Copper enters the human body mainly through food. Large amounts of it are found in legumes, seafood, cabbage, nettles, potatoes, corn, spinach, carrots, apples, and cocoa beans.
About 95% of copper entering the body is absorbed in the gastrointestinal tract. In the blood, it binds to amino acids, serum albumin, transport protein transcuprin and ceruloplasmin.
The optimal rate of copper intake into the body is 2-3 mg per day. With a significant intake of copper into the body, excess copper develops. Moreover, the threshold of its toxicity for humans is 200 mg per day.
Excess copper in the body is manifested by abdominal pain, kidney and liver failure, nausea, vomiting, and neurological disorders. To treat excess copper in the body, enterosorbents are used.
What is copper and what is its role in the body
Copper is a heavy metal and an essential mineral that supports the following body functions:
- iron metabolism
- formation of enzymes that produce energy
- creation of connective tissues
- development of new blood vessels
- balance of hormones that nerve cells produce
- regulation of gene expression
- promoting healthy immune system function
Although many plant and animal food sources naturally contain copper, the human body only stores about 50–120 mg of the substance. Excess copper is excreted from the body with bile, a digestive fluid produced by the liver ().
A person's blood copper level can be checked by a doctor. Typical copper concentrations range from 63.5 to 158.9 mcg per deciliter of blood ().
The recommended daily intake of copper ranges from 340–890 mcg per day for children 18 years of age and younger and up to 900 mcg per day for adults ().
According to the National Institutes of Health (NIH), adults should not consume more than 10 mg of copper per day. Excessive amounts of this metal can be harmful to health ().
Genetics [edit | edit code ]
Wilson-Konovalov disease gene ( ATP7B
) is located on the long arm of chromosome 13 (13q14.3). The gene encodes a P-type ATPase, which transports copper into bile and incorporates it into ceruloplasmin [2]. In 10% of cases the mutation is not detected [3].
Although almost 300 ATP7B
In most populations, Wilson's disease results from a small number of mutations specific to those populations. For example, in Western populations, the H1069Q mutation (replacement of histidine with glutamine at position 1069 of the protein) is present in 37-63% of cases of the disease, while in China this mutation is very rare and R778L (replacement of arginine with leucine at position 778) is more common. Relatively little is known about the impact of mutations on the course of the disease, although some studies suggest that the H1069Q mutation suggests a later onset of neurological symptoms [2] [4].
Normal variations in the PRNP
may alter the course of the disease by increasing the age of onset and influencing the type of symptoms that develop. This gene encodes a prion protein that is active in the brain and other tissues and is also thought to be involved in copper transport [5].
The disease has an autosomal recessive mode of inheritance. That is, the patient must receive the defective gene from both parents (see the figure). People with only one mutant gene are called carriers (heterozygotes). They may experience mild disturbances in copper metabolism [6].
Causes of copper poisoning
It is rare for people to develop copper poisoning. However, it can happen when a person takes in large amounts of the substance from contaminated water, food or air.
According to the Agency for Toxic Substances and Disease Registry, about 635 million kilograms of copper were released into the environment in 2000 ().
Copper in water
In 1991, the Environmental Protection Agency (EPA) published a regulation called the Lead and Copper Rule, which states that public drinking water should not contain more than 1.3 mg of copper per liter of water ().
Tap water flowing through copper pipes or brass faucets can pick up copper particles, especially if those parts have become corroded. Agricultural and industrial waste can also end up in public waterways, contaminating drinking water.
The Centers for Disease Control and Prevention (CDC) recommends flushing household plumbing systems contaminated with copper before drinking or cooking water. They also suggest draining each faucet for at least 15 seconds if the faucet has not been used for six hours or more ().
