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The effect of chelation on bone Pb stores in Pb poisoned children
Aaron J Specht1,2, Yanfen Lin3, Jian Xu3
1School of Health Sciences, Purdue University, West Lafayette, IN, USA. aspecht@purdue.edu.
Insights
Chelation therapy significantly reduces bone lead levels in children with lead poisoning. This treatment lessens the body
Area of Science:
- Pediatric Environmental Health
- Toxicology
- Chelation Therapy
Background:
- Childhood lead exposure is a persistent public health issue with long-term developmental consequences.
- Bone lead represents a significant portion (60-90%) of total body lead burden in children, acting as a reservoir for endogenous lead release.
- The efficacy of chelation therapy for lead poisoning remains a subject of ongoing research and debate.
Purpose of the Study:
- To evaluate the impact of chelation therapy on bone lead levels in children diagnosed with lead poisoning.
- To quantify changes in bone lead stores following intravenous ethylenediaminetetraacetic acid (EDTA) treatment.
Main Methods:
- Children diagnosed with lead poisoning (blood lead >25 µg/dL) at Xinhua Hospital, Shanghai, China, were enrolled.
- Participants received one-week courses of intravenous EDTA chelation therapy, with bone lead levels measured before and after treatment.
- Bone lead measurements and treatment protocols were repeated up to three times over a two-year study period.
Main Results:
- A statistically significant reduction in bone lead levels was observed post-chelation therapy (p < 0.0001).
- This reduction remained significant even after accounting for theoretical bone turnover (p = 0.01).
- The magnitude of bone lead reduction increased with repeated chelation treatments.
Conclusions:
- Chelation therapy is an effective intervention for reducing bone lead stores in children with elevated blood lead levels (>25 µg/dL).
- Reducing bone lead burden through chelation can mitigate the risk of long-term endogenous lead exposure and associated health impacts.
- The study supports chelation therapy as a viable strategy to manage lead poisoning in pediatric populations.
Background:
Lead exposure remains a key problem for children during development. One treatment for lead poisoning is chelation - a topic that remains controversial with varied results. Bone lead serves as a marker of total body burden of lead and encompasses between 60-90% of lead storage in children.
Objective:
In this study, we aimed to identify the change in bone lead as a result of chelation therapy in a group of lead poisoned children (blood lead >25 µg/dL).
Methods:
Upon diagnosis with lead poisoning at Xinhua Hospital in Shanghai, China, children were recruited to our study, had their bone lead levels measured, and underwent one-week of intravenous, in-patient ethylenediaminetetraacetic acid chelation treatment. Up to three clinical visits with the same treatment protocol and bone lead measurements were completed over the two-year study. We measured biomarkers of lead exposure for children exposed via various potential sources, including home contaminants, local industrial emissions, traditional medicines, or lead cookware.
Results:
We observed significant differences with bone lead after chelation therapy (p < 0.0001), even after calculating a conservative model for theoretical decay from known bone turnover (p = 0.01). The difference identified between our observed change in bone lead and literature established bone lead change significantly increased with more chelation treatments. A significant reduction in bone lead was observed following chelation treatment of children with lead poisoning - a difference that increased more with more chelation.
Significance:
Study results indicate that chelation treatment is effective in reducing bone lead stores in children with initial blood lead levels greater than 25 µg/dL.
Impact Statement:
Lead exposure in children is a consistent problem - drastically impacting health across the life span. After exposure, lead stores in the bone of children serving as a potential endogenous source of exposure for years to decades. Our study demonstrated that chelation therapy, while reducing blood lead levels, additionally reduced bone lead levels. A reduction in bone lead would effectively reduce the potential for endogenous release of lead and restrict the damage done by lead exposure.
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