Cadmium
contamination of drinking water and its treatment using biological chelators
Amiri A, PhD1*,
Mirhoseiny
Z, Msc2
1- Assistant
Prof., Dept. of Chemistry, Payame Noor University, P.O. Box, 19395-3697, Tehran,
Iran. 2- MSc in Chemistry, Department of Chemistry, Payame Noor University, P.O.
Box, 19395-3697, Tehran, Iran
Abstract
Received: July 2016, Accepted:
October 2016
Keywords:
Chelation Therapy, Cadmium,
Drinking Water, Rats
Introduction
Cadmium is a toxic metalloid widely present
around the world particularly in soil, water, or contaminated food. Cd is primarily used in metal
plating and coating operations, including transportation equipment, machinery
and baking enamels, photography, and television phosphors. It is also used in
nickel-cadmium and solar batteries, and in pigments (1). Cd
is regularly found in ores together with zinc, copper, and lead. Therefore,
volcanic activity is one natural reason for a temporary increase in environmental
Cd concentrations. Phosphate fertilizers also show a high Cd load. Acute
exposure to Cd fumes may cause flu-like symptoms including chills, fever, and
muscle ache sometimes referred to as "the cadmium blues". Symptoms
may resolve after a week if there is no respiratory damage. More severe exposures can cause
tracheobronchitis, pneumonitis, and pulmonary edema. Symptoms of inflammation
may start hours after the* exposure and include coughs, dryness
and irritation of the nose and throat, headache, dizziness, weakness, fever,
chills, and chest pain. Ingestion of any significant amount of Cd causes
immediate poisoning and damage to the liver and the kidneys. The bones become
soft (osteomalacia), lose bone mineral density (osteoporosis), and become
weaker. This causes pain in the joints and back and also increases the risk of
fractures (2, 3).
The concentrations
of Cd in drinking
water supplies of villages located in the southeastern region of Rafsanjan
plain (Iran) exceed the standard limit permitted by the World
Health Organization (WHO) guidelines (0.010 mg/l). About 10.4% of residents of this
area were exposed to arsenic. Furthermore, the results revealed that 66.6% and
46.7% of the residents of the study area had, respectively, been exposed to
high levels of lead and Cd. The
heavy metals, such as Cd, contamination of drinking water resources in
Rafsanjan plain is linked to both natural presence of sulfide veins in this
area and manmade pollution due to the presence of the main road and agricultural
use of pesticides (4, 5).
Detoxification of Cd is possible with
ethylenediaminetetraacetic acid (EDTA) and other chelators and has been
shown to be therapeutically beneficial in humans and animals when done using the
established protocols. It is clear that EDTA and meso 2,
3-dimercaptosuccinic acid (DMSA) increase
urinary excretion of Cd. In clinical use, EDTA is credited with an anecdotal
report of rheumatoid arthritis relief, reduction of oxidative stress, and
reduction of general metal toxicity. Subsequent human trials in West Bengal
(India) with DMSA failed to provide clinical recoveries in patients chronically
exposed to arsenic and some heavy metals (6-10). Clinical investigations of the
use of some chelators for the removal of toxic metals in rats have been previously
published (11, 12).
Deferasirox {4-[3,5-bis(2-hydroxyphenyl)-1,2,4-triazol-l-yl]-benzoic
acid (ICL670 or DFS)} (Figure 1) is a tridentate chelator with high selectivity
for Fe3+. In 2005, DFS became the first Food and Drug Administration
(FDA) approved oral alternative for treatment of Fe overload, and subsequently,
was approved in
the EU in 2006 (8). Its comparatively long half-life before excretion allows a once-daily
dosage and good overall patient compliance, as well as cost-effectiveness. DFS
possesses a pFe3+ value of 22.5, can penetrate membranes easily, and
possesses good oral availability. Indeed, when orally administered to
hypertransfused rats, DFS promotes the excretion of chelatable iron from
hepatocellular iron stores four to five times more effectively than desferrioxamine
(13). Another developed
orally active chelating agent is deferiprone (1,2-dimethyl-3-hydroxypyrid-4-one
or L1), which is rapidly absorbed in the gastrointestinal tract and
normally appears in serum a few minutes after oral administration. The main
excretion route is the kidneys. L1 is a bidentate iron chelator forming
a 3:1 complex with Fe and it is likely to act intracellular (14, 15). The
presence of Cd in drinking water resources of
Rafsanjan plain at concentrations greater than acceptable limits may result in
various adverse health effects. The therapeutic efficacy of DFS and L1 in reducing Cd concentration in Cd-exposed
rats as a biological model was investigated in the present study.
