Antioxidant Vitamins Reduce Chronic Arsenic Toxicity by Increased Elimination Through Urine in Bangladeshi Adults: A Double-Blind, Placebo Controlled Study.

2.50
Hdl Handle:
http://hdl.handle.net/10755/164017
Category:
Abstract
Type:
Presentation
Title:
Antioxidant Vitamins Reduce Chronic Arsenic Toxicity by Increased Elimination Through Urine in Bangladeshi Adults: A Double-Blind, Placebo Controlled Study.
Author(s):
Rabbani, Golam H.; Ali, Shah Mohammad Keramat; Das, Hirendra Humar; Hossain, Afzal; Gupta, Pradip Kumar Sen; Haq, Engr. Ihtishamul; Islam, M. Moyenul
Author Details:
Golam H. Rabbani, MD, PhD, FACG, Scientist, CRSC Physician, International Centre for Diarrhoeal Disease Research: Centre for Health and Population Research (ICDDR, B), Mohakhali, Dhaka, Bangladesh, email: rabbani@icddrb.org; Shah Mohammad Keramat Ali; Hirendra Humar Das; Afzal Hossain; Pradip Kumar Sen Gupta; Engr. Ihtishamul Haq; M. Moyenul Islam
Abstract:
Background and Objectives: Ground water contamination with toxic levels of arsenic in Bangladesh is one of the largest environmental catastrophes in the world affecting an estimated seventy-five million people. Unfortunately, there is no specific medical treatment for chronic arsenic poisoning. Vitamins and minerals possess powerful antioxidative properties; thus, these agents could be potential therapeutic agents against arsenicosis. Methods: This double-blind, placebo controlled trial was carried out among 319 adult men and women with chronic arsenic poisoning due to prolonged drinking of contaminated tubewell water in nine villages. Selected patients had skin lesions (keratosis, melanosis) and presence of arsenic in their samples of hair, nail, and urine. 158 patients were given 2 caplets of vitamin and mineral preparation (VMS6) daily for 6 months, and then every alternate month for a total of 12 months. Each caplet contains beta carotene, ascorbic acid, alpha tocopherol, selenium, zinc, and folic acid in standard recommended dosages. Identical placebo preparations were similarly administered to 161 patients. Patients were also supplied with arsenic-free water. Results: After 12 months of treatment, VMS6 treated patients significantly (p<0.05) gained a net body weight of 2.78 kg more than the placebo group. VMS6 treated patients also increased their hemoglobin content by 1.7 g/dL. Severity of skin lesions was also reduced from grade 3.0 to grade 1.0 in VMS6 treated patients; these patients also improved their appetite and felt better than the placebo treated patients. Urinary concentrations of total arsenic were reduced to 50% in both groups after 3 months of treatment likely due to the introduction of arsenic-free water and not VMS6 treatment. However, at 6, 9, and 12 months, there were significant (p<0.05) increases in urinary arsenic concentrations in the VMS6 treatment groups compared to placebo. At 9 and 12 months, VMS6 treated patients were excreting more than twice the amounts of arsenic compared to placebo treated patients. Similarly, total arsenic contents in scalp hair and finger nails were significantly reduced in VMS6 treated patients compared to placebo. There were significant positive correlations between urinary arsenic concentrations and those in hair (r2=0.7831) and nail (r2=0.7123). Arsenic contents in hair and nail also correlated with the arsenic concentrations in drinking water (r2=0.8753, hair and r2=0.8289, nail). Urinary concentrations of organic metabolites of arsenic, MMA (10-15%) and DMA (18-20%) were lower in our patients and inorganic arsenic (sum of AsIII and AsV) were relatively higher (70-75%) compared to values in other population groups. This indicates poor methylation, low urinary excretion, and increased retention of arsenic in our patients. However, VMS6 treatment significantly (p<0.05) increased DMA concentrations in urine from 19.2% to 49.85 after 12 months indicating an increase in methylation capacity induced by VMS6 treatment. VMS6 treatment also significantly (p<0.05) reduced the MMA/DMA ratio from 0.61 to 0.44 after 12 months, while there was no change in the placebo group. Conclusions: Antioxidants including vitamins and minerals are useful and safe in reducing arsenic toxicity in Bangladeshi adults by specifically increasing arsenic elimination through urine, hair, and nail. Thus, a combination of antioxidants and clean drinking water could be an important strategy for arsenic mitigation in Bangladesh.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2006
Conference Host:
McMaster University
Conference Location:
Dhaka, Bangladesh
Description:
2006 International Conference: Dhaka, Bangladesh. The International Conference on the Impact of Global Issues on Women and Children, co-organized by McMaster University and the State University of Bangladesh, is an opportunity for the interdisciplinary exchange of development expertise and will be held in Dhaka, Bangladesh from February 12-16, 2006.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleAntioxidant Vitamins Reduce Chronic Arsenic Toxicity by Increased Elimination Through Urine in Bangladeshi Adults: A Double-Blind, Placebo Controlled Study.en_GB
