. In India, West Bengal is the worst affected state by arsenic. To our best knowledge, this is the first study relating arsenic toxicity with oral carcinoma, along with HPV infection, the latter being well established in western countries. To find out a possible correlation between arsenic toxicity and oral carcinoma in the population of West Bengal, in or without any association with human papilloma virus infection. Ethical clearance of this study was obtained from the institutional committee. One hundred and four malignant and 103 premalignant cases were selected for this study along with 200 healthy age and sex-matched individuals selected as control (100 each for malignant and premalignant) (2013-2017). On proper consent, their buccal swab and hair samples were assessed for the presence of HPV DNA by DNA extraction, followed by PCR and arsenic estimation by flow injection hydride generation atomic absorption spectrometry respectively. A very highly significant correlation has been observed between arsenic toxicity, HPV infection and the occurrence of oral carcinoma (p value = 2.18e-06; p value = 0.00100 respectively). A correlation has also been observed between these two factors simultaneously, contributing to this malignancy (phi coefficient = 0.2194839). A statistically significant correlation observed between this metal toxicity and viral infection in the occurrence of oral carcinoma in this population indicates a possible symbiotic role between these two factors in this malignancy.
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Affiliation(s)
- Pritha Pal
- Department of Genetics, Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan, 99 Sarat Bose Road, Kolkata, 700026, India
| | - Ajanta Halder
- Department of Genetics, Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan, 99 Sarat Bose Road, Kolkata, 700026, India.
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Abstract
Dermatology is frequently viewed by physician and surgical colleagues as a specialty with few emergencies. Although the majority of dermatology practice is in the office setting, cutaneous emergencies do occur through referrals from primary care and as ward consults. Even though cutaneous signs of poisoning would be an uncommon emergency consultation, it is important for dermatologists to be aware of the clinical presentations so as to be able instigate appropriate time critical treatments.
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Affiliation(s)
- Michael Joseph Lavery
- Department of Dermatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK; Department of Dermatology, Royal Liverpool & Broadgreen University Hospitals NHS Trust, Liverpool, UK.
| | - Ronni Wolf
- Dermatology Unit, Kaplan Medical Center, Rehovot, Israel, and affiliated with the School of Medicine, Hebrew University and Hadassah Medical Center, Jerusalem, Israel
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Saleem MD, Oussedik E, Picardo M, Schoch JJ. Acquired disorders with hypopigmentation: A clinical approach to diagnosis and treatment. J Am Acad Dermatol 2018; 80:1233-1250.e10. [PMID: 30236514 DOI: 10.1016/j.jaad.2018.07.070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/09/2018] [Accepted: 07/13/2018] [Indexed: 02/07/2023]
Abstract
Acquired hypopigmented skin changes are commonly encountered by dermatologists. Although hypopigmentation is often asymptomatic and benign, occasional serious and disabling conditions present with cutaneous hypopigmentation. A thorough history and physical examination, centered on disease distribution and morphologic findings, can aid in delineating the causes of acquired hypopigmented disorders. The second article in this 2-part continuing medical education series focuses on conditions with a hypopigmented phenotype. Early diagnosis and appropriate management of these disorders can improve a patient's quality of life, halt disease progression, and prevent irreversible disability.
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Affiliation(s)
- Mohammed D Saleem
- Department of Internal Medicine, University of Florida College of Medicine and University of Florida Health, Gainesville, Florida.
| | | | - Mauro Picardo
- Department of Dermatology and Pediatric Dermatology, Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Jennifer J Schoch
- Department of Dermatology, University of Florida, Gainesville, Florida; Department of Pediatrics, University of Florida, Gainesville, Florida
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Rahman ML, Liang L, Valeri L, Su L, Zhu Z, Gao S, Mostofa G, Qamruzzaman Q, Hauser R, Baccarelli A, Christiani DC. Regulation of birthweight by placenta-derived miRNAs: evidence from an arsenic-exposed birth cohort in Bangladesh. Epigenetics 2018; 13:573-590. [PMID: 30099960 PMCID: PMC6140906 DOI: 10.1080/15592294.2018.1481704] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 05/07/2018] [Indexed: 01/01/2023] Open
Abstract
Altered expression of microRNAs (miRNAs) is implicated in fetal growth. However, the mechanisms by which placenta-derived miRNAs regulate birthweight are not well understood. In Phase 1, we compared the expression of 754 miRNAs in the placenta of mothers from two extreme birthweight groups (0.8-2.2 kg vs. 3.3-3.9 kg, n = 77 each) selected from an arsenic-exposed Bangladeshi birth cohort (n = 1,141). We identified 49 miRNAs associated with the extreme birthweight groups and/or gestational age in Phase 1, which were further analyzed in Phase 2 among 364 randomly selected mother-infant pairs. Gestational age was determined by ultrasound. Causal mediation analysis was used to estimate the effect of miRNAs on birthweight considering gestational age a mediator, adjusting for core blood arsenic and other risk factors. miR-1290, miR-195, and let-7g showed significant inverse associations with gestational age, while miR-328 showed significant positive association [false discovery rate (FDR) <0.05]. Via changing gestational age, miR-1290, miR-195, and miR-27a showed significant inverse associations with birthweight, while miR-328 and miR-324-5p showed significant positive associations (FDR <0.05). The effect of miRNAs on birthweight varied by gestational age (for miR-1290, miR-195, miR-328) and in utero arsenic exposure (for miR-1290): stronger effect was observed among infants delivered early in gestation or exposed to higher concentrations of arsenic in cord blood. Gene enrichment analysis with in silico predicted targets identified cell proliferation, inflammation, apoptosis, insulin, and IGF family signaling cascades associated with these miRNAs. Future studies are warranted to replicate these findings and assess these miRNAs as early biomarkers of fetal growth.
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Affiliation(s)
- Mohammad L. Rahman
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Liming Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Linda Valeri
- Department of Psychiatry, McLean Hospital, Laboratory of Psychiatric Biostatistics, Belmont and Harvard Medical School, Boston, MA, USA
| | - Li Su
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Zhaozhong Zhu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shangzhi Gao
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Golam Mostofa
- Department of Medicine, Dhaka Community Hospital Trust, Dhaka, Bangladesh
| | - Qazi Qamruzzaman
- Department of Medicine, Dhaka Community Hospital Trust, Dhaka, Bangladesh
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andrea Baccarelli
- Department of Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David C. Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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11
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Affiliation(s)
- Greta Lindenmayer
- From the Department of Medicine, Royal Darwin Hospital (G.L., J.B., D.H., H.F.), and the Menzies School of Health Research (H.F.), Darwin, NT, the Department of Emergency Medicine, Royal Perth Hospital, Perth, WA (K.H.), and the Western Australian Poison Information Centre, Nedlands, and the New South Wales Poisons Information Centre, Westmead (K.H.) - all in Australia; and the Departments of Endocrinology, Metabolism and Diabetes, and Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (H.F.)
| | - Kerry Hoggett
- From the Department of Medicine, Royal Darwin Hospital (G.L., J.B., D.H., H.F.), and the Menzies School of Health Research (H.F.), Darwin, NT, the Department of Emergency Medicine, Royal Perth Hospital, Perth, WA (K.H.), and the Western Australian Poison Information Centre, Nedlands, and the New South Wales Poisons Information Centre, Westmead (K.H.) - all in Australia; and the Departments of Endocrinology, Metabolism and Diabetes, and Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (H.F.)
| | - Jim Burrow
- From the Department of Medicine, Royal Darwin Hospital (G.L., J.B., D.H., H.F.), and the Menzies School of Health Research (H.F.), Darwin, NT, the Department of Emergency Medicine, Royal Perth Hospital, Perth, WA (K.H.), and the Western Australian Poison Information Centre, Nedlands, and the New South Wales Poisons Information Centre, Westmead (K.H.) - all in Australia; and the Departments of Endocrinology, Metabolism and Diabetes, and Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (H.F.)
| | - Diane Howard
- From the Department of Medicine, Royal Darwin Hospital (G.L., J.B., D.H., H.F.), and the Menzies School of Health Research (H.F.), Darwin, NT, the Department of Emergency Medicine, Royal Perth Hospital, Perth, WA (K.H.), and the Western Australian Poison Information Centre, Nedlands, and the New South Wales Poisons Information Centre, Westmead (K.H.) - all in Australia; and the Departments of Endocrinology, Metabolism and Diabetes, and Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (H.F.)
| | - Henrik Falhammar
- From the Department of Medicine, Royal Darwin Hospital (G.L., J.B., D.H., H.F.), and the Menzies School of Health Research (H.F.), Darwin, NT, the Department of Emergency Medicine, Royal Perth Hospital, Perth, WA (K.H.), and the Western Australian Poison Information Centre, Nedlands, and the New South Wales Poisons Information Centre, Westmead (K.H.) - all in Australia; and the Departments of Endocrinology, Metabolism and Diabetes, and Molecular Medicine and Surgery, Karolinska Institutet, Stockholm (H.F.)
