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Zhao Y, Ray A, Portengen L, Vermeulen R, Peters S. Metal Exposure and Risk of Parkinson Disease: A Systematic Review and Meta-Analysis. Am J Epidemiol 2023; 192:1207-1223. [PMID: 37022311 PMCID: PMC10326611 DOI: 10.1093/aje/kwad082] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/29/2022] [Accepted: 04/04/2023] [Indexed: 04/07/2023] Open
Abstract
Metal exposure has been suggested as a possible environmental risk factor for Parkinson disease (PD). We searched the PubMed, EMBASE, and Cochrane databases to systematically review the literature on the relationship between metal exposure and PD risk and to examine the overall quality of each study and the exposure assessment method. A total of 83 case-control studies and 5 cohort studies published during the period 1963-July 2021 were included, of which 73 were graded as being of low or moderate overall quality. Investigators in 69 studies adopted self-reported exposure and biomonitoring after disease diagnosis for exposure assessment approaches. The meta-analyses showed that concentrations of copper and iron in serum and concentrations of zinc in either serum or plasma were lower, while concentrations of magnesium in CSF and zinc in hair were higher, among PD cases as compared with controls. Cumulative lead levels in bone were found to be associated with increased risk of PD. We did not find associations between other metals and PD. The current level of evidence for associations between metals and PD risk is limited, as biases from methodological limitations cannot be ruled out. High-quality studies assessing metal levels before disease onset are needed to improve our understanding of the role of metals in the etiology of PD.
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Affiliation(s)
| | | | | | | | - Susan Peters
- Correspondence to Dr. Susan Peters, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM Utrecht, the Netherlands (e-mail: )
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Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Biological fluid levels of iron and iron-related proteins in Parkinson's disease: Review and meta-analysis. Eur J Neurol 2020; 28:1041-1055. [PMID: 33098743 DOI: 10.1111/ene.14607] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Several studies suggested a role or iron in the pathogenesis or Parkinson's disease (PD), and substantia nigra iron concentrarions have been found increased in PD. However, the results on cerebrospinal (CSF) and serum/plasma iron levels in PD patients have been controversial. The aim of this systematic review and meta-analysis was to establish the CSF and serum/plasma levels of iron and iron-related proteins (ferritin, transferrin, lactoferrin, haptoglobin, and hepcidine) levels, and the urine levels of iron, in patients with PD. METHODS Four databases (PubMed, EMBASE, MedLine, and Web of Science - Core Collection) were reviewed for studies published from 1966 to October 5, 2020. References of interest were identified. A meta-analysis of eligible studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, using the R software package meta. RESULTS A non-significant trend towards higher CSF iron levels and marginally significantly lower serum/plasma iron levels was observed in patients with PD compared with age- and sex-matched controls. CSF and serum/plasma ferritin and transferrin concentrations, and serum/plasma lactoferrin and haptoglobin concentrations did not differ significantly between PD patients and controls. CONCLUSION The findings of this study suggest an association between decreased serum/plasma iron levels and, possibly, higher CSF iron levels with risk of PD.
