Complex interplay of heavy metals and renal injury: New perspectives from longitudinal epidemiological evidence.

BACKGROUND: Epidemiological studies have reported associations between heavy metals and renal function. However, longitudinal studies are required to further validate these associations and explore the interactive effects of heavy metals on renal function and their directional influence. METHOD: This study, conducted in Northeast China from 2016 to 2021, included a four-time repeated measures design involving 384 participants (1536 observations). Urinary concentrations of chromium (Cr), cadmium (Cd), manganese (Mn), and lead (Pb) were measured, along with renal biomarkers including urinary microalbumin (umAlb), urinary albumin-to-creatinine ratio (UACR), N-acetyl-ß-D-glucosaminidase (NAG), and ß2-microglobulin (ß2-MG) levels. Estimated glomerular filtration rate (eGFR) was calculated. A Linear Mixed Effects Model (LME) examined the association between individual metal exposure and renal biomarkers. Subsequently, Quantile g-computation and Bayesian Kernel Machine Regression (BKMR) models assessed the overall effects of heavy metal mixtures. Marginal Effect models examined the directional impact of metal interactions in the BKMR on renal function. RESULT: Results indicate significant impacts of individual and combined exposures of Cr, Cd, Pb, and Mn on renal biomarkers. Metal interactions in the BKMR model were observed, with synergistic effects of Cd-Cr on NAG, umAlb, UACR; Cd-Pb on NAG, UACR; Pb-Cr on umAlb, UACR, eGFR-MDRD, eGFR-EPI; and an antagonistic effect of Mn-Pb-Cr on UACR. CONCLUSION: Both individual and combined exposures to heavy metals are associated with renal biomarkers, with significant synergistic interactions leading to renal damage. Our findings elucidate potential interactions among these metals, offering valuable insights into the mechanisms linking multiple metal exposures to renal injury.

Joint and interactive effects of metal mixtures on liver damage: Epidemiological evidence from repeated-measures study.

BACKGROUND: The impact of heavy metals on liver function has been examined in numerous epidemiological studies. However, these findings lack consistency and longitudinal validation. METHODS: In this study, we conducted three follow-up surveys with 426 participants from Northeast China. Blood and urine samples were collected, along with questionnaire information. Urine samples were analyzed for concentrations of four metals (chromium [Cr], cadmium [Cd], lead [Pb], and manganese [Mn]), while blood samples were used to measure five liver function indicators (alanine aminotransferase [ALT], aspartate aminotransferase [AST], albumin [ALB], globulin [GLB], and total protein [TP]). We utilized a linear mixed-effects model (LME) to explore the association between individual heavy metal exposure and liver function. Joint effects of metal mixtures were investigated using quantile g-computation and Bayesian kernel machine regression (BKMR). Furthermore, we employed BKMR and Marginal Effect models to examine the interaction effects between metals on liver function. RESULTS: The LME results demonstrated a significant association between urinary heavy metals (Cr, Cd, Pb, and Mn) and liver function markers. BKMR results indicated positive associations between heavy metal mixtures and ALT, AST, and GLB, and negative associations with ALB and TP, which were consistent with the g-comp results. Synergistic effects were observed between Cd-Cr on ALT, Mn-Cr and Cr-Pb on ALB, while an antagonistic effect was found between Mn-Pb and Mn-Cd on ALB. Additionally, synergistic effects were observed between Mn-Cr on GLB and Cd-Cr on TP. Furthermore, a three-way antagonistic effect of Mn-Pb-Cr on ALB was identified. CONCLUSION: Exposure to heavy metals (Cr, Cd, Mn, Pb) is associated with liver function markers, potentially leading to liver damage. Moreover, there are joint and interaction effects among these metals, which warrant further investigation at both the population and mechanistic levels.

Threshold effect of urinary chromium on kidney function biomarkers: Evidence from a repeated-measures study.

