{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:23:23Z","timestamp":1787765003776,"version":"build-2784847793"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"International Research Integration: Chula Research Scholar and the Ratchadapiseksompotch Endowment Fund, Faculty of Medicine, Chulalongkorn University","award":["RA61\/120"],"award-info":[{"award-number":["RA61\/120"]}]},{"name":"International Research Integration: Chula Research Scholar and the Ratchadapiseksompotch Endowment Fund, Faculty of Medicine, Chulalongkorn University","award":["CU-GRS-62-02-30-1"],"award-info":[{"award-number":["CU-GRS-62-02-30-1"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Chronic exposure to lead causes lead to accumulate mainly in the liver. In vivo studies have shown that lead toxicity is related to alterations in the inflammatory response. We aimed to evaluate the association between lead poisoning and liver fibrosis as well as the change in the degree of liver fibrosis, levels of inflammatory mediators and glutathione (GSH) after chelation therapy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Workers from a battery factory who were exposed to lead for >\u200912\u2009months and had a blood lead level (BLL)\u2009>\u200970\u2009\u03bcg\/dL were enrolled (\n n<\/jats:italic>\n \u2009=\u200986) in the study. Participants underwent chelation therapy with intravenous CaNa\n 2<\/jats:sub>\n EDTA for 2\u2009days followed by treatment with oral D-penicillamine for 90\u2009days. The primary outcome was the change in the degree of liver fibrosis, which was presented as liver stiffness (LS) measured by FibroScan\u00ae. Secondary outcomes were the changes in the levels of serum GSH and inflammatory mediators such as tumor necrosis factor-alpha (TNF-\u03b1), interleukin-1\u03b2 (IL-1\u03b2), and interleukin-6 (IL-6) after chelation therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the 86 participants, there was a positive correlation between the duration of lead exposure and LS (r\u2009=\u20090.249,\n p<\/jats:italic>\n \u2009=\u20090.021). To avoid the confounding effect of obesity-related steatosis, only 70 individuals who had controlled attenuation parameters <\u2009296\u2009dB\/m, BMI\u00a0\n <<\/jats:underline>\n \u00a025\u2009kg\/m\n 2<\/jats:sup>\n and normal waist circumference were included in the interventional analysis. After chelation, the mean LS significantly decreased from 5.4\u2009\u00b1\u20090.9 to 4.8\u2009\u00b1\u20091.4\u2009kPa (\n p<\/jats:italic>\n \u2009=\u20090.001). Similarly, all of the inflammatory cytokines studied significantly decreased after chelation (\n p<\/jats:italic>\n \u2009<\u20090.001); TNF-\u03b1 decreased from 371.6\u2009\u00b1\u2009211.3 to 215.8\u2009\u00b1\u2009142.7; the levels of IL-1\u03b2 decreased from 29.8\u2009\u00b1\u20091.7 to 25.9\u2009\u00b1\u20094.3; and the levels of IL-6 decreased from 46.8\u2009\u00b1\u200910.2 to 35.0\u2009\u00b1\u200911.9. On the other hand, the mean GSH level increased significantly from 3.3\u2009\u00b1\u20093.3 to 13.1\u2009\u00b1\u20093.7 (\n p<\/jats:italic>\n \u2009<\u20090.001) after chelation therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The duration of lead exposure was significantly correlated with the degree of liver fibrosis. Chelation treatment was associated with increased levels of GSH and decreased levels of proinflammatory cytokines and could potentially reduce the degree of LS.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n \n This study was retrospectively registered and approved by the Thai Clinical Trial Registry (TCTR) on 2019-11-07. The TCTR identification number is\n TCTR20191108001<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1186\/s12876-020-01386-w","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T04:03:36Z","timestamp":1596859416000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Changes in inflammatory cytokines, antioxidants and liver stiffness after chelation therapy in individuals with chronic lead poisoning"],"prefix":"10.1186","volume":"20","author":[{"given":"Tongluk","family":"Teerasarntipan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roongruedee","family":"Chaiteerakij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5811-0120","authenticated-orcid":false,"given":"Piyapan","family":"Prueksapanich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duangporn","family":"Werawatganon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,8]]},"reference":[{"issue":"6","key":"1386_CR1","first-page":"327","volume":"53","author":"S Kianoush","year":"2015","unstructured":"Kianoush S, Sadeghi M, Balali-Mood M. 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