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Letters to the Editor

NSE as a biomarker of mercury exposure

, &
Page 444 | Received 11 Feb 2014, Accepted 19 Feb 2014, Published online: 19 Mar 2014

Dear Editor,

In their impressive and timely study, Yilmaz et al. (2014) found that circulating biomarkers – neuron-specific enolase (NSE), glutamate receptor (GRIA 1) and S100B were associated – at least in part – with overexposure to metallic mercury vapor (Hg0) among children and adolescent.Citation1 We welcome and support the article by Yilmaz et al. (2014) but we would like to raise one point.Citation1 In the Materials and Methods section, they state that “The children who have a blood mercury level higher than 10 micrograms per liter had a chelation therapy with dimercaptosuccinic acid”.Citation1 Therefore, some patients in the study received doses of water-soluble sodium salt of 2,3-dimercapto-1-propane sulfonic acid (DMPS) to diminish the density of blood mercury concentrations.Citation1 Generally speaking, chelating agents – as DMPS – are medications that have been shown to reduce heavy metals in case of metals overexposure in humans.Citation2 Given that we have previously noted a potential association between serum NSE levels and whole-blood levels of mercury related to the toxic effects induced by mercury vapors (Hg0),Citation3 it would have been valuable to consider the use of chelation therapy as potential confounding variable. If so, mercury biomarker levels NSE associated with mercury overexposure would have been higher than they reported in their outcome.Citation1 This is a possible explanation of the little correlation that they found between the clinical use of serum NSE and recent exposure to mercury vapor.Citation1 Could the authors help us – and the Journal's readers – understand this issue?

Declaration of interest

The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.

References

  • Yilmaz FM, Yilmaz H, Tutkun E, Uysal S, Carman KB, Dilber C, Ercan M. Serum biochemical markers of central nerve system damage in children with acute elemental mercury intoxication. Clin Toxicol (Phila) 2014; 52:32–38.
  • Aposhian HV, Bruce DC, Alter W, Dart RC, Hurlbut KM, Aposhian MM. Urinary mercury after administration of 2,3-dimercaptopropane-1-sulfonic acid: correlation with dental amalgam score. FASEB J 1992; 6:2472–2476.
  • Costa A, Branca V, Pigatto PD, Guzzi G. Pediatric mercury poisoning, brain MRI, and white matter hyperintensities. Eur J Pediatr 2011; 170:677.

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