Chronic kidney disease (CKD) is a public health concern worldwide, and chromium exposure may be a risk factor due to its potential nephrotoxicity. However, research on the association between chromium exposure and kidney function especially the potential threshold effect of chromium exposure is limited. A repeated-measures study involving 183 adults (641 observations) was conducted from 2017 to 2021 in Jinzhou, China. Urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were measured as kidney function biomarkers. Generalized mixed models and two-piecewise linear spline mixed models were used to assess the dose-response relationship and potential threshold effect of chromium on kidney function, respectively. Temporal analysis was conducted by the latent process mixed model to depict the longitudinal change of kidney function over age. Urinary chromium was associated with CKD (odds ratio [OR] = 1.29; 95 % confidence interval [CI], 6.41, 14.06) and UACR (Percent change = 10.16 %; 95 % CI, 6.41 %, 14.06 %), and we did not find significant association between urinary chromium and eGFR (Percent change = 0.06 %; 95 % CI, -0.80 %, 0.95 %). The threshold analyses suggested the existence of threshold effects of urinary chromium, with inflection points at 2.74 µg/L for UACR and 3.95 µg/L for eGFR. Furthermore, we found that chromium exposure exhibited stronger kidney damage over age. Our study provided evidence for the threshold effects of chromium exposure on kidney function biomarkers and the heightened nephrotoxicity of chromium in older adults. More attention should be paid to the supervision of chromium exposure concentrations for preventing kidney damage, especially in older adults.

Independent, combine and interactive effects of heavy metal exposure on dyslipidemia biomarkers: A cross-sectional study in northeastern China.

Dyslipidemia is a common disease in the older population and represents a considerable disease burden worldwide. Epidemiological and experimental studies have indicated associations between heavy metal exposure and dyslipidemia; few studies have investigated the effects of heavy metal mixture and interactions between metals on dyslipidemia. We recruited 1121 participants living in heavy metal-contaminated and control areas in northeast China from a cross-sectional survey (2017-2019). Urinary metals including chromium (Cr), cadmium (Cd), lead (Pb), and manganese (Mn) and dyslipidemia biomarkers, namely triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels, were measured. The generalized linear model (GLM) was used to explore the association of a single metal with dyslipidemia biomarkers. Bayesian kernel machine regression (BKMR) and multivariable linear regression were performed to explore the overall effect of metal mixture and the interaction between metals on dyslipidemia. Heavy metal mixture was positively associated with LDL-C, TC, and TG and negatively with HDL-C. In multivariable linear regression, Pb and Cd exhibited a synergistic association with LDL-C in the participants without hyperlipemia. Mn-Cd and Pb-Cr also showed a synergistic association with increasing the level of LDL-C in subjects without hyperlipemia. Cd-Cr showed an antagonistic association with HDL-C, respectively. Cr-Mn exhibited an antagonistic association with decreased HDL-C and TG levels. No significant interaction was noted among the three metals. Our study indicated that exposure to heavy metals is associated with dyslipidemia biomarkers and the presence of potential synergistic or antagonistic interactions between the heavy metals.

Phylogenetic and Spatiotemporal Analyses of the Complete Genome Sequences of Avian Coronavirus Infectious Bronchitis Virus in China During 1985-2020: Revealing Coexistence of Multiple Transmission Chains and the Origin of LX4-Type Virus.

Infectious bronchitis (IB) virus (IBV) causes considerable economic losses to poultry production. The data on transmission dynamics of IBV in China are limited. The complete genome sequences of 212 IBV isolates in China during 1985-2020 were analyzed as well as the characteristics of the phylogenetic tree, recombination events, dN/dS ratios, temporal dynamics, and phylogeographic relationships. The LX4 type (GI-19) was found to have the highest dN/dS ratios and has been the most dominant genotype since 1999, and the Taiwan-I type (GI-7) and New type (GVI-1) showed an increasing trend. A total of 59 recombinants were identified, multiple recombination events between the field and vaccine strains were found in 24 isolates, and the 4/91-type (GI-13) isolates were found to be more prone to being involved in the recombination. Bayesian phylogeographic analyses indicated that the Chinese IBVs originated from Liaoning province in the early 1900s. The LX4-type viruses were traced back to Liaoning province in the late 1950s and had multiple transmission routes in China and two major transmission routes in the world. Viral phylogeography identified three spread regions for IBVs (including LX4 type) in China: Northeastern China (Heilongjiang, Liaoning, and Jilin), north and central China (Beijing, Hebei, Shanxi, Shandong, and Jiangsu), and Southern China (Guangxi and Guangdong). Shandong has been the epidemiological center of IBVs (including LX4 type) in China. Overall, our study highlighted the reasons why the LX4-type viruses had become the dominant genotype and its origin and transmission routes, providing more targeted strategies for the prevention and control of IB in China.

