Serum levels of chemical elements and carious lesions in children after antitumor therapy

Aim. To study serum concentrations of trace and macro elements and their correlations in children and adolescents after antitumor therapy, depending on the presence or absence of caries.

Materials and methods. The study included 98 patients aged 4 to 17 years who were in remission after an antitumor therapy performed for acute leukemia or lymphomas. Patients with carious tooth lesions were included in group 1 (n = 34) and without caries – in group 2 (n = 64). We used inductively coupled plasma mass spectrometry to calculate the content of essential, conditionally essential and toxic elements in blood serum. The median and interquartile range were calculated, the Mann-Whitney U-test was applied to compare groups, and the Kendall rank correlation coefficient (τ) was calculated for tandem elements.

Results. In both groups, the concentrations of the studied elements were within the reference ranges. In group 1, compared with group 2, higher concentrations of potassium, arsenic, iodine and boron and lower concentrations of lithium and tungsten (p < 0.05) were noted. There were no differences in the concentration of phosphorus, calcium, magnesium, manganese, gold, silver, platinum, aluminum, beryllium, bismuth, cadmium, cobalt, chromium, copper, iron, mercury, lithium, molybdenum, nickel, rubidium, antimony, tin, vanadium, zinc, zirconium and thallium between the groups. Significant correlation coefficients in both groups were obtained for the iron/manganese tandem (τ = 0.24, p < 0.05). Different values of τ were got for nickel/ manganese, cobalt/iron, manganese/phosphorus, beryllium/lithium tandems: τ = 0.342 and τ = 0.14; τ = 0.363 and τ = 0.033; τ = –0.111 and τ = –0.326; τ = –0.365 and τ = 0.42, respectively, for groups 1 and 2.

Conclusion. In patients in remission after antitumor therapy, an association of caries with an increase (within reference values) in the concentration of essential (potassium, iodine) and conditionally essential elements (arsenic, boron), a decrease in the concentration of lithium and tungsten; as well as a change in the ratio of nickel/manganese, cobalt/iron, manganese/ phosphorus and change the direction of the correlation in the beryllium/lithium tandem was revealed.

1. Florea A.M., Büsselberg D. Cisplatin as an anti-tumor drug: cellular mechanisms of activity, drug resistance and induced side effects. Cancers (Basel). 2011; 3(1): 1351–1371. https://doi.org/10.3390/CANCERS3011351. PMID: 24212665.

2. Feng J.F., Lu L., Zeng P., et al. Serum total oxidant/antioxidant status and trace element levels in breast cancer patients. Int J Clin Oncol. 2012; 17 (6): 575–583. https://doi.org/10.1007/S10147-011-0327-Y. PMID: 21968912.

3. Wilmers J., Bargmann S. Nature’s design solutions in dental enamel: Uniting high strength and extreme damage resistance. Acta Biomater. 2020; 107: 1–24. https://doi.org/10.1016/J.ACTBIO.2020.02.019. PMID: 32087326.

4. Habelitz S., Marshall S.J., Marshall G.W., Balooch M. Mechanical properties of human dental enamel on the nanometre scale. Arch Oral Biol. 2001; 46(2): 173–183. https://doi.org/10.1016/S0003-9969(00)00089-3. PMID: 11163325.

5. Akhmedbeili R.M. Modern data on the mineral composition, structure and properties of hard dental tissues. Biomedicine (Baku). 2016; 2: 22–27 (In Russian). https://doi.org/10.24412/FE4PDDYLZZW

6. Mikheikina N.I.. Features of the structure of intact tooth enamel in individuals with different levels of resistance to caries. Zdravookhranenie Yugry: opyt i innovatsii. 2016; 3(8): 13–17 (In Russian). EDN: WMWMJR

7. Burak ZH.M., Sukalo A.V., Terekhova T.N. The impact of lead intoxication on humans and animals, the impact on the development and function of the dentoalveolar system. Medical Journal. 2005; 4: 10–13 (In Russian).

8. Yamamoto T., Hasegawa T., Yamamoto T., et al. Histology of human cementum: Its structure, function, and development. Jpn Dent Sci Rev. 2016; 52(3): 63–74. https://doi.org/10.1016/J.JDSR.2016.04.002. PMID: 28408958.

9. Fischer A., Wiechuła D. Age-dependent changes in Pb concentration in human teeth. Biol Trace Elem Res. 2016; 173(1): 47–54. https://doi.org/10.1007/S12011-016-0643-1. PMID: 26888348.

10. Asaduzzaman K., Khandaker M.U., Binti Baharudin N.A., et al. Heavy metals in human teeth dentine: A bio-indicator of metals exposure and environmental pollution. Chemosphere. 2017; 176: 221–230. https://doi.org/10.1016/J.CHEMOSPHERE.2017.02.114. PMID: 28273529.

