Concomitant Exposure to Lower Doses of Arsenic, Lead, and Manganese Induces Greater Synergistic Neurotoxicity Than Individual Metals in Mice.

People in Bangladesh are often exposed to low to high levels of multiple metals due to contaminated groundwater with various heavy metals such as arsenic (As), lead (Pb), and manganese (Mn). However, the effects of concomitant exposure of these three metals on neurobehavioral changes are yet to be studied. Therefore, this study was intended to assess the neurotoxic effect of As, Pb, and Mn in a mouse model. Elevated plus maze (EPM) and Morris water maze (MWM) tests were conducted to evaluate anxiety, learning, and spatial memory impairment, respectively. The mice exposed to a combination of metals spent least time exploring the open arms and had longer latencies to find the hidden platform than the control and individual metal exposure groups in EPM and MWM tests. Moreover, concomitant multi-metal exposure remarkably decreased the activities of cholinergic and antioxidant enzymes, brain-derived neurotropic factor (BDNF), and nuclear factor erythroid 2-related factor 2 (Nrf2) levels and significantly increased interleukin-6 (IL-6) level in the brain tissue compared to the control and individual metal-exposed mice. Among the mice treated with a single metal, the As-treated mice showed the highest toxic effects than Pb- or Mn-treated mice. Taken together, the present study demonstrated that exposure to a mixture of As, Pb, and Mn, even at lower doses than individual metals, significantly augmented anxiety-like behavior and impaired learning and spatial memory compared to exposure to individual metals, which was associated with the changes of BDNF, Nrf2, IL-6 levels, and related enzyme activities in the brain.