Cited by 38Trace Elements in HealthHeavy Metal Exposure and ToxicityNeurological diseases and metabolism

Copper neurotoxicity: Induction of cognitive dysfunction: A review

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Feng, Duan, Zhao, Yu, Li, Wei, Li, Xuechao, Wan, Jixiang, Wang, Fangjun·2023·Medicine

Abstract

Cognitive dysfunction occurs mainly in certain diseases and in the pathological process of aging. In addition to this, it is also widespread in patients undergoing anesthesia, surgery, and cancer chemotherapy. Neuroinflammation, oxidative stress, mitochondrial dysfunction, impaired synaptic plasticity, and lack of neurotrophic support are involved in copper-induced cognitive dysfunction. In addition, recent studies have found that copper mediates cuproptosis and adversely affects cognitive function. Cuproptosis is a copper-dependent, lipoylated mitochondrial protein-driven, non-apoptotic mode of regulated cell death, which provides us with new avenues for identifying and treating related diseases. However, the exact mechanism by which cuproptosis induces cognitive decline is still unclear, and this has attracted the interest of many researchers. In this paper, we analyzed the pathological mechanisms and therapeutic targets of copper-associated cognitive decline, mainly in the context of neurodegenerative diseases, psychiatric and psychological disorders, and diabetes mellitus.

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  • Copper is implicated in cuproptosis, a form of cell death mediated by direct binding of Cu+ to lipoylated DLAT, leading to its aggregation and proteotoxic stress.

    “Recent studies also implicate copper in cuproptosis, a novel form of cell death mediated by direct binding of Cu⁺ to lipoylated dihydrolipoyl transacetylase (DLAT), leading to its aggregation and proteotoxic stress [111].”

    From Toward a Unified Framework in Molecular Neurobiology of Alzheimer’s Disease: Revisiting the Pathophysiological Hypotheses (2026) · cites this paper as [111]

    Section 3.2 (page not provided) says copper directly binds DLAT, promotes aggregation of lipoylated DLAT, and leads to proteotoxic stress and cuproptosis. It does not identify the directly binding copper as Cu⁺; the Introduction instead describes cuproptosis as triggered by excess Cu²⁺. (LLM, conf=0.84)

