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Manganese in human parenteral nutrition: considerations for toxicity and biomonitoring

Dinamene Santos1, Camila Batoreu1, Luisa Mateus1

  • 1I-Med.UL, Department of Toxicology and Food Sciences, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal.

Neurotoxicology
|November 5, 2013
PubMed

Insights

Excessive manganese (Mn) in parenteral nutrition (PN) can cause neurotoxicity. Current biomonitoring methods for Mn exposure are unreliable, necessitating better approaches for patient safety.

Area of Science:

  • Clinical Chemistry
  • Neurotoxicology
  • Nutritional Science

Background:

  • Iatrogenic risks of excessive manganese (Mn) in parenteral nutrition (PN) are known.
  • Hypermanganesemia and neurotoxicity link to Mn dose, duration, and patient conditions like anemia or cholestasis.
  • Current PN guidelines suggest biomonitoring for Mn after 30 days of supplementation.

Purpose of the Study:

  • To review current approaches for biomonitoring Mn exposure.
  • To assess methods for evaluating Mn-induced neurotoxic risk in PN patients.
  • To address limitations in existing Mn biomonitoring strategies.

Main Methods:

  • Literature review of studies on Mn biomonitoring.
  • Analysis of conflicting data regarding Mn biomarkers.
  • Examination of dopaminergic (DAergic) and catecholaminergic metabolism alterations as potential biomarkers.

Main Results:

  • No definitive biomarker for Mn exposure or neurotoxicity has been identified.
  • Whole blood Mn (WB Mn) levels are variable and not strictly correlated with neurotoxicity.
  • Alterations in DAergic and catecholaminergic metabolism show potential as predictive biomarkers.

Conclusions:

  • Existing methods for Mn biomonitoring in PN patients have significant limitations.
  • Further research is needed to identify reliable biomarkers for Mn exposure and neurotoxicity.
  • Improved biomonitoring is crucial for managing Mn risks in PN patients.
Keywords:
BiomonitoringManganeseNeurotoxicityParenteral nutrition

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