11. Shaik I., Dasari B., Shaik A., et al. Functional role of inorganic trace elements on enamel and dentin formation: A review. J Pharm Bioallied Sci. 2021; 13(Suppl 2): S952–S956. https://doi.org/10.4103%2Fjpbs.jpbs_392_21. PMID: 35017905.

12. Zhukovskaya E.V., Obuchov Y., Gor A., Karelin A. Changes in the composition of electrolytes in the saliva of children and adolescents after the end of anticancer therapy. Trace Elements and Electrolytes. Abstract of Meeting of the Russian Society for Trace Elements in Medicine (RUSTEM). 2021; 38(3): 160. E-pub: May 7, 2021. https://doi.org/10.5414/TEX01685

13. Pathak M.U., Shetty V., Kalra D. Trace elements and oral health: A systematic review. J Adv Oral Res. 2016; 7: 12–20. https://doi.org/10.1177/2229411220160203

14. Poletto A.C., Singi P., Barri R.M., et al. Relationship of levels of trace elements in saliva and dental caries in preschool children using total reflection X-ray fluorescence technique (TXRF)⋆. J Trace Elem Med Biol. 2021; 63: 126663. https://doi.org/10.1016/j.jtemb.2020.126663. PMID: 33069944.

15. Cabré N., Luciano-Mateo F., Arenas M., et al. Trace element concentrations in breast cancer patients. Breast. 2018; 42: 142–149. https://doi.org/10.1016/J.BREAST.2018.09.005. PMID: 30296647.

16. Ding X., Jiang M., Jing H., et al. Analysis of serum levels of 15 trace elements in breast cancer patients in Shandong, China. Environ Sci Pollut Res Int. 2015; 22: 7930–7935. https://doi.org/10.1007/S11356-014-3970-9. PMID: 25520207.

17. Ahmadi N., Mahjoub S., Hosseini R.H., et al. Alterations in serum levels of trace element in patients with breast cancer before and after chemotherapy. Caspian J Intern Med. 2018; 9(2): 134–139. https://doi.org/10.22088/CJIM.9.2.134. PMID: 29732030.

18. Modaressi A., Hadjibabaie M., Shamshiri A.R., et al. Trace elements (Se, Zn, and Cu) levels in patients with newly diagnosed acute leukemia. Int J Hematol Oncol Stem Cell Res. 2015; 6(4): 5–10.

19. Kurdoglu Z., Kurdoglu M., Demir H., Sahin H.G. Serum trace elements and heavy metals in polycystic ovary syndrome. Hum Exp Toxicol. 2012; 31(5): 452–456. https://doi.org/10.1177/0960327111424299. PMID: 22027497.

20. Krasuska-Sławińska E., Dembowska-Bagińska B., Brożyna A., et al. Changes in the chemical composition of mineralised teeth in children after antineoplastic treatment. Contemp Oncol. 2018; 22(1): 37–41. https://doi.org/10.5114/WO.2018.74392. PMID: 29692662.

21. Huynh P.T., Dinh B.T., Nguyen L.T.T., et al. Investigation of the effects of chemotherapy on trace element contents in the nails in patients with colorectal cancer. J Radioanal Nucl Chem. 2021; 328: 1173–1180. https://doi.org/10.1007/s10967-021-07734-8

22. Sousa C., Moutinho C., Vinha A.F., Matos C. Trace minerals in human health: Iron, zinc, copper, manganese and fluorine. IJSRM. Human. 2019; 13(3): 57–80.

23. Zhukovskaya E.V., Nor A.A., Karelin A.F. Parameters of homeostasis of chemical elements in biological samples of patients completed therapy for malignant neoplasms. Trace Elem Med. 2021; 22(2): 43–49 (In Russian). https://doi.org/10.19112/2413-6174-2021-22-5-43-49. EDN: WCZEEP

24. Ivanov S.I., Podunova L.G., Skachkov V.B., et al. Determination of chemical elements in biological media and preparations by inductively coupled plasma atomic emission spectrometry and inductively coupled plasma mass spectrometry: Guidelines. Ministry of Health of the Russian Federation, 2003. 56 p. (In Russian). ISBN 5-7508-0462-3.

25. Doğan M.S. Relation of trace elements on dental health. Trace Elements-Human Health and Environment. 2018; 71. https://dx.doi.org/10.5772/intechopen.75899

26. Kisel’nikova L.P., Alekseeva I.A., Danilova I.G., et al. The study of the features of phosphorus-calcium metabolism in the pathogenesis of caries in adolescent children. Medical Journal of the Russian Federation. 2014; 20(2): 27–30 (In Russian). EDN: SCFEBT

27. Obukhov Y.A. Local and systemic processes influencing the development of caries in children (literature review). Pediatric Bulletin of the South Ural. 2015; 2: 63–66 (In Russian). EDN: VDOYXJ

28. Shaik P.S., Pachava S. The role of vitamins and trace elements on oral health: a systematic review. Int J Med Rev. 2017; 4(1): 22–31. https://doi.org/10.29252/ijmr-040105