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  1. [2]Pisoschi AM Pop A Iordache F. Oxidative stress mitigation by antioxidants – an overview on their chemistry and influences on health status. Eur J Med Chem. 2021; 209: 112891. 33032084
  2. [3]Kalita J Kumar V Misra UK. Memory and learning dysfunction following copper toxicity: biochemical and immunohistochemical basis. Mol Neurobiol. 2018; 55: 3800– 11. 28536976
  3. [4]Chen L Min J Wang F. Copper homeostasis and cuproptosis in health and disease. Signal Transduct Target Ther. 2022; 7: 378. 36414625 PMC9681860
  4. [5]Zhang Y Zhou Q Lu L. Copper induces cognitive impairment in mice via modulation of cuproptosis and CREB signaling. Nutrients. 2023; 15: 972. 36839332 PMC9958748
  5. [6]Li S Sun W Zhang D. Association of zinc, iron, copper, and selenium intakes with low cognitive performance in older adults: a cross-sectional study from National Health and Nutrition Examination Survey (NHANES). J Alzheimers Dis. 2019; 72: 1145– 57. 31683474
  6. [7]Wei J Gianattasio KZ Bennett EE. The associations of dietary copper with cognitive outcomes. Am J Epidemiol. 2022; 191: 1202– 11. 35238336 PMC9890213
  7. [8]Mazhari S Arjmand S Eslami Shahrbabaki M. Comparing copper serum level and cognitive functioning in patients with schizophrenia and healthy controls. Basic Clin Neurosci. 2020; 11: 649– 57. 33643558 PMC7878054
  8. [9]Kazemi T Moodi M Rajabi S. Trace element concentration and cognitive dysfunction in elderly residents in Birjand. Curr Alzheimer Res. 2022; 19: 674– 80. 36100996
  9. [10]Gong Z Song W Gu M. Serum copper and zinc concentrations and cognitive impairment in older adults aged 60 years and older. Biol Trace Elem Res. 2022; 200: 1495– 501. 34057653
  10. [11]Bush AI. Drug development based on the metals hypothesis of Alzheimer’s disease. J Alzheimers Dis. 2008; 15: 223– 40. 18953111
  11. [12]Pamp K Bramey T Kirsch M. NAD(H) enhances the Cu(II)-mediated inactivation of lactate dehydrogenase by increasing the accessibility of sulfhydryl groups. Free Radic Res. 2005; 39: 31– 40. 15875809
  12. [13]Cherny RA Ayton S Finkelstein DI. PBT2 reduces toxicity in a C elegans model of polyQ aggregation and extends lifespan, reduces striatal atrophy and improves motor performance in the R6/2 mouse model of Huntington’s disease. J Huntingtons Dis. 2012; 1: 211– 9. 25063332
  13. [14]Saghazadeh A Mahmoudi M Shahrokhi S. Trace elements in schizophrenia: a systematic review and meta-analysis of 39 studies (N = 5151 participants). Nutr Rev. 2020; 78: 278– 303. 31800085
  14. [15]Hongrong W Qingqi L Rong G. BMI modifies the association between depression symptoms and serum copper levels. Biol Trace Elem Res. 2023; 201: 4216– 29. 36437432
  15. [16]Philbert SA Schönberger SJ Xu J. Elevated hippocampal copper in cases of type 2 diabetes. EBioMedicine. 2022; 86: 104317. 36335667 PMC9646855
  16. [17]Lin X Chen Y Zhang P. The potential mechanism of postoperative cognitive dysfunction in older people. Exp Gerontol. 2020; 130: 110791. 31765741
  17. [18]Li W Cao T Luo C. Crosstalk between ER stress, NLRP3 inflammasome, and inflammation. Appl Microbiol Biotechnol. 2020; 104: 6129– 40. 32447438
  18. [19]He HJ Wang Y Le Y. Surgery upregulates high mobility group box-1 and disrupts the blood-brain barrier causing cognitive dysfunction in aged rats. CNS Neurosci Ther. 2012; 18: 994– 1002. 23078219 PMC6493557
  19. [21]Liu J Liu Y Wang Y. HMGB1 is a mediator of cuproptosis-related sterile inflammation. Front Cell Dev Biol. 2022; 10: 996307. 36211458 PMC9534480
  20. [22]Huang Y Xu W Zhou R. NLRP3 inflammasome activation and cell death. Cell Mol Immunol. 2021; 18: 2114– 27. 34321623 PMC8429580
  21. [23]Kelley N Jeltema D Duan Y. The NLRP3 inflammasome: an overview of mechanisms of activation and regulation. Int J Mol Sci. 2019; 20: 3328. 31284572 PMC6651423
  22. [24]Sun L Yong Y Wei P. Electroacupuncture ameliorates postoperative cognitive dysfunction and associated neuroinflammation via NLRP3 signal inhibition in aged mice. CNS Neurosci Ther. 2022; 28: 390– 400. 34951130 PMC8841296
  23. [25]Wang H He Y Sun Z. Microglia in depression: an overview of microglia in the pathogenesis and treatment of depression. J Neuroinflammation. 2022; 19: 132. 35668399 PMC9168645
  24. [26]Deigendesch N Zychlinsky A Meissner F. Copper regulates the canonical NLRP3 inflammasome. J Immunol. 2018; 200: 1607– 17. 29358279
  25. [27]Yu P Zhang X Liu N. Pyroptosis: mechanisms and diseases. Signal Transduct Target Ther. 2021; 6: 128. 33776057 PMC8005494
  26. [28]Pal A Rani I Pawar A. Microglia and astrocytes in Alzheimer’s disease in the context of the aberrant copper homeostasis hypothesis. Biomolecules. 2021; 11: 1598. 34827595 PMC8615684
  27. [29]An Y Zhang H Wang C. Activation of ROS/MAPKs/NF-κB/NLRP3 and inhibition of efferocytosis in osteoclast-mediated diabetic osteoporosis. FASEB J. 2019; 33: 12515– 27. 31461386 PMC6902677
