Tshala-Katumbay Desire, Mwanza Jean-Claude, Rohlman Diane S, Maestre Gladys, Oriá Reinaldo B
Department of Neurology, Oregon Health &Science University, Portland, Oregon, 97239, USA.
National Institute of Biomedical Research, 1197 Kinshasa I, Congo.
Nature. 2015 Nov 19;527(7578):S187-92. doi: 10.1038/nature16034.
Economic transitions in the era of globalization warrant a fresh look at the neurological risks associated with environmental change. These are driven by industrial expansion, transfer and mobility of goods, climate change and population growth. In these contexts, risk of infectious and non-infectious diseases are shared across geographical boundaries. In low- and middle-income countries, the risk of environmentally mediated brain disease is augmented several fold by lack of infrastructure, poor health and safety regulations, and limited measures for environmental protection. Neurological disorders may occur as a result of direct exposure to chemical and/or non-chemical stressors, including but not limited to, ultrafine particulate matters. Individual susceptibilities to exposure-related diseases are modified by genetic, epigenetic and metagenomic factors. The existence of several uniquely exposed populations, including those in the areas surrounding the Niger Delta or north western Amazon oil operations; those working in poorly regulated environments, such as artisanal mining industries; or those, mostly in sub-Saharan Africa, relying on cassava as a staple food, offers invaluable opportunities to advance the current understanding of brain responses to environmental challenges. Increased awareness of the brain disorders that are prevalent in low- and middle-income countries and investments in capacity for further environmental health-related research are positive steps towards improving human health.
全球化时代的经济转型促使我们重新审视与环境变化相关的神经学风险。这些风险是由工业扩张、货物转移与流动、气候变化以及人口增长所驱动的。在这些背景下,传染病和非传染病的风险跨越地理边界相互关联。在低收入和中等收入国家,由于基础设施匮乏、健康与安全法规不完善以及环境保护措施有限,环境介导的脑部疾病风险增加了数倍。神经系统疾病可能是直接接触化学和/或非化学应激源(包括但不限于超细颗粒物)的结果。个体对与接触相关疾病的易感性会受到遗传、表观遗传和宏基因组因素的影响。存在几个独特的暴露人群,包括尼日尔三角洲周边地区或亚马逊西北部石油作业区的人群;在监管不力的环境中工作的人群,如个体采矿业从业者;以及主要在撒哈拉以南非洲以木薯为主食的人群,这些为推进当前对大脑对环境挑战的反应的理解提供了宝贵机会。提高对低收入和中等收入国家普遍存在的脑部疾病的认识以及对进一步开展与环境卫生相关研究的能力进行投资,是改善人类健康的积极举措。