Bioaccessibility and health risk assessment of mercury in cinnabar containing Traditional Chinese Medicines

Lu, Yuting; Yang, Dan-Yi; Song, Xiaoni; Wang, Sheng; Song, Min; Hang, Taijun

doi:10.1016/j.jtemb.2017.05.006

Cited by 21 publications

(13 citation statements)

References 23 publications

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“…Our study further supported the belief that MN and MCN occur following the use of mercury-containing skinlightening creams. However, MN was also observed following the inappropriate use of CFRs [13]. The results of this study are consistent with those of most international mercury poisoning cases and reports [33] that used small samples.…”

Section: Discussionsupporting

confidence: 91%

“…used for centuries for commercial and medical purposes and are a common constituent of traditional Chinese medicines (TCMs) [11,12]. Unlike TCMs, which are formally approved medical treatments and have reasonably safe levels of bioaccessible Hg [13], Chinese folk remedies (CFRs) involve an informal use of TCMs, rely mostly on experience rather than on formal teachings, and have not been approved by the government [14]. Although incidents of mercury poisoning in China have been occasionally reported domestically and abroad [15,16], there have been no clinical studies involving a large sample size to date.…”

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confidence: 99%

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Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis

Sun

Long

Zhao

et al. 2020

Preprint

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Background: There are no reports on the incidence of mercury poisoning in a large population in China. This study investigated the epidemiology, clinical manifestations, treatment, and follow-up of Chinese patients with mercury poisoning. Methods: Data for 288 mercury poisoning patients were collected at our hospital from July 2014 to September 2019, including sex, age, admission time, blood mercury content, urine mercury content, creatinine, urinary mercury/creatinine ratio, 24-h urinary protein levels, electromyography (EMG) findings, renal biopsy, and follow-up. Patient characteristics were evaluated by statistical and correlation analyses. Results: First, mercury poisoning in China mainly occurred through occupational exposure and the inappropriate use of mercury-containing cosmetics and Chinese folk remedies (CFRs). Second, the most common symptoms were nervous system (50.3%), kidney (16.4%) and breathing (8.0%). Mercury poisoning-induced Nephrotic syndrome (NS) and peripheral neuropathy are common long-term complications. The complications of occupational and cosmetics-induced mercury poisoning are consistent with international belief. However, the NS caused by CFRs is mainly membranous nephropathy and the probability of peripheral neuropathy caused by CFRs is higher than other pathogens. Third, follow-up data shows that 13 patients with EMG-confirmed neurological injury, 10 showed full recovery after 38.5 ± 8.03 months. Furthermore, among 18 patients with NS, 15 had normal urine protein and serum albumin levels after 22.67 ± 10.26 months.Conclusions: Regulation of skin-lightening cosmetic products, safety surveillance of CFRs, and prevention and control of occupational exposure must be improved to decrease the incidence of mercury poisoning in China.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis

Sun

Long

Zhao

et al. 2020

Preprint

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“…Bioaccessible Hg contents of 29 HgS-containing traditional medicines were determined by cold-vapor atomic fluorescence spectrometry after in vitro extractions with the simulated gastrointestinal fluids. According to the daily dosages, the bioaccessible Hg exposures of the majority (27/29) of TCMs except for Shusha Anshen pills and Zixue Pills were within the permitted daily exposure limits established by the International Council for Harmonisation, demonstrating that these traditional medicines may be safe when administrated following the appropriate instructions [55].…”

Section: Chemical Compositions Of Pb Hg and As Affect Their Bioamentioning

confidence: 99%

Chemical Compositions of Metals in Bhasmas and Tibetan Zuotai Are a Major Determinant of Their Therapeutic Effects and Toxicity

Liu

Zhang

Velagapudi

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Minerals are alchemically processed as Bhasmas in Ayurvedic medicines or as Zuotai in Tibetan medicines. Ayurveda is a knowledge system of longevity and considers the mineral elixir made from “nature” capable of giving humans perpetual life. Herbo-metallic preparations have a long history in the treatment of various diseases in India, China, and around the world. Their disposition, pharmacology, efficacy, and safety require scientific evaluation. This review discusses the Bhasmas in Ayurvedic medicines and Zuotai in Tibetan medicines for their occurrence, bioaccessibility, therapeutic use, pharmacology, toxicity, and research perspectives. A literature search on Mineral, Bhasma, Ayurvedic medicine, Zuotai, Tibetan medicine, and Metals/metalloids from PubMed, Google and other sources was carried out, and the relevant papers on their traditional use, pharmacology, and toxicity were selected and analyzed. Minerals are processed to form Bhasma or Zuotai to alter their physiochemical properties distinguishing them from environmental metals. The metals found in Ayurveda are mainly from the intentional addition in the form of Bhasma or Zuotai. Bhasma and Zuotai are often used in combination with other herbals and/or animal-based products as mixtures. The advanced technologies are now utilized to characterize herbo-metallic preparations as Quality Assurance/Quality Control. The bioaccessibility, absorption, distribution, metabolism, and elimination of herbo-metallic preparations are different from environmental metals. The pharmacological basis of Bhasma in Ayurveda and Zuotai in Tibetan medicines and their interactions with drugs require scientific research. Although the toxic potentials of Bhasma and Zuotai differ from environmental metals, the metal poisoning case reports, especially lead (Pb), mercury (Hg), and arsenic (As) from inappropriate use of traditional medicines, are increasing, and pharmacovigilance is desired. In risk assessment, chemical forms of metals in Bhasma and Zuotai should be considered for their disposition, efficacy, and toxicity.

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“…It is stated that the solubility of cinnabar bioavailability is silently dissimilar from mercury vapor, mercuric chloride, along with methyl mercury. A better considerate of toxic kinetic characteristics of cinnabar is necessary for suitable safety valuation of inorganic cinnabar applied inside traditional medicines [30].…”

Section: Identification Quantification and Characterization Of Hgsmentioning

confidence: 99%

New insights and rethinking of cinnabar for chemical and its pharmacological dynamics

Jain

Sarsaiya

et al. 2019

Bioengineered

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Cinnabar is an attractive mineral with many different uses. It is reported that cinnabar is one of the traditional Chinese's medicines extensively use. The main objective of this critical review is to identify the current overview, concept and chemistry of cinnabar, which includes the process developments, challenges, and diverse options for pharmacology research. It is used as a medicine through probable toxicity, especially when taking overdoes. This review is the first to describe the toxicological effects of cinnabar and its associated compounds. Nuclear magnetic resonance (NMR) dependent metabolomics could be useful for examination of the pharmaceutical consequence. The analysis indicated that the accurate preparation methods, appropriate doses, disease status, ages with drug combinations are significant factors for impacting the cinnabar toxicity. Toxicologically, synthetic mercury sulfide or cinnabar should be notable for mercuric chloride, mercury vapor and methyl mercury for future protection and need several prominent advancements in cinnabar research. ARTICLE HISTORY

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Bioaccessibility and health risk assessment of mercury in cinnabar containing Traditional Chinese Medicines

Cited by 21 publications

References 23 publications

Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis

Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis

Chemical Compositions of Metals in Bhasmas and Tibetan Zuotai Are a Major Determinant of Their Therapeutic Effects and Toxicity

New insights and rethinking of cinnabar for chemical and its pharmacological dynamics

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