Oskarsson Björn, Horton D Kevin, Mitsumoto Hiroshi
UC Davis Multidisciplinary ALS Clinic, An ALS Association Certified Center of Excellence, University of California Davis Medical Center, 4860 Y Street, Suite 3700, Sacramento, CA 95817, USA.
Division of Toxicology and Human Health Sciences, ATSDR/CDC, 4770 Buford Highway Northeast, Atlanta, GA 30341, USA.
Neurol Clin. 2015 Nov;33(4):877-88. doi: 10.1016/j.ncl.2015.07.009.
The causes of amyotrophic lateral sclerosis (ALS) are largely unknown, and may always be multiple, including environmental factors. Monogenetic determinants of ALS are involved in roughly 20% of all cases (including 10% familial cases). Less well understood multigenetic causes may contribute to another 20% to 80%. Environmental factors likely play a role in the development of ALS in susceptible individuals, but proved causation remains elusive. This article discusses the possible factors of male gender (males are selectively exposed to different influences, or genetically predisposed to be susceptible), smoking, military service, exercise, electrical exposure, heavy metals, agricultural chemicals, and geographic clusters.
肌萎缩侧索硬化症(ALS)的病因在很大程度上尚不清楚,而且可能一直是多因素的,包括环境因素。单基因决定因素约占所有病例的20%(包括10%的家族性病例)。人们对多基因病因的了解较少,可能占另外的20%至80%。环境因素可能在易感个体患ALS的过程中起作用,但已证实的因果关系仍然难以捉摸。本文讨论了可能的因素,包括男性性别(男性受到不同的选择性影响,或在基因上易感性更高)、吸烟、服兵役、运动、接触电、重金属、农用化学品以及地理聚集性。