Material and Methods
All the chemicals
used in this work were of either analytical grade or of extra pure grade of the
highest purity available locally. Cadmium chloride, deferiprone,
and other materials were purchased from Merck Chemicals Co. (Germany) and
deferasirox was purchased from
Novartis Co. (Basel. Switzerland).
Male Wistar rats were obtained from the animal house facility of Kerman
Neuroscience Research Center (Iran). The animals were kept under a controlled
light/dark (12/12 hours) schedule. The rats were divided randomly into control and
experimental groups. They were treated in groups and were housed in
well-cleaned sterilized cages in an air-conditioned room with the temperature
maintained at 22 ± 2
ºC and
50% humidity. The Animal Ethical Committee of Payame Noor University and Kerman
Neuroscience Research
Center approved the protocols for the experiments.
Experimental Groups: In order to evaluate the
efficacy of chelators (DFS and L1) in removing Cd in Cd-exposed rats, experiments were performed on
Wistar male rats (220 ± 12 g). The animals were classified into 2 groups. The control group (n = 5) was given normal
food and distilled water to drink. The concentrations of Cd and Fe in the control
group rats were compared with the groups that received Cd and chelators. The toxic
groups (n = 25) were given water containing 40 mg/kg body weight Cd2+
as cadmium chloride for 42 days. In order to compare the Cd and Fe concentrations
in tissues, before and after chelation therapy, one group was selected (Vehicle
Cd and Vehicle Fe) and sacrificed before chelation
therapy. Other Cd-exposed animals were divided into 4 sub-groups of 5 rats each
and given the following treatment for 7 consecutive days:
·
Group control chelator (No treatment)
·
Group L1 (100 mg/kg body weight, oral,
once daily)
·
Group DFS (100 mg/kg body weight, oral, once daily)
·
Group DFS+L1 (50 and 50 mg/kg body
weight, respectively, oral, once daily)
All animals of each group were sacrificed under
light ether anesthesia, 48 hours after the last dosing. Kidneys, heart, liver,
and intestine samples were weighed, dried, and collected for determination of Cd
and Fe concentration. The samples were placed in an oven at 60 ºC for 3
days. Then, 1 g of each sample was digested
by 1 ml of HNO3 (10 M). After digestion, the solutions were
vaporized with the addition of 0.5 ml of H2O2 (30%) under
a hood. Subsequently, the fragments were diluted with distilled water to 10 ml
volume. Determination of Cd and Fe in samples was performed using
inductively coupled plasma optical emission spectrometry (ICP-OES) (Vista-
Clinical hematological variables: Blood was collected through cardiac
puncture in heparinized tubes and the hemoglobin (Hb) level, platelet (PLT)
count, red blood cell (RBC) count, and white blood cell (WBC) count were
measured using a hematology analyzer (model K4500, Sysmex Corp., Kobe, Japan).
Results
Oral exposure to Cd may result in adverse effects on
a number of tissues, including kidney, liver, bone, testes, the immune system,
and the cardiovascular system. In humans, death is usually due to excessive
fluid loss as a result of vomiting and diarrhea. Lethal doses in humans have
been reported to range from 1,500 to 8,900 mg, corresponding to doses of about
20 to 130 mg/kg in a 70 kg adult (16). The effects of DFS and L1 chelators
on Cd concentration in various tissues are presented in table 1.
