Articles > Diagnostics
	Products ERYTHROCYTE (Red Blood Cell) Essential & Toxic Elements In general, erythrocytes appear to be more useful to monitor steady-state levels of the essential nutritional and toxic elements. Essential Elements - Erythrocytes Chromium (Cr) - Exposure to chromium (VI) through the air which is produced in industry can result in damage to the nose, lungs, and is a carcinogen. Cobalt (Co) - Cobalt is an essential metal for humans and is part of the enzyme cyanocobalamin (vitamin B12). A deficiency of cobalt is accompanied by all the signs and symptoms of a vitamin B12 deficiency, and is often due to absorption problems (ie. lack of intrinsic factor or malnutrition). Occupational workers can still be exposed to cobalt dust with resulting illnesses as contact dermatitis, cardiomyopathy, liver and kidney damage. Deficiency or toxicity to cobalt can be monitored with erythrocyte, urine or hair analysis. Copper (Cu) - Dietary Cu malnourishment can result in neutropenia, diarrhea, and bone changes. In nutritional copper deficiency, the serum copper may give misleading results due to the inflammatory reaction which increases serum Cu. Erythrocyte copper may be a better index to determine Cu deficiency in patients with inflammation. Genetic defect in copper absorption can result in Menke's (kinky hair) syndrome or excessive accumulation of Cu in the liver, brain, cornea and kidney due to an inborn error of Cu metabolism (Wilson's disease). Magnesium (Mg) - In erythrocytes, magnesium is over twice the concentration found in plasma with over 55% in the ionized form. As the intracellular Mg is bound to ATP, it may be a better index of the bio-energetic activity on a long-term basis. It has been reported to be significantly lower in women with premenstrual tension syndrome, hypertension, and chronic fatigue syndrome. Manganese-(Mn) - Deficiency of manganese can result in convulsive disorders such as epilepsy, myasthenia gravis, and impaired insulin activity. Excess levels may result in iron-deficiency anemia due to its interference of dietary iron absorption. Manganese poisoning can occur in workers in battery manufacturing, and from well water with excessive content. Increased erythrocyte concentrations have been reported in patients with rheumatoid arthritis. Measurement of erythrocyte Mn may provide a better index of nutritional intake than plasma or urine levels. Molybdenum (Mo) - Diseases associated with Mo deficiency include gout with uric acid accumulation, cancer susceptibility as it plays a role in its prevention, and in sulfur metabolism. High exposure to Mo is toxic as it is an antagonist to copper. Urine and hair Mo are useful for the biological monitoring from occupational or environmental exposure. Erythrocyte Mo is a more sensitive for the detection of deficiency in patients on TPN with findings of 60% below normal values compared to 4% using plasma. Potassium (K) - The homeostasis of K is regulated by its excretion by the kidneys. RBC potassium is a more useful index of nutritional and tissue content than plasma measurement. In a study of elderly men and women, low erythrocyte K were found in 20%, but only 2% in plasma. Selenium (Se) - Deficiency of selenium has been documented in humans in China named Keshan's disease in the form of myocardiopathy, and as an endemic degenerative osteoarthropathy, named Kaschin-Beck's disease. Deficiency can also occur in patients on long-term total parenteral nutrition. Selenium is an essential component of glutathione peroxidase which plays a role as an antioxidant. Other key functions include immune regulation, and reduced cancer mortality (ie. lung, prostate, and colorectal). Toxicity from overdoses has resulted in several metabolic and physical changes such as impaired bone development, liver disease, hair loss, and fatigue. High selenium intake, especially in children can cause stunting of growth. This element can be monitored in plasma, erythrocytes, urine and hair. Vanadium (V) - As with many other elements, toxicity to vanadium has resulted in skeletal abnormalities, fetal toxicity, and teratogenicity. Its toxic effects results from its ability to interfere with biological functions of amino acids, peptides, nucleotides, ATP and carbohydrates. Industrial inhalation of vanadium dust can produce respiratory, cardiac and central nervous system problems. Erythrocyte vanadium appears to be a more sensitive index to detect deficiency (RBC 14% versus plasma 0%) than plasma as found in TPN patients. Zinc (Zn) - Erythrocyte zinc have potential application in which deficiency relates to taste and smell dysfunction (dysgeusia) and in relationship to neural tube defects in the early stages of pregnancy. The higher concentration of Zn in RBC appear to be a more sensitive index to detect cellular deficiency (42%) than in plasma (32%) sample comparisons. Toxic Elements - Erythrocytes Antimony (Sb) - Acute exposure can result in heart, liver and kidney damage, while chronic exposure results in skin, mucus membrane and lung conditions. Unlike arsenic, antimony is not methylated in vivo, but is excreted in the bile and in the urine. In normal subjects, Sb is four-fold higher in erythrocytes than in plasma. Elevated RBC indicates recent or chronic exposure. Arsenic (As) - In humans, acute severe arsenic poisoning result in paralytic symptoms of shock, vasodilation, cyanosis, coma and death from circulatory failure. Chronic intoxication from exposures such as from arsenic pesticides or herbicides can result in skin, lung and lymphatic cancers. As arsenic is largely excreted through the urine as methylated derivatives, urine is used to monitor acute toxic exposure while hair can be used to assess longer term arsenic accumulation. Approximately equal amounts of (As) are distributed into the plasma and the RBC, but the resident time is short (<2 hr). Blood is not a good sample for assessing arsenic poisoning due to its relative rapid clearance. Cadmium (Cd) - Acute air exposure can result in respiratory distress while chronic exposure results in kidney tubular damage. In blood, 90% of the cadmium is bound to erythrocytes, and has a half-life of 70-120 days. Depending upon the rate of exposure, the body burden increases during the first 4 months, and is reflected in the blood concentration. Both whole blood or erythrocytes and urine concentrations should be used to monitor chronic (Cd) exposure. Lead (Pb) - Development of mental retardation, encephalopathy, and anaemia are some of the clinical effects of lead toxicity. Over 93% of the lead is bound to hemoglobin in the blood such that erythrocyte lead is a very sensitive marker of lead exposure. This represents about 5% of the exchangeable pool distributed between blood and soft tissues. The majority of the lead is sequestered in bone with a half-life of 20-30 years. Mercury (Hg) - Damages from overexposure presents as proximal kidney tubule damage, and sensory nervous disturbances in the brain. Methylmercury is more toxic than inorganic Hg due to its lipid solubility, and bio-accumulation effect. The central nervous system is its target organ, and since Hg can cross the placenta freely, normal development of the fetal brain can be highly affected. Nickel (Ni) - Environmental and occupational exposure to nickel can result in diseases of the respiratory system, the nasal cavities and sinuses, the immune system, and the skin. Ni concentrations in serum reflects recent exposure, and its upper content of 25 nmol/L in normal subjects is about half of that found in erythrocytes (51 nmol/L). RBC levels may reflect more extended exposure. Thallium (Tl) - Exposure to high levels can result in harmful health effects of the nervous system (numbness of fingers and toes), the lungs, heart, liver and kidneys. Blood thallium is not as good an indicator because of its short half-life. Erythrocyte Tl levels (up to 0.39 nmol/L) are higher than that found in plasma (up to 0.14 nmol/L) in the general population. Urine is usually monitored for excessive exposure.
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