Changes in metal levels and chromosome aberrations in the peripheral blood of patients after metal-on-metal hip arthroplasty

A prospective study was performed to investigate changes in metal levels and chromosome aberrations in patients within 2 years of receiving metal-on-metal hip arthroplasties. There was a statistically significant increase of cobalt and chromium concentrations, with a small increase in molybdenum, in whole blood at 6, 12, and 24 months after surgery. There was also a statistically significant increase of both chromosome translocations and aneuploidy in peripheral blood lymphocytes at 6, 12, and 24 months after surgery. The changes were generally progressive with time, but the change in aneuploidy was much greater than in chromosome translocations. No statistically significant correlations were found in secondary analyses between chromosome translocation indices and cobalt or chromium concentration in whole blood. Although the clinical consequences of these changes, if any, are unknown, future epidemiological studies could usefully include direct comparisons of patients with implants of different composition.

Molybdenum derived from nanomaterials incorporates into molybdenum enzymes and affects their activities in vivo

Many nanoscale biomaterials fail to reach the clinical trial stage due to a poor understanding of the fundamental principles of their in vivo behaviour. Here we describe the transport, transformation and bioavailability of MoS2 nanomaterials through a combination of in vivo experiments and molecular dynamics simulations. We show that after intravenous injection molybdenum is significantly enriched in liver sinusoid and splenic red pulp. This biodistribution is mediated by protein coronas that spontaneously form in the blood, principally with apolipoprotein E. The biotransformation of MoS2 leads to incorporation of molybdenum into molybdenum enzymes, which increases their specific activities in the liver, affecting its metabolism. Our findings reveal that nanomaterials undergo a protein corona-bridged transport-transformation-bioavailability chain in vivo, and suggest that nanomaterials consisting of essential trace elements may be converted into active biological molecules that organisms can exploit. Our results also indicate that the long-term biotransformation of nanomaterials may have an impact on liver metabolism.

Ion release in patients with metal-on-metal hip bearings in total joint replacement: a comparison with metal-on-polyethylene bearings

Polyethylene (PE) wear has been shown to be a problem in long-term joint replacement using metal-on-PE bearing. The use of metallic heads articulating with metallic cups could solve this problem: success will be enhanced if wear and corrosion of the articulating surfaces are maintained at a low level. New models with metal-on-metal bearing have been proposed, to be used mainly for young subjects: such coupling seems to have a reduced release, but it is unclear yet if the medium-term corrosion rate is really negligible or, on the contrary, it is significantly higher than in the metal-on-PE bearing. Aim of our study was the comparison of ion release in the serum of two groups of patients who had the same type of stable cementless prosthesis, but different bearing: twenty-six patients with metal-on-metal (Group A) and fifteen patients with metal-on-PE bearing (Group B) were examined. The follow-up was 14-38 months for group A and 18-34 months for group B. The serum concentration of chromium (Cr), cobalt (Co) and molybdenum (Mo) was measured. Twenty-two patients before surgery were used for comparison (Group C). The reference values were obtained from a population of twenty-two healthy subjects (Group D). Our findings indicate that metal-on-metal bearings produce a significantly higher systemic release of cobalt and chromium (ng/ml) when compared with levels found in metal-on-PE, pre-surgery and reference groups. Such a high release should induce to improve the bearing materials or, at least, to study the biologic fate of metal ions and consequently their long-term effects. In such a way a risk-to-benefit ratio for the patient could be established.

Exposure to chromium, cobalt and molybdenum from metal-on-metal total hip replacement and hip resurfacing arthroplasty

BACKGROUND

All metal implants--and metal-on-metal bearings in particular--corrode and cause a release of metal ions. Because cobalt and chromium have been shown to be carcinogenic and mutagenic in human and animal models, systemic toxicity and cancer risk are considered to be possible disadvantages of the metal-on-metal articulation. This study was designed to investigate the serum concentration profiles of chromium, cobalt and molybdenum after implantation of a Birmingham hip resurfacing arthroplasty (BHR) and a cementless total hip replacement with a 28-mm Metasul articulation (MTHR), over the first 2 years after implantation.