  28. [30]Selakovic D Ali D Eftekhari A. Editorial: iatrogenic neurotoxicity – mechanisms, prevention, and treatment. Front Neurosci. 2023; 17: 1184317. 37034178 PMC10075354
  29. [31]Bartolotti N Lazarov O. CREB signals as PBMC-based biomarkers of cognitive dysfunction: a novel perspective of the brain-immune axis. Brain Behav Immun. 2019; 78: 9– 20. 30641141 PMC6488430
  30. [32]Lisman J Cooper K Sehgal M. Memory formation depends on both synapse-specific modifications of synaptic strength and cell-specific increases in excitability. Nat Neurosci. 2018; 21: 309– 14. 29434376 PMC5915620
  31. [33]Naletova I Satriano C Pietropaolo A. The copper(II)-assisted connection between NGF and BDNF by means of nerve growth factor-mimicking short peptides. Cells. 2019; 8: 301. 30939824 PMC6523629
  32. [34]Hawkins BT Davis TP. The blood-brain barrier/neurovascular unit in health and disease. Pharmacol Rev. 2005; 57: 173– 85. 15914466
  33. [35]Liebner S Fischmann A Rascher G. Claudin-1 and claudin-5 expression and tight junction morphology are altered in blood vessels of human glioblastoma multiforme. Acta Neuropathol. 2000; 100: 323– 31. 10965803
  34. [36]Wang J Chen J Tang Z. The effects of copper on brain microvascular endothelial cells and claudin via apoptosis and oxidative stress. Biol Trace Elem Res. 2016; 174: 132– 41. 27038183
  35. [37]Kadry H Noorani B Cucullo L. A blood-brain barrier overview on structure, function, impairment, and biomarkers of integrity. Fluids Barriers CNS. 2020; 17: 69. 33208141 PMC7672931
  36. [39]Bowman GL Dayon L Kirkland R. Blood-brain barrier breakdown, neuroinflammation, and cognitive decline in older adults. Alzheimers Dement. 2018; 14: 1640– 50. 30120040
  37. [40]Rajeev V Fann DY Dinh QN. Pathophysiology of blood brain barrier dysfunction during chronic cerebral hypoperfusion in vascular cognitive impairment. Theranostics. 2022; 12: 1639– 58. 35198062 PMC8825579
  38. [41]Zhu H Liu W Fang H. Inflammation caused by peripheral immune cells across into injured mouse blood brain barrier can worsen postoperative cognitive dysfunction induced by isoflurane. BMC Cell Biol. 2018; 19: 23. 30268095 PMC6162931
  39. [42]Liu H Lai W Liu X. Exposure to copper oxide nanoparticles triggers oxidative stress and endoplasmic reticulum (ER)-stress induced toxicology and apoptosis in male rat liver and BRL-3A cell. J Hazard Mater. 2021; 401: 123349. 32659578
  40. [43]Chakraborty J Pakrashi S Sarbajna A. Quercetin attenuates copper-induced apoptotic cell death and endoplasmic reticulum stress in SH-SY5Y cells by autophagic modulation. Biol Trace Elem Res. 2022; 200: 5022– 41. 35149956
  41. [44]Hetz C Saxena S. ER stress and the unfolded protein response in neurodegeneration. Nat Rev Neurol. 2017; 13: 477– 91. 28731040
  42. [45]Scheper W Hoozemans JJ. The unfolded protein response in neurodegenerative diseases: a neuropathological perspective. Acta Neuropathol. 2015; 130: 315– 31. 26210990 PMC4541706
  43. [46]Koksal AR Verne GN Zhou Q. Endoplasmic reticulum stress in biological processing and disease. J Investig Med. 2021; 69: 309– 15. 33472886
  44. [47]Thangwong P Jearjaroen P Govitrapong P. Melatonin improves cognitive function by suppressing endoplasmic reticulum stress and promoting synaptic plasticity during chronic cerebral hypoperfusion in rats. Biochem Pharmacol. 2022; 198: 114980. 35219702
  45. [48]Marinesco S Carew TJ. Serotonin release evoked by tail nerve stimulation in the CNS of aplysia: characterization and relationship to heterosynaptic plasticity. J Neurosci. 2002; 22: 2299– 312. 11896169 PMC6758260
  46. [49]Ben-Ari Y Gaiarsa J-L Tyzio R. GABA: a pioneer transmitter that excites immature neurons and generates primitive oscillations. Physiol Rev. 2007; 87: 1215– 84. 17928584
  47. [50]Chauhan PS Misra UK Kalita J. A study of glutamate levels, NR1, NR2A, NR2B receptors and oxidative stress in rat model of Japanese encephalitis. Physiol Behav. 2017; 171: 256– 67. 28108334
  48. [51]Li Z Wang G Zhong S. Alleviation of cognitive deficits and high copper levels by an NMDA receptor antagonist in a rat depression model. Compr Psychiatry. 2020; 102: 152200. 32892027
  49. [52]Zulfugarova P Zivari-Ghader T Maharramova S. A mechanistic review of pharmacological activities of homeopathic medicine licorice against neural diseases. Front Neurosci. 2023; 17: 1148258. 36950127 PMC10025333
  50. [53]Lin X Wei G Huang Z. Mitochondrial proteomic alterations caused by long-term low-dose copper exposure in mouse cortex. Toxicol Lett. 2016; 263: 16– 25. 27769873
  51. [54]Sheline CT Choi DW. Cu2+ toxicity inhibition of mitochondrial dehydrogenases in vitro and in vivo. Ann Neurol. 2004; 55: 645– 53. 15122704
  52. [55]Arciello M Rotilio G Rossi L. Copper-dependent toxicity in SH-SY5Y neuroblastoma cells involves mitochondrial damage. Biochem Biophys Res Commun. 2005; 327: 454– 9. 15629136
  53. [56]Martínez-Hernández MI Acosta-Saavedra LC Hernández-Kelly LC. Microglial activation in metal neurotoxicity: impact in neurodegenerative diseases. Biomed Res Int. 2023; 2023: 7389508. 36760476 PMC9904912
