Membrane transport of nonessential toxic heavy metals (type D heavy metals) not only controls their access to intracellular target sites but also helps determine their uptake, distribution, and excretion from the body. The critical role of membranes in the toxicology of class D metals has attracted the attention of many investigators, and extensive information has been collected on the mechanism(s) of metal transfer across membranes. Characteristics of metal transport in different cells, or even on opposite sides of the same cell, or under different physiological conditions, are not identical, and no unitary hypothesis has been formulated to explain this process in all cells. However, it seems possible that the mechanisms proposed for different cells represent variations on a few common themes.
The high reactivity of heavy metals with biological systems is well documented, although some disagreement remains on the precise dose-effect relationships involved. This represents a question of considerable importance, especially in attempts to assess the risks of exposure. The implicit assumption is usually made that a threshold concentration of specific metals exists in the most sensitive target organ, so that an increased frequency of functional lesions will be expected if this threshold is exceeded. The threshold for the metal defines its so-called critical level, and this review was written in order to examine the theoretical and practical difficulties in establishing such a level. Among these may be cited, for instance, the dependence of what constitutes the target tissue on the speciation of the metal, the changes in apparent critical level with rate and route of metal administration, the short half-life of some of the metals as well as their compartmentation in the tissues, and the considerable initiation delay frequently preceding the appearance of lesions. For these and other reasons a useful approximate value for a critical concentration has only been proposed so far for the total Cd concentration in the renal cortex of chronically exposed human adults.
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