Trace Elements and other Electrolytes
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What are the toxic trace elements?
-aluminum -Arsenic -Cadmium -Lead -Mercury
What are the essential trace elements tested in the lab?
-chromium -copper -Fluorine -Iodine -Manganese -Molybdenum -Selenium -Zinc
increased copper absorption is facilitated by binding to ____________
amino acids -can be used as treatment to increase levels
Copper source dietary (~___% of intake is absorbed)
50
Copper is Excreted mainly in ______, with some excretion via urine around ______ug/day
bile, <40
Copper is important for enzymatic activity and is a ___________.
cofactors
examples of copper cofactors
Ceruloplasmin***, cytochrome oxidase, dopamine β-hydroxylase, tyrosinase, and many others. Fe2+ —-> Fe3+
copper carrier that is important for iron
Ceruloplasmin*** (ferroxidase?)
Copper: In plasma, _____% bound to ceruloplasmin (ferroxidase, an enzyme important in Fe2+ oxidation prior to “transferrin” binding)
95 -small amount associated with albumin (not strong binding)
Copper induces ____________ synthesis (complexes with Cd2+, Cu2+, and Zn2+)
Metallothionein
What is the function of Cysteine (-SH) rich low MW protein?
unclear Research indicate that protection against metal toxicity against oxidative stress (similar to how transferrin prevents damage from iron)
Glutathione is reduced from _____ oxidized from GS. 2GSH/GSSG ratio What does an increased ratio mean? a decreased?
GSH -can handle more oxidative stress -increased in cells, could have damage by oxidative stress
diet contains about ____ mg/d of copper
1.2
During the last 3 months of pregnancy, liver development occurs. A premature baby has less ______ storage in the liver.
copper -also abnormal hematological characters and abnormal bone formation
Typically in male infant @ 2-3 month X-linked genetic defect
Menke’s Kinky Hair Syndrome
• Impaired Cu2+ intestinal absorption • Severe cerebellar & cerebral degeneration, failure to thrive, osteoporosis, motor delay, and death within the first decade of life (about 3 year)
Menke’s Kinky Hair Syndrome:
how is Menke’s Kinky Hair Syndrome treated?
Cu-histidine if caught ealry
causes of copper deficiency?
Decreased dietary intake ▪ ↓ Activities of various Enzymes - Microcytic-hypochromic anemia, neutropenia, heart disease, bone & joint osteoarthritis, hypothermia, hypercholesterolemia. - decreased antioxidant protection and metabolic activity
What levels are considered copper deficiency for plasma and ceruloplasmin?
< 10μM (70mg/dl) : [Cu++] plasma < 220mg/L: ceruloplasmin
Copper excess Can be detected with * ____ Liver function * “ [Cu2+] in urine (> _______)
decreased, 500μg/L
copper excess is associated with _____________ disease
Wilson’s
↑ copper accumulation in liver, brain, kidney, & cornea of the eye (rings of Cooper-Kayser-Fleisher rings). * No copper found in serum due to a decrease in “ceruloplasmin” -with increased non-ceruloplasmin bound Cu2+
Wilson’s disease
What is the treatment for Wilson’s disease?
chelating agents, .V administration, e.g. Penicillamine
increased copper causes…. ________ Vit. C ________ Zinc _________Vit. A
decrased decreased increased