  54. [57]Guan Y Han F. Key mechanisms and potential targets of the NLRP3 inflammasome in neurodegenerative diseases. Front Integr Neurosci. 2020; 14: 37. 32792920 PMC7393579
  55. [58]Lim SL Rodriguez-Ortiz CJ Hsu H-W. Chronic copper exposure directs microglia towards degenerative expression signatures in wild-type and J20 mouse model of Alzheimer’s disease. J Trace Elem Med Biol. 2020; 62: 126578. 32599538 PMC7655674
  56. [59]Caetano-Silva ME Rund LA Vailati-Riboni M. Copper-binding peptides attenuate microglia inflammation through suppression of NF-kB pathway. Mol Nutr Food Res. 2021; 65: e2100153. 34532985 PMC8612997
  57. [60]Zhou Q Zhang Y Lu L. Copper induces microglia-mediated neuroinflammation through ROS/NF-κB pathway and mitophagy disorder. Food Chem Toxicol. 2022; 168: 113369. 35985369
  58. [61]Torres-Acosta N O'Keefe JH O'Keefe EL. Therapeutic potential of TNF-α inhibition for Alzheimer’s disease prevention. J Alzheimers Dis. 2020; 78: 619– 26. 33016914 PMC7739965
  59. [62]Decourt B Lahiri DK Sabbagh MN. Targeting tumor necrosis factor alpha for Alzheimer’s disease. Curr Alzheimer Res. 2017; 14: 412– 25. 27697064 PMC5328927
  60. [63]Liao Y Xing Q Li Q. Astrocytes in depression and Alzheimer’s disease. Front Med. 2021; 15: 829– 41. 34811642
  61. [64]Bhattacharjee A Ghosh S Chatterji A. Neuron-glia: understanding cellular copper homeostasis, its cross-talk and their contribution towards neurodegenerative diseases. Metallomics. 2020; 12: 1897– 911. 33295934
  62. [65]Chi S Cui Y Wang H. Astrocytic Piezo1-mediated mechanotransduction determines adult neurogenesis and cognitive functions. Neuron. 2022; 110: 2984– 2999.e8. 35963237
  63. [66]Lian H Litvinchuk A Chiang AC-A. Astrocyte-microglia cross talk through complement activation modulates amyloid pathology in mouse models of Alzheimer’s disease. J Neurosci. 2016; 36: 577– 89. 26758846 PMC4710776
  64. [67]Scheiber IF Dringen R. Copper-treatment increases the cellular GSH content and accelerates GSH export from cultured rat astrocytes. Neurosci Lett. 2011; 498: 42– 6. 21571036
  65. [68]Chen SH Lin J-K Liu S-H. Apoptosis of cultured astrocytes induced by the copper and neocuproine complex through oxidative stress and JNK activation. Toxicol Sci. 2008; 102: 138– 49. 18056745
  66. [69]Scheiber IF Schmidt MM Dringen R. Zinc prevents the copper-induced damage of cultured astrocytes. Neurochem Int. 2010; 57: 314– 22. 20600438
  67. [70]Witt B Stiboller M Raschke S. Characterizing effects of excess copper levels in a human astrocytic cell line with focus on oxidative stress markers. J Trace Elem Med Biol. 2021; 65: 126711. 33486291
  68. [71]Pike CJ Cummings BJ Monzavi R. Beta-amyloid-induced changes in cultured astrocytes parallel reactive astrocytosis associated with senile plaques in Alzheimer’s disease. Neuroscience. 1994; 63: 517– 31. 7891862
  69. [72]Wu J Yang J-J Cao Y. Iron overload contributes to general anaesthesia-induced neurotoxicity and cognitive deficits. J Neuroinflammation. 2020; 17: 110. 32276637 PMC7149901
  70. [73]Doguer C Ha JH Collins JF. Intersection of iron and copper metabolism in the mammalian intestine and liver. Compr Physiol. 2018; 8: 1433– 61. 30215866 PMC6460475
  71. [74]Xue Q Yan D Chen X. Copper-dependent autophagic degradation of GPX4 drives ferroptosis. Autophagy. 2023; 19: 1982– 96. 36622894 PMC10283421
  72. [75]Xue Q Kang R Klionsky DJ. Copper metabolism in cell death and autophagy. Autophagy. 2023; 19: 2175– 95. 37055935 PMC10351475
  73. [76]Bonaz B Bazin T Pellissier S. The vagus nerve at the interface of the microbiota-gut-brain axis. Front Neurosci. 2018; 12: 49. 29467611 PMC5808284
  74. [77]Agirman G Yu KB Hsiao EY. Signaling inflammation across the gut-brain axis. Science. 2021; 374: 1087– 92. 34822299
  75. [78]Socała K Doboszewska U Szopa A. The role of microbiota-gut-brain axis in neuropsychiatric and neurological disorders. Pharmacol Res. 2021; 172: 105840. 34450312
  76. [79]Mangiola F Ianiro G Franceschi F. Gut microbiota in autism and mood disorders. World J Gastroenterol. 2016; 22: 361– 8. 26755882 PMC4698498
  77. [80]Zhan G Hua D Huang N. Anesthesia and surgery induce cognitive dysfunction in elderly male mice: the role of gut microbiota. Aging (Albany NY). 2019; 11: 1778– 90. 30904902 PMC6461176
  78. [81]Dai J Yang X Yuan Y. Toxicity, gut microbiota and metabolome effects after copper exposure during early life in SD rats. Toxicology. 2020; 433-434: 152395. 32027963
  79. [82]Li CY Li X-Y Shen L. Regulatory effects of transition metals supplementation/deficiency on the gut microbiota. Appl Microbiol Biotechnol. 2021; 105: 1007– 15. 33449129
  80. [83]Zhang L Yang Z Yang M. Copper-induced oxidative stress, transcriptome changes, intestinal microbiota, and histopathology of common carp (Cyprinus carpio). Ecotoxicol Environ Saf. 2022; 246: 114136. 36242823

