COMPARISON OF CADMIUM AND NICKEL LEVELS IN BLOOD AND PLEURAL FLUID IN IPF AND COPD PATIENTS. STUDY FROM LARKANA

Abstract

Introduction: Two serious respiratory diseases, idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD), significantly impact global health. They are linked to pulmonary fibrosis and reduced lung function, possibly due to environmental exposure to heavy metals like nickel (Ni) and cadmium (Cd). This study seeks to measure and compare the concentrations of nickel and cadmium in the blood and pleural fluid of patients with COPD and IPF. Methodology: Between March and June 2020, a study was conducted involving fifty patients (25 with IPF and 25 with COPD) at tertiary care hospitals in Sindh, Pakistan. Blood and pleural fluid samples were collected under sterile conditions after obtaining informed consent. Nickel and cadmium concentrations were measured using atomic absorption spectrophotometry, while also recording clinical and demographic data, including occupational exposure and smoking status. Results: In every patient the levels of nickel and cadmium were higher than reference ranges. In comparison to IPF patients COPD patients had higher concentrations (cadmium: 4. 85 ± 1. 10 µg/L blood 6. 38 ± 1. 25 µg/L pleural fluid nickel: 3. 89 ± 0. 92 µg/L blood 5. 21 ± 1. 03 µg/L pleural fluid nickel: 2. 76 ± 0. 69 and 3. 95 ± 0. 84 µg/L). The accumulation of pleural fluid was consistently greater than that of blood. Conclusion: Both the pulmonary and systemic compartments have markedly increased levels of nickel and cadmium especially in COPD. Cadmium is more toxic and higher pleural fluid concentrations are indicative of localized lung exposure. These metals could be used as biomarkers of disease severity and environmental exposure.