Serological Heavy Metal Assessment in Persons with IBD.

Abstract

BACKGROUND: Emerging evidence implicates heavy metals (HM) as environmental factors which may influence Crohn's disease (CD) and ulcerative colitis (UC) pathogenesis. METHODS: The present report includes two related studies. The first ('serum-only') compares HM serum levels (parts per billion, ppb) in people with CD and UC, including aluminum (Al), chromium (Cr), mercury (Hg), and titanium (Ti) compared to people with multiple sclerosis (MS) and healthy controls (HC). The second study correlated serum and tissue levels of HM in 18 persons undergoing colonoscopy and biopsy. Serum and intestinal biopsies of Al, Cr, Ti, and Hg concentrations were quantified using inductively coupled plasma mass spectrometry for both studies. RESULTS: The serum-only study included 287 participants (CD (n=100), UC (n=50), MS (n=49), and HC (n= 88)). Versus HC, adjusted serum Al concentrations were higher in CD [fold change, 1.34; 95%CI (1.12-1.61)], lower in UC [0.64; 95%CI (0.51-0.80)], and lower in MS [0.76; 95%CI (0.60-0.97)]. Ti concentrations were lower in all three disease groups versus HC. Cr concentrations, higher in MS [2.34; 95% CI (1.59-3.45)], did not differ significantly between HC and either CD or UC. Hg concentrations were higher in both CD [2.17; 95%CI (1.52-3.09) and MS [1.62; 95%CI (1.02-2.59)]. In our small exploratory substudy, we found no statistically significant correlation between serum and intestinal tissue HM levels. CONCLUSION: Our report demonstrates differences in serum HM levels in people with CD relative to persons with UC or HC. Future research will benefit from the evaluation of these disparities and identification of potential implicated mechanisms.

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