Toenails as biomarker of exposure to essential trace metals: A review

Health problems associated with essential trace metals can result from both inadequate (i.e., low intake) and excessive exposures (i.e., from environmental and/or occupational source). Thus, measuring the exposure level is a real challenge for epidemiologists. Among non-invasive biomarkers that inte...

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Detalhes bibliográficos
Autores: Gutierrez-Gonzalez, Enrique, García-Esquinas, Esther, Fernandez de Larrea-Baz, Nerea, Salcedo-Bellido, Inmaculada, Navas-Acien, Ana, Lope Carvajal, Virginia, Gómez-Ariza, José Luis, Pastor-Barriuso, Roberto, Pollan-Santamaria, Marina, Perez-Gomez, Beatriz
Formato: artículo
Fecha de publicación:2019
País:España
Recursos:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/12958
Acesso em linha:http://hdl.handle.net/20.500.12105/12958
Access Level:acceso abierto
Palavra-chave:Metals
Biomarkers
Environmental Exposure
Humans
Nails
Reproducibility of Results
Selenium
Trace Elements
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spelling Toenails as biomarker of exposure to essential trace metals: A reviewGutierrez-Gonzalez, EnriqueGarcía-Esquinas, EstherFernandez de Larrea-Baz, NereaSalcedo-Bellido, InmaculadaNavas-Acien, AnaLope Carvajal, VirginiaGómez-Ariza, José LuisPastor-Barriuso, RobertoPollan-Santamaria, MarinaPerez-Gomez, BeatrizMetalsBiomarkersEnvironmental ExposureHumansNailsReproducibility of ResultsSeleniumTrace ElementsHealth problems associated with essential trace metals can result from both inadequate (i.e., low intake) and excessive exposures (i.e., from environmental and/or occupational source). Thus, measuring the exposure level is a real challenge for epidemiologists. Among non-invasive biomarkers that intend to measure long-term exposure to essential trace metals, the toenail is probably the biological matrix with the greatest potential. This systematic review collects the current evidence regarding the validity of toenail clippings as exposure biomarker for trace metals such as boron, cobalt, copper, iron, manganese, molybdenum, selenium, silicon, vanadium and zinc. Special attention was paid to the time-window of exposure reflected by the toenail, the intraindividual variability in exposure levels over time in this matrix, and the relationship of toenail with other biomarkers, personal characteristics and environmental sources. Our search identified 139 papers, with selenium and zinc being the most studied elements. The variability among studies suggests that toenail levels may reflect different degrees of exposure and probably correspond to exposures occurred 3-12 months before sampling (i.e., for manganese/selenium). Few studies assessed the reproducibility of results over time and, for samples obtained 1-6 years apart, the correlation coefficient were between 0.26 and 0.66. Trace metal levels in toenails did not correlate well with those in the blood and urine and showed low-moderate correlation with those in the hair and fingernails. Available data suggests that for some elements (Se, Mn, Zn) toenail concentrations reflect long-term external exposures in fairly reproducible levels, while for other metals, this association has not yet been assessed. Among dietary factors, only toenail selenium showed clear associations with the intake of supplements or specific foods. The toenail levels could also represent occupational exposure, for instance, Mn exposure in welders. The scarcity of information on other essential trace elements, together with the great heterogeneity among studies makes the validation of the usage of toenails as biomarkers of exposure to these elements difficult. Standardization of sample collection, quality control, analytical techniques and reporting procedures might facilitate further research focused on the clear understanding of the significance of essential levels in this promising matrix and would enhance its utility in epidemiological research.ElsevierInstituto de Salud Carlos III20212021-05-1320192019-01-0120192019-01-01review articlehttp://purl.org/coar/resource_type/c_dcae04bcVoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfapplication/ziphttp://hdl.handle.net/20.500.12105/12958reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/129582026-06-12T12:43:37Z
dc.title.none.fl_str_mv Toenails as biomarker of exposure to essential trace metals: A review
title Toenails as biomarker of exposure to essential trace metals: A review
spellingShingle Toenails as biomarker of exposure to essential trace metals: A review
Gutierrez-Gonzalez, Enrique
