Metabolomic Profiling in Atherosclerotic Lesions and the Effect of Heavy Metals on the Course of Disease: A Literature Review

Abstract

Introduction: In the developed metallurgical industry, maximum permissible concentrations of heavy metals in the work environment are often exceeded, and the elevated exposure levels have a detrimental effect on workers’ health. Heavy metals cause oxidative stress, which is key factor in the development of atherosclerotic lesions. Atherosclerosis, in its turn, is the primary cause of heart attacks and stroke, which account for 85 % of all deaths from cardiovascular diseases. Objective: To study molecular mechanisms of atherosclerosis and the impact of heavy metals on the disease course. Methods: We applied methods of information analysis based on the review and generalization of published up-to-date research data on the pathogenesis and effects of heavy metals on the course of atherosclerosis found in NLM, Scopus, CyberLeninka, Google Scholar, and eLibrary abstract and citation databases, as well as on information portals, as of January 2022. More than 400 papers were analyzed and 66 full-text articles were found eligible for inclusion in this review. Results: We established the relationship between the exposure to heavy metals and the molecular mechanisms of atherosclerosis and compared the main stages of the disease development with the respective blood metabolomic profiles. Conclusions: Our literature review has revealed problems in the regulatory framework and practical assessment of the contribution of heavy metal exposures to the course of atherosclerotic lesions. So far, the effect of heavy metals only on isolated processes of the pathogenesis of atherosclerosis has been established, such as a change in permeability and destruction of vascular membranes, increased oxidative stress, inflammation, proliferation of smooth muscle cells, changes in blood rheological properties, and an increased risk of thrombosis. The observed patterns in the change in concentrations of some blood metabolites and the potential adverse vascular effect of heavy metals will help develop new methods for detecting atherosclerosis and include industrial workers in the group at risk of the disease for its early diagnosis.