Inflammation and Oxidative Stress Biomarkers in Heavy Metal Toxicity: Bridging the Gap to Personalized Clinical Interventions.

Abstract

Heavy metal exposure (e.g., Pb, Cd, Hg, and As) remains a critical public health concern because of bioaccumulation and links to chronic diseases like hypertension, diabetes, and cancer. This systematic review (PRISMA compliant) synthesizes evidence from 32 studies (2015-2025) elucidating toxicity mechanisms via oxidative stress, inflammation, endocrine disruption, and epigenetic dysregulation. Key biomarkers-blood/urinary metal levels, oxidative stress markers (8-OHdG and MDA), and inflammatory cytokines (CRP, IL-6, and TNF-α)-enable early detection and toxicity assessment. Pro-inflammatory responses dominated across studies, with Pb and Cd consistently elevating CRP, TNF-α, and IL-6, alongside tissue-specific inflammation (liver and kidneys). ELISA emerged as the primary analytical method, although biomarker variability underscored influences of dose, duration, and individual susceptibility. Critically, anti-inflammatory IL-10 was frequently downregulated. We highlight the clinical utility of biomarkers in public health surveillance, chelation therapy, and preventive strategies. Future directions prioritize omics-based profiling, CRISPR technology, portable biosensors, and standardized protocols for real-time monitoring and personalized risk assessment. Integrating current biomarkers with these innovations will advance precision medicine to mitigate heavy metal toxicity globally.