title: Lead, cadmium and mercury in cerebrospinal fluid and risk of amyotrophic lateral sclerosis: A case-control study.
abstract: Exposure to neurotoxic chemicals such as pesticides, selenium, and heavy metals have been suggested to play a role in the etiology of amyotrophic lateral sclerosis (ALS). We assessed exposure to lead, cadmium, and mercury in 38 ALS patients (16 men and 22 females) and 38 hospital-admitted controls by using their cerebrospinal fluid (CSF) content as biomarker. We determined CSF heavy metal levels with inductively coupled plasma sector field mass spectrometry, according to a methodology specifically developed for this biological matrix. ALS patients had higher median values for Pb (155 vs. 132ng/L) but lower levels for Cd (36 vs. 72ng/L) and Hg (196 vs. 217ng/L). In the highest tertile of exposure, ALS odds ratio was 1.39 (95% CI 0.48-4.25) for Pb, 0.29 (0.08-1.04) for Cd and 3.03 (0.52-17.55) for Hg; however, no dose-response relation emerged. Results were substantially confirmed after conducting various sensitivity analyses, and after stratification for age and sex. Though interpretation of these results is limited by the statistical imprecision of the estimates, and by the possibility that CSF heavy metal content may not reflect long-term antecedent exposure, they do not lend support to a role of the heavy metals cadmium, lead and mercury in ALS etiology.
authors.affiliation: Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia Medical School, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA. Electronic address: marco.vinceti@unimore.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Vinceti
authors.affiliation: Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia Medical School, Modena, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Filippini
authors.affiliation: Department of Neurology, Sant'Agostino-Estense Hospital, National Health Service, Local Health Unit of Modena, Modena, Italy.
authors.forename: Jessica
authors.initials: J
authors.lastname: Mandrioli
authors.affiliation: Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia Medical School, Modena, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Violi
authors.affiliation: Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia Medical School, Modena, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Bargellini
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Weuve
authors.affiliation: Department of Neurology, Sant'Agostino-Estense Hospital, National Health Service, Local Health Unit of Modena, Modena, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Fini
authors.affiliation: Helmholtz Center Munich, German Research Center for Environmental Health GmbH, Research Unit Analytical BioGeoChemistry, Neuherberg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Grill
authors.affiliation: Helmholtz Center Munich, German Research Center for Environmental Health GmbH, Research Unit Analytical BioGeoChemistry, Neuherberg, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Michalke
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000134:cerebrospinal fluid*; D002104:Cadmium / Q000134:cerebrospinal fluid*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007854:Lead / Q000134:cerebrospinal fluid*; D008297:Male; D008628:Mercury / Q000134:cerebrospinal fluid*; D008875:Middle Aged; D016017:Odds Ratio
chemical_list: D002104:Cadmium; D007854:Lead; D008628:Mercury
keywords: Amyotrophic lateral sclerosis; Cadmium; Cerebrospinal fluid; Environment; Lead; Mercury