Association between urine metals and liver function biomarkers in Northeast China: A cross-sectional study.

BACKGROUND: After heavy metals enter the body, they affect a variety of organs, particularly the main metabolic organ, the liver. Moreover, people are more likely to be exposed to multiple metals than to a single metal. We explored the associations between exposure to a heavy metal mixture and liver function biomarkers. METHODS: This study involved 1171 residents living in areas with or without heavy metal exposure in northeast China. Urine concentrations of chromium (Cr), cadmium (Cd), lead (Pb), and manganese (Mn) were measured. Total protein (TP), albumin (ALB), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were used as biomarkers of liver function. A generalized linear model (GLM), quantile g-computation, and Bayesian kernel machine regression (BKMR) were used to explore the associations between the four metals and liver function. RESULTS: GLM analysis revealed that Cr level was negatively associated with TP (ß = - 0.57; 95% CI: - 0.89, - 0.26) and ALB (ß = - 0.27; 95% CI: - 0.47, - 0.07) levels, and Cd level was positively associated with AST (ß = 1.04; 95% CI: 0.43, 1.65) and ALT (ß = 0.94; 95% CI: 0.08, 1.79) levels. ALB (ß = 0.26; 95% CI: 0.10, 0.41) and ALT (ß = 0.52; 95% CI: 0.02, 1.02) levels were positively associated with urine Mn concentration. The quantile g-computation indicated that exposure to a mixture of the four metals was significantly associated with TP (ß = - 0.56; 95% CI: - 0.94, - 0.18) and ALT (ß = 0.84; 95% CI: 0.04, 1.63) levels. Among the metals, Cr had the strongest effect on TP and Cd had that on AST. The BKMR model indicated that mixed metal exposure was negatively associated with TP and ALB levels and positively associated with ALT and AST levels. CONCLUSION: Exposure to mixtures of heavy metals may influence liver function. Cr and Cd may be the largest contributors.

Negatively interactive effect of chromium and cadmium on obesity: Evidence from adults living near ferrochromium factory.

BACKGROUND: Researchers have reported that chromium (Cr) exposure may be associated with metabolism of glucose and lipids in residents living in a long-term Cr polluted area. Previous statistical analysis is mainly focused on individual chromium exposure. Furtherly, we aim to investigated the independent, combined, and interaction effects of the co-exposure of urine Cr (UCr) with cadmium (UCd), lead (UPb) and manganese (UMn) on body mass index (BMI), waist circumference, and the risk of overweight and abdominal obesity. METHOD: We enrolled 1187 participants from annual surveys between 2017 and 2019. Heavy metal concentrations in urine were standardized using covariate-adjusted urine creatinine levels. Multiple linear/logistic regression models were applied to measure the single effect of urine heavy metal concentration on the outcomes. The quantile-based g-computation (g-comp) model was used to evaluate the combined effect of metal mixture on the outcomes and to compare the contribution of each metal. Both additive and multiplicative interactions were measured for UCr with UCd, UPb, UMn on the outcomes. Analysis was performed on the overall population and stratified by smoking habit. RESULTS: For the overall study population, UCr was positively associated with BMI (p trend = 0.023) and waist circumference (p trend = 0.018). For smoking participants, the g-comp model demonstrated that the metal mixture was negatively associated with BMI, with UCr and UCd contributing the most in the positive and negative direction. A negative additive interaction was observed between UCr and UCd on BMI and abdominal obesity. We did not observe a significant interaction effect of UCr with UPb or UMn. CONCLUSION: Our study indicated that Cr and Cd exposure may be associated with BMI and waist circumference, with combined and interaction effects of the heavy metals noted. Further epidemiological and experimental researches could simultaneously consider single and complex mixed exposure to verify the findings and biological mechanisms.

Association of environmental exposure to chromium with differential DNA methylation: An epigenome-wide study.

