Inflammation and Oxidative Stress Biomarkers in Heavy Metal Toxicity: Bridging the Gap to Personalized Clinical Interventions

ABSTRACT Heavy metal exposure (e.g., Pb, Cd, Hg, and As) remains a critical public health concern because of bioaccumulation and links to chronic diseases like hypertension, diabetes, and cancer. This systematic review (PRISMA compliant) synthesizes evidence from 32 studies (2015–2025) elucidating toxicity mechanisms via oxidative stress, inflammation, endocrine disruption, and epigenetic dysregulation. Key biomarkers—blood/urinary metal levels, oxidative stress markers (8‐OHdG and MDA), and inflammatory cytokines (CRP, IL‐6, and TNF‐α)—enable early detection and toxicity assessment. Pro‐inflammatory responses dominated across studies, with Pb and Cd consistently elevating CRP, TNF‐α, and IL‐6, alongside tissue‐specific inflammation (liver and kidneys). ELISA emerged as the primary analytical method, although biomarker variability underscored influences of dose, duration, and individual susceptibility. Critically, anti‐inflammatory IL‐10 was frequently downregulated. We highlight the clinical utility of biomarkers in public health surveillance, chelation therapy, and preventive strategies. Future directions prioritize omics‐based profiling, CRISPR technology, portable biosensors, and standardized protocols for real‐time monitoring and personalized risk assessment. Integrating current biomarkers with these innovations will advance precision medicine to mitigate heavy metal toxicity globally.