A Longitudinal Study of Association between Heavy Metals and Itchy Eyes, Coughing in Chronic Cough Patients: Related with Non-Immunoglobulin E Mediated Mechanism

Abstract

The association between heavy metals exposure and respiratory diseases or allergic sensitization showing high serum immunoglobulin E (IgE) has been suggested. However, previous findings have been inconsistent and the mechanisms responsible remain unclear. We evaluated heavy metal exposure and its association with coughing, itchy eyes in chronic cough patients with different IgE levels. Ninety outpatients in Kanazawa University Hospital were recruited between January–June 2011. Subjects whose total IgE measured by radioimmunosorbent test were asked to record their daily symptoms. We collected daily total suspended particles (TSP) from which concentrations of calcium (Ca), cadmium (Cd), chromium (Cr), iron (Fe), manganese (Mn), nickel (Ni), and lead (Pb) were determined then divided into high and low level groups. Generalized estimating equations were applied to compute the relationship between concentrations of these metals and symptoms. All metals at high levels were significantly associated with itchy eyes compared with low levels, with exception of Ca, the six others were significant in patients with IgE < 250 IU/mL. Cd, Fe, Mn had association with coughing (odds ratio-OR (95% confidence interval-CI): 1.13 (1.03, 1.24), 1.22 (1.05, 1.42), and 1.13 (1.01, 1.27), respectively), this relationship remained significant for Cd (OR (95% CI): 1.14 (1.03, 1.27)) and Mn (OR (95% CI): 1.15 (1.00, 1.31)) in patients with lower IgE. Our findings demonstrate the relationship between aerial heavy metals and itchy eyes, coughing in chronic cough patients, suggesting these symptoms may be due to a non-IgE mediated mechanism.

Elevated Blood Cadmium and Lead Levels in Chronic Pruritic Dermatoses

“…Although multiple studies have reported associations between pollutants and cutaneous disease, the underlying mechanism remains unclear (Araviiskaia et al, 2019;Kim et al, 2016;Weng et al, 2017). Previous studies have described non-IgEemediated mechanisms of pruritus with heavy metal exposure, suggesting that heavy metals may have a direct role that needs to be elucidated in further studies (Nguyen et al, 2016;Weng et al, 2017). Whereas our results reveal an age differential between our cohorts, previous literature reveals no association between age and blood heavy metal levels (Chang et al, 2018).…”

“…Tannery workers with increased serum chromium (P < 0.05) were found to have increased cutaneous complaints of rough skin, itch, and rash (P < 0.001; Islam et al, 2019). Ocular pruritus was also found to be associated with aerial heavy metal exposure (Nguyen et al, 2016). Finally, blood lead levels have been found to be a positive predictor of uremic pruritus in patients undergoing hemodialysis (Weng et al, 2017).…”

Different Transport Behaviors between Asian Dust and Polycyclic Aromatic Hydrocarbons in Urban Areas: Monitoring in Fukuoka and Kanazawa, Japan

“…It has been considered that these organic and inorganic pollutants were simultaneously long-range transported to Japan by westerly winds. They are thought to be common causes of hospital admission for respiratory, cerebrovascular, and cardiovascular diseases [10], cough prevalence [11][12][13], itchy eyes [14], asthma exacerbation [15], and seasonal allergic rhinitis [7,16].…”

Recommended dose of sufentanil during induction of general anesthesia to avoid coughing and drastic hemodynamic fluctuations in patients undergoing surgery

“…This cough is usually sudden and irritating, and it may lead to a sudden increase in blood pressure, tachycardia, and pneumothorax, and especially in the absence of strict fasting, the gastric contents could reflux into the mouth, causing life-threatening asphyxia via inhalation into the lungs. 4 Thus, finding an effective way to suppress cough is of important clinical significance.…”