Multiple low-level exposures: Hg interactions with co-occurring neurotoxic substances in early life

• Published in: Biochimica et biophysica acta. General subjects 2019-12, Vol.1863 (12), p.129243, Article 129243
• Main Author: Dórea, José G.
• Format: Article
• Language: English
• Subjects: Breastfeeding; Child; Child Development - drug effects; Children; Developmental Disabilities - etiology; Dose-Response Relationship, Drug; Female; Fetus - drug effects; Humans; Infants; Mercury; Mercury - adverse effects; Nervous System - drug effects; Neurodevelopment; Neurotoxins - adverse effects; Pregnancy; Vaccines - adverse effects
• ISSN: 0304-4165; 1872-8006
• DOI: 10.1016/j.bbagen.2018.10.015

All chemical forms of Hg can affect neurodevelopment; however, low levels of organic Hg (methylmercury-MeHg and ethylmercury-EtHg in Thimerosal-containing vaccines, hereafter ‘TCV’) exposures during early life (pregnancy and lactation) co-occur with other environmental neurotoxic substances. These neurotoxicants may act in parallel, synergistically, or antagonistically to Hg. Nevertheless, the risks of neurotoxicity associated with multiple neuro-toxicants depend on type, time, combinations of exposure, and environmental and/or genetic-associated factors. Neurological developmental disorders, delays in cognition and behavioral outcomes associated with multiple exposures (which include Hg) may show transient or lasting outcomes depending on constitutional and/or environmental factors that can interact to neutralize, aggravate or attenuate these effects; often these studies are challenging to interpret. During pregnancy and lactation, fish-MeHg exposure is frequently confounded with the opposing effects of neuroactive nutrients (in fish) that lead to positive, negative, or no effects on neurobehavioral tests. In infancy, exposures to acute binary mixtures (TCV- EtHg and Al-adjuvants in infant immunizations) are associated with increased risks of tics and other developmental disorders. Despite the certitude that promulgates single environmental neurotoxicants, empirical comparisons of combined exposures indicate that Hg-related outcome is uneven. Hg in combination with other neurotoxic mixtures may elevate risks of neurotoxicity, but these risks arise in circumstances that are not yet predictable. Therefore, to achieve the goals of the Minamata treaty and to safeguard the health of children, low levels of mercury exposure (in any chemical form) needs to be further reduced whether the source is environmental (air- and food-borne) or iatrogenic (pediatric TCVs). [Display omitted] •Hg exposures during early life co-occur with a variety of neurotoxic substances.•Low levels of neurotoxic substances occur in air, food, and pharmaceuticals.•Binary mixtures are frequently found for EtHg-Al (TCV) and for environmental HgPb.•Additive, synergistic, or antagonistic effects are observed from randomly occurring combinations.