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Affiliation(s)
| | | | - Elena García-Martín
- University Institute of Molecular Pathology Biomarkers, UNEx, ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
| | - José A G Agúndez
- University Institute of Molecular Pathology Biomarkers, UNEx, ARADyAL Instituto de Salud Carlos III, Cáceres, Spain
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Maass F, Michalke B, Willkommen D, Leha A, Schulte C, Tönges L, Mollenhauer B, Trenkwalder C, Rückamp D, Börger M, Zerr I, Bähr M, Lingor P. Elemental fingerprint: Reassessment of a cerebrospinal fluid biomarker for Parkinson's disease. Neurobiol Dis 2019; 134:104677. [PMID: 31733347 DOI: 10.1016/j.nbd.2019.104677] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 09/16/2019] [Accepted: 11/11/2019] [Indexed: 12/14/2022] Open
Abstract
The aim of the study was to validate a predictive biomarker machine learning model for the classification of Parkinson's disease (PD) and age-matched controls (AMC), based on bioelement abundance in the cerebrospinal fluid (CSF). For this multicentric trial, participants were enrolled from four different centers. CSF was collected according to standardized protocols. For bioelement determination, CSF samples were subjected to inductively coupled plasma mass spectrometry. A predefined Support Vector Machine (SVM) model, trained on a previous discovery cohort was applied for differentiation, based on the levels of six different bioelements. 82 PD patients, 68 age-matched controls and 7 additional Normal Pressure Hydrocephalus (NPH) patients were included to validate a predefined SVM model. Six differentiating elements (As, Fe, Mg, Ni, Se, Sr) were quantified. Based on their levels, SVM was successfully applied to a new local cohort (AUROC 0.76, Sensitivity 0.80, Specificity 0.83), without taking any additional features into account. The same model did not discriminate PD and AMCs / NPH from three external cohorts, likely due to center effects. However, discrimination was possible in cohorts with a full elemental data set, now using center-specific discovery cohorts and a cross validated approach (AUROC 0.78 and 0.88, respectively). Pooled PD CSF iron levels showed a clear correlation with disease duration (p = .0001). In summary, bioelemental CSF patterns, obtained by mass spectrometry and integrated into a predictive model yield the potential to facilitate the differentiation of PD and AMC. Center-specific biases interfere with application in external cohorts. This must be carefully addressed using center-defined, local reference values and models.
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Affiliation(s)
- Fabian Maass
- Department of Neurology, University Medical Center Goettingen, Germany.
| | - Bernhard Michalke
- Research Unit Analytical BioGeoChemistry, German Research Center for Environmental Health, Helmholtz Zentrum Munich, Neuherberg, Germany.
| | - Desiree Willkommen
- Research Unit Analytical BioGeoChemistry, German Research Center for Environmental Health, Helmholtz Zentrum Munich, Neuherberg, Germany.
| | - Andreas Leha
- Department of Medical Statistics, University Medical Center, Goettingen, Germany.
| | - Claudia Schulte
- DZNE, German Center for Neurodegenerative Diseases, University of Tuebingen, Germany; Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany.
| | - Lars Tönges
- Department of Neurology, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Germany.
| | - Brit Mollenhauer
- Department of Neurology, University Medical Center Goettingen, Germany; Paracelsus-Elena-Klinik, Kassel, Germany.
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Kassel, Germany; Dept. Neurosurgery, University Medical Center, Goettingen, Germany
| | - Daniel Rückamp
- Federal Institute for Geosciences and Natural Resources, Hannover, Germany.
| | - Matthias Börger
- Department of Neurology, University Medical Center Goettingen, Germany.
| | - Inga Zerr
- Department of Neurology, University Medical Center Goettingen, Germany; DZNE, German Center for Neurodegenerative Diseases Goettingen, Germany.
| | - Mathias Bähr
- Department of Neurology, University Medical Center Goettingen, Germany; Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Goettingen, Germany.
| | - Paul Lingor
- Department of Neurology, University Medical Center Goettingen, Germany; DZNE, German Center for Neurodegenerative Diseases Goettingen, Germany; Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Goettingen, Germany; Center for Biostructural Imaging of Neurodegeneration (BIN), University Medical Center Goettingen, Germany; Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany.