METHODS

We analyzed profiles of metal ion serum levels in 111 patients implanted with a BHR, in 74 patients implanted with an MTHR, and in 130 implant-free probands control subjects using atomic absorption spectrophotometry.

RESULTS

Chromium and cobalt concentrations (in microg/L) of all BHR and MTHR patients differed significantly from those of control subjects (chromium: < 0.25; cobalt: 0.25). The median chromium and cobalt concentrations in BHR patients had increased to 5.1 and 4.3 microg/L 2 years after surgery. Concentrations in BHR patient exceeded those in the unilateral MTHR patients. Molybdenum serum concentrations hardly changed over time in either group and were not significantly different from the concentrations seen in the control subjects.

INTERPRETATION

During the first 2 years after surgery, the Birmingham hip resurfacing arthroplasty leads to a significantly greater increase in serum chromium and cobalt levels than the 28-mm metal-on-metal MTHR. Observation of patients over a longer period will be necessary in order to evaluate any chronic adverse effects to the system due to elevated chromium and cobalt serum concentrations.

Environmental exposure to metals and male reproductive hormones: circulating testosterone is inversely associated with blood molybdenum

OBJECTIVE

To explore associations between exposure to metals and male reproductive hormone levels.

DESIGN

Cross-sectional epidemiology study with adjustment for potential confounders.

SETTING

University Medical Center.

PATIENT(S)

Men recruited through two infertility clinics in Michigan.

INTERVENTION(S)

Metal concentrations and reproductive hormone levels were measured in blood samples collected from 219 men.

MAIN OUTCOME MEASURE(S)

Serum FSH, LH, inhibin B, T, and sex hormone-binding globulin levels.

RESULT(S)

Cadmium, copper, and lead were all significantly or suggestively positively associated with T when modeled individually, findings that are consistent with limited previous human and animal studies. Conversely, molybdenum was associated with reduced T. A significant inverse trend between molybdenum and T remained when additionally considering other metals in the model, and a positive association between T and zinc was also found. Finally, in exploratory analysis there was evidence for an interaction between molybdenum and zinc, whereby high molybdenum was associated with a 37% reduction in T (relative to the population median level) among men with low zinc.

CONCLUSION(S)

Although reductions in T and reproductive toxicity after molybdenum exposure have been previously demonstrated in animal studies, more research is needed to determine whether molybdenum poses a risk to human reproductive health.

Trace elements status in diabetes mellitus type 2: possible role of the interaction between molybdenum and copper in the progress of typical complications

It is well established that both, the deficiency and possible overload of mineral micronutrients have adverse health effects. It is also generally accepted that non-essential xenobiotics contribute to oxidative damage, which is considered one of the principal factors in diabetes and its complications. The purpose of this work was to gain an insight on the global role of metal/metalloids in the progress of diabetes mellitus type 2. In such approach, aluminum, vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, selenium, molybdenum, mercury, cadmium and lead were determined by inductively coupled plasma-mass spectrometry (ICP-MS) in serum and urine of 76 diabetic patients (age 52 ± 8 years, 5-16 years of DM2, 52 subjects with slight-to-moderate complications and 24 with severe complications). A series of anthropometric and clinical parameters usually evaluated in the follow-up of patients were assessed by standard methods. Statistical analysis (unpaired t-test, analysis of correlation and principal component analysis) was then carried out in search of possible relationships existing among metals/metalloids and these parameters. The results obtained suggest that antagonistic interaction between molybdenum and copper might be involved in the progress of diabetes complications.