dc.contributor.authorRabbani, Golam H.en_US
dc.contributor.authorAli, Shah Mohammad Keramaten_US
dc.contributor.authorDas, Hirendra Humaren_US
dc.contributor.authorHossain, Afzalen_US
dc.contributor.authorGupta, Pradip Kumar Senen_US
dc.contributor.authorHaq, Engr. Ihtishamulen_US
dc.contributor.authorIslam, M. Moyenulen_US
dc.author.detailsGolam H. Rabbani, MD, PhD, FACG, Scientist, CRSC Physician, International Centre for Diarrhoeal Disease Research: Centre for Health and Population Research (ICDDR, B), Mohakhali, Dhaka, Bangladesh, email: rabbani@icddrb.org; Shah Mohammad Keramat Ali; Hirendra Humar Das; Afzal Hossain; Pradip Kumar Sen Gupta; Engr. Ihtishamul Haq; M. Moyenul Islamen_US
dc.identifier.urihttp://hdl.handle.net/10755/164017-
dc.description.abstractBackground and Objectives: Ground water contamination with toxic levels of arsenic in Bangladesh is one of the largest environmental catastrophes in the world affecting an estimated seventy-five million people. Unfortunately, there is no specific medical treatment for chronic arsenic poisoning. Vitamins and minerals possess powerful antioxidative properties; thus, these agents could be potential therapeutic agents against arsenicosis. Methods: This double-blind, placebo controlled trial was carried out among 319 adult men and women with chronic arsenic poisoning due to prolonged drinking of contaminated tubewell water in nine villages. Selected patients had skin lesions (keratosis, melanosis) and presence of arsenic in their samples of hair, nail, and urine. 158 patients were given 2 caplets of vitamin and mineral preparation (VMS6) daily for 6 months, and then every alternate month for a total of 12 months. Each caplet contains beta carotene, ascorbic acid, alpha tocopherol, selenium, zinc, and folic acid in standard recommended dosages. Identical placebo preparations were similarly administered to 161 patients. Patients were also supplied with arsenic-free water. Results: After 12 months of treatment, VMS6 treated patients significantly (p<0.05) gained a net body weight of 2.78 kg more than the placebo group. VMS6 treated patients also increased their hemoglobin content by 1.7 g/dL. Severity of skin lesions was also reduced from grade 3.0 to grade 1.0 in VMS6 treated patients; these patients also improved their appetite and felt better than the placebo treated patients. Urinary concentrations of total arsenic were reduced to 50% in both groups after 3 months of treatment likely due to the introduction of arsenic-free water and not VMS6 treatment. However, at 6, 9, and 12 months, there were significant (p<0.05) increases in urinary arsenic concentrations in the VMS6 treatment groups compared to placebo. At 9 and 12 months, VMS6 treated patients were excreting more than twice the amounts of arsenic compared to placebo treated patients. Similarly, total arsenic contents in scalp hair and finger nails were significantly reduced in VMS6 treated patients compared to placebo. There were significant positive correlations between urinary arsenic concentrations and those in hair (r2=0.7831) and nail (r2=0.7123). Arsenic contents in hair and nail also correlated with the arsenic concentrations in drinking water (r2=0.8753, hair and r2=0.8289, nail). Urinary concentrations of organic metabolites of arsenic, MMA (10-15%) and DMA (18-20%) were lower in our patients and inorganic arsenic (sum of AsIII and AsV) were relatively higher (70-75%) compared to values in other population groups. This indicates poor methylation, low urinary excretion, and increased retention of arsenic in our patients. However, VMS6 treatment significantly (p<0.05) increased DMA concentrations in urine from 19.2% to 49.85 after 12 months indicating an increase in methylation capacity induced by VMS6 treatment. VMS6 treatment also significantly (p<0.05) reduced the MMA/DMA ratio from 0.61 to 0.44 after 12 months, while there was no change in the placebo group. Conclusions: Antioxidants including vitamins and minerals are useful and safe in reducing arsenic toxicity in Bangladeshi adults by specifically increasing arsenic elimination through urine, hair, and nail. Thus, a combination of antioxidants and clean drinking water could be an important strategy for arsenic mitigation in Bangladesh.en_GB
dc.date.available2011-10-27T11:36:39Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:36:39Z-
dc.conference.date2006-
dc.conference.hostMcMaster Universityen_US
dc.conference.locationDhaka, Bangladeshen_US
dc.description2006 International Conference: Dhaka, Bangladesh. The International Conference on the Impact of Global Issues on Women and Children, co-organized by McMaster University and the State University of Bangladesh, is an opportunity for the interdisciplinary exchange of development expertise and will be held in Dhaka, Bangladesh from February 12-16, 2006.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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