Elevated blood lead and cadmium levels associated with chronic infections among non-smokers in a cross-sectional analysis of NHANES data
Tóm tắt
Experimental animal studies, in vitro experiments, and clinical assessments have shown that metal toxicity can impair immune responses. We analyzed data from a United States representative National Health and Nutrition Examination Survey (NHANES) to explore associations between chronic infections and elevated blood concentrations of lead and cadmium among non-smoking NHANES participants. NHANES data from 1999 to 2012 were examined and weighted to represent the United States population. Multivariable logistic regression was used to estimate adjusted odds ratios (AOR) and 95 % confidence intervals (CI) for heavy metal associations with seropositivity for Helicobacter pylori, Toxoplasma gondii, and Hepatitis B virus (HBV) infections. Available 2-year survey cycles for infection seroprevalence varied by pathogen, from 1 to 7 cycles. Available sample size, disease seroprevalence, and participant age range also varied by pathogen of interest. After controlling for demographic characteristics and general health condition, an elevated blood lead level above the survey population median was significantly associated with seropositivity for all three pathogens (AORs = 1.2–1.5). In addition, an elevated blood cadmium level above the median was significantly associated with HBV (AOR = 1.5; 95 % CI = 1.2–2.0) and H. pylori (AOR = 1.5; 95 % CI = 1.2–1.7) seropositivity. Age-specific analyses for H. pylori and T. gondii indicated stronger associations among children under 13 years of age, particularly for lead exposure and H. pylori seropositivity, and weaker associations among those over 35 years of age. The results of this cross-sectional human health survey suggest that the immunological effects of lead and cadmium toxicity may be associated with an increased susceptibility to chronic infections.
Tài liệu tham khảo
Bernier J, Brousseau P, Krzystyniak K, Tryphonas H, Fournier M. Immunotoxicity of heavy metals in relation to Great Lakes. Environ Health Perspect. 1995;103 Suppl 9:23–34.
Razani-Boroujerdi S, Edwards B, Sopori ML. Lead stimulates lymphocyte proliferation through enhanced T cell-B cell interaction. J Pharmacol Exp Ther. 1999;288(2):714–9.
Krocova Z, Macela A, Kroca M, Hernychova L. The immunomodulatory effect(s) of lead and cadmium on the cells of immune system in vitro. Toxicol In Vitro. 2000;14(1):33–40.
Valentino M, Rapisarda V, Santarelli L, Bracci M, Scorcelletti M, Di Lorenzo L, et al. Effect of lead on the levels of some immunoregulatory cytokines in occupationally exposed workers. Hum Exp Toxicol. 2007;26(7):551–6.
Mishra KP, Singh VK, Rani R, Yadav VS, Chandran V, Srivastava SP, et al. Effect of lead exposure on the immune response of some occupationally exposed individuals. Toxicology. 2003;188(2-3):251–9.
Marth E, Barth S, Jelovcan S. Influence of cadmium on the immune system. Description of stimulating reactions. Cent Eur J Public Health. 2000;8(1):40–4.
Mishra KP. Lead exposure and its impact on immune system: a review. Toxicol In Vitro. 2009;23(6):969–72.
Rager JE, Yosim A, Fry RC. Prenatal exposure to arsenic and cadmium impacts infectious disease-related genes within the glucocorticoid receptor signal transduction pathway. Int J Mol Sci. 2014;15(12):22374–91.
Garcia-Leston J, Roma-Torres J, Mayan O, Schroecksnadel S, Fuchs D, Moreira AO, et al. Assessment of immunotoxicity parameters in individuals occupationally exposed to lead. J Toxicol Environ Health A. 2012;75(13-15):807–18.
Zelikoff JT, Bowser D, Squibb KS, Frenkel K. Immunotoxicity of low level cadmium exposure in fish: an alternative animal model for immunotoxicological studies. J Toxicol Environ Health. 1995;45(3):235–48.
Abadin H, Ashizawa A, Stevens YW, et al. Toxicological Profile for Lead. Atlanta (GA): Agency for Toxic Substances and Disease Registry (US); 2007 Aug. Available from:http://www.ncbi.nlm.nih.gov/books/NBK158766/.
Henn SA, Sussell AL, Li J, Shire JD, Alarcon WA, Tak S. Characterization of lead in US workplaces using data from OSHA's integrated management information system. Am J Ind Med. 2011;54(5):356–65.
Tsydenova O, Bengtsson M. Chemical hazards associated with treatment of waste electrical and electronic equipment. Waste Manag. 2011;31(1):45–58.
Faroon O, Ashizawa A, Wright S, Tucker P, Jenkins K, Ingerman L, Rudisill C. Toxicological profile for cadmium. Atlanta; 2012.
Andersen O, Nielsen JB, Nordberg GF. Nutritional interactions in intestinal cadmium uptake--possibilities for risk reduction. Biometals. 2004;17(5):543–7.
Bernard A. Cadmium & its adverse effects on human health. Indian J Med Res. 2008;128(4):557–64.