Serum metal ion exposure after total knee arthroplasty

All metal implants release metal ions because of corrosion. This has been studied and debated, especially in metal-on-metal total hip arthroplasties. Total knee arthroplasty implants have large metal surface areas and therefore substantial potential for corrosion. We determined changes in serum levels of metal ions in 41 patients after cemented unconstrained total knee arthroplasty without patellar resurfacing, 18 with unilateral total knee arthroplasty (median, 66 months after surgery) and 23 patients with bilateral total knee arthroplasties (75 and 50 months after first and second surgeries, respectively). Serum concentrations of chromium, cobalt, and molybdenum were analyzed and related to the number of total knee arthroplasties and compared with those of 130 control patients without implants. The median chromium, cobalt, and molybdenum concentrations were 0.92, 3.28, and 2.55 microg/L, respectively, in the unilateral total knee arthroplasty sample and 0.98, 4.28, and 2.40 microg/L, respectively, in the bilateral total knee arthroplasty sample. We observed no difference between the serum levels in patients with unilateral and bilateral arthroplasties, but the serum levels of chromium and cobalt of both study groups were greater than those of the control group (less than 0.25 microg/L). The patients who had total knee arthroplasty had molybdenum profiles that were similar to those of the control group (median, 2.11 microg/L).

Association of plasma and urine metals levels with kidney function: A population-based cross-sectional study in China

OBJECTIVES

Although environmental exposure to multiple metals is common, epidemiological studies on the associations of exposure to 23 metals with kidney function have not been analyzed. We aimed to investigate the associations of 23 metals levels with renal function.

METHODS

We conducted a cross-sectional study in four rural regions of Hunan province. Plasma and urine metals levels were determined by inductively coupled plasma mass spectrometer (ICP-MS). Two-level logistic regression was used to investigate the associations of metals levels with estimated glomerular filtration rate (eGFR) with adjustment for confounding factors. We conducted a sensitivity analysis of the results using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

RESULTS

A total of 3553 participants completed the investigation. Five metals (plasma arsenic and molybdenum; urine copper, rubidium, and strontium) were identified to be significantly associated with renal function. Participants in the highest quartile of plasma arsenic and molybdenum were at 17.95 (95% CI: 6.35-50.76) and 24.23 (95% CI: 7.42-79.19) fold risk of abnormal eGFR, respectively, compared with the lowest quartile. The highest quartiles of urine copper, rubidium, and strontium were associated with 3.70 (95% CI:1.92-7.14), 0.16 (95% CI:0.07-0.37) and 0.08 (95% CI: 0.03-0.21) fold risk of abnormal eGFR. The sensitivity analysis revealed that plasma arsenic, molybdenum and urine copper, rubidium and strontium levels retained similar associations with abnormal eGFR.

CONCLUSION

Plasma arsenic and molybdenum, and urine copper are risk factors for abnormal renal function, while urine rubidium and strontium are protective factors for renal function.

Determination of trace amounts of cadmium, cobalt, chromium, iron, molybdenum, nickel, selenium, titanium, vanadium and zinc in blood and milk by neutron activation analysis

The concentrations of Cd, Co, Cr, Fe, Mo, Ni, Se, Ti, V and Zn in biological fluids, human blood serum and market milk were determined by neutron activation analysis, with enrichment by coprecipitation. The pre-concentration of these trace elements was accomplished by converting the dissolved trace metal ions into their pyrrolidinedithiocarbamate (1-pyrrolidinecarbodithioate) chelates, followed by coprecipitation with a metal carrier such as Ni, Pb or Bi. The coprecipitation was carried out prior to irradiation for the short-lived nuclides (V, Ti and Se) and after irradiation for the other elements. The validity of the method was checked using certified biological reference materials; the concentrations of trace elements found by the proposed method agreed well with the published certified data. The limits of detection for Cd, Co, Cr, Fe, Mo, Ni, Se (obtained through the long-lived isotope 75Se) and Zn under the present experimental conditions were found to be 5, 5, 10, 520, 5, 70, 10 and 150 ng, respectively, for 5 ml of biological liquor. The limits of detection for Ti and V obtained (through their short-lived radionuclides 51Ti and 52V, respectively) were found to be 180 and 1.4 ng, respectively, for 50 ml of market milk, or 70 and 0.7 ng for 1 ml of blood serum.