Table
1: Concentration
of cadmium (mg/kg) in cadmium-intoxicated rats before and after chelation
therapy
Group |
Control |
Vehicle Cd |
DFS |
L1 |
DFS + L1 |
Heart |
0.12 ± 0.01 |
6.31 ± 0.32* |
4.52 ± 0.37† |
5.04 ± 0.12* |
4.02 ± 0.19† |
Kidney |
0.7 2± 0.05 |
42.31 ± 0.21* |
9.06 ± 0.24* |
8.01 ± 0.32† |
7.07 ± 0.24† |
Liver |
0.55 ± 0.02 |
15.11 ± 0.32* |
6.62 ± 0.34* |
7.02 ± 0.29† |
4.12 ± 0.25† |
Intestine |
0.32 ± 0.01 |
6.96 ± 0.03* |
4.21 ± 0.32† |
5.97 ± 0.23 |
3.01 ± 0.19† |
Values
are presented as mean ± SEM (n = 5); *Significant at Ρ <
0.05 when compared with control; †Significant at Ρ < 0.05
when compared with vehicle Cd
Table
2: Concentration
of iron (mg/kg) in cadmium-intoxicated rats before and after chelation therapy
Group |
Control |
Vehicle Fe |
DFS |
L1 |
DFS + L1 |
Heart |
5.02 ± 0.42 |
4.76 ± 0.21 |
4.13 ± 0.29 |
3.06 ± 0.27* |
3.01 ± 0.13* |
Kidney |
7.51 ± 0.23 |
5.85 ± 0.34* |
6.01 ± 0.39 |
6.12 ± 0.29 |
5.12 ± 0.22* |
Liver |
9.03 ± 0.31 |
6.98 ± 0.27* |
5.21 ± 0.31* |
4.12 ± 0.21* |
3.01 ± 0.21* |
Intestine |
5.02 ± 0.24 |
4.16 ± 0.33 |
4.03 ± 0.22 |
4.01 ± 0.20 |
4.01 ± 0.23 |
Values
are presented as mean ± SEM (n = 5); *Significant at Ρ < 0.05 when
compared with control
The maximum amount of Cd accumulation was observed
in the kidneys and liver, respectively. In order to investigate the spontaneous
elimination of Cd from the body by the biological system, the control chelator
group was treated without chelation therapy and the removal of Cd by the
biological system in this group was not noticeable. After the chelation
therapy, the obtained results indicated that Cd concentration had significantly
reduced in all tissues. There was a statistical difference between DFS and L1
in reducing the amount of Cd in various tissues. As single therapy efficiencies
of chelators were compared in this study, it was found that DFS was more
effective in decreasing Cd level in all tissues, whereas L1 was more
effective in reducing Cd level in the kidneys. The results of Fe concentrations
before and after chelation therapy are provided in table 2.
Fe concentration had significantly decreased after
the chelation therapy. Thus, consumption of Fe tablets is recommended for
returning the Fe level to its normal state. Combination of DFS + L1
shows more efficiency in decreasing Fe level. The effects of exposure to Cd and
treatment with chelators either individually or in combination on some hematological
variables are shown in table 3.
Table
3: Hematological
variables in the blood of cadmium-intoxicated rats before and after chelation
therapy
Group |
Control |
Vehicle Cd |
DFS |
L1 |
DFS + L1 |
WBC |
12.01 ± 2.11 |
12.01 ± 3.12 |
15.44 ± 2.21 |
10.11 ± 1.10 |
11.61 ± 1.29 |
RBC |
8.22 ± 0.54 |
9.08 ± 0.11 |
8.55 ± 0.21 |
8.51 ± 0.12 |
8.65 ± 0.34 |
Hb |
133.7 ± 11.4 |
120.7 ± 3 |
126.7 ± 1.3 |
121.5 ± 6 |
122.2 ± 4.5 |
PLT |
679.6 ± 55.5 |
260.7 ± 88.7 |
553.6 ± 101.1* |
221.7 ± 98.1 |
701.7 ± 56.4* |
WBC:
White blood cell count as × 103/μl; RBC: Red blood cell count
as × 106/μl; Hb: Hemoglobin as g/l; PLT: Platelet as × 103/μl;
Values are presented as mean ± SEM (n = 5); *Significant at Ρ < 0.05
when compared with vehicle Cd
Discussion
Through the survey
of corrosion indexes, it was recognized that drinking water from wells and
aqueducts in rural areas adjacent to Rafsanjan plain has scaling tendency.