Jarup L, Hellstrom L, Alfven T, Carlsson MD, Grubb A, Persson B, et al. Low level exposure to cadmium and early kidney damage: the OSCAR study. Occup Environ Med. 2000;57(10):668–72.
Integrated Risk Information System Chemical Assessment Summary for Cadmium (CASRN 7440-43-9). United States Environmental Protection Agency, National Center for Environmental Assessment. Washington, DC. Last revised 3-31-1987. Available fromhttp://cfpub.epa.gov/ncea/iris/iris_documents/documents/subst/0141_summary.pdf.
CDC. National Health and Nutrition Examination Survey Data. Hyattsville: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2013.
Johnson CL, Paulose-Ram R, Ogden CL, Carroll MD, Kruszon-Moran D, Dohrmann SM, Curtin LR. National health and nutrition examination survey: analytic guidelines, 1999-2010. Vital Health Stat 2. 2013 (161):1–24.
CDC. National Health and Nutrition Examination Survey Laboratory Protocol 11: Helicobacter pylori IgG antibodies in serum by enzyme immunoassay. Hyattsville: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2008.
Miller DT, Paschal DC, Gunter EW, Stroud PE, D'Angelo J. Determination of lead in blood using electrothermal atomisation atomic absorption spectrometry with a L'vov platform and matrix modifier. Analyst. 1987;112(12):1701–4.
Parsons PJ, Slavin W. A rapid Zeeman graphite furnace atomic absorption spectrometric method for the determination of lead in blood. Spectrochimica Acta. 1993;48B(6/7):15.
Stoeppler M, Brandt K. Determination of cadmium in whole blood and urine by electrothermal atomic-absorption spectrophotometry. Fresenius Z Anal Chem. 1980;300:9.
CDC Division of Laboratory Sciences. Laboratory Protocol Blood Cadmium and Lead Atomic Absorption Spectroscopy. Method No. 1090A/02-OD, Revised August 22, 2001. Atlanta: National Center for Environmental Health; 2001.
Jones RL. Laboratory Procedure Manual. In: Lead and Cadmium (ICPMS) in Whole Blood, NHANES 2005-2006. Atlanta: Inorganic Toxicology and Nutrition, Division of Laboratory Sciences, National Center for Environmental Health; 2004. p. 40.
Caruso RV, O'Connor RJ, Stephens WE, Cummings KM, Fong GT. Toxic metal concentrations in cigarettes obtained from U.S. smokers in 2009: results from the International Tobacco Control (ITC) United States survey cohort. Int J Environ Res Public Health. 2014;11(1):202–17.
Hukkanen J, Jacob 3rd P, Benowitz NL. Metabolism and disposition kinetics of nicotine. Pharmacol Rev. 2005;57(1):79–115.
Monzon H, Forne M, Esteve M, Rosinach M, Loras C, Espinos JC, et al. Helicobacter pylori infection as a cause of iron deficiency anaemia of unknown origin. World J Gastroenterol. 2013;19(26):4166–71.
Hosmer DW, Lemeshow S. Confidence interval estimation of interaction. Epidemiology. 1992;3(5):452–6.
Checconi P, Sgarbanti R, Celestino I, Limongi D, Amatore D, Iuvara A, et al. The environmental pollutant cadmium promotes influenza virus replication in MDCK cells by altering their redox state. Int J Mol Sci. 2013;14(2):4148–62.
Frisk P, Molin Y, Ilback NG. Tissue uptake of mercury is changed during the course of a common viral infection in mice. Environ Res. 2008;106(2):178–84.
Seth P, Husain MM, Gupta P, Schoneboom A, Grieder BF, Mani H, et al. Early onset of virus infection and up-regulation of cytokines in mice treated with cadmium and manganese. Biometals. 2003;16(2):359–68.
Sheehan MC, Burke TA, Breysse PN, Navas-Acien A, McGready J, Fox MA. Association of markers of chronic viral hepatitis and blood mercury levels in US reproductive-age women from NHANES 2001-2008: a cross-sectional study. Environ Health. 2012;11:62.
Xu X, Hu H, Dailey AB, Kearney G, Talbott EO, Cook RL. Potential health impacts of heavy metals on HIV-infected population in USA. PLoS One. 2013;8(9). e74288.
Hu H, Scheidell J, Xu X, Coatsworth AM, Khan MR. Associations between blood lead level and substance use and sexually transmitted infection risk among adults in the United States. Environ Res. 2014;135:21–30.
Cardenas A, Smit E, Houseman EA, Kerkvliet NI, Bethel JW, Kile ML. Arsenic exposure and prevalence of the Varicella Zoster virus in the United States: NHANES (2003-2004 and 2009-2010). Environ Health Perspect. 2015;123(6):590–6.
Mudipalli A. Lead hepatotoxicity & potential health effects. Indian J Med Res. 2007;126(6):518–27.
