The invention provides a non-invasive arsenic speciation and metallomics-basednailbiomarkers of chronic disease outcomes including cancers associated witharsenic andtoxic metal exposures and the methods for cancer diagnosis and prognosis usingthesebiomarkers. The biomarkers are proportions and ratios of several arsenicspecies andother metal profiles measured in biological nail samples. Metallomics is thecomprehensive analysis of the entirety of metal species within a biologicalspecimen.Our invention has demonstrated for the first time that the proportions ofarsenic speciesin human nails are associated with chronic disease including cancers anddifferbetween individuals with and without chronic disease including cancers. Thus,analysisof arsenic species combined with other interacting metals (such as selenium)inbiological nail samples can be used to monitor an individual's exposuresrelated tohealth and chronic disease outcomes, and to quantify an individual's cancerrisk,diagnosis and prognosis.Chronic exposure to toxic metals including arsenic has been linked to a numberofhuman diseases affecting multiple organ systems, including several cancers,diabetes,and cardiovascular and neurological disease. Most cases assessing canceroutcomesassociated with arsenic exposure have used on analysis of urine, in whicharsenic has ashort residence time (3 - 4 days), and which is thus better suited forassessing short-term,acute exposure. Since many arsenic-related cancers arise from chronic exposureand can develop over the course of several years, measuring longer-termbiomarkersmay prove to be a more relevant assessment. To the best of our knowledge, thisis thefirst invention for indicating exposures related to chronic disease outcomes,diseaserisk, disease presence, and disease prognosis, specifically related to chronicdiseaseincluding skin, lung, bladder, and kidney cancer, and type II diabetes.To the best of our knowledge, this is the first large study investigating theassociationsbetween arsenic exposure and various cancers using toenail arsenic speciationanalysis, a potentially important, more relevant biomarker for chronicdiseases.Toenails have been shown to be more reliable as markers of long-term exposurethanhair or fingernails, as they are less prone to contamination and washouteffects fromthings such as shampoo, nail polish, or regular handling of items
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