Lead content of neuromuscular tissue in amyotrophic lateral sclerosis: case report and other considerations

Petkau, A. John; Sawatzky, A.; Hillier, Chris; Hoogstraten, Jan

doi:10.1136/oem.31.4.275

Cited by 23 publications

(14 citation statements)

References 25 publications

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“…Significantly higher levels of lead in the plasma, cerebrospinal fluid and in the spinal cord of patients affected by ALS were re ported [46][47][48][49], although other authors dis agreed. In addition, the existence of an asso ciation between heavy metal exposure and ALS was denied in other epidemiological sur veys [50,51], Therefore substantial doubt re mains about any role played by lead in the pathogenesis of ALS.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Survey of Amyotrophic Lateral Sclerosis in the Province of Reggio Emilia, Italy: Influence of Environmental Exposure to Lead

et al. 1996

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We carried out a retrospective incidence, prevalence and mortality survey of amyotrophic lateral sclerosis (ALS) in the province of Reggio Emilia, northern Italy. Based on 79 patients, the mean incidence per year for the period 1980 through 1992 was 1.5 cases per 100,000. On December 31st, 1992, the prevalence rate was 5.4 per 100,000. In the 10-year period of 1983–1992 the average mortality rate was 1.3 per 100,000 per year. The average age at onset was 61.3 ± 10.2, the average survival period thereafter was 26.3 months ± 17.7; 27.3 ± 17.6 for classic ALS, 19.5 ±8.4 for progressive bulbar palsy and 36.3 ±41.4 for pseudopolyneuritic ALS. The incidence rate, recorded in public health district No. 12, an area with documented lead pollution since the 1970s, was standardized to the sex and age of the population of the province. Its incidence and prevalence rate were comparable to the rates found in the remaining area of the province.

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Section: Discussionmentioning

confidence: 99%

Epidemiological Survey of Amyotrophic Lateral Sclerosis in the Province of Reggio Emilia, Italy: Influence of Environmental Exposure to Lead

et al. 1996

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“…However, one must consider the possibility of drawing erroneous conclusions from such a small sample of ALS subjects. There is also conflicting evidence as to whether elevated levels of lead in skeletal muscle are present in ALS patients [11,15] . Lastly, the administration of a metal chelating agent to ALS patients did not lead to detectible mobilization of lead stores [16] .…”

Section: Leadmentioning

confidence: 99%

The Association of Exposure to Lead, Mercury, and Selenium and the Development of Amyotrophic Lateral Sclerosis and the Epigenetic Implications

et al. 2010

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Metal exposures are an intriguing potential culprit in the cause of sporadic amyotrophic lateral sclerosis (ALS). For one, there are numerous case reports linking different metals to an ALS phenotype. Furthermore, some investigators have demonstrated higher levels of certain metals in the blood, bone, cerebrospinal fluid, urine, or spinal cords of patients with ALS compared to controls. There are also many case-control studies looking at the possible association of certain metals with the development of ALS. We have reviewed the relevant literature regarding metal exposures and the risk of developing ALS. We found that many different metals have been implicated as having a role in ALS, but there is more literature investigating the role of lead than any other metal. Despite many studies, the role, if any, of this metal in the pathogenesis of ALS remains unclear. Similarly, other metals either have inconclusive, conflicting, or insufficient results in order to make a definitive conclusion. One explanation for these findings is that metal exposures alone are insufficient for the development of ALS. Perhaps an interaction between the metal exposure and an individual’s genetic makeup is required to produce epigenetic changes that ultimately lead to ALS.

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“…Several early studies investigated the relationship of ALS to lead levels in various body compartments, including blood, cerebrospinal fl uid, nerve or muscle, and bone [22,[26][27][28][29][30][31][32][33][34][35] . Results were inconsistent but generally showed little elevation in lead levels in ALS patients compared to controls.…”

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confidence: 99%

Lead Exposure as a Risk Factor for Amyotrophic Lateral Sclerosis

Kamel

Umbach

et al. 2005

Neurodegener Dis

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Background: The etiology of amyotrophic lateral sclerosis (ALS) likely involves an environmental component. We qualitatively assessed literature on ALS and lead exposure. Problems of study design make case reports and studies of lead in blood or tissues difficult to interpret. Most previous case-control studies found an association of ALS with self-reported occupational exposure to lead, with increased risks of 2- to >4-fold. However, these results may have been affected by recall bias. Objective: To address inconsistencies among published reports, we used both lead biomarkers and interview data to assess lead exposure, and we evaluated the role of genetic susceptibility to lead. Methods: We conducted a case-control study in New England in 1993–1996 with 109 ALS cases and 256 population-based controls. We measured blood and bone lead levels, the latter using X-ray fluorescence, and interviewed participants regarding sources of lead exposure. Results: In our study, ALS was associated with self-reported occupational lead exposure, with a dose response for cumulative days of exposure. ALS was also associated with blood and bone lead levels, with a 1.9-fold increase in risk for each µg/dl increment in blood lead and a 2.3- to 3.6-fold increase for each doubling of bone lead. A polymorphism in the δ-aminolevulinic acid dehydratase gene was associated with a 1.9-fold increase in ALS risk. Conclusion: These results, together with previous studies, suggest that lead exposure plays a role in the etiology of ALS. An increase in mobilization of lead from bone into blood may play a role in the acute onset of disease.

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Lead content of neuromuscular tissue in amyotrophic lateral sclerosis: case report and other considerations

Cited by 23 publications

References 25 publications

Epidemiological Survey of Amyotrophic Lateral Sclerosis in the Province of Reggio Emilia, Italy: Influence of Environmental Exposure to Lead

Epidemiological Survey of Amyotrophic Lateral Sclerosis in the Province of Reggio Emilia, Italy: Influence of Environmental Exposure to Lead

The Association of Exposure to Lead, Mercury, and Selenium and the Development of Amyotrophic Lateral Sclerosis and the Epigenetic Implications

Lead Exposure as a Risk Factor for Amyotrophic Lateral Sclerosis

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