Measuring the impact of manganese exposure on children's neurodevelopment: advances and research gaps in biomarker-based approaches.
Measuring the impact of manganese exposure on children's neurodevelopment: advances and research gaps in biomarker-based approaches.
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DOI：
10.1186/s12940-016-0174-4
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发表时间：
2016-08-30
期刊：
影响因子：
--
通讯作者：
Stepanov I
中科院分区：
文献类型：
--
作者：
Coetzee DJ;McGovern PM;Rao R;Harnack LJ;Georgieff MK;Stepanov I
儿童暴露于锰（Mn）是一个公共卫生问题，缺乏关于锰暴露安全水平的一致政策指南。确定锰暴露阈值的复杂性部分与其作为健康所需的低水平必需微量营养素和高水平神经毒素的双重作用有关。存在的问题与年龄有关的易感性过量锰，特别是儿童，以及如何最好地衡量慢性暴露。为了解决这一问题，我们进行了系统的审查研究儿童的锰暴露和神经发育的结果集中在选择生物标志物为基础的和环境测量锰暴露，以确定科学进步和研究差距。检索了截至2016年3月的PubMed和EMBASE数据库，以查找以英语发表的研究，使用基于生物标志物或环境的Mn暴露测量，并测量了0-18岁儿童的至少一种神经学结局。最终，来自13个国家的36篇论文被选中。研究设计为横断面（24）、前瞻性队列（9）和病例对照（3）。首先评估了婴儿（6篇论文）、幼儿或学龄前儿童（3篇论文）和学龄儿童（27篇论文）中锰暴露的神经发育结局。学龄儿童的研究最常使用头发或血液的锰生物标志物测量智商（IQ）分数。较高的头发锰浓度始终与较低的智商分数，而血液生物标志物和智商分数的研究结果不一致。婴儿和幼儿的研究最常测量智力和精神发育;锰的生物标志物（头发、脐带血、牙釉质、母亲或儿童血液和牙本质）之间的结果不一致。虽然很少有研究测量锰的环境来源，但头发生物标志物与饮用水和婴儿配方奶粉中的锰有关。只有一篇论文量化了锰的环境来源和血液浓度之间的关联。发锰是学龄儿童锰暴露的更一致和有效的生物标志物。准确测量儿童暴露于锰是至关重要的，以解决这些知识差距，在未来的研究。然而，鉴于胎儿和婴儿对过量锰的独特脆弱性，迫切需要对胎儿和婴儿可行的生物标志物进行研究。
Children’s exposure to manganese (Mn) is a public health concern and consistent policy guidelines for safe levels of Mn exposure is lacking. The complexity of establishing exposure thresholds for Mn partially relates to its dual role as an essential micronutrient with low levels required for good health, but also as a neurotoxin at high levels. Questions exist about the age-related susceptibility to excess Mn, particularly for children, and how best to measure chronic exposures. To address this concern we conducted a systematic review of studies examining children’s exposure to Mn and neurodevelopmental outcomes focused on selection of biomarker-based and environmental measurements of Mn exposure to identify the scientific advances and research gaps. PubMed and EMBASE databases were searched through March 2016 for studies that were published in English, used a biomarker-based or environmental measurement of Mn exposure, and measured at least one neurological outcome for children aged 0–18 years. Ultimately, thirty-six papers from 13 countries were selected. Study designs were cross-sectional (24), prospective cohorts (9), and case control (3). Neurodevelopmental outcomes were first assessed for Mn exposure in infants (6 papers), toddlers or preschoolers (3 papers) and school-age children (27 papers). Studies of school-aged children most frequently measured Intelligence Quotient (IQ) scores using Mn biomarkers of hair or blood. Higher hair concentrations of Mn were consistently associated with lower IQ scores while studies of blood biomarkers and IQ scores had inconsistent findings. Studies of infants and toddlers most frequently measured mental and psychomotor development; findings were inconsistent across biomarkers of Mn (hair, cord blood, tooth enamel, maternal or child blood and dentin). Although few studies measured environmental sources of Mn, hair biomarkers were associated with Mn in drinking water and infant formula. Only one paper quantified the associations between environmental sources of Mn and blood concentrations. Hair-Mn was the more consistent and valid biomarker of Mn exposure in school-aged children. Accurate measurement of children’s exposure to Mn is crucial for addressing these knowledge gaps in future studies. However, research on biomarkers feasible for fetuses and infants is urgently needed given their unique vulnerability to excessive Mn.
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影响因子：
48
作者：
Grandjean, Philippe;Landrigan, Philip J.
通讯作者：
Landrigan, Philip J.
影响因子：
10.4
作者：
Claus Henn B;Schnaas L;Ettinger AS;Schwartz J;Lamadrid-Figueroa H;Hernández-Avila M;Amarasiriwardena C;Hu H;Bellinger DC;Wright RO;Téllez-Rojo MM
通讯作者：
Téllez-Rojo MM
影响因子：
11.4
作者：
Eastman, Rachel R.;Jursa, Tom P.;Benedetti, Chiara;Lucchini, Roberto G.;Smith, Donald R.
通讯作者：
Smith, Donald R.
影响因子：
10.4
作者：
Bouchard MF;Sauvé S;Barbeau B;Legrand M;Brodeur MÈ;Bouffard T;Limoges E;Bellinger DC;Mergler D
通讯作者：
Mergler D
影响因子：
10.4
作者：
Aschner, M
通讯作者：
Aschner, M