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Phlebotomy increases cadmium uptake in hemochromatosis
1Institute of Environmental Medicine, Division of Metals and Health, Karolinska Institutet, Stockholm, Sweden. Agneta.Akesson@imm.ki.se
Environmental Health Perspectives
|April 7, 2000
Summary
Hereditary hemochromatosis (HH) treatment, specifically phlebotomy, increases cadmium absorption. This suggests that phlebotomy, not HH itself, enhances cadmium uptake, requiring further investigation into genotype-dependent absorption.
Area of Science:
- Environmental toxicology
- Human physiology
- Medical genetics
Background:
- Intestinal absorption of cadmium, a nephrotoxic pollutant, increases with depleted iron stores.
- This enhanced absorption may involve the divalent metal transporter 1 (DMT1).
- Hereditary hemochromatosis (HH) is characterized by excessive iron absorption.
Purpose of the Study:
- To investigate if hereditary hemochromatosis (HH) is associated with increased absorption of cadmium and lead.
- To determine the role of HH and its treatment (phlebotomy) in heavy metal absorption.
Main Methods:
- Blood cadmium, lead, and iron status markers were measured.
- 21 non-smoking subjects with genetically confirmed HH (HFE mutations) and 21 matched controls were studied.
- Comparison of heavy metal levels between HH patients and controls, considering phlebotomy treatment duration.
Main Results:
- Blood cadmium concentrations were significantly higher in HH subjects undergoing maintenance phlebotomy compared to controls.
- A positive, age-independent association was found between blood cadmium levels and years of phlebotomy treatment.
- Blood lead levels showed a similar, though less pronounced, increase with phlebotomy treatment.
Conclusions:
- Phlebotomy treatment for HH, rather than the disease itself, appears to increase cadmium uptake.
- Further research is necessary to confirm if the HH disease state decreases cadmium absorption and if absorption is genotype-dependent.