Toenails as a biomarker of exposure to arsenic: A review

Signes-Pastor, Antonio J.; Gutiérrez‐González, Enrique; García-Villarino, Miguel; Rodríguez-Cabrera, Francisco; López-Moreno, Jorge J.; Varea-Jiménez, Elena; Pastor-Barriuso, Roberto; Pollán, Marina; Navas‐Acien, Ana; Pérez‐Gómez, Beatriz

doi:10.1016/j.envres.2020.110286

Cited by 49 publications

(40 citation statements)

References 141 publications

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“…In our study participants the toenail concentrations of aluminium, selenium, zinc and the other elements were similar to concentrations in the homogenized published literature in the same matrix (Amaral et al 2012 ; Gutiérrez-González et al 2019 ; Salcedo-Bellido et al 2021 ; Signes-Pastor et al 2020 ).…”

Section: Discussionsupporting

confidence: 88%

“…One type of such conditions are the disease-induced pathophysiological processes that we already mentioned in the Introduction and in previous papers (Porta et al 2007 , 2008 , 2009 , 2014 , 2005 , 2021 ; Porta 2001 ; Gasull et al 2019 ). Related but different are the metabolic requirements of the tumor (He 2011 ; Gutiérrez-González et al 2019 ; Salcedo-Bellido et al 2021 ; Signes-Pastor et al 2020 ; Longnecker et al 1993 ; Garland et al 1993 ; Hunter et al 1990 ; Hopps 1977 ; Sukumar 2006 ). A third mechanism can operate as follows: symptoms (such as tiredness, loss of appetite, weight loss, abdominal pain, nausea) caused by the still subclinical disease can cause changes in the diet of the subject that change the intake of some nutrients and subsequently their body concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Problems in using toenails as a matrix for measurement of biomarkers include variability in growth rate, external contamination, and inconsistent protocols for collection and analysis (He 2011 ; Gutiérrez-González et al 2019 ; Salcedo-Bellido et al 2021 ; Signes-Pastor et al 2020 ; Orloff et al 2009 ). Because in the present study sample collection was conducted in-hospital, collection of toenails was similar for all study patients, and the external contamination of nails was minimized by having toenails collected immediately after bathing and scraping, and by sonicating nails in the laboratory prior to analysis (Nichols et al 1998 ).…”

Section: Discussionmentioning

confidence: 99%

“…Information on concentrations of trace elements in nails has long been used in humans to cost-effectively measure exposure and internal dose. In healthy and physically stable individuals, and compared to blood, urine, or hair samples, levels in toenails of mercury, manganese, and arsenic appear to reflect better the corresponding concentrations in the organism for a time frame from a few months to a year preceding sample collection (Amaral et al 2012 ; He 2011 ; Gutiérrez-González et al 2019 ; Salcedo-Bellido et al 2021 ; Signes-Pastor et al 2020 ; Longnecker et al 1993 ; Garland et al 1993 ; Hunter et al 1990 ; Hopps 1977 ; Sukumar 2006 ; Ntihabose et al 2018 ; Marchiset-Ferlay et al 2012 ).…”

Section: Introductionmentioning

confidence: 99%

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Timing of Toenail Collection and Concentrations of Metals in Pancreatic Cancer. Evidence Against Disease Progression Bias