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Shen X, Yang H, Zhang D, Jiang H. Iron Concentration Does Not Differ in Blood but Tends to Decrease in Cerebrospinal Fluid in Parkinson's Disease. Front Neurosci 2019; 13:939. [PMID: 31616238 PMCID: PMC6775209 DOI: 10.3389/fnins.2019.00939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
Abstract
Background Iron accumulation in the substantia nigra in PD patients was acknowledged, but the studies on alteration of iron levels in blood and cerebrospinal fluids (CSF) reported inconsistent results. Objective To determinate the alterations of blood and CSF levels of iron in PD patients, a case-control study and a meta-analysis both in blood and CSF were conducted. Methods In the case-control study, 43 PD patients and 33 controls were recruited to test iron metabolism, 15 normal and 12 PD patients donated CSF. Levels in iron were quantified by inductively coupled atomic emission spectrometry. Iron metabolism was analyzed by routine blood tests. In the meta-analysis, a comprehensive literature search was performed on relevant studies published from Jan 1980 to Dec 2018 in PubMed, Web of Science and EMBASE databases. The pooled standard mean difference (SMD) with random effects model was selected to estimate the association between iron levels and PD. Results In the case-control study, the iron level in serum in the controls and PD patients were 110.00 ± 48.75 μg/dl and 107.21 ± 34.25 μg/dl, respectively, no significant difference was found between them (p = 0.850), with a small effect size (Cohen’s d: 0.12; 95% CI: 0.08–0.17). Ferritin level in PD patients was lower than controls (p = 0.014). The CSF levels of iron in control and the PD patients were 20.14 ± 3.35 ng/dl and 16.26 ± 4.82 ng/dl, respectively. CSF levels of iron were lower in PD compared with that of controls (p = 0.021), with a moderate effect size (Cohen’s d: 0.51; 95% CI: 0.43–0.65). In the meta-analysis, 22 eligible studies and a total of 3607 participants were identified. Blood levels of iron did not differ significant between PD patients and the controls [SMD (95% CI): −0.03 (−0.30, 0.24)], but CSF iron levels tended to be lower in PD patients compared with that in the controls [SMD (95% CI): −0.33 (−0.65, −0.00)]. Conclusion Iron homeostasis may be disturbed in CSF, but not in the peripheral blood in PD.
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Affiliation(s)
- Xiaoli Shen
- Department of Physiology, Shandong Provincial Key Laboratory of Pathogenesis and Prevention of Neurological Disorders and State Key Disciplines: Physiology, Qingdao University, Qingdao, China.,Department of Epidemiology and Health Statistics, Qingdao University, Qingdao, China
| | - Huazhen Yang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Qingdao University, Qingdao, China
| | - Hong Jiang
- Department of Physiology, Shandong Provincial Key Laboratory of Pathogenesis and Prevention of Neurological Disorders and State Key Disciplines: Physiology, Qingdao University, Qingdao, China
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Willkommen D, Lucio M, Schmitt-Kopplin P, Gazzaz M, Schroeter M, Sigaroudi A, Michalke B. Species fractionation in a case-control study concerning Parkinson's disease: Cu-amino acids discriminate CSF of PD from controls. J Trace Elem Med Biol 2018; 49:164-170. [PMID: 29472131 DOI: 10.1016/j.jtemb.2018.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/02/2018] [Accepted: 01/17/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Parkinson's disease is affecting about 1% of the population above 65 years. Improvements in medicine support prolonged lifetime which increases the total concentration of humans affected by the disease. It is suggested that occupational and environmental exposure to metals like iron (Fe), manganese (Mn), copper (Cu) and zinc (Zn) can influence the risk for Parkinson's disease. These metals play a key role as cofactors in many enzymes and proteins. METHODS In this case-control study, we investigated the Mn-, Fe-, Cu- and Zn-species in cerebrospinal fluid (CSF) by size-exclusion chromatography hyphenated to inductively coupled plasma mass spectrometry (SEC-ICP-MS) and the total concentration of these metals by inductively coupled plasma sector field mass spectrometry (ICP-sf-MS). RESULTS The investigation of total metal concentration and speciation provided only minor changes, but it produced strong significance for a number of ratios. The analysis revealed a strong change in the ratio between total concentration of Fe and the amino acid-fraction of Cu. This could be observed when analyzing both the respective element concentrations of the fraction (which also depends on individual variation of the total element concentration) as well as when being expressed as percentage of total concentration (normalization) which more clearly shows changes of distribution pattern independent of individual variation of total element concentrations. CONCLUSION Speciation analysis, therefore, is a powerful technique to investigate changes in a case-control study where ratios of different species play an important role.
