Cárdenas A, Roels H, Bernard A M, Barbon R, Buchet J P, Lauwerys R R, Roselló J, Ramis I, Mutti A, Franchini I
Unité de Toxicologie Industrielle et Médecine du Travail, Faculté de Médecine, Université Catholique de Louvain.
Br J Ind Med. 1993 Jan;50(1):28-36. doi: 10.1136/oem.50.1.28.
The present study has been carried out in the framework of a collaborative research project on the development of new markers of nephrotoxicity. A battery of more than 20 potential indicators of renal changes has been applied to 50 workers exposed to lead (Pb) and 50 control subjects. After application of selection criteria 41 exposed and 41 control workers were eventually retained for the final statistical analysis. The average blood Pb concentration of exposed workers was 480 micrograms/l and their mean duration of exposure was 14 years. The battery of tests included parameters capable of detecting functional deficits (for example, urinary proteins of low or high molecular weight), biochemical alterations (for example, urinary eicosanoids, glycosaminoglycans, sialic acid) or cell damage (for example, urinary tubular antigens or enzymes) at different sites of the nephron or the kidney. The most outstanding effect found in workers exposed to Pb was an interference with the renal synthesis of eicosanoids, resulting in lower urinary excretion of 6-keto-PGF1 alpha and an enhanced excretion of thromboxane (TXB2). The health significance of these biochemical alterations, detectable at low exposure to Pb is unknown. As they were not associated with any sign of renal dysfunction, they may represent reversible biochemical effects or only contribute to the degradation of the renal function from the onset of clinical Pb nephropathy. The urinary excretion of some tubular antigens was also positively associated with duration of exposure to Pb. Another effect of Pb that might deserve further study is a significant increase in urinary sialic acid concentration.
本研究是在一项关于肾毒性新标志物开发的合作研究项目框架内开展的。一组超过20种潜在的肾脏变化指标已应用于50名铅（Pb）暴露工人和50名对照受试者。在应用筛选标准后，最终保留了41名暴露工人和41名对照工人进行最终统计分析。暴露工人的平均血铅浓度为480微克/升，平均暴露时长为14年。该组测试包括能够检测肾单位或肾脏不同部位功能缺陷（例如，低分子量或高分子量尿蛋白）、生化改变（例如，尿类二十烷酸、糖胺聚糖、唾液酸）或细胞损伤（例如，肾小管抗原或酶）的参数。在铅暴露工人中发现的最显著影响是对类二十烷酸肾脏合成的干扰，导致6 - 酮 - PGF1α尿排泄降低和血栓素（TXB2）排泄增加。在低铅暴露水平下可检测到的这些生化改变的健康意义尚不清楚。由于它们与任何肾功能障碍迹象均无关联，它们可能代表可逆的生化效应，或者仅在临床铅肾病发作时对肾功能退化有影响。一些肾小管抗原的尿排泄也与铅暴露时长呈正相关。铅的另一个可能值得进一步研究的影响是尿唾液酸浓度显著增加。
