Relationship of fractalkine with arsenic exposure and the risk of cardiovascular diseases

Cardiovascular diseases (CVDs), the leading cause of arsenic-related morbidity and mortality, are a major public health concern in many countries, including Bangladesh. Understanding the mediators of increased CVD risk associated with arsenic exposure is decisive. Fractalkine (CX3CL1), a CX3C chemokine with both chemotactic and adhesive functions, acts by interacting with its specific receptor, CX3CR1. Fractalkine is implicated in atherosclerosis, leading to CVDs. However, the association between chronic arsenic exposure and serum fractalkine levels and its implication in CVDs have not yet been documented. The present study aimed to investigate the relationship between arsenic exposure and serum fractalkine levels, especially regarding the risk of CVDs. The study included 413 participants from low- and high-arsenic exposure rural areas in Bangladesh. Fractalkine levels in serum were measured by immunoassay, and the risk of CVDs was assessed by measuring the serum high-density lipoprotein cholesterol (HDL-C) and hypertension. We found that participants from high-exposure areas had nearly twice the serum fractalkine levels compared to those in low-exposure area (p < 0.001). A one-unit increase of log₂-transformed water, hair, and nail arsenic showed significantly higher propensity score adjusted odd ratios (aORs) in the second and third tertiles of serum fractalkine in comparison to the first tertile. Serum fractalkine levels were inversely associated with HDL-C levels and positively linked to blood pressure and ORs of hypertension. Finally, the associations between arsenic exposure and hypertension were found to be mediated by serum fractalkine. These results suggest that arsenic-exposure-related increases in fractalkine levels may be implicated in the pathogenesis of CVDs.