Thus, it is necessary to stop economical loss and hygienic harms in order to
maintain water quality stabilization. Water corrosion leads to increase in
toxic metals concentration, such as arsenic, copper, lead, Cd, zinc, nickel,
iron, and manganese in water. Toxic metals have acute health risks for water
consumers. Scaling water leads to economic and technical problems (16). After
absorption, Cd is transported throughout the body, usually bound to a
sulfhydryl group-containing protein like metallothionein. About 30% deposits in
the liver and 30% in the kidneys, with the rest distributed throughout the body.
The half-life of Cd in the blood has been estimated at 75 to 128 days (16). It
was found that as Cd concentration increased in tissues, Fe concentration
decreased in the kidneys and liver, which is probably due to interference by Cd
in the Fe uptake mechanism.
The combined therapy procedure can likely increase
metal excretion, target specific metal tissues, minimize side effects, and
improve compliance. Many studies have now reported the high
absorption/distribution, long-term efficacy, and safety of DFS and L1
in removing some toxic metal ions and treating Fe overload in patients with
β-thalassemia major (8-10). After administration of chelators, the Cd
content was reduced. The results show that both chelators (DFS and L1)
increase the removal of Cd from the tissues. L1 is able to
redistribute Fe in mammals
(17). DFS, by virtue of its small size and the ability to penetrate cells, is efficient
in scavenging excess toxic Cd (16, 18). The comparison of single and combined
therapy showed that the combined chelation therapy (DFS + L1) is
more effective in reducing Cd concentration in all tissues. No effects of Cd or
any of the two treatments (L1 or DFS) were observed on WBC, RBC, and
Hb and PLT count showed a decrease in the Cd-exposed rats. Cd had no effect on
these variables in the present study. This can be attributed to the short
duration of Cd exposure. Treatment with DFS and DFS + L1 provided
significant recovery in terms of PLT counts.
Conclusion
Chelation
therapy is one of the most effective ways to remove toxic metals from the
biological system.
The comparison of the results indicates that the
combined therapy (DFS + L1) enhanced the removal of Cd from rat
organs considerably. Each of the chelators (DFS and L1) has a
different target tissue. Therefore, their combination can effectively help the
removal Cd from various tissues. This study might be effective for preliminary
testing of the efficacy of chelating agents in the removal of Cd. Therefore,
after essential preclinical experiments, the same study can be suggested for
human administration.
Acknowledgments
The
authors would like to thank Professor V. Sheibani from Kerman Neuroscience Research
Center for his assistance.
Conflict
of Interest: None declared.
References
1.
Nordberg GF. Biomarkers of exposure, effects and
susceptibility in humans and their application in studies of interactions among
metals in China. Toxicol Lett 2010; 192(1):45-9.
2.
Zalups RK, Ahmad S. Molecular handling of cadmium in
transporting epithelia. Toxicol Appl Pharmacol 2003; 186(3):163-88.
3.
Matovic V, Buha
A, Bulat Z, Dukic-Cosic D. Cadmium toxicity revisited: focus on oxidative
stress induction and interactions with zinc and magnesium. Arh Hig Rada
Toksikol 2011; 62(1):65-76.
4.
