The metabolism of copper and Wilson's disease

The use of the word nutrition very frequently conjures up in the mind the idea of many foods composed of carbohydrate, fat or protein.Sometimes thought is given to minerals such as calcium, sodium and potassium but rarely is consideration given to copper, its normal metabolism, and abnormalities that result from alterations in dietary intake of copper.We all take in the diet and require some z mg Cu/day and in normal subjects there is a fairly accurate degree of balance between intake and output (Cartwright, Hodges, Gubler, Mahoney, Daum, Wintrobe & Bean, 1954).Occasionally excess Cu has been taken by mouth, as recorded by Percival (1785) when a young girl of 17 died from severe intestinal lesions.It would appear to be extremely rare, if not impossible, for man to suffer from a deficient intake, even though a lack of Cu in cattle (Ryi, 1959), dogs (Van Wyk, Baxter, Akeroyd & Motulsky, 1953), pigs (Lahey, Gubler, Chase, Cartwright & Wintrobe, 1952; Follis, Bush, Cartwright & Wintrobe, 1955; Bush, Jensen, Athens, Ashenbrucker, Cartwright & Wintrobe, 1956) and sheep (Marston, 1952) results in definite abnormalities.This lack may be because there is insufficient Cu in the food or because of the presence of other substances in the soil, such as molybdenum which causes an increased Cu excretion (Dick, 1953), or because the Cu is present in possibly a nonavailable form (Phlsson & Grimsson, 1953).In pigs (Gubler, Lahey, Chase, Cart-Wright & Wintrobe, 1952) and in rats (Chase, Gubler, Cartwright & Wintrobe, 1952) lack of Cu results in anaemia through interference with iron metabolism.Gallagher, Judah & Rees (1956) have also demonstrated a disturbance of phospholipid synthesis in the Cu-deficient rat.Neither these nor any other manifestations of a deficiency in animals have been found in man.Premature infants with a low dietary Cu intake of 15 pg/kg daily showed no resulting anaemia or other abnormality (