Trace elements in obese Turkish children

The quality of the diet of obese children is poor. Eating habits may alter micronutrient status in obese patients. In this study, we determined the serum levels of selenium, zinc, vanadium, molybdenum, iron, copper, beryllium, boron, chromium, manganese, cobalt, silver, barium, aluminum, nickel, cadmium, mercury, and lead in obese Turkish children. Thirty-four obese and 33 healthy control subjects were enrolled in the study. Serum vanadium and cobalt levels of obese children were significantly lower than those of the control group (0.244 ± 0.0179 vs. 0.261 ± 0.012 μg/l, p < 0.001, and 0.14 ± 0.13 vs. 0.24 ± 0.15 μg/l, p = 0.011, respectively). There was no significant difference between groups regarding the other serum trace element levels. In conclusion, there may be alterations in the serum levels of trace elements in obese children and these alterations may have a role in the pathogenesis of obesity.

Copper metabolism in rats given di- or trithiomolybdates

As one of a series of studies on the influence of S substitution of MoO4(2-) on the action of Mo as an antagonist of Cu, the effects of MoO2S2(2-) and MoOS3(2-) on the metabolism of Cu by rats have been investigated. Administration of either oxythiomolybdate increased both plasma Cu concentration and the retention of Cu by the albumin fraction of plasma. In contrast to the effects of MoS4(2-), described previously, neither oxythiomolybdate inhibited 64Cu absorption from the digestive tract or induced biochemical or clinical signs of Cu deficiency. Evidence is discussed suggesting that the potency of the thio- and oxythiomolybdates as inhibitors of Cu utilization is directly proportional to the degree of thio substitution within the series series MoO4- chi S chi 2-.

Does ion release differ between hip resurfacing and metal-on-metal THA?

Modern metal-on-metal hip resurfacing was introduced as a bone-preserving method of joint reconstruction for young and active patients; however, the large diameter of the bearing surfaces is of concern for potential increased metal ion release. We hypothesized there were no differences in serum concentrations of chromium, cobalt, and molybdenum between patients who had metal-on-metal hip resurfacing (Group A; average head diameter, 48 mm; median followup, 24 months) and patients who had 28-mm metal-on-metal THA (Group B; median followup, 25 months). Serum concentrations also were compared with concentrations in healthy subjects. We identified no differences in ion levels between Groups A and B. A distinction was made according to gender. Women showed a higher chromium release in Group A whereas men had a higher cobalt release in Group B. Values obtained from Group A were higher than those of the control subjects. Our data suggest metal-on-metal bearings for THA should not be rejected because of concern regarding potential increased metal ion release; however, patients with elevated ion levels, even without loosening or toxicity, could be at higher risk and should be followed up periodically.

LEVEL OF EVIDENCE

Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Effects of dietary molybdenum and sulphur on the distribution of copper in plasma and kidneys of sheep

1. A 30-week study has been made in growing ewe lambs of the effects of dietary supplementation with molybdenum, or Mo plus inorganic sulphate on the distribution of copper in their blood plasma and kidneys. 2. The addition of 25 mg Mo and 5 g SO42-/kg diet increased Cu concentrations in plasma and kidney and decreased those in liver. Plasma caeruloplasmin activities (ferroxidase; EC 1.16.3.1) were unaffected. 3. Subcellular fractionation of the kidney cortex and gel filtration of the plasma and kidney cortex cytosol showed that the increased Cu content of these tissues was associated with abnormalities in the distribution of Cu. It appeared that both Cu and Mo were associated with the same proteins. 4. Dietary supplementation with Mo alone (25 mg/kg) had no effect on plasma or kidney Cu concentrations, suggesting that S metabolism is involved in the formation of the abnormal Cu-binding proteins in plasma and kidney. 5. The results are discussed in relation to the induction of Mo-induced Cu-deficiency states and the possible involvement of thiomolybdates.

