Vinceti Marco, Filippini Tommaso, Mandrioli Jessica, Violi Federica, Bargellini Annalisa, Weuve Jennifer, Fini Nicola, Grill Peter, Michalke Bernhard
Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia Medical School, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia Medical School, Modena, Italy.
J Trace Elem Med Biol. 2017 Sep;43:121-125. doi: 10.1016/j.jtemb.2016.12.012. Epub 2017 Jan 3.
Exposure to neurotoxic chemicals such as pesticides, selenium, and heavy metals have been suggested to play a role in the etiology of amyotrophic lateral sclerosis (ALS). We assessed exposure to lead, cadmium, and mercury in 38 ALS patients (16 men and 22 females) and 38 hospital-admitted controls by using their cerebrospinal fluid (CSF) content as biomarker. We determined CSF heavy metal levels with inductively coupled plasma sector field mass spectrometry, according to a methodology specifically developed for this biological matrix. ALS patients had higher median values for Pb (155 vs. 132ng/L) but lower levels for Cd (36 vs. 72ng/L) and Hg (196 vs. 217ng/L). In the highest tertile of exposure, ALS odds ratio was 1.39 (95% CI 0.48-4.25) for Pb, 0.29 (0.08-1.04) for Cd and 3.03 (0.52-17.55) for Hg; however, no dose-response relation emerged. Results were substantially confirmed after conducting various sensitivity analyses, and after stratification for age and sex. Though interpretation of these results is limited by the statistical imprecision of the estimates, and by the possibility that CSF heavy metal content may not reflect long-term antecedent exposure, they do not lend support to a role of the heavy metals cadmium, lead and mercury in ALS etiology.
接触农药、硒和重金属等神经毒性化学物质被认为在肌萎缩侧索硬化症（ALS）的病因中起作用。我们通过将脑脊液（CSF）含量作为生物标志物，评估了38例ALS患者（16例男性和22例女性）和38例住院对照者的铅、镉和汞暴露情况。我们根据专门为此生物基质开发的方法，采用电感耦合等离子体质谱法测定了脑脊液中的重金属水平。ALS患者的铅中位数较高（155对132ng/L），但镉（36对72ng/L）和汞（196对217ng/L）水平较低。在最高暴露三分位数中，铅的ALS比值比为1.39（95%CI 0.48-4.25），镉为0.29（0.08-1.04），汞为3.03（0.52-17.55）；然而，未出现剂量反应关系。在进行各种敏感性分析以及按年龄和性别分层后，结果得到了实质性证实。尽管这些结果的解释受到估计值统计不精确性以及脑脊液重金属含量可能无法反映长期既往暴露的可能性的限制，但它们并不支持镉、铅和汞等重金属在ALS病因中的作用。
