Atterling Brolin Kajsa, Schaeffer Eva, Kuri Ashvin, Rumrich Isabell Katharina, Schumacher Schuh Artur Francisco, Darweesh Sirwan K L, Kaasinen Valtteri, Tolppanen Anna-Maija, Chahine Lana M, Noyce Alastair J
Translational Neurogenetics Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden.
Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Mov Disord. 2025 Feb;40(2):204-221. doi: 10.1002/mds.30067. Epub 2024 Nov 27.
The age-standardized prevalence of Parkinson's disease (PD) has increased substantially over the years and is expected to increase further. This emphasizes the need to identify modifiable risk factors of PD, which could form a logical entry point for the prevention of PD. The World Health Organization (WHO) has recommended reducing exposure to specific environmental factors that have been reported to be associated with PD, in particular pesticides, trichloroethylene (TCE), and air pollution. In this review we critically evaluate the epidemiological and biological evidence on the associations of these factors with PD and review evidence on whether these putative associations are causal. We conclude that when considered in isolation, it is difficult to determine whether these associations are causal, in large part because of the decades-long lag between relevant exposures and the incidence of manifest PD. However, when considered in tandem with evidence from complementary research lines (such as animal models), it is increasingly likely that these associations reflect harmful causal effects. Fundamentally, whilst we highlight some evidence gaps that require further attention, we believe the current evidence base is sufficiently strong enough to support our call for stronger policy action. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
多年来，帕金森病（PD）的年龄标准化患病率大幅上升，预计还会进一步增加。这凸显了识别PD可改变风险因素的必要性，这些因素可能成为预防PD的合理切入点。世界卫生组织（WHO）建议减少接触据报道与PD相关的特定环境因素，特别是农药、三氯乙烯（TCE）和空气污染。在本综述中，我们严格评估了这些因素与PD关联的流行病学和生物学证据，并审视了这些假定关联是否具有因果关系的证据。我们得出结论，单独考虑时，很难确定这些关联是否具有因果关系，这在很大程度上是因为相关暴露与明显PD发病之间存在数十年的滞后。然而，与补充研究方向（如动物模型）的证据一并考虑时，这些关联越来越有可能反映有害的因果效应。从根本上说，虽然我们强调了一些需要进一步关注的证据空白，但我们认为目前的证据基础足够有力，足以支持我们呼吁采取更强有力政策行动的主张。© 2024作者。《运动障碍》由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版。