Malakootian M,
Darabi-Fard Z, Amirmahani N, Nasiri A. Evaluation of arsenic, copper,
lead, cadmium, and iron concentration in drinking water resources of central
and southern Bardsir plain, Iran, in 2014. Journal of Kerman University of Medical
Sciences 2015; 22(5): 542-54.
5.
Malakootian M,
Mobini M, Sharifi I, Haghighi Fard A. Evaluation of corrosion and scaling potential
of wells drinking water and aqueducts in rural areas adjacent to Rafsanjan
fault in during october to december 2013.
Journal of Rafsanjan University of Medical Sciences 2014; 13(3):293-304.
6.
Waters RS, Bryden
NA, Patterson KY, Veillon C, Anderson RA. EDTA chelation effects on urinary
losses of cadmium, calcium, chromium, cobalt, copper, lead, magnesium, and
zinc. Biol Trace Elem Res 2001; 83(3):207-21.
7.
Kelley C. Cadmium
therapeutic agents. Curr Pharm Des 1999; 5(4):229-40.
8.
Tandon SK, Prasad
S, Singh S. Chelation in metal intoxication: influence of cysteine or N-acetyl
cysteine on the efficacy of 2, 3-dimercaptopropane-1-sulphonate in the
treatment of cadmium toxicity. J Appl Toxicol 2002; 22(1):67-71.
9.
Bamonti F,
Fulgenzi A, Novembrino C, Ferrero ME. Metal chelation
therapy in rheumathoid arthritis: a case report. Successful management of
rheumathoid arthritis by metal chelation therapy. Biometals 2011; 24(6):1093-8.
10.
Piga A, Galanello
R, Forni GL, Cappellini MD, Origa R, Zappu A, et al. Randomized phase
II trial of deferasirox (Exjade, ICL
670), a once-daily, orally administered iron chelator, in comparison to deferoxamine
in thalassemia patients with transfusional iron overload. Haematologica 2006; 91(7):873-80.
11.
Amiri A, Fatemi SJ, Fatemi SN. Removal of thallium by combining
desferrioxamine and deferiprone chelators in rats. Biometals 2007;
20(2):159-63.
12.
Fatemi SJ, Tubafard S, Nadi B. Evaluation of the effect of cadmium on rat
organs and investigation of diethyl carbamate as an oral drug in treatment of
cadmium toxicity. Med Chem Res 2009; 18(3):179-86.
13.
Voskaridou E, Christoulas D, Terpos E. Successful chelation therapy with
the combination of deferasirox and deferiprone in a patient with thalassaemia
major and persisting sever iron overload after single-agent chelation
therapies. Br J Haematol 2011; 154(5):654-6.
14.
Hershko C, Konijn AM, Nick HP, Breuer W, Cabatchik ZI, Link G. ICL670A: a
new synthetic oral chelator: evaluation in hyper transfused rats with selective
radio iron probes of hepatocellular and reticuloendothelial iron stores and in
iron-loaded rat heart cell in culture. Blood 2001; 97(4):1115-22.
15.
Steinhauser S, Heinz U, Bartholoma M, Weyhermuller T, Nick H,
Hegetschweiler K. Complex formation of ICL670 and related ligands with Fe-III
and Fe-II. Berichte der deutschen chemischen
Gesellschaft 2004; 21:4177-92.
16.
Luparello C,
Sirchia R, Longo A. Cadmium as a transcriptional modulator in human cells. Crit
Rev Toxicol 2011; 41(1):75-82.
17.
Neufeld EJ. Oral chelators deferasirox and deferiprone for transfusional
iron overload in thalassemia major: new data, new questions. Blood 2006;
107(9):3436-41.
18.
Wan L, Zhang H.
Cadmium toxicity: effects on cytoskeleton, vesicular trafficking and cell wall
reconstruction. Plant Signal Behav 2012; 7(3):345-8.
* Corresponding author: Asghar Amiri, Dept. of
Chemistry, Payame Noor University, P.O. Box, 19395-3697, Tehran, Iran.
Email: a.amiri@pnu.ac.ir