Ingre Caroline, Roos Per M, Piehl Fredrik, Kamel Freya, Fang Fang
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Clin Epidemiol. 2015 Feb 12;7:181-93. doi: 10.2147/CLEP.S37505. eCollection 2015.
Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease. It is typically fatal within 2-5 years of symptom onset. The incidence of ALS is largely uniform across most parts of the world, but an increasing ALS incidence during the last decades has been suggested. Although recent genetic studies have substantially improved our understanding of the causes of ALS, especially familial ALS, an important role of non-genetic factors in ALS is recognized and needs further study. In this review, we briefly discuss several major genetic contributors to ALS identified to date, followed by a more focused discussion on the most commonly examined non-genetic risk factors for ALS. We first review factors related to lifestyle choices, including smoking, intake of antioxidants, physical fitness, body mass index, and physical exercise, followed by factors related to occupational and environmental exposures, including electromagnetic fields, metals, pesticides, β-methylamino-L-alanine, and viral infection. Potential links between ALS and other medical conditions, including head trauma, metabolic diseases, cancer, and inflammatory diseases, are also discussed. Finally, we outline several future directions aiming to more efficiently examine the role of non-genetic risk factors in ALS.
肌萎缩侧索硬化症（ALS）是最常见的运动神经元疾病。通常在症状出现后的2至5年内致命。世界大部分地区ALS的发病率基本一致，但有研究表明在过去几十年中ALS的发病率呈上升趋势。尽管最近的基因研究极大地增进了我们对ALS病因的理解，尤其是家族性ALS的病因，但非遗传因素在ALS中的重要作用已得到认可，仍需进一步研究。在这篇综述中，我们简要讨论了迄今为止确定的几种导致ALS的主要遗传因素，随后更集中地讨论了ALS最常研究的非遗传风险因素。我们首先回顾与生活方式选择相关的因素，包括吸烟、抗氧化剂摄入、身体健康状况、体重指数和体育锻炼，接着讨论与职业和环境暴露相关的因素，包括电磁场、金属、农药、β-甲基氨基-L-丙氨酸和病毒感染。还讨论了ALS与其他疾病之间的潜在联系，包括头部创伤、代谢性疾病、癌症和炎症性疾病。最后，我们概述了几个未来的研究方向，旨在更有效地研究非遗传风险因素在ALS中的作用。
