Metal concentrations in cerebrospinal fluid, blood, serum, plasma, hair, and nails in amyotrophic lateral sclerosis: A systematic review and meta-analysis.

Autor: Kamalian A; Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA. Electronic address: akamali4@jhmi.edu., Foroughmand I; Bloomberg School of Public Health, Johns hopkins University, Baltimore, MD, USA., Koski L; Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 77 Stockholm, Sweden., Darvish M; Clinical Research Development Center, Shahid Modarres Hospital, Tehran, Iran., Saghazadeh A; Systematic Review and Meta Analysis Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Poursina st., Enghelab-e-Eslami avenue, Tehran, Iran., Kamalian A; School of Medicine, Yazd Shahid Sadoughi University of Medical Sciences, Shahid Bahonar Square, Yazd, Iran., Razavi SZE; Physical Medicine and Rehabilitation Department, Imam Khomeini Hospital Complex, Tohid Square, Tehran University of Medical Sciences, Tehran, Iran; Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital complex, Tehran University of Medical Sciences, Tehran, Iran., Abdi S; Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Poursina st., Enghelab-e-Eslami avenue, Tehran, Iran., Dehgolan SR; School of Medicine, Tehran University of Medical Sciences, Poursina st., Enghelab-e-Eslami avenue, Tehran, Iran., Fotouhi A; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran., Roos PM; Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 77 Stockholm, Sweden; Department of Clinical Physiology, St. Göran Hospital University Unit, St. Göransplan 1, 112 81 Stockholm, Sweden.
Jazyk: angličtina
Zdroj: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) [J Trace Elem Med Biol] 2023 Jul; Vol. 78, pp. 127165. Date of Electronic Publication: 2023 Mar 30.
DOI: 10.1016/j.jtemb.2023.127165
Abstrakt: Background: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with progressive muscle wasting, paralysis, and respiratory failure. Whereas approximately 10-15 % of ALS cases are familial, the etiology of the remaining, sporadic ALS cases remains largely unknown. Environmental exposures have been suggested as causative factors for decades, and previous studies have found elevated concentrations of metals in ALS patients.
Purpose: This meta-analysis aims to assess metal concentrations in body fluids and tissues of ALS patients.
Methods: We searched the MEDLINE and EMBASE databases on December 7th, 2022 for cross-sectional, case-control, and cohort studies which measure metal concentrations in whole blood, blood plasma, blood serum, cerebrospinal fluid (CSF), urine, erythrocytes, nail, and hair samples of ALS patients. Meta-analysis was then performed when three or more articles existed for a comparison.
Findings: Twenty-nine studies measuring 23 metals were included and 13 meta-analyses were performed from 4234 screened entries. The meta-analysis results showed elevated concentrations of lead and selenium. Lead, measured in whole blood in 6 studies, was significantly elevated by 2.88 µg/L (95 % CI: 0.83-4.93, p = 0.006) and lead, measured in CSF in 4 studies, was significantly elevated by 0.21 µg/L (95 % CI: 0.01 - 0.41, p = 0.04) in ALS patients when compared to controls. Selenium, measured in serum/plasma in 4 studies, was significantly elevated by 4.26 µg/L (95% CI: 0.73 - 7.79, p = 0.02) when compared to controls.Analyses of other metal concentrations showed no statistically significant difference between the groups.
Conclusion: Lead has been discussed as a possible causative agent in ALS since 1850. Lead has been found in the spinal cord of ALS patients, and occupational exposure to lead is more common in ALS patients than in controls. Selenium in the form of neurotoxic selenite has been shown to geochemically correlate to ALS occurrence in Italy. Although no causal relationship can be established from the results of this meta-analysis, the findings suggest an involvement of lead and selenium in the pathophysiology of ALS. After a thorough meta-analysis of published studies on metal concentrations in ALS it can only be concluded that lead and selenium are elevated in ALS.
Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest.
(Copyright © 2023 Elsevier GmbH. All rights reserved.)
Databáze: MEDLINE
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