Introduction: Previous studies have reported that chromium (Cr)-induced epigenetic alterations and DNA methylation play a vital role in the pathogenesis of diseases induced by chromium exposure. Epigenomic analyses have been limited and mainly focused on occupational chromium exposure; their findings are not generalizable to populations with environmental Cr exposure. Methods: We identified the differential methylation of genes and regions to elucidate the mechanisms of toxicity related to environmental chromium exposure. DNA methylation was measured in blood samples collected from individuals in Cr-contaminated (n = 10) and unexposed areas (n = 10) by using the Illumina Infinium HumanMethylation850K array. To evaluate the relationship between chromium levels in urine and CpG methylation at 850 thousand sites, we investigated differentially methylated positions (DMPs) and differentially methylated regions (DMRs) by using linear models and DMRcate method, respectively. The model was adjusted for biologically relevant variables and estimated cell-type compositions. Results: At the epigenome-wide level, we identified five CpGs [cg20690919 (p FDR =0.006), cg00704664 (p FDR =0.024), cg10809143 (p FDR =0.043), cg27057652 (p FDR =0.047), cg05390480 (p FDR =0.024)] and one DMR (chr17: 19,648,718-19,648,972), annotated to ALDH3A1 genes (p < 0.05) as being significantly associated with log2 transformed urinary chromium levels. Discussion: Environmental chromium exposure is associated with DNA methylation, and the significant DMPs and DMR being annotated to cause DNA damage and genomic instability were found in this work. Research involving larger samples is required to further explore the epigenetic effect of environmental chromium exposure on health outcomes through DNA methylation.

Identification of a novel avian coronavirus infectious bronchitis virus variant with three-nucleotide-deletion in nucleocapsid gene in China.

A novel avian infectious bronchitis virus (IBV) variant, designated as GX-NN160421, was isolated from vaccinated chicken in Guangxi, China, in 2016. Based on analysis of the S1 gene sequence, GX-NN160421 belonged to the New-type 1 (GVI-1) strain. More importantly, three consecutive nucleotides (AAC) deletions were found in the highly conserved structure gene N. The serotype of GX-NN160421 was different from those of the commonly used vaccine strains. The mortality of the GX-NN160421 strain was 3.33%, which contrasted with 50% mortality in the clinical case, but high levels of virus shedding lasted at least 21 days. In conclusion, the first novel IBV variant with three-nucleotide-deletion in the N gene was identified, and this unique variant is low virulent but with a long time of virus shedding, indicating the continuing evolution of IBV and emphasizing the importance of limiting exposure to novel IBV strains as well as extensive monitoring of new IBVs.

Construction and Immunogenicity Comparison of Three Virus-Like Particles Carrying Different Combinations of Structural Proteins of Avian Coronavirus Infectious Bronchitis Virus.

Infectious bronchitis virus (IBV) poses massive economic losses in the global poultry industry. Here, we firstly report the construction and immunogenicity comparison of virus-like particles (VLPs) carrying the S, M and E proteins (SME-VLPs); VLPs carrying the S and M proteins (SM-VLPs); and VLPs carrying the M and E proteins (ME-VLPs) from the dominant serotype representative strain GX-YL5 in China. The neutralizing antibody response induced by the SME-VLPs was similar to that induced by the inactivated oil vaccine (OEV) of GX-YL5, and higher than those induced by the SM-VLPs, ME-VLPs and commercial live vaccine H120. More importantly, the SME-VLPs elicited higher percentages of CD4+ and CD8+ T lymphocytes than the SM-VLPs, ME-VLPs and OEV of GX-YL5. Compared with the OEV of GX-YL5, higher levels of IL-4 and IFN-γ were also induced by the SME-VLPs. Moreover, the mucosal immune response (sIgA) induced by the SME-VLPs in the tear and oral swabs was comparable to that induced by the H120 vaccine and higher than that induced by the OEV of GX-YL5. In the challenge experiment, the SME-VLPs resulted in significantly lower viral RNA levels in the trachea and higher protection scores than the OEV of GX-YL5 and H120 vaccines, and induced comparable viral RNA levels in the kidneys, and tear and oral swabs to the OEV of GX-YL5. In summary, among the three VLPs, the SME-VLPs carrying the S, M and E proteins of IBV could stimulate the strongest humoral, cellular and mucosal immune responses and provide effective protection, indicating that it would be an attractive vaccine candidate for IB.