Copper in food
Many foods contain copper. Here are examples of copper-rich foods:
- animal meats such as beef and turkey
- organ meats such as liver and heart
- shellfish such as oysters, crabs and lobsters
- grains such as millet and cereals
- vegetables such as spinach, asparagus and tomatoes
- dairy products such as milk and yogurt
- seeds, nuts and legumes
- tofu
- potato
- mushrooms
- raw avocado
- chocolate
People eat and drink about 1 mg of copper every day. The body effectively prevents large amounts of this substance from entering the bloodstream. However, a person may develop copper poisoning if they eat food served or prepared with corroded copper utensils or other utensils ().
Copper in the air
There is a small amount of copper in the air. On average, air contains 1–200 nanograms (ng) of metal per cubic meter (m³) of air. However, copper concentrations can reach 5000 ng/m³ in areas near copper smelters and industrial mines ().
People who work in agriculture, water treatment, and mining may inhale copper particles and vapors during the workday.
The Occupational Safety and Health Administration states that the concentration of copper dust in work area air should not exceed 1 mg/m³ over an 8-hour shift ().
Diseases
Diseases that reduce the liver's ability to remove excess copper from the body can lead to copper poisoning. Here are some of these diseases (, ,):
- Wilson's disease, a rare genetic disorder involving mutations in the ATP7B gene, which moves excess copper into bile
- Menkes disease, an inherited disorder caused by a mutation in the ATP7A gene, which transports copper throughout the body
- liver disease
- hepatitis or liver inflammation
- Hodgkin's lymphoma or lymph node cancer
- leukemia or blood cell cancer
- brain cancer
- liver cancer
- mammary cancer
- diabetes
Copper intrauterine devices
Intrauterine devices (IUDs) are long-acting contraceptives.
The IUD is held inside the uterus, and its core contains a synthetic form of the hormone progesterone. Non-hormonal IUDs contain a thin copper wire.
Copper wire causes inflammation in the uterus, which kills sperm and eggs.
Current evidence does not suggest that copper IUDs increase the risk of copper toxicity. In a 1980 study, researchers found that long-term use of these devices did not affect copper levels in the blood or urine ().
In a more recent 2021 rat study, researchers observed the effects of copper IUDs at 20, 40, and 60 times the recommended dosage. After 26 weeks, researchers found no signs of copper toxicity or organ damage ().
However, the rats had elevated white blood cell counts, which the researchers explained as part of the body's natural inflammatory response to copper. These data confirm the safety of long-term use of copper IUDs.
However, these results do not apply directly to humans. With this in mind, the researchers are encouraging further clinical studies.
According to the Academy of Breastfeeding Medicine, copper IUDs have no known effect on breast milk production or secretion ().
History [edit | edit code]
The English neurologist Samuel Wilson (English S. Wilson - a more normative rendering of Wilson) (1878 - 1937) in 1912 described changes in the brain typical for hepato-cerebral dystonia, established the constant presence of cirrhosis of the liver and described the clinic of a new disease, which he named progressive lenticular degeneration (lat. lenticularis lenticular).
The main symptoms of the disease were a variety of involuntary movements in the limbs and trunk, muscle rigidity leading to stiffness, dysphagia and dysarthria, affective outbursts, and sometimes mental disorders, but there were no signs of damage to the pyramidal tracts. Even earlier, K. Westphal (1883) and A. Strumpel (1898) described a disease that, due to its clinical similarity to multiple sclerosis, was called “pseudosclerosis.” The disease was characterized by widespread, sweeping, rhythmic involuntary movements, increased muscle tone, amia, dysarthria and severe mental disorders, including such an intellectual disorder as dementia.
It later turned out that progressive lenticular degeneration and pseudosclerosis are different forms of the same disease, which Gall (1921) called hepatolenticular degeneration. However, changes in the brain with it are never limited to the lenticular nuclei and are often even more pronounced in other parts of the brain.