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Bjørklund G, Aaseth J, Chirumbolo S, Urbina MA, Uddin R. Effects of arsenic toxicity beyond epigenetic modifications. Environ Geochem Health 2018; 40:955-965. [PMID: 28484874 DOI: 10.1007/s10653-017-9967-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/21/2017] [Indexed: 05/24/2023]
Abstract
Worldwide chronic arsenic (As) poisoning by arsenic-contaminated groundwater is one of the most threatening public health problems. Chronic inorganic As (inAs) exposure has been associated with various forms of cancers and numerous other pathological effects in humans, collectively known as arsenicosis. Over the past decade, evidence indicated that As-induced epigenetic modifications have a role in the adverse effects on human health. The main objective of this article is to review the evidence on epigenetic modifications induced by arsenicals. The epigenetic components play a crucial role in the regulation of gene expression, at both transcriptional and posttranscriptional levels. We synthesized the large body of existing research on arsenic exposure and epigenetic mechanisms of health outcomes with an emphasis on recent publications. Changes in patterns of DNA methylation, histone posttranslational modifications, and microRNAs have been repeatedly observed after inAs exposure in laboratory studies and in studies of human populations. Such alterations have the potential to disturb cellular homeostasis, resulting in the modulation of key pathways in the As-induced carcinogenesis. The present article reviews recent data on As-induced epigenetic effects and concludes that it is time for heightened awareness of pathogenic arsenic exposure, particularly for pregnant women and children, given the potential for a long-lasting disturbed cellular homeostasis.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610, Mo i Rana, Norway.
| | - Jan Aaseth
- Innlandet Hospital Trust and Inland Norway University of Applied Sciences, Elverum, Norway
| | - Salvatore Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Mauricio A Urbina
- Departamento de Zoología, Facultad de Ciencias Naturales y Oceanográficas, Universidad de Concepción, Casilla 160-C, Concepción, Chile
| | - Riaz Uddin
- Department of Pharmacy, Stamford University Bangladesh, Dhaka, Bangladesh
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13
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Shafique S, Naseem N, Javaid QUA, Nagi AH. Histopathological Changes in Arsenic Kushta Induced Nephrotoxicity in Wistar Rats. J Coll Physicians Surg Pak 2017; 27:92-96. [PMID: 28292386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/16/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To determine the nephrotoxic effects of arsenic kushta (Kushta Sam-ul-Far) in Wistar rats. STUDY DESIGN Experimental study. PLACE AND DURATION OF STUDY Department of Morbid Anatomy and Histopathology, University of Health Sciences, Lahore from May to August 2014. METHODOLOGY This experimental study was conducted on 48 healthy Wistar rats, each weighing 200 - 250 grams. The rats were randomly divided into 4 experimental groups each containing 12 rats. Group I was taken as control given flour pellets. Group II was given single dose (180 mg/kg) of arsenic kushta for 2 weeks. Group III received 150 mg/kg of arsenic kushta for 12 weeks; whereas, group IV was also given 150 mg/kg of arsenic kushta for 12 weeks along with 75 mg of BSA (bovine serum albumin). Histopathological changes in glomeruli, tubules and interstitium were noted in the kidney. RESULTS Mesangial proliferation, thickening of basement membrane, necrosis, and interstitial edema were mainly observed in all the above groups except group I which served as control. These changes were seen in greater severity in high dose groups and the group given BSA injection along with kushta (group III, IV). CONCLUSION Herbo-mineral preparations of arsenic kushta are nephrotoxic in rats and may have similar toxic effects in human beings.
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Affiliation(s)
- Sadaf Shafique
- Department of Morbid Anatomy and Histopathology, University of Health Sciences, Lahore
| | - Nadia Naseem
- Department of Morbid Anatomy and Histopathology, University of Health Sciences, Lahore
| | - Qurat -ul-Ain Javaid
- Department of Morbid Anatomy and Histopathology, University of Health Sciences, Lahore
| | - A H Nagi
- Department of Morbid Anatomy and Histopathology, University of Health Sciences, Lahore
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14
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Hausauer AK, Hoffmann R, Terushkin V, Meehan SA, Femia AN, Pomeranz MK. Acral keratoses and squamous-cell carcinomas likely associated with arsenic exposure. Dermatol Online J 2016; 22:13030/qt434929px. [PMID: 28329540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 06/06/2023] Open
Abstract
Chronic arsenic exposure is known to inducepunctate keratoses with an increased risk ofprimary squamous-cell carcinoma. Drinking wateris currently the major source of arsenic exposureworldwide and is considered one of the mostsubstantial environmental carcinogens. We describethe case of a 61-year-old Hungarian woman withscattered, acral, hyperkeratotic papules and a historyof five palmoplantar squamous-cell carcinomasas well as two other extremity non-melanomaskin cancers. Prior to immigration, she had livedin a county of Southern Hungary that is known tohave elevated concentrations of inorganic arsenicin the drinking water above the World HealthOrganization's current maximum threshold forsafety. To date, this report is the first to describethe phenomenon of palmoplantar squamouscellcarcinomas in a patient from this region andunderscores the importance of vigilant screening inthose individuals who have spent substantial time inhigh-risk regions internationally and domestically.
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Affiliation(s)
- Amelia K Hausauer
- Ronald O. Perelman Department of Dermatology, NYU School of Medicine, NYU Langone Medical Center
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Guo Z, Hu Q, Tian J, Yan L, Jing C, Xie HQ, Bao W, Rice RH, Zhao B, Jiang G. Proteomic profiling reveals candidate markers for arsenic-induced skin keratosis. Environ Pollut 2016; 218:34-38. [PMID: 27552035 DOI: 10.1016/j.envpol.2016.08.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/20/2016] [Accepted: 08/05/2016] [Indexed: 06/06/2023]
Abstract
Proteomics technology is an attractive biomarker candidate discovery tool that can be applied to study large sets of biological molecules. To identify novel biomarkers and molecular targets in arsenic-induced skin lesions, we have determined the protein profile of arsenic-affected human epidermal stratum corneum by shotgun proteomics. Samples of palm and foot sole from healthy subjects were analyzed, demonstrating similar protein patterns in palm and sole. Samples were collected from the palms of subjects with arsenic keratosis (lesional and adjacent non-lesional samples) and arsenic-exposed subjects without lesions (normal). Samples from non-exposed healthy individuals served as controls. We found that three proteins in arsenic-exposed lesional epidermis were consistently distinguishably expressed from the unaffected epidermis. One of these proteins, the cadherin-like transmembrane glycoprotein, desmoglein 1 (DSG1) was suppressed. Down-regulation of DSG1 may lead to reduced cell-cell adhesion, resulting in abnormal epidermal differentiation. The expression of keratin 6c (KRT6C) and fatty acid binding protein 5 (FABP5) were significantly increased. FABP5 is an intracellular lipid chaperone that plays an essential role in fatty acid metabolism in human skin. This raises a possibility that overexpression of FABP5 may affect the proliferation or differentiation of keratinocytes by altering lipid metabolism. KRT6C is a constituent of the cytoskeleton that maintains epidermal integrity and cohesion. Abnormal expression of KRT6C may affect its structural role in the epidermis. Our findings suggest an important approach for future studies of arsenic-mediated toxicity and skin cancer, where certain proteins may represent useful biomarkers of early diagnoses in high-risk populations and hopefully new treatment targets. Further studies are required to understand the biological role of these markers in skin pathogenesis from arsenic exposure.