Metals
Biomarkers
Environmental Exposure
Humans
Nails
Reproducibility of Results
Selenium
Trace Elements
title_short Toenails as biomarker of exposure to essential trace metals: A review
title_full Toenails as biomarker of exposure to essential trace metals: A review
title_fullStr Toenails as biomarker of exposure to essential trace metals: A review
title_full_unstemmed Toenails as biomarker of exposure to essential trace metals: A review
title_sort Toenails as biomarker of exposure to essential trace metals: A review
dc.creator.none.fl_str_mv Gutierrez-Gonzalez, Enrique
García-Esquinas, Esther
Fernandez de Larrea-Baz, Nerea
Salcedo-Bellido, Inmaculada
Navas-Acien, Ana
Lope Carvajal, Virginia
Gómez-Ariza, José Luis
Pastor-Barriuso, Roberto
Pollan-Santamaria, Marina
Perez-Gomez, Beatriz
author Gutierrez-Gonzalez, Enrique
author_facet Gutierrez-Gonzalez, Enrique
García-Esquinas, Esther
Fernandez de Larrea-Baz, Nerea
Salcedo-Bellido, Inmaculada
Navas-Acien, Ana
Lope Carvajal, Virginia
Gómez-Ariza, José Luis
Pastor-Barriuso, Roberto
Pollan-Santamaria, Marina
Perez-Gomez, Beatriz
author_role author
author2 García-Esquinas, Esther
Fernandez de Larrea-Baz, Nerea
Salcedo-Bellido, Inmaculada
Navas-Acien, Ana
Lope Carvajal, Virginia
Gómez-Ariza, José Luis
Pastor-Barriuso, Roberto
Pollan-Santamaria, Marina
Perez-Gomez, Beatriz
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Instituto de Salud Carlos III
dc.subject.none.fl_str_mv Metals
Biomarkers
Environmental Exposure
Humans
Nails
Reproducibility of Results
Selenium
Trace Elements
topic Metals
Biomarkers
Environmental Exposure
Humans
Nails
Reproducibility of Results
Selenium
Trace Elements
description Health problems associated with essential trace metals can result from both inadequate (i.e., low intake) and excessive exposures (i.e., from environmental and/or occupational source). Thus, measuring the exposure level is a real challenge for epidemiologists. Among non-invasive biomarkers that intend to measure long-term exposure to essential trace metals, the toenail is probably the biological matrix with the greatest potential. This systematic review collects the current evidence regarding the validity of toenail clippings as exposure biomarker for trace metals such as boron, cobalt, copper, iron, manganese, molybdenum, selenium, silicon, vanadium and zinc. Special attention was paid to the time-window of exposure reflected by the toenail, the intraindividual variability in exposure levels over time in this matrix, and the relationship of toenail with other biomarkers, personal characteristics and environmental sources. Our search identified 139 papers, with selenium and zinc being the most studied elements. The variability among studies suggests that toenail levels may reflect different degrees of exposure and probably correspond to exposures occurred 3-12 months before sampling (i.e., for manganese/selenium). Few studies assessed the reproducibility of results over time and, for samples obtained 1-6 years apart, the correlation coefficient were between 0.26 and 0.66. Trace metal levels in toenails did not correlate well with those in the blood and urine and showed low-moderate correlation with those in the hair and fingernails. Available data suggests that for some elements (Se, Mn, Zn) toenail concentrations reflect long-term external exposures in fairly reproducible levels, while for other metals, this association has not yet been assessed. Among dietary factors, only toenail selenium showed clear associations with the intake of supplements or specific foods. The toenail levels could also represent occupational exposure, for instance, Mn exposure in welders. The scarcity of information on other essential trace elements, together with the great heterogeneity among studies makes the validation of the usage of toenails as biomarkers of exposure to these elements difficult. Standardization of sample collection, quality control, analytical techniques and reporting procedures might facilitate further research focused on the clear understanding of the significance of essential levels in this promising matrix and would enhance its utility in epidemiological research.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019-01-01
2019
2019-01-01
2021
2021-05-13
dc.type.none.fl_str_mv review article
http://purl.org/coar/resource_type/c_dcae04bc
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12105/12958
url http://hdl.handle.net/20.500.12105/12958
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/zip
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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