Multiple exposure pathways and urinary chromium in residents exposed to chromium.

BACKGROUND: Environmental hexavalent chromium contamination in northeast China has been ongoing for over 60 years and health outcomes related with chromium (Cr) pollution were observed in polluted arears, but exposure pathways remains unclear. This study aims to evaluate the association between Cr exposure dose through multiple exposure pathways and Cr concentration in urine, and identify the most contributed pathway. METHODS: We used risk assessment tools with individual exposure parameters to estimate eight individual Cr exposure doses (CD) for three exposure routes (inhalation, ingestion, and dermal contact) with four environmental media (underground water, soil, household dust, and PM10 in ambient air) in 134 residents living in three chromium polluted villages. We used the covariate-adjusted standardized urinary Cr concentration (casUCr) as the internal Cr exposure biomarker. Ridge Regression, Weighted Quantile Sum Regression (WQS) and Bayesian Kernel Machine Regression (BKMR) models were used to assess the effect of overall eight CDs on urine Cr concentration and compare the contribution of each CD. RESULTS: In the ridge regression analysis, Cr exposure through ingestion of dust (ßstd = 0.418, p-value = 0.009), inhalation of dust (ßstd = 0.384, p = 0.031) and dermal contact with soil (ßstd = 0.264, p = 0.192) had the highest impact on casUCr. In the WQS model, the overall CDs demonstrated a non-significant positive association with casUCr. CDs of dust ingestion, air inhalation and dust inhalation had the largest contribution on casUCr when fitted in the WQS model. In the BKMR model, the hierarchical variable selection showed that casUCr was mainly affected by CDs of household dust and dermal contact with soil. CD of dermal contact with soil exhibited a negative association with casUCr, while CDs of dust showed positive or non-linear trend. CONCLUSIONS: This research proposed a new method to calculate individual Cr exposure dose of multi-pathway and applied different statistical methods to identify predominant pathway. For this study, Cr exposure through dust has the strongest effect on Cr concentration in urine. The results could help conduct target interventions to reduce Cr intake, such as blocking dust exposure to reduce Cr uptake for villagers living in these contaminated areas.

Oxidative stress and DNA damage in a long-term hexavalent chromium-exposed population in North China: a cross-sectional study.

OBJECTIVE: The International Agency for Research on Cancer classifies hexavalent chromium (Cr(VI)) as a human carcinogen. As reported, cancer mortality was higher in Cr(VI)-contaminated areas. Scientists have recommended studying its health impact on people living in contaminated areas. This study aims to evaluate the health risk for people living in Cr(VI)-contaminated areas. DESIGN: We conducted a cross-sectional study in rural areas of north-eastern China. Malondialdehyde (MDA), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) were used as oxidative stress parameters, and 8-hydroxy-2 deoxyguanosine (8-OHdG) as a DNA damage biomarker. We collected information on demographics, lifestyles and length of residence from all participants using a questionnaire. Biological specimens and environmental media samples were collected on the same day as the survey was done. We used t-test, χ2 test, Wilcoxon rank-sum test and multivariate linear regression analysis. PARTICIPANTS: The study included 319 participants exposed to Cr(VI) and 307 unexposed participants, with 447 women and 179 men. These participants met the following criteria: (1) living in the areas for more than 10 years; (2) age older than 18 years; and (3) without occupational chromium exposure. RESULTS: Our study revealed that serum concentration of MDA (p<0.001), serum activities of CAT (p<0.001) and GSH-Px (p<0.001), as well as urine concentration of 8-OHdG (p=0.008) in the exposed group were significantly higher than those in the unexposed group. However, serum SOD activity was significantly lower in the exposed group, compared with that in the unexposed group (p<0.001). Cr(VI) exposure and smoking have an interaction effect on GSH-Px activity (p<0.05). Cr(VI) exposure and alcohol drinking also have an interaction effect on GSH-Px activity (p<0.05). Longer residence in the exposed areas increased the oxidative levels (p<0.05). CONCLUSIONS: The findings of this study showed elevated oxidative stress and DNA damage in people exposed to Cr(VI).