LEAD AND OTHER NEUROTOXINS AS RISK FACTORS FOR AMYOTROPHIC LATERAL SCLEROSIS

神经退行性疾病对公共卫生构成越来越大的挑战 随着人口老龄化。 因为只有姑息治疗这些 疾病是已知的，确定可预防的原因至关重要 重要性 目前正在开展工作，以评估暴露于 环境中的神经毒素会增加 神经退行性疾病，特别是在遗传易感性 个体肌萎缩侧索硬化症（ALS）是一种神经退行性疾病， 运动系统的疾病;每1000例死亡中有1例是由于这种疾病 疾病 ALS的病因基本上是未知的，但有一些 有证据表明，环境神经毒素，特别是铅，可能是 涉案 评估这些药物在ALS中作用的病例对照研究 正在进行中 这项研究的主要假设是， 终生接触铅是ALS的危险因素; 感兴趣包括汞、溶剂和杀虫剂。 这项研究将 最终包括100例ALS病例、50例临床对照和200例 人口控制;目前有85例病例和25例临床对照， 注册了 通过使用X射线测量骨铅来评估铅暴露 荧光，一种新开发的技术，能够测量 非侵入性的低水平的骨铅目前在一般 人口 铅和其他神经毒素的暴露也被评估 使用结构化的面对面访谈，调查饮食，生活， 风格，以及医疗，居住和职业史。 膳食 抗氧化剂摄入量将作为一个保护因素进行评估， 其他疾病关系的修饰语。 基因多态性 参与异生物质代谢也正在研究中，使用PCR和 RFLA，以便可以评估基因-环境相互作用。 数据将 使用包括逻辑回归的多变量技术进行分析， 为了检查神经毒素的单独和联合作用， 其他变量并控制混杂。从中获得的洞察力 研究可能有助于预防或治疗这种疾病的措施 毁灭性的疾病 此外，阐明了 ALS中的环境可能为未来的其他研究提供一个范例。 神经退行性疾病

Neurodegenerative diseases pose an increasing challenge to public health as the population ages. Since only palliative treatments for these diseases are known, identifying preventable causes is of paramount importance. Work is in progress to evaluate the hypothesis that exposure to environmental neurotoxins increases the risk of developing neurodegenerative disease, particularly in genetically sus- ceptible individuals. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of the motor system; 1 of every 1000 deaths is due to this disease. The etiology of ALS is essentially unknown, but there is some evidence that environmental neurotoxins, particularly lead, may be involved. A case-control study to assess the role of these agents in ALS is underway. The primary hypothesis of the study is that cumulative lifetime exposure to lead is a risk factor for ALS; other neurotoxins of interest include mercury, solvents, and pesticides. The study will ultimately include 100 ALS cases, 50 clinical controls, and 200 population controls; presently 85 cases and 25 clinical controls are enrolled. Lead exposure is assessed by measuring bone lead using x-ray fluorescence, a newly developed technique capable of measuring noninvasively the low levels of bone lead present in the general population. Exposure to lead and other neurotoxins is also assessed using a structured in-person interview which investigates diet, life- style, and medical, residential, and occupational history. Dietary antioxidant intake will be evaluated as a protective factor and as a modifier of other exposure-disease relationships. Polymorphisms in genes involved in xenobiotic metabolism are also being studied, using PCR and RFLA, so that gene-environment interactions can be evaluated. Data will be analyzed using multivariate techniques including logistic regression, in order to examine the separate and joint effects of neurotoxins and other variables and to control for confounding. Insight gained from this study may contribute to measures for prevention or cure of this devastating disease. Moreover, elucidation of the role of the environment in ALS may provide a paradigm for future studies of other neurodegenerative diseases.