Metal hypersensitivity and metal ion levels in patients with coated or uncoated total knee arthroplasty: a randomised controlled study

PURPOSE

Metal ion release by orthopaedic implants may cause local and systemic effects and induce hypersensitivity reactions. Coated implants have been developed to prevent or reduce these effects. This study was initiated to investigate the safety of a novel coating for total knee arthroplasty (TKA) implants.

METHODS

A total of 120 patients undergoing primary TKA with no history of hypersensitivity and no other metal implant were randomised to receive either a coated or uncoated implant. Chromium (Cr), cobalt (Co), molybdenum (Mb) and nickel (Ni) hypersensitivity patch testing and plasma ion concentrations were evaluated pre-operatively and one year post-operatively.

RESULTS

At the one year follow-up both groups demonstrated significant improvement in knee function and quality of life. One new weakly positive reaction to Co in the TKA group with coated implant and two doubtful skin reactions to Ni (one in each group) were noted. Even with sensitisation to implant materials no skin reactions were observed. Plasma metal ion concentrations did not increase and were not elevated at the one year follow-up in either group.

CONCLUSIONS

Sensitisation after TKA was rare and had no influence on clinical results. TKA with coated implant and standard TKA demonstrated no plasma metal ion elevation.

Determination of molybdenum in human serum by neutron activation analysis

Several investigators have reported serum molybdenum determinations in healthy humans. However, their results diverge quite widely. We determined the element by neutron activation analysis in 30 individuals. We found a mean value of 0.58 ng/ml, a standard deviation of 0.21 ng/ml and a range of 0.28--1.17 ng/ml.

The role of organic sulphur in the copper-molybdenum-S interrelationship in ruminant nutrition

1. The ability of organic and inorganic sulphur to influence the copper and molybdenum metabolism of sheep was compared in a series of three 2 X 2 factorial design experiments. In each experiment, four groups of five to seven hypocupraemic ewes were repleted with a basal diet supplemented with 6 mg Cu/kg and containing S and Mo at one of two concentrations, 1 or 4 g S and 0-5 or 4-5 mg Mo/kg respectively. Sodium sulphate (Expt I), methionine (Expt 2) or cysteine (Expt 3) were used as the S sources. Cu and Mo concentrations in plasma were estimated in each experiment and in Expt 3 the concentrations of Cu in liver and Mo in urine were also estimated. 2. The effects of the three S sources on Cu and Mo metabolism were similar. Repletion of the plasma Cu pool was unaffected by Mo alone, reduced by S alone and totally inhibited by Mo+S. Plasma Mo was greatly increased by Mo supplements, slightly decreased by S supplements and unaffected by Mo and S supplements given together. 3. In Expt 3 the treatments were found to affect urinary Mo and plasma Mo in a similar manner; S prevented dietary Mo from increasing Mo excretion. The only group to show a significant repletion of the liver Cu pool was that given Mo alone. 4. Supplementation of the diet with organic S significantly reduced the within-treatment variation in plasma Cu and Mo. liver Cu and urinary Mo. 5. It is suggested that variations in dietary S and Mo within the normal range for herbage affect the Cu and Mo metabolism of the grazing animal, and that total S rather than inorganic S is the more useful measurement in the context of the Cu-Mo-S interrelationship.

Biochemical abnormalities in workers exposed to molybdenum dust

Exposure to molybdenum in dust was measured in a molybdenite roasting plant. This exposure was accompanied by large elevations of serum ceruloplasmin and smaller increases in mean serum uric acid levels in the workers. Absorption of molybdenum from the dust was demonstrated by increases in plasma and urinary molybdenum levels. It remains necessary to demonstrate whether such exposure results in long-term health effects.

