Abstract
Background: Exposure to inorganic arsenic (iAs) through drinking water is currently a serious threat to public health of millions of people worldwide including Bangladesh. Some recent studies have shown that telomere dysfunction is emerging as an important factor in the pathogenesis of different cardiovascular diseases. Arsenic plays significant role on telomere dysfunction by altering the expression of telomere-related genes. The study was aimed to investigate the effects of arsenic on hTERT mRNA levels and their combined role in increasing CVD susceptibility.
 Methods: In this cross sectional study, total of 50 CVD patients who underwent open heart surgery were recruited for this study. Urine, nail and cardiac tissue samples were collected and analyzed for As. Blood samples were quantified for hTERT expression analysis using real-time polymerase chain reaction.
 Results: The hTERT mRNA expression was found approx. 10 fold higher in the As-exposed patients than the As-unexposed patients (p<0.01). A strong positive correlation (p<0.01, R>0.3) was found between the hTERT mRNA levels and As contents in the cardiac tissue, nail and urine samples of the study subjects. The significant increase (approx. 4 fold) in the hTERT mRNA expression was found in the patients with coronary artery disease (CAD) than the non-CAD patients.
 Conclusions: The results of the study suggest that arsenic exposure increases hTERT mRNA expression which may in turn modify As-induced cardiovascular outcomes. The findings of this study will help to look deep into the association of As exposure in cardiovascular disease pathogenesis to open a new window in the diagnosis and treatment procedure of CVD.
 Bangladesh Med Res Counc Bull 2019; 45: 03-10
Highlights
Arsenic (As) is a well-known poison and widely distributed element in the environment with which humans usually come into contact through food, water, air, and soil.[1,2] Chronic arsenic exposure is associated with increased risk for arsenic skinArsenic exposure and cardiovascular diseases telomere.[6]
The significant increase in the human telomerase reverse transcriptase (hTERT) mRNA expression was found in the patients with coronary artery disease (CAD) than the non-CAD patients
The results of the study suggest that arsenic exposure increases hTERT mRNA expression which may in turn modify As-induced cardiovascular outcomes
Summary
Arsenic exposure and cardiovascular diseases telomere.[6] This loss of genetic material corresponds to the phenomenon called ‘‘the end replication problem’’.7. If this shortening of telomeres is not repaired, they eventually reach a critical length that triggers cell senescence or apoptosis. Because telomere length (TL) shortens with age in most human tissues, it is considered a potential biomarker of aging and a potential contributor to age-related diseases.[8]. Telomere maintenance is tightly regulated by telomerase and other telomere-associated proteins. Telomerase is capable of preventing the loss of chromosomes at each cell division by adding telomeric sequences (TTAGGG repeats) to the ends of chromosomes. Arsenic plays significant role on telomere dysfunction by altering the expression of telomere-related genes
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