Global Health Center, Center for Research on Occupational and Environmental Toxicology, and Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR 97239, United States.
Neurotoxicology. 2012 Jun;33(3):605-16. doi: 10.1016/j.neuro.2012.02.015. Epub 2012 Feb 28.
The neurotoxic actions of chemical agents on humans and animals are usually studied with little consideration of the subject's nutritional status. States of protein-calorie, vitamin and/or mineral undernutrition are associated with a range of neurodevelopmental, neurological and psychiatric disorders, commonly with involvement of both the central and the peripheral nervous system. Undernutrition can modify risk for certain chemical-induced neurologic diseases, and in some cases undernutrition may be a prerequisite for neurotoxicity to surface. In addition, neurologic disease associated with undernutrition or neurotoxicity may show similarities in clinical and neuropathological expression, especially in the peripheral nervous system. The combined effects of undernutrition and chemical neurotoxicity are most relevant to people with low incomes who experience chronic hunger, parasitism and infectious disease, monotonous diets of plants with neurotoxic potential (notably cassava), environmental pollution from rapid industrial development, chronic alcohol abuse, or prolonged treatment with certain therapeutic drugs. Undernutrition alone or in combination with chemical exposure is also important in high-income societies in the setting of drug and alcohol abuse, old age, food faddism, post-bariatric surgery, and drug treatment for certain medical conditions, including cancer and tuberculosis. The nutritional demands of pregnancy and lactation increase the risk of fetal and infant undernutrition and chemical interactions therewith.
化学物质对人类和动物的神经毒性作用通常在很少考虑研究对象营养状况的情况下进行研究。蛋白质-热量、维生素和/或矿物质营养不良状态与一系列神经发育、神经和精神疾病有关，通常涉及中枢和外周神经系统。营养不良会改变某些化学诱导的神经疾病的风险，在某些情况下，营养不良可能是神经毒性显现的先决条件。此外，与营养不良或神经毒性相关的神经疾病在临床和神经病理学表现上可能存在相似之处，尤其是在外周神经系统。营养不良和化学神经毒性的联合作用与收入较低的人群最为相关，这些人群经历慢性饥饿、寄生虫和传染病、具有神经毒性潜力的植物（特别是木薯）的单调饮食、快速工业发展造成的环境污染、慢性酗酒或长期使用某些治疗药物。在高收入社会中，营养不良单独或与化学物质暴露相结合，在药物和酒精滥用、老年、饮食时尚、减肥手术后以及某些医疗条件（包括癌症和结核病）的药物治疗中也很重要。妊娠和哺乳期的营养需求增加了胎儿和婴儿营养不良以及与之相关的化学相互作用的风险。