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Affiliation(s)
- Zhiling Guo
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Qin Hu
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Jijing Tian
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Li Yan
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Chuanyong Jing
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Heidi Qunhui Xie
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Wenjun Bao
- JMP Life Sciences, SAS Institute, Cary, NC 27513, USA
| | - Robert H Rice
- Department of Environmental Toxicology, University of California, Davis, CA 95616-8588, USA
| | - Bin Zhao
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
| | - Guibin Jiang
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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Rana T, Bera AK, Das S, Bhattacharya D, Pan D, Das SK. Inhibition of Oxidative Stress and Enhancement of Cellular Activity by Mushroom Lectins in Arsenic Induced Carcinogenesis. Asian Pac J Cancer Prev 2016; 17:4185-4197. [PMID: 27797216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Chronic arsenicosis is a major environmental health hazard throughout the world, including India. Animals and human beings are affected due to drinking of arsenic contaminated ground water, due to natural mineral deposits, arsenical pesticides or improperly disposed arsenical chemicals. Arsenic causes cancer with production of free radicals and reactive oxygen species (ROS) that are neutralized by an elaborate antioxidant defense system consisting of enzymes and numerous non-enzymatic antioxidants. Dietary antioxidant supplements are useful to counteract the carcinogenesis effects of arsenic. Oyster mushroom lectins can be regarded as ingredients of popular foods with biopharmaceutical properties. A variety of compounds have been isolated from mushrooms, which include polysaccharides and polysaccharopeptides with immune-enhancing effects. Lectins are beneficial in reducing arsenic toxicity due to anticarcinogenetic roles and may have therapeutic application in people suffering from chronic exposure to arsenic from natural sources, a global problem that is especially relevant to millions of people on the Indian subcontinent.
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Affiliation(s)
- Tanmoy Rana
- Indian Veterinary Research Institute, Eastern Regional Station, Kolkata, India E-mail :
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Abstract
OBJECTIVE Arsenic (As) exposure may cause several medical problems. There were a few studies investigated whether it has affected bone tissue in women. However, there was no study in men. The aim of this study was to evaluate associations between bone mineral density (BMD) and As exposure in men subjects. MATERIAL AND METHODS We enrolled in this study 254 subjects who due to chronic As exposure suspected and 82 subjects as a control group. Hair As levels were detected by a hair analysis (Varian AA240Z Zeeman Atomic Absorption Spectrometer, USA). BMD measurements were obtained using dual-energy X-ray absorptiometry instrumentation. We investigated associations between the hair As levels and BMD measurements. RESULTS The frequency of osteoporosis and osteopenia was found to be 0.8% and 54.5%, respectively, in the As exposure group. The frequency of osteoporosis was found to be 1% and osteopenia was 32.4% in control subjects. There was significant difference between two groups (p < 0.001). Hair As level has a median 1.01 (min: 0.06 and max: 25.71). There were no significant correlation between hair As levels and BMD measurements. CONCLUSION According to our observations, As exposure was associated with bone metabolism. Possible cause of osteopenia may be exposure to As. Further investigations are needed to estimate the relationship between As and bone metabolism.
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Affiliation(s)
- Ayla Akbal
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Onsekiz Mart University , Çanakkale , Turkey and
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Pierce BL, Tong L, Argos M, Gao J, Farzana J, Roy S, Paul-Brutus R, Rahaman R, Rakibuz-Zaman M, Parvez F, Ahmed A, Quasem I, Hore SK, Alam S, Islam T, Harjes J, Sarwar G, Slavkovich V, Gamble MV, Chen Y, Yunus M, Rahman M, Baron JA, Graziano JH, Ahsan H. Arsenic metabolism efficiency has a causal role in arsenic toxicity: Mendelian randomization and gene-environment interaction. Int J Epidemiol 2014; 42:1862-71. [PMID: 24536095 DOI: 10.1093/ije/dyt182] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Arsenic exposure through drinking water is a serious global health issue. Observational studies suggest that individuals who metabolize arsenic efficiently are at lower risk for toxicities such as arsenical skin lesions. Using two single nucleotide polymorphisms(SNPs) in the 10q24.32 region (near AS3MT) that show independent associations with metabolism efficiency, Mendelian randomization can be used to assess whether the association between metabolism efficiency and skin lesions is likely to be causal. METHODS Using data on 2060 arsenic-exposed Bangladeshi individuals, we estimated associations for two 10q24.32 SNPs with relative concentrations of three urinary arsenic species (representing metabolism efficiency): inorganic arsenic (iAs), monomethylarsonic acid(MMA) and dimethylarsinic acid (DMA). SNP-based predictions of iAs%, MMA% and DMA% were tested for association with skin lesion status among 2483 cases and 2857 controls. RESULTS Causal odds ratios for skin lesions were 0.90 (95% confidence interval[CI]: 0.87, 0.95), 1.19 (CI: 1.10, 1.28) and 1.23 (CI: 1.12, 1.36)for a one standard deviation increase in DMA%, MMA% and iAs%,respectively. We demonstrated genotype-arsenic interaction, with metabolism-related variants showing stronger associations with skin lesion risk among individuals with high arsenic exposure (synergy index: 1.37; CI: 1.11, 1.62). CONCLUSIONS We provide strong evidence for a causal relationship between arsenic metabolism efficiency and skin lesion risk. Mendelian randomization can be used to assess the causal role of arsenic exposure and metabolism in a wide array of health conditions.exposure and metabolism in a wide array of health conditions.Developing interventions that increase arsenic metabolism efficiency are likely to reduce the impact of arsenic exposure on health.
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Abstract
BACKGROUND Arsenic is a ubiquitous, naturally occurring metalloid that poses a significant human cancer risk. While water consumption provides the majority of human exposure, millions of individuals worldwide are significantly exposed to arsenic through naturally occurring levels of arsenic in grains, vegetables, meats and fish, as well as through food processed with water containing arsenic. Thus, we estimated the global burdens of disease for bladder, lung, and skin cancers attributable to inorganic arsenic in food. METHODS To determine foodborne inorganic arsenic exposures worldwide, we used World Health Organization estimates of food consumption in thirteen country clusters, in conjunction with reported measurements of total and inorganic arsenic in different foods. We estimated slope factors for arsenic-related bladder and lung cancers, and used the U.S. Environmental Protection Agency skin cancer slope factor, to calculate the annual risk of the cancer incidence in males and females within each country cluster. RESULTS We estimated that each year 9,129 to 119,176 additional cases of bladder cancer, 11,844 to 121,442 of lung cancer, and 10,729 to 110,015 of skin cancer worldwide are attributable to inorganic arsenic in food. CONCLUSIONS These estimates indicate that foodborne arsenic exposure causes a significant global burden of human disease. IMPACT Estimating the global cancer burden caused by arsenic exposure in food will support policies that reduce exposure to disease-promoting environmental hazards.
