Assessment of Some Heavy Metals and Trace Elements in a Sample of Patients with Viral Hepatitis in Baghdad

Najlaa Fattah-Allah Rasheed; Hind Salman Jassim; Ahmad Saadi Hassan

doi:10.51173/jt.v4i3.507

Authors

Najlaa Fattah-Allah Rasheed Laboratories Department, Balad General Hospital, Iraqi Ministry of Health, Salah Al-Din, Iraq
Hind Salman Jassim Technical Institute / Baquba, Middle Technical University, Baghdad, Iraq.
Ahmad Saadi Hassan College of Health & Medical Technology - Baghdad, Middle Technical University, Baghdad, Iraq

DOI:

https://doi.org/10.51173/jt.v4i3.507

Keywords:

HBV, HCV, Heavy metal, Trace element

Abstract

The liver is a vital metabolic organ that performs a variety of complex biochemical functions such as metabolism, detoxification, and excretion. Impairment of liver functions disrupts trace element metabolism, causing oxidative stress, which subsequently leads to liver inflammation and fibrosis. This study aims to evaluate zinc (Zn), copper (Cu), iron (Fe), cadmium (Cd), and lead (Pb) levels in chronic viral hepatitis (HBV or HCV) patients in Baghdad. One hundred fifty samples of blood were collected from fifty patients with hepatitis B, fifty patients with hepatitis C, and fifty individuals without viral hepatitis as controls at the Gastroenterology and Hepatology Teaching Hospital in Baghdad during the period from November 2021 to March 2022. Patients with viral hepatitis had highly significant elevated levels of lead, cadmium, and copper compared with the controls (P-value = 0.000), whereas zinc and iron levels were highly significantly lower in the patient groups than in the control group (P-value = 0.000). In conclusion, viral hepatitis patients showed varying levels of zinc, copper, iron, cadmium, and lead compared to healthy controls.

Downloads

Download data is not yet available.

References

Karimkhanilouyi S, Ghorbian S. Nucleic acid vaccines for hepatitis B and C virus. Infect Genet Evol. 2019;75:103968.

Wang C, Cheng P-N, Kao J-H. Systematic review: chronic viral hepatitis and metabolic derangement. Aliment Pharmacol Ther. 2020 Jan 1;51.

Osna NA, Donohue Jr TM, Kharbanda KK. Alcoholic liver disease: pathogenesis and current management. Alcohol Res Curr Rev. 2017;38(2):147.

Himoto T, Masaki T. Current trends of essential trace elements in patients with chronic liver diseases. Nutrients. 2020;12(7):1–22.

García-Niño WR, Pedraza-Chaverrí J. Protective effect of curcumin against heavy metals-induced liver damage. Food Chem Toxicol. 2014;69:182–201.

Nyarko E. Cadmium, Arsenic And Lead Levels In Persons With Chronic Hepatitis B In The Ejura-Sekyedumase District, Ghana. University of Ghana; 2015.

Al-Fartusie F, Mohssan S. Essential Trace Elements and Their Vital Roles in Human Body. Indian J Adv Chem Sci. 2017 Jan 1;5:127–36.

Batanova VG, Sobolev A V, Magnin V. Trace element analysis by EPMA in geosciences: Detection limit, precision, and accuracy. In: IOP Conference Series: Materials Science and Engineering. IOP Publishing; 2018. p. 12001.

Ali H, Khan E. What are heavy metals? Long-standing controversy over the scientific use of the term ‘heavy metals’–proposal of a comprehensive definition. Toxicol Environ Chem. 2018;100(1):6–19.

Kim J-J, Kim Y-S, Kumar V. Heavy metal toxicity: An update of chelating therapeutic strategies. J Trace Elem Med Biol. 2019;54:226–31.

Attar T. A mini-review on importance and role of trace elements in the human organism. Chem Rev Lett. 2020;3(3):117–30.

Guo C-H, Chen P-C, Lin K-P, Shih M-Y, Ko W-S. Trace metal imbalance associated with oxidative stress and inflammatory status in anti-hepatitis C virus antibody positive subjects. Environ Toxicol Pharmacol. 2012;33(2):288–96.

Agarwal A, Avarebeel S, Choudhary NS, Goudar M, Tejaswini CJ. Correlation of Trace Elements in Patients of Chronic Liver Disease with Respect to Child- Turcotte- Pugh Scoring System. J Clin Diagn Res [Internet]. 2017/09/01. 2017 Sep;11(9): OC25–8. Available from: https://pubmed.ncbi.nlm.nih.gov/29207755

Nordberg M, Nordberg GF. Trace element research-historical and future aspects. J trace Elem Med Biol organ Soc Miner Trace Elem. 2016 Dec;38:46–52.