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Affiliation(s)
- Desiree Willkommen
- Helmholtz Zentrum München, Analytical Biogeochemistry, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
| | - Marianna Lucio
- Helmholtz Zentrum München, Analytical Biogeochemistry, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Philippe Schmitt-Kopplin
- Helmholtz Zentrum München, Analytical Biogeochemistry, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; TU München, Lehrstuhl für Analytische Lebensmittelchemie, Wissenschaftszentrum Weihenstephan, Alte Akademie 10, 85354 Freising, Germany
| | - Malaz Gazzaz
- Uniklinik Köln, Institut I für Pharmakologie, Zentrum für Pharmakologie, Gleueler Straße 24, 50931 Köln, Germany
| | - Michael Schroeter
- Uniklinik Köln, Klinik und Poliklinik für Neurologie und Psychiatrie, Kerpener Str. 62, 50924 Köln, Germany
| | - Ali Sigaroudi
- Uniklinik Köln, Institut I für Pharmakologie, Zentrum für Pharmakologie, Gleueler Straße 24, 50931 Köln, Germany; Universitätsspital Zürich, Klinik für Klinische Pharmakologie und Toxikologie, Rämistraße 100, 8091 Zürich, Switzerland
| | - Bernhard Michalke
- Helmholtz Zentrum München, Analytical Biogeochemistry, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
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Du K, Liu MY, Pan YZ, Zhong X, Wei MJ. Association of circulating manganese levels with Parkinson's disease: A meta-analysis. Neurosci Lett 2017; 665:92-98. [PMID: 29191695 DOI: 10.1016/j.neulet.2017.11.054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 11/15/2017] [Accepted: 11/25/2017] [Indexed: 12/14/2022]
Abstract
Whether systemic manganese (Mn) dysfunctions in Parkinson's Disease (PD) is still under ongoing debate. The recent reported studies on the circulating Mn levels in PD showed inconsistent results. A meta-analysis study was conducted to evaluate the association of circulating Mn levels with PD, and to clarify whether Mn should be considered as a potential risk factor for PD. A systematic searching was performed based on PubMed, web of science, and China National Knowledge Infrastructure (CNKI). Finally, 22 studies were identified, involving 637 PD patients and 802 health controls (HC) individuals for serum Mn, 1258 PD patients and 1304 HC individuals for peripheral blood Mn, and 195 PD patients and 196 HC individuals for cerebrospinal fluid (CSF) Mn. Forest plots were adopted to represent the comparison of the groups by assessing standardized mean difference with random effects model. This meta-analysis revealed a significantly increased serum Mn levels in PD patients (SMD=0.78; 95% CI [0.32, 1.24]; P=0.001), and it was further confirmed when serum, plasma and whole blood studies were analyzed together (SMD=0.58; 95% CI [0.25, 0.91]; P=0.001). Instead, no significant differences of CSF Mn were observed between PD patients and HC individuals (SMD=-0.09; 95% CI [-0.47, 0.29]; P=0.644). These results supported the notion that elevated Mn level should be a potential risk factor for PD, although the high heterogeneity and methodological limitations recommended caution in the interpretations for the present findings.
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Affiliation(s)
- Ke Du
- School of Pharmacy, Department of Pharmacology, China Medical University, Shenyang, Liaoning 110122, China
| | - Ming-Yan Liu
- School of Pharmacy, Department of Pharmacology, China Medical University, Shenyang, Liaoning 110122, China
| | - Yan-Zhu Pan
- School of Pharmacy, Department of Pharmacology, China Medical University, Shenyang, Liaoning 110122, China
| | - Xin Zhong
- School of Pharmacy, Department of Pharmacology, China Medical University, Shenyang, Liaoning 110122, China
| | - Min-Jie Wei
- School of Pharmacy, Department of Pharmacology, China Medical University, Shenyang, Liaoning 110122, China; Liaoning Key Laboratory of Molecular Targeted Anti-tumor Drug Development and Evaluation, Shenyang, Liaoning 110122, China.