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Affiliation(s)
- Shilpi Oberoi
- Authors' Affiliations: Departments of Environmental and Occupational Health and
| | - Aaron Barchowsky
- Authors' Affiliations: Departments of Environmental and Occupational Health and Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Felicia Wu
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan
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Yunus FM, Rahman MJ, Alam MZ, Hore SK, Rahman M. Relationship between arsenic skin lesions and the age of natural menopause. BMC Public Health 2014; 14:419. [PMID: 24886424 PMCID: PMC4038403 DOI: 10.1186/1471-2458-14-419] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 04/22/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women's reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh. METHODS We compared menopausal age in two groups of women--with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies--participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women. RESULTS Women with arsenic skin lesions were 1.5 years younger (p <0.001) at the time of menopause compared to those without arsenic skin lesions. After adjusting with contraceptive use, body mass index, urinary arsenic level and family history of premature menopause, the difference between the groups' age at menopause was 2.1 years earlier (p <0.001) for respondents with arsenic skin lesions. CONCLUSIONS The study showed a statistically significant association between chronic exposure to arsenic and age at menopause. Heavily exposed women experienced menopause two years earlier than those with lower or no exposure.
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Affiliation(s)
- Fakir Md Yunus
- BRAC Research and Evaluation Division, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh
| | - Musarrat Jabeen Rahman
- ICDDR, B – Water, Sanitation and Hygiene Research Group, Center for Communicable Diseases (CCD), Moyeen Center, House-9b, Road-3, Gulshan-1, Dhaka 1212, Bangladesh
| | - Md Zahidul Alam
- Department of Biology, University of Texas at Arlington, 76010 Arlington, TX, USA
| | - Samar Kumar Hore
- ICDDR, B- Chronic Disease Epidemiology and Genetics Research Group, Centre for Control of Chronic Diseases (CCCD), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka 1212, Bangladesh
| | - Mahfuzar Rahman
- ICDDR, B – Public Health Sciences Division, the Centre for Health and Population Research, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka 1212, Bangladesh
- UChicago Research Bangladesh, House 4, Road 2B, Sector 4, Uttara, Dhaka, Bangladesh
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Chen CJ. Health hazards and mitigation of chronic poisoning from arsenic in drinking water: Taiwan experiences. Rev Environ Health 2014; 29:13-19. [PMID: 24552958 DOI: 10.1515/reveh-2014-0007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 01/15/2014] [Indexed: 06/03/2023]
Abstract
There are two endemic areas of long-term exposure to arsenic from drinking water in Taiwan. Residents in the southwestern and northeastern endemic areas started using high-arsenic artesian well water in the early 1910s and late 1940s, respectively. Public water supply system using surface water was implemented in southwestern and northeastern endemic areas in the 1970s and 1990s, respectively. Systemic health hazards of long-term exposure to arsenic in drinking water have been intensively investigated since the 1960s, especially after 1985 in Taiwan. Several diseases have been well documented to be associated with chronic arsenic poisoning from drinking water showing a dose-response relation. They include characteristic skin lesions like hyperpigmentation or depigmentation, hyperkeratosis in palms and soles, and Bowen disease, peripheral vascular disease (specifically blackfoot disease), ischemic heart disease, cerebral infarction, microvascular diseases, abnormal peripheral microcirculation, carotid atherosclerosis, QT prolongation and increased dispersion in electrocardiography, hypertension, goiter, diabetes mellitus, cataract (specifically posterior subcapsular lens opacity), pterygium, slow neural conduction, retarded neurobehavioral development, erectile dysfunction, and cancers of the skin, lung, urinary bladder, kidney, and liver. The method of choice to mitigate arsenic poisoning through drinking water is to use safe drinking water from uncontaminated sources.
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Ramsey KA, Foong RE, Sly PD, Larcombe AN, Zosky GR. Early life arsenic exposure and acute and long-term responses to influenza A infection in mice. Environ Health Perspect 2013; 121:1187-93. [PMID: 23968752 PMCID: PMC3801203 DOI: 10.1289/ehp.1306748] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 07/23/2013] [Indexed: 05/04/2023]
Abstract
BACKGROUND Arsenic is a significant global environmental health problem. Exposure to arsenic in early life has been shown to increase the rate of respiratory infections during infancy, reduce childhood lung function, and increase the rates of bronchiectasis in early adulthood. OBJECTIVE We aimed to determine if early life exposure to arsenic exacerbates the response to early life influenza infection in mice. METHODS C57BL/6 mice were exposed to arsenic in utero and throughout postnatal life. At 1 week of age, a subgroup of mice were infected with influenza A. We then assessed the acute and long-term effects of arsenic exposure on viral clearance, inflammation, lung structure, and lung function. RESULTS Early life arsenic exposure reduced the clearance of and exacerbated the inflammatory response to influenza A, and resulted in acute and long-term changes in lung mechanics and airway structure. CONCLUSIONS Increased susceptibility to respiratory infections combined with exaggerated inflammatory responses throughout early life may contribute to the development of bronchiectasis in arsenic-exposed populations.
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Affiliation(s)
- Kathryn A Ramsey
- Division of Clinical Sciences, Telethon Institute for Child Health Research, Subiaco, Western Australia, Australia
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Ghosh SK, Bandyopadhyay D, Bandyopadhyay SK, Debbarma K. Cutaneous malignant and premalignant conditions caused by chronic arsenicosis from contaminated ground water consumption: a profile of patients from eastern India. Skinmed 2013; 11:211-216. [PMID: 24053006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Natural arsenic pollution is a major global health problem. The two worst affected areas e Bangladesh and West Bengal, India. Arsenic is a well-documented human carcinogen that affects many organs including the skin. The authors sought to find out the clinical patterns of different malignant and premalignant conditions associated with chronic arsenicosis from drinking contaminated ground water in a group of patients from eastern India. This was a clinical observational study. Patients with chronic arsenicoses with suspected cutaneous malignancies for whom dermatology service was sought were enrolled in the study. A total of 24 patients (male to female ratio, 11:1; age range, 32-71 years; mean age, 52.2 years) were evaluated. Squamous cell carcinoma (SCC) was the commonest malignancies in our series, seen in 10 (41.7%) patients. This was followed by Bowen's disease (9 [37.5%]) and basal cell carcinoma (8 [33.3%]). Three patients (12.5%) had > 1 type of cutaneous malignancies. Multicentric lesions were seen in 3 cases. The most common site of involvement was the chest (8 [33.3%]). No statistically significant correlation was found between number of lesions and arsenic content in the hairs and nails of the patients.
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Affiliation(s)
- Sudip Kumar Ghosh
- Department of Dermatology, Venereology, & Leprosy, R.G. Kar Medical College, Kolkata, India.
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Shrivastav A, Sarkar G. Medical image. Hand in chronic arsenicosis. N Z Med J 2013; 126:75-76. [PMID: 23831883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Ankit Shrivastav
- Department of Endocrinology and Metabolism, Institute of Post Graduate Medical Education and Research, Kolkata, India.
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Chen JW, Wang SL, Wang YH, Sun CW, Huang YL, Chen CJ, Li WF. Arsenic methylation, GSTO1 polymorphisms, and metabolic syndrome in an arseniasis endemic area of southwestern Taiwan. Chemosphere 2012; 88:432-8. [PMID: 22440634 DOI: 10.1016/j.chemosphere.2012.02.059] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 02/05/2012] [Accepted: 02/17/2012] [Indexed: 05/03/2023]
Abstract
Previous studies have shown that hair arsenic (As) levels are associated with an increased prevalence of metabolic syndrome (MetS), which is a strong predictor for type 2 diabetes. The objective of this study was to evaluate whether urinary arsenic methylation is related to MetS in an arseniasis endemic area of southwestern Taiwan, taking genetic factors into account. Subjects were from a community-based cohort recruited in 1990 from three villages in Putai Township. In 2002-2003, we successfully followed 247 subjects and measured their urinary arsenic species including inorganic arsenic, monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), as well as the coding region polymorphisms of three genes known to involve in arsenic methylation. Results showed that subjects of MetS had a history of consuming well water of higher arsenic concentration as compared to those without MetS. We also found a significant association between urinary arsenic species and risk for MetS, where the odds ratio of MetS was increased with decreasing proportion of MMA and low rate of primary methylation (defined as MMA/inorganic As). The increased risk associated with low primary methylation rate was further modified by the GSTO1 A140D polymorphism, with the D allele carriers showing a slightly higher risk for MetS. Our results suggest that a low MMA% is associated with increased risk for MetS among As-exposed subjects and the genetic polymorphism of GSTO1, an enzyme responsible for the reduction of pentavalent arsenic species, may also play a modest modification role.