Rikans LE, Yamano T. Mechanisms of cadmium-mediated acute hepatotoxicity. J Biochem Mol Toxicol. 2000;14(2):110–7.
Gainer JH. Lead aggravates viral disease and represses the antiviral activity of interferon inducers. Environ Health Perspect. 1974;7:113–9.
Sell S, Ilic Z. Dietary cadmium may enhance the progression of hepatocellular tumors in hepatitis B transgenic mice. Carcinogenesis. 1994;15(9):2057–60.
Xu X, Chen X, Zhang J, Guo P, Fu T, Dai Y, et al. Decreased blood hepatitis B surface antibody levels linked to e-waste lead exposure in preschool children. J Hazard Mater. 2015;298:122–8.
Al-Jubbawy AAHS, Wtwt MAA, Shirafy ANA. Correlation of some trace elements and chronic hepatitis B infections in Babylon. J Nat Sci Res. 2013;3(6):6.
Robert-Gangneux F, Darde ML. Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev. 2012;25(2):264–96.
Webster JP, Lamberton PH, Donnelly CA, Torrey EF. Parasites as causative agents of human affective disorders? The impact of anti-psychotic, mood-stabilizer and anti-parasite medication on Toxoplasma gondii's ability to alter host behaviour. Proc Biol Sci. 2006;273(1589):1023–30.
Mauel J, Ransijn A, Buchmuller-Rouiller Y. Lead inhibits intracellular killing of Leishmania parasites and extracellular cytolysis of target cells by macrophages exposed to macrophage activating factor. J Leukoc Biol. 1989;45(5):401–9.
Dorer MS, Talarico S, Salama NR. Helicobacter pylori's unconventional role in health and disease. PLoS Pathog. 2009;5(10):e1000544.
Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1(8390):1311–5.
Suzuki R, Shiota S, Yamaoka Y. Molecular epidemiology, population genetics, and pathogenic role of Helicobacter pylori. Infect Genet Evol. 2012;12(2):203–13.
Ruggiero P. Helicobacter pylori and inflammation. Curr Pharm Des. 2010;16(38):4225–36.
Dooley CP, Cohen H, Fitzgibbons PL, Bauer M, Appleman MD, Perez-Perez GI, et al. Prevalence of Helicobacter pylori infection and histologic gastritis in asymptomatic persons. N Engl J Med. 1989;321(23):1562–6.
Stahler FN, Odenbreit S, Haas R, Wilrich J, Van Vliet AH, Kusters JG, et al. The novel Helicobacter pylori CznABC metal efflux pump is required for cadmium, zinc, and nickel resistance, urease modulation, and gastric colonization. Infect Immun. 2006;74(7):3845–52.
Diacomanolis V, Noller BN, Ng JC. Bioavailability and pharmacokinetics of arsenic are influenced by the presence of cadmium. Chemosphere. 2014;112:203–9.
Wang G, Fowler BA. Roles of biomarkers in evaluating interactions among mixtures of lead, cadmium and arsenic. Toxicol Appl Pharmacol. 2008;233(1):92–9.
Exon JH, Koller LD, Kerkvliet NI. Lead-cadmium interaction: effects on viral-induced mortality and tissue residues in mice. Arch Environ Health. 1979;34(6):469–75.
Cobbina SJ, Chen Y, Zhou Z, Wu X, Feng W, Wang W, et al. Low concentration toxic metal mixture interactions: effects on essential and non-essential metals in brain, liver, and kidneys of mice on sub-chronic exposure. Chemosphere. 2015;132:79–86.
Hambach R, Lison D, D'Haese PC, Weyler J, De Graef E, De Schryver A, et al. Co-exposure to lead increases the renal response to low levels of cadmium in metallurgy workers. Toxicol Lett. 2013;222(2):233–8.
Kim Y, Ha EH, Park H, Ha M, Kim Y, Hong YC, et al. Prenatal lead and cadmium co-exposure and infant neurodevelopment at 6 months of age: the Mothers and Children's Environmental Health (MOCEH) study. Neurotoxicology. 2013;35:15–22.
Clemow YH, Wilkie MP. Effects of Pb plus Cd mixtures on toxicity, and internal electrolyte and osmotic balance in the rainbow trout (Oncorhynchus mykiss). Aquat Toxicol. 2015;161:176–88.
Sobus JR, DeWoskin RS, Tan YM, Pleil JD, Phillips MB, George BJ, et al. Uses of NHANES biomarker data for chemical risk assessment: trends, challenges, and opportunities. Environ Health Perspect. 2015;123(10):919–27.
Laschi-Loquerie A, Eyraud A, Morisset D, Sanou A, Tachon P, Veysseyre C, et al. Influence of heavy metals on the resistance of mice toward infection. Immunopharmacol Immunotoxicol. 1987;9(2-3):235–41.
Shrivastava R, Upreti RK, Seth PK, Chaturvedi UC. Effects of chromium on the immune system. FEMS Immunol Med Microbiol. 2002;34(1):1–7.