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Cicero CE, Mostile G, Vasta R, Rapisarda V, Signorelli SS, Ferrante M, Zappia M, Nicoletti A. Metals and neurodegenerative diseases. A systematic review. ENVIRONMENTAL RESEARCH 2017; 159:82-94. [PMID: 28777965 DOI: 10.1016/j.envres.2017.07.048] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 07/26/2017] [Accepted: 07/28/2017] [Indexed: 05/28/2023]
Abstract
Neurodegenerative processes encompass a large variety of diseases with different pathological patterns and clinical presentation such as Amyotrophic Lateral Sclerosis (ALS), Alzheimer Disease (AD) and Parkinson's disease (PD). Genetic mutations have a known causative role, but the majority of cases are likely to be probably caused by a complex gene-environment interaction. Exposure to metals has been hypothesized to increase oxidative stress in brain cells leading to cell death and neurodegeneration. Neurotoxicity of metals has been demonstrated by several in vitro and in vivo experimental studies and it is likely that each metal could be toxic through specific pathways. The possible pathogenic role of different metals has been supported by some epidemiological evidences coming from occupational and ecological studies. In order to assess the possible association between metals and neurodegenerative disorders, several case-control studies have also been carried out evaluating the metals concentration in different biological specimens such as blood/serum/plasma, cerebrospinal fluid (CSF), nail and hair, often reporting conflicting results. This review provides an overview of our current knowledge on the possible association between metals and ALS, AD and PD as main neurodegenerative disorders.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Rosario Vasta
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Venerando Rapisarda
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Margherita Ferrante
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "G. F. Ingrassia", University of Catania, Catania, Italy.
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Franěk T, Kotaška K, Průša R. Manganese and selenium concentrations in cerebrospinal fluid of seriously ill children. J Clin Lab Anal 2017; 31. [PMID: 28205254 DOI: 10.1002/jcla.22122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/30/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The homeostasis of essential trace elements such as selenium and manganese may be altered in patients with severe diseases of various etiologies (trauma brain injuries, tumors, leukemias, lymphomas, neurological diseases). METHODS Concentration of manganese and selenium were determined in cerebrospinal fluid by electrothermal atomic absorption spectrometry in 50 hospitalized children with various clinical ethiologies including oncological, neurological, and brain related diseases. RESULTS The concentrations of manganese in cerebrospinal fluid of children were 0.97±0.67 μg/L. The concentrations of selenium were 13.3±3.5 μg/L. The concentrations were similar as published in adults. The values did not correlated with the age, gender and severity of the disease. CONCLUSION We evaluated values of selenium and manganese in cerebrospinal fluid of seriously diseased children.
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Affiliation(s)
- Tomáš Franěk
- Department of Medical Chemistry and Clinical Biochemistry 2nd Faculty of Medicine, Faculty Hospital Motol, Charles University, Prague, Czech Republic
| | - Karel Kotaška
- Department of Medical Chemistry and Clinical Biochemistry 2nd Faculty of Medicine, Faculty Hospital Motol, Charles University, Prague, Czech Republic
| | - Richard Průša
- Department of Medical Chemistry and Clinical Biochemistry 2nd Faculty of Medicine, Faculty Hospital Motol, Charles University, Prague, Czech Republic
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Copper dyshomoeostasis in Parkinson's disease: implications for pathogenesis and indications for novel therapeutics. Clin Sci (Lond) 2016; 130:565-74. [PMID: 26957644 DOI: 10.1042/cs20150153] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Copper is a biometal essential for normal brain development and function, thus copper deficiency or excess results in central nervous system disease. Well-characterized disorders of disrupted copper homoeostasis with neuronal degeneration include Menkes disease and Wilson's disease but a large body of evidence also implicates disrupted copper pathways in other neurodegenerative disorders, including Parkinson's disease, Alzheimer's disease, Amyotrophic lateral sclerosis, Huntington's disease and prion diseases. In this short review we critically evaluate the data regarding changes in systemic and brain copper levels in Parkinson's disease, where alterations in brain copper are associated with regional neuronal cell death and disease pathology. We review copper regulating mechanisms in the human brain and the effects of dysfunction within these systems. We then examine the evidence for a role for copper in pathogenic processes in Parkinson's disease and consider reports of diverse copper-modulating strategies in in vitro and in vivo models of this disorder. Copper-modulating therapies are currently advancing through clinical trials for Alzheimer's and Huntington's disease and may also hold promise as disease modifying agents in Parkinson's disease.