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Affiliation(s)
- Jein-Wen Chen
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Taiwan
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Gomez-Rubio P, Klimentidis YC, Cantu-Soto E, Meza-Montenegro MM, Billheimer D, Lu Z, Chen Z, Klimecki WT. Indigenous American ancestry is associated with arsenic methylation efficiency in an admixed population of northwest Mexico. J Toxicol Environ Health A 2012; 75:36-49. [PMID: 22047162 PMCID: PMC3572940 DOI: 10.1080/15287394.2011.615107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Many studies provide evidence relating lower human arsenic (As) methylation efficiency, represented by high percent urinary monomethylarsonic acid (MMA(V)), with several As-induced diseases, possibly due to the fact that MMA(V) serves as a proxy for MMA(III), the most toxic As metabolite. Some epidemiological studies suggested that indigenous Americans (AME) methylate As more efficiently; however, data supporting this have been equivocal. The aim of this study was to characterize the association between AME ancestry and As methylation efficiency using a panel of ancestry informative genetic markers to determine individual ancestry proportions in an admixed population (composed of two or more isolated ancestral populations) of 746 individuals environmentally exposed to As in northwest Mexico. Total urinary As (TAs) mean and range were 170.4 and 2.3-1053.5 μg/L, while percent AME (%AME) mean and range were 72.4 and 23-100. Adjusted (gender, age, AS3MT 7388/M287T haplotypes, body mass index [BMI], and TAs) multiple regression model showed that higher AME ancestry is significantly associated with lower percentage of urinary As excreted as MMA(V) (%uMMA) in this population (p < .01). Data also demonstrated a significant interaction between BMI and gender, indicating negative association between BMI and %uMMA, stronger in women than men (p < .01). Moreover, age and the AS3MT variants 7388 (intronic) and M287T (nonsynonymous) were also significantly associated with As methylation efficiency (p < .01). This study highlights the importance of BMI and indigenous American ancestry in some of the observed variability in As methylation efficiency, underscoring the need to be considered in epidemiology studies, particularly those carried out in admixed populations.
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Affiliation(s)
- Paulina Gomez-Rubio
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, Arizona
| | - Yann C. Klimentidis
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ernesto Cantu-Soto
- Department of Environmental Sciences, Instituto Tecnologico de Sonora, Ciudad Obregon, Sonora, Mexico
| | - Maria M. Meza-Montenegro
- Department of Environmental Sciences, Instituto Tecnologico de Sonora, Ciudad Obregon, Sonora, Mexico
| | - Dean Billheimer
- Department of Agricultural and Biosystems Engineering, University of Arizona, Tucson, Arizona
| | - Zhenqiang Lu
- Arizona Statistical Consulting Laboratory, University of Arizona, Tucson, Arizona
| | - Zhao Chen
- Division of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Walter T. Klimecki
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, Arizona
- To whom correspondence should be addressed: Walter Klimecki, DVM, Ph.D., 1657 E Helen St, RM319, Thomas Keating Bldg. Tucson, AZ 85721, Tel. 520-626-7470, Fax. 520-626-2466,
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Sengupta A, Saha K, Jash D, Bandyopadhyay A. Pulmonary cavity due to chronic eosinophilic pneumonia associated with arsenicosis. JNMA J Nepal Med Assoc 2012; 52:29-32. [PMID: 23279770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
In developing country like India arsenic poisoning is a major public health problem. Association of chronic eosinophilic pneumonia and chronic diarrhea with arsenicosis is rare. Also pulmonary cavity formation in chronic eosinophilic pneumonia is very uncommon. A 44-year-old male patient, resident of an arsenic affected area was admitted for evaluation of chronic diarrhoea, persistent peripheral eosinophilia along with radiologically visible cavity in right upper zone. There were dermatological manifestations of arsenicosis along with presence of noncirrhotic portal fibrosis and peripheral eosinophilia. On bronchoalveolar lavage study, eosinophil comprised 40% of total cellularity making the diagnosis of chronic eosinophilic pneumonia. After ruling out all possible causes of diarrhoea and chronic eosinophilic pneumonia, we came to conclusion that arsenic could be implicated as causative agent.
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Affiliation(s)
- A Sengupta
- Department of Pulmonary Medicine, NRS Medical College and Hospital, Kolkata, West Bengal, India
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Del Razo LM, García-Vargas GG, Valenzuela OL, Castellanos EH, Sánchez-Peña LC, Currier JM, Drobná Z, Loomis D, Stýblo M. Exposure to arsenic in drinking water is associated with increased prevalence of diabetes: a cross-sectional study in the Zimapán and Lagunera regions in Mexico. Environ Health 2011; 10:73. [PMID: 21864395 PMCID: PMC3169452 DOI: 10.1186/1476-069x-10-73] [Citation(s) in RCA: 153] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 08/24/2011] [Indexed: 05/18/2023]
Abstract
BACKGROUND Human exposures to inorganic arsenic (iAs) have been linked to an increased risk of diabetes mellitus. Recent laboratory studies showed that methylated trivalent metabolites of iAs may play key roles in the diabetogenic effects of iAs. Our study examined associations between chronic exposure to iAs in drinking water, metabolism of iAs, and prevalence of diabetes in arsenicosis-endemic areas of Mexico. METHODS We used fasting blood glucose (FBG), fasting plasma insulin (FPI), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), and insulin resistance (HOMA-IR) to characterize diabetic individuals. Arsenic levels in drinking water and urine were determined to estimate exposure to iAs. Urinary concentrations of iAs and its trivalent and pentavalent methylated metabolites were measured to assess iAs metabolism. Associations between diabetes and iAs exposure or urinary metabolites of iAs were estimated by logistic regression with adjustment for age, sex, hypertension and obesity. RESULTS The prevalence of diabetes was positively associated with iAs in drinking water (OR 1.13 per 10 ppb, p < 0.01) and with the concentration of dimethylarsinite (DMAsIII) in urine (OR 1.24 per inter-quartile range, p = 0.05). Notably, FPI and HOMA-IR were negatively associated with iAs exposure (β -2.08 and -1.64, respectively, p < 0.01), suggesting that the mechanisms of iAs-induced diabetes differ from those underlying type-2 diabetes, which is typically characterized by insulin resistance. CONCLUSIONS Our study confirms a previously reported, but frequently questioned, association between exposure to iAs and diabetes, and is the first to link the risk of diabetes to the production of one of the most toxic metabolites of iAs, DMAsIII.
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Affiliation(s)
- Luz M Del Razo
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, México DF, México
| | - Gonzalo G García-Vargas
- Facultad de Medicina, Universidad Juárez del Estado de Durango, Gómez Palacio, Durango, México
| | - Olga L Valenzuela
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, México DF, México
| | - Erika Hernández Castellanos
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, México DF, México
| | - Luz C Sánchez-Peña
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, México DF, México
| | - Jenna M Currier
- Curriculum in Toxicology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Zuzana Drobná
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dana Loomis
- School of Community Health Sciences/MS-274, University of Nevada, Reno, Nevada, USA (Current affiliation: Department of Epidemiology and Eppley Cancer Institute, University of Nebraska Medical Center, Omaha NE, USA
| | - Miroslav Stýblo
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Yamaoka H, Ikoma N, Kato M, Akasaka E, Tamiya S, Matsuyama T, Ozawa A, Fukunaga Y. Multiple Bowen's disease in a patient with a history of possible arsenic exposure: a case report. Tokai J Exp Clin Med 2011; 36:53-57. [PMID: 21769774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Accepted: 06/06/2011] [Indexed: 05/31/2023]
Abstract
A 81-year-old man with a patch of scaly erythema on his scrotum visited Hiratsuka Kyosai Hospital in June 2006. Reddish, scaly plaques, which were untreated, were present on his back and lower legs since 1999. Pathological examination of the lesions on the scrotum revealed Bowen's disease; therefore he was referred to our clinic for further treatment. During his visit Tokai University Hospital, irregularly bordered scaly erythematous patches were observed on his back, left arm, right knee, and right foot, sizing from 2 to 4 cm in diameter. He was treated with phenol and liquid nitrogen cryotherapy; however, he dropped out of clinic after receiving treatment for a year. At this point, most lesions were cured and only scars remained. In June 2009, he revisited Tokai University Hospital, and this time, multiple scaly erythematous patches were noted on his back and both the arms and legs. The results of the biopsies of 4 lesions obtained from the back, right arm, right knee, and the right foot led to the diagnosis of multiple Bowens' disease. During the inquiry, we learned that since birth, he has resided in Hiratsuka City and had often used water from wells. We researched the possibilities of water and soil contaminations in the Hiratsuka area.
