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三氯乙烯:帕金森病的隐形病因?

Trichloroethylene: An Invisible Cause of Parkinson's Disease?

机构信息

Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA.

Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.

出版信息

J Parkinsons Dis. 2023;13(2):203-218. doi: 10.3233/JPD-225047.

Abstract

The etiologies of Parkinson's disease (PD) remain unclear. Some, such as certain genetic mutations and head trauma, are widely known or easily identified. However, these causes or risk factors do not account for the majority of cases. Other, less visible factors must be at play. Among these is a widely used industrial solvent and common environmental contaminant little recognized for its likely role in PD: trichloroethylene (TCE). TCE is a simple, six-atom molecule that can decaffeinate coffee, degrease metal parts, and dry clean clothes. The colorless chemical was first linked to parkinsonism in 1969. Since then, four case studies involving eight individuals have linked occupational exposure to TCE to PD. In addition, a small epidemiological study found that occupational or hobby exposure to the solvent was associated with a 500% increased risk of developing PD. In multiple animal studies, the chemical reproduces the pathological features of PD.Exposure is not confined to those who work with the chemical. TCE pollutes outdoor air, taints groundwater, and contaminates indoor air. The molecule, like radon, evaporates from underlying soil and groundwater and enters homes, workplaces, or schools, often undetected. Despite widespread contamination and increasing industrial, commercial, and military use, clinical investigations of TCE and PD have been limited. Here, through a literature review and seven illustrative cases, we postulate that this ubiquitous chemical is contributing to the global rise of PD and that TCE is one of its invisible and highly preventable causes. Further research is now necessary to examine this hypothesis.

摘要

帕金森病(PD)的病因仍不清楚。有些病因,如某些基因突变和头部外伤,广为人知或易于识别。然而,这些原因或风险因素并不能解释大多数病例。其他不太明显的因素肯定在起作用。其中之一是一种广泛使用的工业溶剂和常见的环境污染物,其在 PD 中的可能作用尚未得到充分认识:三氯乙烯(TCE)。TCE 是一种简单的六原子分子,可以脱去咖啡的咖啡因、去除金属部件的油脂并干洗衣物。这种无色化学物质于 1969 年首次与帕金森病联系在一起。从那时起,四项涉及 8 人的病例研究将职业暴露于 TCE 与 PD 联系起来。此外,一项小型流行病学研究发现,职业或业余接触该溶剂会使 PD 的发病风险增加 500%。在多项动物研究中,该化学物质再现了 PD 的病理特征。暴露不仅限于那些接触该化学物质的人。TCE 污染室外空气、污染地下水并污染室内空气。这种分子,像氡一样,从地下土壤和地下水中蒸发出来,进入家庭、工作场所或学校,通常未被察觉。尽管污染广泛且工业、商业和军事用途不断增加,但对 TCE 和 PD 的临床研究一直很有限。在这里,通过文献回顾和七个说明性病例,我们假设这种无处不在的化学物质正在导致全球 PD 发病率的上升,并且 TCE 是其隐形且高度可预防的原因之一。现在有必要进行进一步的研究来检验这一假设。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4453/10041423/b8b4b368920c/jpd-13-jpd225047-g001a.jpg

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