Cardiovascular diseases (CVDs) have long been a critical public health issue and remains a leading cause of death worldwide (Timmis et al., 2023).According to the World Health Organization (WHO), CVDs account for an estimated 17.9 million deaths globally each year (Kaptoge et al., 2019). CVDs encompass a group of disorders affecting the heart and blood vessels, including coronary heart disease, heart failure, heart rate variability, and stroke (ref). Established risk factors for CVDs include age, sex, family history, and lifestyle factors such as tobacco use, unhealthy diet, obesity, physical inactivity, stress, and alcohol consumption (CDC, 2024; Flora & Nayak, 2019). In recent years, exposure to environmental pollutants, such as fine particulate matter (PM2.5) in the air and toxic metals like cadmium, lead, and arsenic, has been strongly linked to the progression of CVDs and the incidence of cardiovascular events (Hamed, 2022; Sun, 2023). In 2019, nearly 62% of all deaths related to environmental pollution were attributed to CVDs, according to the Global Burden of Disease research (Murray et al., 2020). While air pollution is already recognized as a risk factor for CVDs, medical societies have not yet uniformly addressed vascular toxicity from contaminant metals despite epidemiological evidence linking chronic exposure to low and low-moderate levels of these metals (Lamas et al., 2023).
Cadmium (Cd) is a trace metal present in the natural environment in rocks and soil, and is released into water and air during weathering processes(Fuller et al., 2022; Landrigan et al., 2018; Satarug & Phelps, 2020). However, anthropogenic activities such as mining and other industrial processes release Cd into the environment at concentrations toxic to both humans and ecosystems (Françoise Pinot et al., 2000). Cd was recently ranked seventh on the Agency for Toxic Substances and Disease Registry substance priority list, underscoring the need to better understand its impacts on human health (Agency for Toxic Substances and Disease Registry, 2022). Routes of exposure in occupational settings include the extraction and processing of ore, processing of Cd-containing industrial waste, or through phosphate fertilizers (Françoise Pinot et al., 2000; Thun et al., 1991; Verbeeck et al., 2020). Non-occupational exposure can occur through cigarette smoking, or exposure through Cd-contaminated water or air (Satarug & Moore, 2004). However, the primary source of exposure tends to be from diet (Jean et al., 2018; Wang et al., 2021). Of particular concern is Cd’s long half-life, which can span decades and lead to various human health impacts (Satarug et al., 2010).
The negative health impacts of Cd exposure in humans, including genotoxic damage, nephrotoxic injury, disruptions to calcium homeostasis, osteomalacia (Palus et al., 2003; Satarug & Moore, 2004; Staessen et al., 1996), and its classification as a known carcinogen (Hartwig, 2013), have been well-documented. Cd is known to target multiple organ systems and could predispose humans to increased risk of hypertension, Alzheimer’s disease, and impaired reproductive health (Kumar & Sharma, 2019; Satarug & Phelps, 2020). Increasing attention has focused on the impacts of Cd on the cardiovascular system. A recent population-based study reported a significant association between the blood levels of Cd and increased susceptibility to coronary heart disease (Ci et al., 2024), hypertension (Shin et al., 2012), and arterial disease (Tinkov et al., 2018). While the association between Cd and cardiovascular disorders is becoming more established, the pathophysiological mechanisms require further (Lamas et al., 2023).
Zebrafish serve as a well-established model for investigating how environmental pollutants, including metals, impact development, morphology and cardiovascular system in the lab (Chen et al., 2021; Shelton et al., 2023, 2024; Staudt & Stainier, 2012). Field studies of zebrafish help us ground our metrics ethologically (Kelly et al., 2021; Shelton et al., 2020; Suriyampola et al., 2016). Cellular differentiation and cellular migration during development, and the electrical properties of zebrafish hearts, closely mirror patterns observed in mammals, making them valuable for studying physiological and molecular mechanisms underlying toxicant exposures (Heideman et al., 2005; Staudt & Stainier, 2012). Their transparent early life stages allow for easy visualization of basic cardiovascular responses, including cardiac output (consisting of stroke volume and heart rate), the presence of pericardial edemas, and heart malformations (Perrichon et al., 2017). Various transgenic zebrafish lines enable visualization of cardiac malformations following toxicant exposures in live animals (Heideman et al., 2005). Furthermore, unlike mammals, zebrafish are capable of regenerating cardiac tissue following injury, providing valuable insights into the molecular mechanisms underlying cardiac regeneration in vertebrate tissues (Lepilina et al., 2006; Poss et al., 2002) and how toxicants can impact these repair processes (Hofsteen et al., 2013).