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Affiliation(s)
- Hanako Yamaoka
- Department of Dermatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Abstract
According to history books, tuberculosis was responsible for the death of Simon Bolivar at the age of 47 years in 1830. The results of an autopsy performed by Alexandre Prospère Révérend, the French physician who cared for him during the terminal phase of his illness, have long been regarded as proof of the diagnosis. On careful reanalysis of Bolivar's medical history and post mortem examination, we reach a different conclusion. On the basis of several critical clinical, epidemiological, and pathological features of his fatal disorder, we conclude that either paracoccidioidomycosis or bacterial bronchiectasis complicating chronic arsenic intoxication was more likely responsible for his death than was tuberculous "consumption."
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Affiliation(s)
- Paul G Auwaerter
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Wang L, Wan F, Duan HP. [Clinical research on correlation between occupational acute arsine poisoning and thrombotic thrombocytopenic purpura]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2010; 28:929-930. [PMID: 21241609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Milton AH, Shahidullah SM, Smith W, Hossain KS, Hasan Z, Ahmed KT. Association between chronic arsenic exposure and nutritional status among the women of child bearing age: a case-control study in Bangladesh. Int J Environ Res Public Health 2010; 7:2811-21. [PMID: 20717540 PMCID: PMC2922727 DOI: 10.3390/ijerph7072811] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Revised: 06/13/2010] [Accepted: 06/30/2010] [Indexed: 12/02/2022]
Abstract
The role of nutritional factors in arsenic metabolism and toxicity is yet to be fully elucidated. A low protein diet results in decreased excretion of DMA and increased tissue retention of arsenic in experimental studies. Malnourished women carry a higher risk of adverse pregnancy outcomes. Chronic exposure to high arsenic (>50 microg/L) through drinking water also increases the risk of adverse pregnancy outcomes. The synergistic effects (if any) of malnutrition and chronic arsenic exposure may worsen the adverse pregnancy outcomes. This population based case control study reports the association between chronic arsenic exposure and nutritional status among the rural women in Bangladesh. 348 cases (BMI < 18.5) and 360 controls (BMI 18.5-24.99) were recruited from a baseline survey conducted among 2,341 women. An excess risk for malnutrition was observed among the participants chronically exposed to higher concentrations of arsenic in drinking water after adjusting for potential confounders such as participant's age, religion, education, monthly household income and history of oral contraceptive pills. Women exposed to arsenic >50 microg/L were at 1.9 times (Odds Ratio = 1.9, 95% CI = 1.1-3.6) increased risk of malnutrition compared to unexposed. The findings of this study suggest that chronic arsenic exposure is likely to contribute to poor nutritional status among women of 20-45 years.
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Affiliation(s)
- Abul H Milton
- Centre for Clinical Epidemiology & Biostatistics (CCEB), School of Medicine, The University of Newcastle, Callaghan, NSW, Australia.
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Kamien M. A diagnostic challenge in peripheral neuropathy. Clin Med (Lond) 2010; 10:245. [PMID: 20726454 DOI: 10.7861/clinmedicine.10-3-245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Max Kamien
- School of Primary, Aboriginal, Rural Health Care, University of Western Australia, 328 Stirling Highway, Claremont, Western Australia 6010.
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Wang CH, Chen CL, Hsiao CK, Chiang FT, Hsu LI, Chiou HY, Hsueh YM, Wu MM, Chen CJ. Arsenic-induced QT dispersion is associated with atherosclerotic diseases and predicts long-term cardiovascular mortality in subjects with previous exposure to arsenic: A 17-Year follow-up study. Cardiovasc Toxicol 2010; 10:17-26. [PMID: 19957052 DOI: 10.1007/s12012-009-9059-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Chronic arsenic poisoning is a major worldwide public health problem. Recently, we had reported chronic arsenic poisoning was dose-dependently associated with ventricular abnormalities quantified by electrocardiographic QT prolongation linking to atherosclerotic diseases. An association of chronic arsenic poisoning with ventricular repolarization inhomogeneity quantified by QT dispersion (QTD) is of particular interest from a theoretical and practical perspective. We aimed to further elucidate (1) the association of chronic arsenic exposure with ventricular abnormalities quantified by QTD, (2) the association of QTD with atherosclerotic diseases and (3) the predictability of QTD for long-term mortality in subjects with chronic arsenic poisoning. We followed up 280 men and 355 women living in arseniasis-endemic area in southwestern coast in Taiwan for 17 years. QTD in electrocardiogram and carotid intima-media thickness by ultrasonography were measured. Coronary artery disease was diagnosed by an abnormal electrocardiogram and a definite history. Cumulative arsenic exposure was significantly associated with QTD showing a dose-response relationship (P < 0.001). Significant associations of the QTD with coronary artery disease and carotid atherosclerosis existed after adjustment for potential confounders in the multiple linear regression analysis (all P values < 0.05). In the multivariate Cox regression analyses, the hazard ratios (95% confidence interval, P value) of cumulative cardiovascular and all-cause mortality were 3.9 (2.1-6.2, P = 0.002) and 1.4 (0.9-2.3, P = 0.10), respectively, for QTD > or = 65 ms compared with QTD < 65. QTD may be indicated as an early biomarker for atherosclerotic diseases and a significant and strong predictor of cardiovascular mortality in population with chronic arsenic exposure.
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Affiliation(s)
- Chih-Hao Wang
- Department of Cardiology, Cardinal Tien Hospital, Fu-Jen Catholic University, Hsintien, Taipei, Taiwan.
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Yorifuji T, Tsuda T, Grandjean P. Unusual cancer excess after neonatal arsenic exposure from contaminated milk powder. J Natl Cancer Inst 2010; 102:360-1. [PMID: 20068193 DOI: 10.1093/jnci/djp536] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Abstract
Arsenic is ubiquitously distributed in nature throughout Earth's crust and thus the major source of exposure to this metalloid for the general population is naturally polluted drinking water from wells. In East Asia, more than 30 million people are chronically exposed to arsenic. Interestingly, the manifestations of vascular diseases caused by prolonged exposure to arsenic are consistent with those induced by impaired production of endothelium-derived nitric oxide (NO). However, no information has been available on the relation between NO synthesis and chronic arsenic poisoning in humans. A cross-sectional study in an endemic area of chronic arsenic poisoning in Inner Mongolia and experimental animal studies indicated that long-term exposure to arsenic by drinking water causes reduction of NO production in endothelial cells. Subsequent examinations with rabbits showed that decreased NO production during arsenic exposure is, at least in part, due to an "uncoupling" of endothelial NO synthase evoked by decreased levels of (6R)-5,6,7,8-tetrahydro-L-biopterin (BH(4)), a cofactor of the enzyme, leading to endothelial dysfunction. Furthermore, an intervention study in the area of chronic arsenic poisoning in Inner Mongolia suggested that decreased NO levels and peripheral vascular disease in arsenosis patients can be reversed by exposure cessation. In our cellular experiments, we found that arsenic exposure causes adaptive responses against oxidative stress and arsenic cytotoxicity through Nrf2 activation. This review summarizes the results of our recent studies on a fusion of field and laboratory studies on the chronic arsenic poisoning and cellular protection against the metalloid.
