cigarette smoking . exposed to cadmium : interaction with Urinary neutral endopeptidase in workers

Objectives-Structural impairment ofthe renal proximal tubular epithelium induced by cadmium (Cd) was investigated by measuring the concentration ofneutral endopeptidase 24.11 (NEP), an ectoenzyme of the apical brush border, in the urine of 106 male workers employed in a Cd smelter (among whom 52 were occupationally exposed to Cd), and by comparing it with other tubular markers (low molecular weight proteins, lysosomal enzymes). Methods-NEP (EC 3.4.24.11), P-Nacetyl-glucosaminidase (NAG) (EC 3.2.1. 30), and NAG-B isoenzyme activities were measured by fluorimetric assays, whereas the concentrations of retinol binding protein (RBP), P,-microglobulin (pM), and Clara cell protein (CC16) were measured by automated latex agglutination techniques. Results-An increased urinary excretion ofNEP as well as microproteins was found only in subjects excreting more than 5 Itg Cd/g creatinine. In this group, NEP concentrations were significantly higher in the subjects who smoked. This significant interaction could not be found for any other marker tested. Conclusions-The data suggest that NEP enzymuria is high even at low exposures to Cd (with a threshold of urinary cadmium excretion (U-Cd) at 5 pg/g creatinine), indicating early structural alterations. Moreover, its particular sensitivity to smoking could be useful in the detection of new population clusters potentially more susceptible to development ofnephrotoxic insult. (Occup Environ Med 1997;54:432-436)