Modabbernia Amirhossein, Arora Manish, Reichenberg Abraham
aDepartment of Psychiatry bSeaver Center for Autism Research and Treatment cDepartment of Preventive Medicine dFriedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
Curr Opin Pediatr. 2016 Apr;28(2):243-9. doi: 10.1097/MOP.0000000000000332.
This article presents a new hypothesis about the possible relation between early life exposure to metals and psychosis. We review limitations of available research, and discuss novel approaches to overcome previous methodological barriers.
Mechanistic studies suggest a possible association between excess lead, manganese, cadmium, arsenic, or copper, and zinc deficiency, and several biochemical disturbances related to psychosis, such as altered neurotransmitters levels, excitotoxicity, and inflammation. Furthermore, studies suggest that some metals (lead, manganese, cadmium excess, and zinc deficiency) are associated with schizophrenia or psychosis-related phenotype. However, previous studies had multiple methodological limitations. Importantly, metal exposure was often measured after disease development and seldom determined during critical developmental periods. Most studies fell short of depicting the exact timing of exposure and the change in exposure over time. Here, we propose several methods to overcome these methodological limitations.
There is a plausible role of early life exposure to metals in the cause of psychosis. Owing to methodological limitations in exposure measurement, this has not been well characterized. Considering the wide exposure to metals and the high cost of psychosis to society, this hypothesis should be rigorously examined.
本文提出了一个关于早年接触金属与精神病之间可能关系的新假说。我们回顾了现有研究的局限性，并讨论了克服先前方法障碍的新方法。
机制研究表明，铅、锰、镉、砷或铜过量以及锌缺乏与精神病相关的几种生化紊乱之间可能存在关联，如神经递质水平改变、兴奋性毒性和炎症。此外，研究表明某些金属（铅、锰、镉过量和锌缺乏）与精神分裂症或精神病相关表型有关。然而，先前的研究存在多种方法学局限性。重要的是，金属暴露通常在疾病发展后进行测量，而在关键发育时期很少进行测定。大多数研究未能描述暴露的确切时间以及随时间的暴露变化。在此，我们提出了几种方法来克服这些方法学局限性。
早年接触金属在精神病病因中可能起到一定作用。由于暴露测量方面的方法学局限性，这一点尚未得到充分描述。鉴于金属暴露广泛且精神病给社会带来高昂代价，这一假说应得到严格检验。