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Affiliation(s)
- Yoshito Kumagai
- Doctoral Programs in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
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Masotti A, Da Sacco L, Bottazzo GF, Sturchio E. Risk assessment of inorganic arsenic pollution on human health. Environ Pollut 2009; 157:1771-1772. [PMID: 19162384 DOI: 10.1016/j.envpol.2008.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Accepted: 12/07/2008] [Indexed: 05/27/2023]
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Wang JP, Wang SL, Lin Q, Zhang L, Huang D, Ng JC. Association of arsenic and kidney dysfunction in people with diabetes and validation of its effects in rats. Environ Int 2009; 35:507-511. [PMID: 18793801 DOI: 10.1016/j.envint.2008.07.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We studied villagers with and without diabetes from arsenic-endemic areas and a nearby control site in Xinjiang Autonomous Region, PR China. Water and urinary arsenic were assayed for exposure measurement. Urinary NAG (N-acetyl-beta-glucosaminidase), a kidney function test, blood glucose, triglyceride, cholesterol, high density lipid and low density lipid were measured. Villagers from endemic areas were found to have higher urinary arsenic concentrations. The NAG results also suggest that chronic arsenic exposure presents a significant adverse impact on the kidney function of villagers in the endemic areas. However, blood glucose levels of diabetes individuals were lower than those from the control site. These observations were validated in rats which were chronically exposed to arsenic in drinking water. The distinct relationship between chronic arsenic exposure and diabetes mellitus requires further investigation. A rodent model is a useful tool for study of this type.
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Affiliation(s)
- Jian Ping Wang
- The University of Queensland, National Research Centre for Environmental Toxicology, Faculty of Health Sciences, 39 Kessels Road, Coopers Plains, Brisbane, QLD 4108, Australia
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Huang YL, Hsueh YM, Huang YK, Yip PK, Yang MH, Chen CJ. Urinary arsenic methylation capability and carotid atherosclerosis risk in subjects living in arsenicosis-hyperendemic areas in southwestern Taiwan. Sci Total Environ 2009; 407:2608-14. [PMID: 19187952 DOI: 10.1016/j.scitotenv.2008.12.061] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Revised: 12/18/2008] [Accepted: 12/22/2008] [Indexed: 05/21/2023]
Abstract
Long-term exposure to inorganic arsenic from artesian drinking well water is associated with carotid atherosclerosis in the Blackfoot Disease (BFD)-hyperendemic area in Taiwan. The current study examined the arsenic methylation capacity and its risk on carotid atherosclerosis. A total of 304 adults (158 men and 146 women) residing in the BFD-hyperendemic area were included. The extent of carotid atherosclerosis was assessed by duplex ultrasonography. Chronic arsenic exposure was estimated by an index of cumulative arsenic exposure (CAE) and the duration of artesian well water consumption. Urinary levels of inorganic arsenite [As(III)], arsenate [As(V)], monomethylarsonic acid [MMA(V)] and dimethylarsinic acid [DMA(V)] were determined by high performance liquid chromatography linked on-line to a hydride generator and atomic absorption spectrometry (HPLC-HG-AAS). The percentage of arsenic species, primary methylation index [PMI=MMA(V)/(As(III)+As(V)] and secondary methylation index [SMI=DMA(V)/MMA(V)] were calculated and employed as indicators of arsenic methylation capacity. Results showed that women and younger subjects had a more efficient arsenic methylation capacity than did men and the elderly. Carotid atherosclerosis cases had a significantly greater percentage of MMA(V) [%MMA(V)] and a lower percentage of DMA [%DMA (V)] compared to controls. Subjects in the highest two tertiles of PMI with a median of CAE >0 mg/L-year had an odds ratio (OR) and a 95% confidence interval (CI) of carotid atherosclerosis of 2.61 and 0.98-6.90 compared to those in the highest two tertiles of PMI with a CAE=0 mg/L-year. We conclude that individuals with greater exposure to arsenic and lower capacity to methylate inorganic arsenic may be at a higher risk to carotid atherosclerosis.
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Affiliation(s)
- Ya-Li Huang
- Department of Public Health, School of Medicine, Taipei Medical University, Taipei, Taiwan
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Chen YC, Xu L, Guo YLL, Su HJJ, Smith TJ, Ryan LM, Lee MS, Christiani DC. Polymorphisms inGSTT1andp53and urinary transitional cell carcinoma in south-western Taiwan: A preliminary study. Biomarkers 2008; 9:386-94. [PMID: 15764300 DOI: 10.1080/13547500400010122] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Little is known about the relevance of genetic polymorphisms to arsenic-related bladder cancer. A preliminary case-control study was conducted to explore the association between genetic polymorphisms of GSTT1, p53 codon 72 and bladder cancer in southern Taiwan, a former high arsenic exposure area. Fifty-nine urinary transitional cell carcinoma (TCC) patients from a referral centre in south-western Taiwan and 81 community controls matched on residence were recruited from 1996 to 1999. A questionnaire was administered to obtain arsenic exposure and general health information. Genotypes of p53 codon 72 and GSTT1 were analysed by polymerase chain reaction-restriction fragment length polymerase. The combined variant genotypes (heterozygous or homozygous variant) of p53 codon 72 and GSTT1 null were observed in 29% of cases and in 44% of controls, respectively. In this preliminary study, bladder cancer risk was slightly elevated for subjects carrying the variant genotype of p53 codon 72 or in subjects carrying the GSTT1 null genotype. Variants in p53 codon 72 increased the risk of bladder cancer among smokers. However, the results were not statistically significant and larger confirmatory studies are needed to clarify the role of candidate gene polymorphisms and bladder cancer risk in arsenic exposed populations.
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Affiliation(s)
- Y-C Chen
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, MA 02115, Boston, USA.
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Abstract
CONTEXT High chronic exposure to inorganic arsenic in drinking water has been related to diabetes development, but the effect of exposure to low to moderate levels of inorganic arsenic on diabetes risk is unknown. In contrast, arsenobetaine, an organic arsenic compound derived from seafood intake, is considered nontoxic. OBJECTIVE To investigate the association of arsenic exposure, as measured in urine, with the prevalence of type 2 diabetes in a representative sample of US adults. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study in 788 adults aged 20 years or older who participated in the 2003-2004 National Health and Nutrition Examination Survey (NHANES) and had urine arsenic determinations. MAIN OUTCOME MEASURE Prevalence of type 2 diabetes across intake of arsenic. RESULTS The median urine levels of total arsenic, dimethylarsinate, and arsenobetaine were 7.1, 3.0, and 0.9 mug/L, respectively. The prevalence of type 2 diabetes was 7.7%. After adjustment for diabetes risk factors and markers of seafood intake, participants with type 2 diabetes had a 26% higher level of total arsenic (95% confidence interval [CI], 2.0%-56.0%) and a nonsignificant 10% higher level of dimethylarsinate (95% CI, -8.0% to 33.0%) than participants without type 2 diabetes, and levels of arsenobetaine were similar to those of participants without type 2 diabetes. After similar adjustment, the odds ratios for type 2 diabetes comparing participants at the 80th vs the 20th percentiles were 3.58 for the level of total arsenic (95% CI, 1.18-10.83), 1.57 for dimethylarsinate (95% CI, 0.89-2.76), and 0.69 for arsenobetaine (95% CI, 0.33-1.48). CONCLUSIONS After adjustment for biomarkers of seafood intake, total urine arsenic was associated with increased prevalence of type 2 diabetes. This finding supports the hypothesis that low levels of exposure to inorganic arsenic in drinking water, a widespread exposure worldwide, may play a role in diabetes prevalence. Prospective studies in populations exposed to a range of inorganic arsenic levels are needed to establish whether this association is causal.