et al. 2021

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Trace elements such as cadmium, arsenic, zinc or selenium increase or decrease risk of a wide range of human diseases. Their levels in toenails may provide a measure of mid-term intake of trace elements for studies in humans. However, in biologically and clinically aggressive diseases as pancreatic cancer, the progression of the disease could modify such concentrations and produce reverse causation bias. The aim was to analyze the influence of specific time intervals between several clinical events and the collection of toenails upon concentrations of trace elements in patients with pancreatic cancer. Subjects were 118 incident cases of pancreatic adenocarcinoma prospectively recruited in eastern Spain. Toenails were collected at cancer diagnosis, and soon thereafter interviews were conducted. Information on cancer signs and symptoms was obtained from medical records and patient interviews. Levels of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. General linear models adjusting for potential confounders were applied to analyze relations between log concentrations of trace elements and the time intervals, including the interval from first symptom of cancer to toenail collection (iST). Toenail concentrations of the 12 trace elements were weakly or not influenced by the progression of the disease or the diagnostic procedures. Concentrations of aluminum were slightly higher in subjects with a longer iST (age, sex and stage adjusted geometric means: 11.44 vs. 7.75 µg/g for iST > 120 days vs. ≤ 40 days). There was a weak inverse relation of iST with concentrations of zinc and selenium (maximum differences of about 20 and 0.08 µg/g, respectively). Conclusions: concentrations of the trace elements were weakly or not influenced by the development of the disease before toenail collection. Only concentrations of aluminum increased slightly with increasing iST, whereas levels of zinc and selenium decreased weakly. Even in an aggressive disease as pancreatic cancer, toenail concentrations of trace elements may provide a valid measure of mid-term intake of trace elements, unaffected by clinical events and disease progression. Supplementary Information The online version contains supplementary material available at 10.1007/s12403-021-00436-2.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Timing of Toenail Collection and Concentrations of Metals in Pancreatic Cancer. Evidence Against Disease Progression Bias

et al. 2021

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“…This metalloid recognized as a human carcinogen by the International Agency for Research on Cancer (IARC) and the United States Environmental Protection Agency (USEPA) is found in organic and inorganic forms and with different oxidation states (− 3, 0, + 3, + 5) in the environment 6 , 7 . Non-occupational exposure to inorganic arsenic (arsenite and arsenate) through the consumption of drinking water sources causes carcinogenic and non-carcinogenic health effects in the exposed human population 3 , 8 , 9 . Acute and chronic human health effects of arsenic exposure include skin lesions, cardiovascular disease, anemia, renal impairment, as well as respiratory disorders, and different types of cancers (lung, skin, liver, kidney, and bladder) 10 – 12 .…”

Section: Introductionmentioning

confidence: 99%

Application of fingernail samples as a biomarker for human exposure to arsenic-contaminated drinking waters

Shokoohi

Khazaei

Karami

et al. 2022

Sci Rep

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This study evaluated the relationship between arsenic uptake via drinking water ingestion and arsenic concentration in fingernails as a biomarker for human exposure. For this purpose, we collected fingernail samples from 40 healthy participants of arsenic-affected rural regions of Kaboudrahang County, the west of Iran. A total of 49 fingernail samples were also collected from individuals who lived in areas where contamination of drinking water sources with arsenic had not been reported. It was found that the fingernails arsenic contents in 50 and 4.08% of the samples collected from arsenic-contaminated and reference villages were higher than the normal arsenic values of nails (0.43–1.08 µg/g), respectively. Based on the results of adjusted multiple linear regression, a significant association was found between groundwater and fingernails arsenic concentration (p < 0.001). Moreover, a statistically significant association was shown between arsenic in the fingernail samples and gender (p = 0.037). Fingernails arsenic contents were not significantly affected by other variables including age, smoking habits, and BMI (p > 0.05). In light of the results of this study, the use of biological indicators such as fingernail tissues due to easier sampling and less risk of external contamination is suitable for assessing exposure to heavy metals in contaminated areas.

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Arsenic, Antimony, and Bismuth

Madden

Fowler²

2023

Patty's Toxicology

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Arsenic, Antimony, and Bismuth are members of Group V of the Periodic Table of Elements. These elements have been used for a variety of medicinal and pest control purposes over a number of centuries. They have also been used in metallic alloys and in the production of III–V semiconductors to increase electronic speeds of computer chips. Arsenicals are largely metabolized by methylation pathways and bismuth is known to induce the metal‐binding protein metallothionein and to form electron–dense cytoplasmic and intranuclear inclusion bodies.

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Toenails as a biomarker of exposure to arsenic: A review

Cited by 49 publications

References 141 publications

Timing of Toenail Collection and Concentrations of Metals in Pancreatic Cancer. Evidence Against Disease Progression Bias

Timing of Toenail Collection and Concentrations of Metals in Pancreatic Cancer. Evidence Against Disease Progression Bias

Application of fingernail samples as a biomarker for human exposure to arsenic-contaminated drinking waters

Arsenic, Antimony, and Bismuth

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