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Future Directions
Summary
This review paper looks at where metal toxicity research is headed, arguing scientists need to study not just how much of a metal (like lead or mercury) is in your body, but its exact chemical form, where it ends up in cells, and how it interacts with other exposures like microplastics. One key insight: treatments that successfully lower metal levels in the blood don't always improve brain health, showing that simply "detoxing" isn't enough, future research needs better tools to understand how metals actually damage the brain so we can develop smarter, more personalized ways to protect it.
Metal neurotoxicity research is moving beyond total elemental burden to investigating chemical speciation, intracellular distribution, mixed exposures and individual susceptibility. This chapter explores how metallomics, ferroptosis, neuroimmune and epigenetic reprogramming, gene–environment interactions, the gut–brain axis and microplastics may clarify links between metals and neurodegeneration. It evaluates neurotoxic and essential metals, human cell models, organoids, blood–brain barrier platforms, spatial metallomics and multi-omics. Biomarkers must distinguish exposure, internal dose, biological effects and neural injury. Evidence from succimer and deferiprone shows that lowering a metal biomarker does not necessarily improve neurological outcomes. Future priorities include life-course exposure assessment, realistic mixture studies, selective restoration of metal homeostasis and precision environmental neurology.