Molybdenum intake influences molybdenum kinetics in men

The objectives of this study were to determine physiologic adaptations that occur when humans are exposed to a wide range of molybdenum intake levels and to identify the pathways that are influenced by dietary intake. Four males consumed each of 5 daily molybdenum intakes of 22, 72, 121, 467, and 1490 microg/d (0.23, 0.75, 1.3, 4.9, and 15.5 micromol/d) for 24 d each. During each treatment period, oral and intravenous doses of (100)Mo and (97)Mo were administered. Serial plasma, urine, and fecal samples were analyzed for labeled and unlabeled molybdenum. Compartmental modeling was used to determine rates of distribution and elimination at each dietary intake level. Three pathways were sensitive to daily molybdenum intake. With increasing intake, absorption and urinary molybdenum excretion increased, whereas the fraction deposited in tissues decreased. Kinetic analysis suggested a daily intake of 115-120 microg/d (1.20-1.25 micromol/d) would maintain initial plasma molybdenum levels at their prestudy values and that their prestudy dietary intake was well above the Recommended Dietary Allowance of 45 microg/d. The physiological adaptations to changing intake that the model demonstrated may help prevent molybdenum deficiency and toxicity.

The release of metals from metal-on-metal surface arthroplasty of the hip

The aim of the study was to evaluate the serum and urine levels of cobalt (Co), chromium (Cr), manganese (Mn), molybdenum (Mo) and nickel (Ni) in patients who had undergone metal-on-metal hybrid surface arthroplasties on the supposition that a release of metals would occur due to the large head size of this type of implant. Metal levels were determined by using an analytical method based on sector field inductively coupled plasma mass spectrometry. Results showed a significant difference between patients and control subjects in mean levels of Co and Cr in serum (p<0.0001 and p=0.02, respectively) and in urine (p<0.0001 for both). No significant differences were observed in mean serum and urinary levels of Mn, Mo and Ni. Although the clinical consequences of these changes, if any, are unknown, further studies could be performed in a larger number of subjects implanted with a total surface arthroplasty at follow-up times over different periods.

Maternal-foetal status of copper, iron, molybdenum, selenium and zinc in obese gestational diabetic pregnancies

Obesity is well known to be a contributory risk factor for several disease states, including diabetes mellitus. Paucity of data on maternal-foetal status of essential trace elements in obese diabetic pregnancies prompted us to undertake this study. Maternal venous and umbilical arterial and venous blood samples were collected from obese gestational diabetic patients (Body Mass Index (BMI) >30) and control obese pregnant women (BMI>30) at time of spontaneous delivery or caesarean sections and concentrations of essential trace elements such as Cu, Fe, Mo, Se and Zn were determined in various samples by atomic absorption spectrophotometry. Activities of antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPX) and total antioxidant (TAO) in maternal and umbilical blood were assessed using appropriate reagent kits. Maternal-foetal disposition and exchange parameters of elements studied were assessed using established criteria. Concentrations of Cu, Fe, Mo, Se and Zn in serum of control obese pregnant women (n=10) averaged 2404, 2663, 11.0, 89.0 and 666 microg/l respectively, while in the obese diabetic group (n=11), the corresponding values averaged 2441, 2580, 13.3, 85.1 and 610 microg/l respectively. Activities of antioxidant enzymes such as SOD, GPX and TAO were not significantly different in maternal veins of control and diabetic groups. Varying differences were noted in the case of antioxidant enzyme activities in umbilical blood samples of control and study groups. We conclude that obesity is not associated with significant alterations in antioxidant enzyme status in gestational diabetes and only with relatively minor alterations in status of some essential trace elements.