In 1960, the Soviet neuropathologist N.V. Konovalov proposed the name “hepato-cerebral dystrophy”, significantly expanded the understanding of the pathophysiology, pathogenesis and clinic of this disease and identified 4 forms of damage to the nervous system and one abdominal. [1]
Symptoms of copper poisoning
Copper is present in almost all tissues of the body. High concentrations of the substance accumulate in:
- bones
- muscles
- brain
- liver
- kidneys
Copper poisoning can cause a variety of symptoms, including ():
- abdominal pain
- nausea and vomiting
- diarrhea (diarrhea)
- blue or green stool
- dark sticky stool with blood
- headache
- dizziness
- fatigue
- fever or chills
- aching muscles
- extreme thirst
- tachycardia or abnormally fast heartbeat
- changes in taste, which may lead to decreased appetite or anorexia
Copper poisoning can also cause the following neurological and psychological symptoms:
- sudden mood swings
- symptoms of depression or anxiety
- feeling irritable or overexcited
- difficulty focusing
Copper poisoning can have serious health effects, such as:
- renal failure
- heart failure
- loss of red blood cells
- liver disease
- brain damage
- death
Pathological anatomy [edit | edit code ]
In the brain, with hepatocerebral dystrophy, the lenticular nucleus, especially the putamen, softens with the formation of small cysts. Other formations are also affected: the caudate nucleus, deep layers of the cortex, the cerebellum, in particular the dentate nuclei, subtubercular nuclei; in other parts of the brain the changes are less pronounced.
All changes are divided into angiotoxic and cytotoxic. The first are expressed in atony of blood vessels, especially small ones, and changes in their walls. As a result, stasis occurs, widespread perivascular edema with anoxia of nervous tissue and its death; Hemorrhages and their traces in the form of accumulations of hemosiderin are frequent.
Treatment of copper poisoning
Doctors can treat copper poisoning and other types of heavy metal poisoning with the following treatments:
- Zinc : prevents the accumulation of copper in the liver and gastrointestinal tract.
- Chelation therapy : Binds copper particles in the bloodstream into a compound that is filtered by the kidneys and excreted in the urine.
- Gastric lavage : Directly removes copper from the stomach.
- Medicines : Medicines such as corticosteroids may help reduce brain swelling.
- Hemodialysis : uses a machine that filters waste from the blood. This treatment is useful for people with kidney damage.
Therapy
Copper poisoning requires immediate hospitalization. In the hospital, the patient is given appropriate treatment:
- Rinse the stomach using a tube. At the beginning and at the end of the manipulations, the victim is injected with a solution of sodium dimercaptopropanesulfonate or potassium hexacyanoferrate (yellow blood salt). This substance binds copper molecules, helping to speed up the process of their removal from the body.
- Antidote therapy is carried out. Unitol, a universal antidote for injection, can be used as an antidote. Dimercaprol is also used: 10 ml once, and then 5 ml at intervals of 3 hours, for 2-3 days. In addition, sodium thiosulfate or penicillamine can be used.
- Sorbents are prescribed to absorb and remove microelement residues. Forced diuresis is performed.
- Restore electrolyte balance disturbed due to diarrhea and vomiting. To do this, the patient is given drips of water-salt solutions and glucose.
Symptomatic therapy is selected taking into account the condition of the victim.
For intense pain, morphine or atropine is prescribed. Vomiting is stopped with the help of chlorpromazine and chlorpromazine. If the development of hemolysis (destruction of red blood cells) is recorded, the patient is prescribed injections of sodium bicarbonate and vitamins. Inhalation poisoning is treated in a similar way. The symptoms of foundry fever, characteristic of this type of intoxication, are relieved with antitussives and expectorants, acetylsalicylic acid and aminophylline.
Summarize
Copper is an essential mineral that supports various body functions such as enzyme production and neurological functions.
However, exposure to high levels of copper through water or food can lead to copper poisoning. Genetic diseases may also play a role.
Excess copper in the body can damage the liver, kidneys, heart and brain. If left untreated, copper poisoning can have serious health consequences and even lead to death.
If you think your tap water has higher than normal levels of copper, you may want to contact your local water supplier. You should seek immediate medical attention if you have recently taken large amounts of copper.