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Affiliation(s)
- Ana Navas-Acien
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Room W7033B, Baltimore, MD 21205, USA.
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Li L, Ekström EC, Goessler W, Lönnerdal B, Nermell B, Yunus M, Rahman A, Arifeen SE, Persson LÅ, Vahter M. Nutritional status has marginal influence on the metabolism of inorganic arsenic in pregnant Bangladeshi women. Environ Health Perspect 2008; 116:315-21. [PMID: 18335097 PMCID: PMC2265039 DOI: 10.1289/ehp.10639] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 11/15/2007] [Indexed: 05/20/2023]
Abstract
BACKGROUND The interindividual variation in metabolism of inorganic arsenic (iAs), involving methylation via one-carbon metabolism, has been well documented, but the reasons remain unclear. OBJECTIVES In this population-based study we aimed to elucidate the effect of nutrition on As methylation among women in Matlab, Bangladesh, where people are chronically exposed to iAs via drinking water. METHODS We studied effects of macronutrient status using body mass index (BMI) among 442 women in early pregnancy (gestational week 8), and effects of micronutrient status (plasma folate, vitamin B12, zinc, ferritin, and selenium) among 753 women at gestational week 14. Arsenic metabolites in urine were measured by HPLC combined with hydride generation inductively coupled plasma mass spectrometry. RESULTS The median concentration of As in urine was 97 microg/L (range, 5-1,216 microg/L, adjusted by specific gravity). The average proportions of iAs, monomethylarsonic acid, and dimethylarsinic acid in urine in gestational week 8 were 15%, 11%, and 74%, respectively. Thus, the women had efficient As methylation in spite of being poorly nourished (one-third had BMIs < 18.5 kg/m2) and having elevated As exposure, both of which are known to decrease As methylation. The metabolism of iAs was only marginally influenced by micronutrient status, probably because women, especially in pregnancy and with low folate intake, have an efficient betaine-mediated remethylation of homocysteine, which is essential for an efficient As methylation. CONCLUSIONS In spite of the high As exposure and prevalent malnutrition, overall As methylation in women in early pregnancy was remarkably efficient. The As exposure level had the greatest impact on As methylation among the studied factors.
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Affiliation(s)
- Li Li
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Walter Goessler
- Institute of Chemistry - Analytical Chemistry, Karl-Franzens University, Graz, Austria
| | - Bo Lönnerdal
- Department of Nutrition, University of California-Davis, Davis, California, USA
| | - Barbro Nermell
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mohammad Yunus
- ICDDR,B (International Centre for Diarrhoeal Disease Research, Bangladesh), Centre for Health and Population Research, Dhaka, Bangladesh
| | - Anisur Rahman
- International Maternal and Child Health, Uppsala University, Uppsala, Sweden
- ICDDR,B (International Centre for Diarrhoeal Disease Research, Bangladesh), Centre for Health and Population Research, Dhaka, Bangladesh
| | - Shams El Arifeen
- ICDDR,B (International Centre for Diarrhoeal Disease Research, Bangladesh), Centre for Health and Population Research, Dhaka, Bangladesh
| | - Lars Åke Persson
- International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Chu HA, Crawford-Brown DJ. Inorganic arsenic in drinking water and bladder cancer: a meta-analysis for dose-response assessment. Int J Environ Res Public Health 2008; 3:316-22. [PMID: 17159272 DOI: 10.3390/ijerph2006030039] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Most arsenic cancer risk assessments have been based solely on epidemiological studies to characterize the dose-response relationship for arsenic-associated cancer and to perform risk calculations. However, current epidemiological evidence is too inconsistent and fraught with uncertainty regarding arsenic exposure to provide reliable estimates. This makes it hard to draw a firm conclusion about the shape and slope of the dose-response relationship from individual studies. Meta-analysis is a statistical approach to combining results across studies and offers expanded opportunities for obtaining an improved dose-response relationship. In this study, a meta-analysis of arsenic studies was conducted by combining seven epidemiological studies from different regions to get an overall dose-response relationship between the amount of arsenic intake and the excess probability of bladder cancer. Both the fixed-effect and random-effect models were used to calculate the averaged coefficient of the linear-logistic regression model. A homogeneity test was also conducted. The final product of this research is an aggregated dose-response model in the range of empirical observation of arsenic. Considering the most recent arsenic MCL (maximum contaminant level, i.e. 10microg/L), the associated bladder cancer risk (lifetime excess probability) at this MCL is 2.29 x 10-5.
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Affiliation(s)
- Huei-An Chu
- Department of Environmental Sciences and Engineering, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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48
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Li J, Wang ZH, Zhang XD, Wang SX, Jia QZ, Han LL, Qiao XY, Wu ZM, Jing YL, Wu M. [Investigation and analysis of neonate deformity in water arsenic exposure areas]. Zhonghua Yu Fang Yi Xue Za Zhi 2008; 42:93-95. [PMID: 18642660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To explore the level and feature of neonate deformity in water arsenic exposure areas, as to finding out an evidence for the study and prevention of the arsenic exposure. METHODS The birth situation of neonate was surveyed from 1998 to 2004 in water arsenic exposure areas according to cross-sectional survey. The results were classified in accordance with ICD-10 and common surveillance of china. The population of Shanyin County served as the common people and the data were analyzed by SPSS 11.5 for windows. RESULTS The neonates surveyed were 2467 cases. There were 49 neonates deformity found in this investigation, giving a neonate deformity rate of 198.62 per 10,000 cases, which was shown significantly higher in water arsenic exposure areas than in the normal (U = 3.23, P < 0.01), with types of nervous system deformity, limbs deformity and congenital heart disease as in system classification. There was no significant difference of deformity rate in different sex neonates (chi2 = 0.32, P > 0.05). CONCLUSION The drinking high-arsenic water over a long period of time should be a risk factor of neonate deformity. Prevention and treatment of endemic arsenic exposure should be urgently needed.
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Affiliation(s)
- Jun Li
- Shanxi Institute for Prevention and Treatment of Endemic Disease, Linfen 041000, China
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49
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Barro-Traoré F, Tiendrébéogo SRM, Lallogo S, Tiendrébéogo S, Dabal M, Ouédraogo H. [Cutaneous manifestations of arsenicisme in Burkina Faso: epidemiological and clinical features]. Mali Med 2008; 23:7-11. [PMID: 19437806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The main aetiology of human arsenic toxicity provide from natural geological source. The characteristic skin lesions of arsenic toxicity may be used as an indicator of high exposure. We have registered 45 cases. The age bracket was one to 70 years. We have registered 27 women (60%) and 18 men (40%). The cutaneous manifestations have been dominated by the palmo plantar hyperkeratosis and hyperpigmentations (77,8% each one). The urinary concentrations of arsenic were 13 microg/l to 212 microg/l; they were 69 to 101 microg/l in the drinking water localized in the golden area, however they were normal outside this area. The clinical features were similar with the description of the literature. Intoxication of drinking water is problem of public health and we recommend checking all the other golden areas to find some appropriate solutions.
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Affiliation(s)
- F Barro-Traoré
- Service de Dermatologie-Vénéréologie du Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
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50
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Shah MM, Jan A, Munawwar AZ, Arif M, Ahmed R. Gastroenteritis exhumed. J Ayub Med Coll Abbottabad 2008; 20:140-142. [PMID: 19024210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Nature of presenting symptoms and even signs of disease can lead to a diagnosis that seems routine but is in fact erroneous because a sufficient index of suspicion is not generated in the mind of the physician dealing with the case. A young girl of about 16 years was brought to the Casualty Department, DHQ Hospital Bannu on 12 Sep 2004 with complains of severe vomiting and diarrhoea; the casualty medical officer diagnosed her as a case of acute gastroenteritis.
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