Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA.
Institute of Data Science, Maastricht University, Maastricht, Netherlands.
Neurotox Res. 2021 Jun;39(3):924-948. doi: 10.1007/s12640-020-00320-y. Epub 2021 Jan 5.
While there is significant investigation and investment in brain and neurodegenerative disease research, current understanding of the etiologies of illnesses like Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and brain cancer remains limited. Environmental exposure to the pollutant formaldehyde, an emerging neurotoxin widely used in industry, is suspected to play a critical role in mediating these disorders, although findings are limited and inconsistent. Focusing on highly exposed groups, we performed a meta-analysis of human epidemiological studies of formaldehyde and neurodegenerative disease (N = 19) or brain tumors (N = 12). To assess the biological plausibility of observed associations, we then conducted a bioinformatics analysis using WikiPathways and the Comparative Toxicogenomics Database and identified candidate genes and pathways that may be related to these interactions. We reported the meta-relative risk (meta-RR) of ALS following high exposures to formaldehyde was increased by 78% (meta-RR = 1.78, 95% confidence interval, CI 1.20-2.65). Similarly, the meta-RR for brain cancer was increased by 71% (meta-RR = 1.71; 95% CI 1.07-2.73) among highly exposed individuals. Multiple sensitivity analyses did not reveal sources of heterogeneity or bias. Our bioinformatics analysis revealed that the oxidative stress genes superoxide dismutase (SOD1, SOD2) and the pro-inflammatory marker tumor necrosis factor (TNF) were identified as the top relevant genes, and the folate metabolism, vitamin B metabolism, and the ALS pathways were highly affected by formaldehyde and related to the most brain diseases of interest. Further inquiry revealed the two metabolic pathways are also intimately tied with the formaldehyde cycle. Overall, our bioinformatics analysis supports the link of formaldehyde exposure to ALS or brain tumor reported from our meta-analysis. This new multifactorial approach enabled us to both interrogate the robustness of the epidemiological data and identify genes and pathways that may be involved in these interactions, ultimately lending strong evidence and potential biological plausibility for the association between formaldehyde exposure and brain disease.
虽然对大脑和神经退行性疾病的研究进行了大量的调查和投资,但目前对阿尔茨海默病 (AD)、帕金森病 (PD)、肌萎缩侧索硬化症 (ALS) 和脑癌等疾病的病因的了解仍然有限。环境暴露于甲醛这种新兴的神经毒素中,这种毒素在工业中广泛使用,被怀疑在介导这些疾病中起着关键作用,尽管研究结果有限且不一致。我们专注于高度暴露的人群,对 19 项甲醛与神经退行性疾病 (N = 19) 或脑肿瘤 (N = 12) 的人类流行病学研究进行了荟萃分析。为了评估观察到的关联的生物学合理性,我们随后使用 WikiPathways 和比较毒理学基因组数据库进行了生物信息学分析,并确定了可能与这些相互作用相关的候选基因和途径。我们报告了高暴露于甲醛后 ALS 的荟萃相对风险 (meta-RR) 增加了 78%(meta-RR = 1.78,95%置信区间,CI 1.20-2.65)。同样,高暴露个体的脑癌荟萃相对风险增加了 71%(meta-RR = 1.71;95% CI 1.07-2.73)。多项敏感性分析并未发现异质性或偏倚的来源。我们的生物信息学分析表明,氧化应激基因超氧化物歧化酶 (SOD1、SOD2) 和促炎标志物肿瘤坏死因子 (TNF) 被确定为最相关的基因,叶酸代谢、维生素 B 代谢和 ALS 途径受到甲醛的强烈影响,并与最感兴趣的脑疾病有关。进一步研究表明,这两种代谢途径也与甲醛循环密切相关。总体而言,我们的生物信息学分析支持我们荟萃分析报告的甲醛暴露与 ALS 或脑肿瘤之间的联系。这种新的多因素方法使我们能够既询问流行病学数据的稳健性,又能确定可能参与这些相互作用的基因和途径,最终为甲醛暴露与脑疾病之间的关联提供了强有力的证据和潜在的生物学合理性。