metallothionein and Osteomalacia

The first health effects of cadmium (Cd) were reported already in 1858. Respiratory and gastrointestinal symptoms occurred among persons using Cd-containing polishing agent. The first experimental toxicological studies are from 1919. Bone effects and proteinuria in humans were reported in the 1940's. After World War II, a bone disease with fractures and severe pain, the itai-itai disease, a form of Cd-induced renal osteomalacia, was identified in Japan. Subsequently, the toxicokinetics and toxicodynamics of Cd were described including its binding to the protein metallothionein. International warnings of health risks from Cd-pollution were issued in the 1970's. Reproductive and carcinogenic effects were studied at an early stage, but a quantitative assessment of these effects in humans is still subject to considerable uncertainty. The World Health Organization in its International Program on Chemical Safety, WHO/IPCS (1992) (Cadmium. Environmental Health Criteria Document 134, IPCS. WHO, Geneva, 1-280.) identified renal dysfunction as the critical effect and a crude quantitative evaluation was presented. In the 1990's and 2000 several epidemiological studies have reported adverse health effects, sometimes at low environmental exposures to Cd, in population groups in Japan, China, Europe and USA (reviewed in other contributions to the present volume). The early identification of an important role of metallothionein in cadmium toxicology formed the basis for recent studies using biomarkers of susceptibility to development of Cd-related renal dysfunction such as gene expression of metallothionein in peripheral lymphocytes and autoantibodies against metallothionein in blood plasma. Findings in these studies indicate that very low exposure levels to cadmium may give rise to renal dysfunction among sensitive subgroups of human populations such as persons with diabetes.

Topics: Animals; Biomarkers; Cadmium; Dose-Response Relationship, Drug; Environmental Monitoring; Environmental Pollutants; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Kidney Diseases; Metallothionein; Osteomalacia; Protein Binding; Reproduction; Risk Assessment; Toxicology

Cadmium (Cd) is an environmental pollutant and is toxic to a number of organs. Chronic exposure to Cd causes loss of bone mass and increased incidence of bone fractures, as seen in Itai-itai patients and laboratory animals. Metallothionein (MT), a low-molecular weight, cysteine-rich, metal-binding protein, has been shown to play an important role in the detoxication of Cd. Thus, this study was designed to test the hypothesis that MT protects against Cd-induced bone injury. Wild-type and MT-I/II knockout (MT-null) mice were given repeated sc injections of CdCl(2) over a wide range of doses for 10 weeks, and Cd-induced bone injury was examined. Cd produced dose- and time-dependent increases in bone Cd content. However, the concentration of Cd in bone was much lower than that found in the liver and kidney (11 vs 400 and 120 microg/g, respectively) of the same mice. There was no difference in bone Cd content between wild-type and MT-null mice. Repeated Cd injections produced a dose-dependent loss of bone mass (up to 25%), as shown by analysis of the femur, tibia, and lumbar vertebrae. The loss of bone mass was more marked in MT-null mice than in wild-type mice, as shown by dry bone weight, defatted bone weight, bone ash weight, and total calcium content. X-ray photography showed decreasing bone density along the entire bone length with increasing dose and time of Cd exposure. The decrease in bone density was more marked in MT-null mice than in wild-type mice at the same dose and time points. Histopathology showed dilatation of haversian canals with increased osteoid seams, rounded osteocytes with expanded pericellular space, and expansion of hyperplastic bone marrow into metaphyseal cortical bone. Again, these lesions were more marked in MT-null mice. In conclusion, this study demonstrates that deficiency in MT renders animals more susceptible to Cd-induced bone mass loss and bone injury, and thus indicates that MT plays a protective role in Cd-induced toxicity in bone, as it does in other tissues.

Topics: Animals; Bone and Bones; Bone Density; Cadmium; Cadmium Chloride; Disease Models, Animal; Female; Genetic Predisposition to Disease; Homozygote; Injections, Subcutaneous; Male; Metallothionein; Mice; Mice, Knockout; Osteomalacia

The effects of long-term administration of cadmium (Cd) chloride on the bone were studied using ovariectomized rats. The rats were injected iv with the compound at doses of 1.0 and 2.0 mg/kg, 5 days a week, for 13 weeks. The serum concentrations of calcium and inorganic phosphorus were significantly increased from 8 weeks in the 2.0 mg/kg group. The bone Cd content was gradually increased for 13 weeks in a dose-dependent manner. Calcium and phosphorus contents in the bone, and serum levels of parathyroid hormone and osteocalcin, were not significantly different between Cd-treated and control rats. Histopathologically, chronic Cd nephropathy such as tubular atrophy and interstitial fibrosis was observed with clinical polyuria and increased enzymuria. The skeletal changes were detected mainly in the femur and tibia. In the metaphysis of Cd-treated rats, cancellous bone mass increased with time. This change was detected as an increased opacity by a roentgenogram. In the cortical bone of the midshaft haversian canals were dilated with clearly bordered osteoid seams and showed a motheaten pattern in rats in the 2.0 mg/kg group at 13 weeks. In the present study, we report Cd nephropathy and osteomalacic changes in ovariectomized rats with iv injection of CdCl2 for 13 weeks. Although an involvement of the indirect action of Cd through renal failure could not be ruled out in this experiment, our biochemical and pathological data suggested that osteomalacia was induced by a direct action of Cd on the bone through abnormal calcium homeostasis.

Topics: Animals; Body Weight; Cadmium; Calcium; Female; Hematologic Tests; Kidney; Liver; Metallothionein; Osteocalcin; Osteomalacia; Osteopetrosis; Ovariectomy; Parathyroid Hormone; Phosphorus; Rats; Rats, Sprague-Dawley; Urinalysis