Roohani N, Hurrell R, Kelishadi R, Schulin R. Zinc and its importance for human health: An integrative review. J Res Med Sci Off J Isfahan Univ Med Sci. 2013;18(2):144.

Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metab. 2013;62(Suppl. 1):19–29.

Osredkar J, Sustar N. Copper, and zinc, biological role and significance of copper/zinc imbalance. J Clin Toxicol S. 2011;3(2161):495.

Polishchuk E V, Concilli M, Iacobacci S, Chesi G, Pastore N, Piccolo P, et al. Wilson disease protein ATP7B utilizes lysosomal exocytosis to maintain copper homeostasis. Dev Cell. 2014;29(6):686–700.

Xue-Shan Z, Qi W, Zhong R, Li-hong P, Zhi-han T, Zhi-sheng J, et al. Imbalanced cholesterol metabolism in Alzheimer’s disease. Clin Chim Acta. 2016;456:107–14.

Kodama H, Fujisawa C, Bhadhprasit W. Inherited copper transport disorders: biochemical mechanisms, diagnosis, and treatment. Curr Drug Metab. 2012;13(3):237–50.

Dev S, Babitt JL. Overview of iron metabolism in health and disease. Hemodial Int. 2017;21:S6–20.

Waldvogel-Abramowski S, Waeber G, Gassner C, Buser A, Frey BM, Favrat B, et al. Physiology of iron metabolism. Transfus Med Hemotherapy. 2014;41(3):213–21.

Teerasarntipan T, Chaiteerakij R, Prueksapanich P, Werawatganon D. Changes in inflammatory cytokines, antioxidants and liver stiffness after chelation therapy in individuals with chronic lead poisoning. BMC Gastroenterol [Internet]. 2020;20(1):263. Available from: https://doi.org/10.1186/s12876-020-01386-w

Rehman K, Fatima F, Waheed I, Akash MSH. Prevalence of exposure of heavy metals and their impact on health consequences. J Cell Biochem. 2018;119(1):157–84.

Flora G, Gupta D, Tiwari A. Toxicity of lead: a review with recent updates. Interdiscip Toxicol. 2012;5(2):47.

Wu X, Cobbina SJ, Mao G, Xu H, Zhang Z, Yang L. A review of toxicity and mechanisms of individual and mixtures of heavy metals in the environment. Environ Sci Pollut Res. 2016;23(9):8244–59.

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.

Hossein-Khannazer N, Azizi G, Eslami S, Alhassan Mohammed H, Fayyaz F, Hosseinzadeh R, et al. The effects of cadmium exposure in the induction of inflammation. Immunopharmacol Immunotoxicol. 2020;42(1):1–8.

Aldabagh M, I Kader S, M Ali N. • Serum levels of copper, zinc, iron, and magnesium in Iraqis patient with chronic hepatitis C. Kerbala J Med. 2011;4(10):1146–50.

Larjushina I, Notova s. V, Duskaeva AK, Tarasova EI. Influence of deficient nutrition on trace element status and antioxidant defense system. IOP Conf Ser Earth Environ Sci. 2019 Nov 15;341:12180.

Huang Y, Zhang Y, Lin Z, Han M, Cheng H. Altered serum copper homeostasis suggests higher oxidative stress and lower antioxidant capability in patients with chronic hepatitis B. Medicine (Baltimore). 2018;97(24).

Wołonciej M, Milewska E, Roszkowska-Jakimiec W. Trace elements as an activator of antioxidant enzymes [Internet]. Vol. 70, Postepy higieny i medycyny doswiadczalnej (Online). Zakład Analizy Instrumentalnej,Uniwersytet Medyczny w Białymstoku.; 2016. p. 1483–98. Available from: http://europepmc.org/abstract/MED/28100855

Olechnowicz J, Tinkov A, Skalny A, Suliburska J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci. 2018;68(1):19–31.

Kora MAEA, Tawfeek AR, Sakr MA. The value of serum zinc in early detection of nephropathy in type 2 diabetic patients. Menoufia Med J. 2019;32(3):910.

Choi S, Liu X, Pan Z. Zinc deficiency and cellular oxidative stress: prognostic implications in cardiovascular diseases. Acta Pharmacol Sin. 2018;39(7):1120–32.

Halfdanarson TR, Kumar N, Li C, Phyliky RL, Hogan WJ. Hematological manifestations of copper deficiency: a retrospective review. Eur J Haematol. 2008;80(6):523–31.