Plasma molybdenum reflects dietary molybdenum intake

The relationship between plasma molybdenum (Mo) and dietary intake has not been investigated in humans. We developed an isotope dilution method to determine molybdenum in 0.5 mL blood plasma by ICP-MS and conducted a study to determine the effect of dietary intake on plasma molybdenum. Twelve young men consumed a very low Mo diet (22 microg/day) for 24 days while confined to the WHNRC metabolic research unit and plasma molybdenum was monitored. (97)Mo was infused in four of the subjects (Group 1) to follow its clearance from the blood. The other eight remained in unit for 120 days (an additional 96 days). Four consumed the 22 microg/day molybdenum diet for 102 days followed by 467 microg/day for 18 days (Group 2). and four consumed five levels of dietary molybdenum for 24 days each (Group 3). (100)Mo was added to the diet one or more times at each dietary level. Total plasma molybdenum and (100)Mo were monitored throughout the study. Plasma molybdenum in the 12 subjects decreased from 8.2 +/- 0.5 to 6.1 +/- 0.5 nmol/L after 13 days of low molybdenum intake and was 5.1 +/- 0.5 nmol/L after 24 days. In Group 2, average plasma molybdenum was 7.8 +/- 0.9 nmol/L at the beginning of the study, 5.4 +/- 0.4 nmol/L during the 102 days low molybdenum period, and 16.5 +/- 0.6 nmol/L during the high molybdenum period. Plasma molybdenum in Group 3 was 4.2 +/- 2.1 nmol/L at 22 microg/day; 5.8 +/- 2.5 nmol/L at 72 microg/day; 6.6 +/- 2.3 nmol/L at 121 microg/day; 19.7 nmol/L +/-2.1 at 467 microg/day; and 43.9 +/- 2.1 nmol/L at 1490 microg/day. The results demonstrate that, in contrast to most other essential minerals, plasma molybdenum reflects low and high dietary molybdenum intakes within 14 days and may a useful indicator of low and high dietary intakes.

Comparative mechanism and toxicity of tetra- and dithiomolybdates in the removal of copper

Tetrathiomolybdate (TTM) can be used as a specific chelator to remove copper (Cu) accumulating in the form bound to metallothionein (MT) in the livers of Wilson disease patients and Long-Evans rats with a cinnamon-like coat color (LEC rats). However, an adverse effect, hepatotoxicity, was observed occasionally on its clinical application. The mechanism underlying the adverse effect of TTM has been studied in comparison with dithiomolybdate (DTM), and a safer and more effective therapy by TTM was proposed based on the mechanism. The activity of glutamic-pyruvic transaminase (GPT) in serum was shown to increase significantly on the treatment of Wistar rats with sulfide produced through hydrolytic degradation of TTM and DTM, the latter being more easily degraded. The hydrolytic degradation of TTM was enhanced under acidic conditions. Cu in Cu-containing enzymes such as Cu,Zn-superoxide dismutase (SOD) in liver and ceruloplasmin (Cp) in plasma was decreased by excessive thiomolybdates, the Cu being found in the plasma in the form of a Cu/thiomolybdate/albumin complex. The decreased amounts of Cu in SOD and Cp were explained by the sequestration of Cu from their chaperones by thiomolybdates rather than the direct removal of Cu from the enzymes. Although both TTM and DTM remove Cu from MT, DTM is not appropriate as a therapeutic agent for Wilson disease due to its easy hydrolysis and production of sulfide.

Chromate transport in human leukocytes

Chromium is a trace metal of importance in human physiology and, in addition, as 51-chromate, has been extensively used as a label in the study of blood cell pool sizes and intravascular kinetics. The transport characteristics of 51-chromate were investigated in normal human leukocytes. Chromate uptake is unidirectional over a 1 hr incubation with extracellular chromate concentrations up to 200 mumoles/liter. Under these conditions, intracellular 51-chromium is in a form in which it is nonexchangeable. Influx is temperature sensitive with a Q(10) of approximately 2 and may be energy dependent since a variety of metabolic poisons strongly inhibit uptake. The unidirectional influx of chromate follows Michaelis-Menten kinetics; the maximum velocity is 52 mmumoles/g dry weight of cells per min and the chromate concentration at which influx velocity is half maximal is 87 mumoles/liter. This transport mechanism is highly specific for chromate; other divalent tetrahedral anions only slightly inhibit influx at concentrations up to 10 times that of chromate. Metavanadate, however, competitively inhibits chromate influx at equimolar concentrations. Exposure of cells to unlabeled chromate leads to inhibition of subsequent influx of 51-chromate. It is suggested that this is due to a primary inhibitory effect of chromate on cellular energy metabolism.