Cited by

Sorted by citations

Authors
Feng, D., Zhao, Y., Li, W., Li, X., Wan, J., & Wang, F.
Affiliations
  • Affiliated Hospital of North Sichuan Medical College (CN)
  • General Surgery Department, Enyang District People’s Hospital, Bazhong City, China
  • ICU, Bazhong District People’s Hospital, Bazhong, China.
Corresponding author
Wang, Fangjun
Venue
Medicine
Published
2023-12-01
Volume
102
Issue
48
Pages
e36375
ISSN
  • 0025-7974 (ISSN-L)
  • 1536-5964
OpenAlex
W4389257744
Cited by
38
References
3
Citations by year
2026: 14 · 2025: 14 · 2024: 10
FWCI
1.27
Type
journal article
Language
en
Open access
Locations
  • Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Heavy Metal Exposure and Toxicity
  • Life Sciences › Neuroscience › Neurology › Neurological diseases and metabolism
Keywords
copper neurotoxicity, cognitive impairment, cuproptosis, neuroinflammation, oxidative stress, mitochondrial dysfunction, synaptic plasticity, neurotrophic support, neurodegenerative diseases, mental illness, diabetes mellitus, aging, chemotherapy
MeSH terms
Aging, Copper, Humans, Apoptosis, Oxidative Stress, Neurodegenerative Diseases, Cognitive Dysfunction

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