Pócsi István, Dockrell Mark E, Price Robert G
Department of Molecular Biotechnology and Microbiology, Faculty of Science and Technology, University of Debrecen, Debrecen, Hungary.
SWT Institute of Renal Research, Carshalton, London, UK.
Biomark Insights. 2022 Jul 14;17:11772719221111882. doi: 10.1177/11772719221111882. eCollection 2022.
Environmental and occupational exposure to heavy metals and metalloids is a major global health risk. The kidney is often a site of early damage. Nephrotoxicity is both a major consequence of heavy metal exposure and potentially an early warning of greater damage. A paradigm shift occurred at the beginning of the 21st century in the field of renal medicine. The medical model of kidney failure and treatment began to give way to a social model of risk factors and prevention with important implications for environmental health. This development threw into focus the need for better biomarkers: markers of exposure to known nephrotoxins; markers of early damage for diagnosis and prevention; markers of disease development for intervention and choice of therapy. Constituents of electronic waste, e-waste or e-pollution, such as cadmium (Cd), lead (Pb), mercury (HG), arsenic (As) and silica (SiO) are all potential nephrotoxins; they target the renal proximal tubules through distinct pathways. Different nephrotoxic biomarkers offer the possibility of identifying exposure to individual pollutants. In this review, a selection of prominent urinary markers of tubule damage is considered as potential tools for identifying environmental exposure to some key metallic pollutants.
环境和职业性接触重金属和类金属是全球主要的健康风险。肾脏常常是早期损伤的部位。肾毒性既是重金属接触的主要后果，也可能是更大损伤的早期预警。21世纪初，肾脏医学领域发生了范式转变。肾衰竭和治疗的医学模式开始让位于风险因素和预防的社会模式，这对环境卫生具有重要意义。这一发展凸显了对更好生物标志物的需求：接触已知肾毒素的标志物；用于诊断和预防的早期损伤标志物；用于干预和治疗选择的疾病发展标志物。电子垃圾、电子废物或电子污染的成分，如镉（Cd）、铅（Pb）、汞（Hg）、砷（As）和二氧化硅（SiO）都是潜在的肾毒素；它们通过不同途径靶向肾近端小管。不同的肾毒性生物标志物为识别个体污染物暴露提供了可能性。在本综述中，一些突出的肾小管损伤尿液标志物被视为识别环境中某些关键金属污染物暴露的潜在工具。
