Mercury is a heavy metal responsible for intoxications worldwide. Most toxic form is methylmercury that has affinity for the central nervous system, with recognized neurotoxicity. Some regions of the Amazon are well characterized by mercury exposure in humans, as the region of the Tapajos, due to local mining activity, for example. However, others, such as Tucuruí, remain virtually unstudied, with only one study in humans to date. In the Amazon, there is a large number of studies showing mercury exposure, however, intoxication and susceptibility studies are far less numerous in the Amazonian populations, and even today, there is no study analyzing simultaneously the three factors. The objective of this study was to determine the exposure (mercury content in the body by using mercury levels in hair samples), the individual susceptibility (genetic predisposition of each individual to suffer a damage because the exposure, using the genotyping of apolipoprotein E) and the intoxication (quantifying the extent of the damage already caused by using biomarkers such as S100B and NSE) in Amazonian riverside populations. Three hundred eighty-eight individuals, selected after inclusion and exclusion criteria were studied. The genotype of apolipoprotein E more frequent was ɛ3/ɛ3, followed by ɛ3/ɛ4. Allelic frequencies were 0.043: 0.784: 0.173 to ε2: ɛ3: ɛ4, respectively. The median level of total mercury in hair was 4.2 μg/g (1.9- 10.2). A significant proportion of participants (24.8%) had mercury levels above 10 μg/g, as recommended by the WHO limit, and 12.8% of participants showed a total content of mercury greater or equal to 20 μg/g. Interestingly, Tucuruí levels were much higher than levels in the Tapajós (area recognized by the presence of mining gold activity). We identified 29% of patients with ApoE4 (considered at risk) and 8 maximum risk individuals (carriers of ApoE4 and mercury content above the limit of 10 μg/g). Moreover, there was a significant difference in mRNA levels of S100B protein between groups exposed to high and low levels of mercury. For the first time, markers of the three spheres of influence in human toxicology (exposure, susceptibility and poisoning) were studied. Our data already support the use of these markers to monitoring the Amazonian populations. This knowledge will assist the development of prevention strategies and making government decisions facing the problem of the impact of the mercury in the Amazon.
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