Cd is known to cause a wide array of impacts in larval and adult zebrafish (Avallone et al., 2015; Shelton et al., 2023, 2024; Wold et al., 2017). Impairments to the cardiovascular system vary across studies and are both concentration- and life-stage specific. Common themes are that Cd often leads to cardiac edema (Cheng et al., 2000; Mitovic et al., 2021; Yin et al., 2014)) and/or reduced heart rate (bradycardia) (P. Liu, Zhao, et al., 2021). For example, in developing zebrafish, waterborne exposure to 1.0 µM Cd led to a reduced heart rate at 72 Hours Post-Fertilization (hpf), but not at 48 hpf (P. Liu, Wang, et al., 2021). Another study, testing a wider concentration response through 4 Days Post-Fertilization (dpf; 0.01-10 µM, 1.124–1124 µg/L waterborne Cd), showed tachycardia (increased heart rate) at 5 dpf. However, when these same groups were later examined as adults after being reared in control water (8–10 months), zebrafish exposed to Cd during development exhibited an inconsistent concentration response, where bradycardia was observed at 1.0 µM Cd but not at lower and higher concentrations (Wold et al., 2017)(Wold et al 2017). Here, we ask if the inconsistencies in bradycardia are due to morphological differences or other compensatory mechanisms.
Over the past decades, selenium (Se) has emerged as a potential therapeutic agent to counteract Cd-induced toxicity in various animal organs and tissues, including the heart(Chen et al., 2017; Li et al., 2013; R. Liu et al., 2018; S. Liu et al., 2014; Tan et al., 2017). Se is an essential trace element for many eukaryotes, including mammals and fish, primarily found in natural food sources as selenomethionine, selenocysteine, selenium-methylselenocysteine (organic forms), and selenate (inorganic form) (Burk & Hill, 2015; Castellano et al., 2005; Whanger, 2002). Selenite, another inorganic form of Se, is naturally present mainly in phytoplankton and is also added to nutritional supplements (Lei et al., 2022). In its form as selenocysteine, Se is incorporated into proteins to form selenoproteins, which are crucial for maintaining redox balance in cells (Lu & Holmgren, 2009; Reeves & Hoffmann, 2009). At low levels, Se exhibits potent antioxidant activity by upregulating selenoproteins such as glutathione peroxidase (GPx) and thioredoxin reductase (TrxR). These enzymes help eliminate reactive oxygen species (ROS) and suppress oxidative stress-mediated cell damage, a major mechanism underlying Cd-induced toxicity and related to the etiology of several chronic diseases, including CVD (Cuypers et al., 2010; Forman & Zhang, 2021; J. Liu et al., 2009; Valko et al., 2006). However, other mechanisms have been proposed to explain the role of Se in alleviating Cd-induced cell damage. Se can sequester Cd, forming a biologically inert compound, thereby reducing Cd accumulation in cells and tissues. This sequestration has been suggested as the major mechanism of action of Se against Cd toxicity (Zwolak & Zaporowska, 2012). The activation of the Nrf2 pathway, a master regulator of cellular redox homeostasis, has also been proposed as a mechanism by which Se counteracts Cd-induced oxidative stress, thereby mitigating its toxicity (Zhang et al., 2017, 2020). However, Se has one of the narrowest therapeutic windows, with a fine line between its protective and toxic effects. Although experimental evidence has demonstrated the protective role of Se against heart damage, including the cardiotoxicity induced by Cd (Cai et al., 2017; Feng et al., 2022), other observational studies and randomized trials have linked Se to an increased risk of cardiovascular disease even at low concentrations (Alexanian et al., 2014; Al-Mubarak et al., 2021; Flores-Mateo et al., 2006; Rayman et al., 2011). These inconsistent findings highlight the need for additional studies to gain new insights into the role of Se in cardiac health and its beneficial doses.
The overall goal of this study was to determine whether or not prophylactic exposure to Se served to alter Cd-induced alterations to cardiac phenotypes. This was achieved by assessing the presence of pericardial edema and measuring heart rate across various combinations of Cd and Se concentrations in developing zebrafish. These endpoints were measured in control, Cd-exposed, Se-exposed, and Se to Cd transferred zebrafish. In addition, we sought to determine if Se protective effects were dependent on the length of Se pre-exposure. We hypothesized that Cd exposure would lead to concentration dependent pericardial edema and bradycardia, as has been noted in other studies on zebrafish (Cheng et al., 2000; P. Liu, Wang, et al., 2021; Mitovic et al., 2021; Yin et al., 2014). Further, we hypothesized that Se would have cardioprotective effects, but that these effects were likely to be dependent on Se concentration and how long zebrafish were pre-exposed.