Jaiser SR, Winston GP. Copper deficiency myelopathy. J Neurol [Internet]. 2010/03/16. 2010 Jun;257(6):869–81. Available from: https://pubmed.ncbi.nlm.nih.gov/20232210

Gupta S, Read SA, Shackel NA, Hebbard L, George J, Ahlenstiel G. The role of micronutrients in the infection and subsequent response to hepatitis C virus. Cells. 2019;8(6):603.

Bayraktar N, Bayraktar M. Evaluation of serum proinflammatory cytokines, oxidative stress, and other biochemical markers in chronic viral hepatitis B and C infections. Int J Med Biochem. 2020;3(2):101–5.

Mohammad MK, Zhou Z, Cave M, Barve A, McClain CJ. Zinc and liver disease. Nutr Clin Pract Off Publ Am Soc Parenter Enter Nutr. 2012 Feb;27(1):8–20.

Nangliya V, Sharma A, Yadav D, Sunder S, Nijhawan S, Mishra S. Study of trace elements in liver cirrhosis patients and their role in prognosis of disease. Biol Trace Elem Res. 2015 May;165(1):35–40.

Kalkan A, Bulut V, Avci S, Celik I, Bingol NK. Trace elements in viral hepatitis. J trace Elem Med Biol. 2002;16(4):227–30.

Gonzaga ER, Guiance IR, Henriquez R, Mortimore G, Freeman J. The Role of the Liver in Iron Homeostasis and What Goes Wrong? J Ren Hepatic Disord. 2021;5(2):26–33.

Gkamprela E, Deutsch M, Pectasides D. Iron deficiency anemia in chronic liver disease: etiopathogenesis, diagnosis, and treatment. Ann Gastroenterol. 2017;30(4):405.

HASSAN AH, SALIH SS, SALIM AK. Comparing the Levels of Some Trace Elements with Liver Enzymes in Chronic Renal Failure Patients with Viral Hepatitis B and or C. Int J Pharm Res. 2020;12(1).

Ganz T. Hepcidin and iron regulation, 10 years later. Blood, J Am Soc Hematol. 2011;117(17):4425–33.

Yang H-H, Chen G-C, Li D-M, Lan L, Chen L-H, Xu J-Y, et al. Serum iron and risk of nonalcoholic fatty liver disease and advanced hepatic fibrosis in US adults. Sci Rep. 2021;11(1):1–11.

Krueger WS, Wade TJ. Elevated blood lead and cadmium levels associated with chronic infections among non-smokers in a cross-sectional analysis of NHANES data. Environ Heal. 2016;15(1):1–13.

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.

Andjelkovic M, Buha Djordjevic A, Antonijevic E, Antonijevic B, Stanic M, Kotur-Stevuljevic J, et al. Toxic effect of acute cadmium and lead exposure in rat blood, liver, and kidney. Int J Environ Res Public Health. 2019;16(2):274.

Alissa EM, Ferns GA. Heavy metal poisoning and cardiovascular disease. J Toxicol. 2011Sep;2011.

Assi MA, Hezmee MNM, Abd Wahid Haron MYM, Sabri MAR. The detrimental effects of lead on human and animal health. Vet world. 2016;9(6):660.

Alhusaini A, Fadda L, Hasan IH, Ali HM, El Orabi NF, Badr AM, et al. Arctium lappa root extract prevents Lead-induced liver injury by attenuating oxidative stress and inflammation and activating Akt/GSK-3β signaling. Antioxidants. 2019;8(12):582.

Adikwu E, Deo O, Geoffrey OBP. Hepatotoxicity of cadmium and roles of mitigating agents. Br J Pharmacol Toxicol. 2013;4(6):222–31.

Zhai Q, Narbad A, Chen W. Dietary strategies for the treatment of cadmium and lead toxicity. Nutrients. 2014;7(1):552–71.

Reeves PG, Chaney RL. Marginal nutritional status of zinc, iron, and calcium increases cadmium retention in the duodenum and other organs of rats fed rice-based diets. Environ Res. 2004;96(3):311–22.

Hammad TA, Sexton M, Langenberg P. Relationship between blood lead and dietary iron intake in preschool children: a cross-sectional study. Ann Epidemiol. 1996;6(1):30–3.

Yang A-M, Lo K, Zheng T-Z, Yang J-L, Bai Y-N, Feng Y-Q, et al. Environmental heavy metals, and cardiovascular diseases: Status and future direction. Chronic Dis Transl Med. 2020;6(4):251–9.

Kasperczyk A, Prokopowicz A, Dobrakowski M, Pawlas N, Kasperczyk S. The effect of occupational lead exposure on blood levels of zinc, iron, copper, selenium and related proteins. Biol Trace Elem Res. 2012;150(1):49–55.

Skalnaya MG, Skalny A V. Essential trace elements in human health: a physician’s view. Tomsk Publ House Tomsk State Univ. 2018;224.