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Dusek P, Roos PM, Litwin T, Schneider SA, Flaten TP, Aaseth J. The neurotoxicity of iron, copper and manganese in Parkinson's and Wilson's diseases. J Trace Elem Med Biol 2015; 31:193-203. [PMID: 24954801 DOI: 10.1016/j.jtemb.2014.05.007] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 05/05/2014] [Accepted: 05/22/2014] [Indexed: 12/14/2022]
Abstract
Impaired cellular homeostasis of metals, particularly of Cu, Fe and Mn may trigger neurodegeneration through various mechanisms, notably induction of oxidative stress, promotion of α-synuclein aggregation and fibril formation, activation of microglial cells leading to inflammation and impaired production of metalloproteins. In this article we review available studies concerning Fe, Cu and Mn in Parkinson's disease and Wilson's disease. In Parkinson's disease local dysregulation of iron metabolism in the substantia nigra (SN) seems to be related to neurodegeneration with an increase in SN iron concentration, accompanied by decreased SN Cu and ceruloplasmin concentrations and increased free Cu concentrations and decreased ferroxidase activity in the cerebrospinal fluid. Available data in Wilson's disease suggest that substantial increases in CNS Cu concentrations persist for a long time during chelating treatment and that local accumulation of Fe in certain brain nuclei may occur during the course of the disease. Consequences for chelating treatment strategies are discussed.
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Affiliation(s)
- Petr Dusek
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Institute of Neuroradiology, University Medicine Göttingen, Göttingen, Germany.
| | - Per M Roos
- Department of Neurology, Division of Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tomasz Litwin
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Trond Peder Flaten
- Department of Chemistry, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Aaseth
- Department of Medicine, Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger, Norway
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11
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Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Cerebrospinal fluid biochemical studies in patients with Parkinson's disease: toward a potential search for biomarkers for this disease. Front Cell Neurosci 2014; 8:369. [PMID: 25426023 PMCID: PMC4227512 DOI: 10.3389/fncel.2014.00369] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/20/2014] [Indexed: 12/14/2022] Open
Abstract
The blood-brain barrier supplies brain tissues with nutrients and filters certain compounds from the brain back to the bloodstream. In several neurodegenerative diseases, including Parkinson's disease (PD), there are disruptions of the blood-brain barrier. Cerebrospinal fluid (CSF) has been widely investigated in PD and in other parkinsonian syndromes with the aim of establishing useful biomarkers for an accurate differential diagnosis among these syndromes. This review article summarizes the studies reported on CSF levels of many potential biomarkers of PD. The most consistent findings are: (a) the possible role of CSF urate on the progression of the disease; (b) the possible relations of CSF total tau and phosphotau protein with the progression of PD and with the preservation of cognitive function in PD patients; (c) the possible value of CSF beta-amyloid 1-42 as a useful marker of further cognitive decline in PD patients, and (d) the potential usefulness of CSF neurofilament (NFL) protein levels in the differential diagnosis between PD and other parkinsonian syndromes. Future multicentric, longitudinal, prospective studies with long-term follow-up and neuropathological confirmation would be useful in establishing appropriate biomarkers for PD.
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Affiliation(s)
| | | | - Elena García-Martín
- Department of Biochemistry and Molecular Biology, University of ExtremaduraCáceres, Spain
- AMGenomicsCáceres, Spain
| | - José A. G. Agúndez
- AMGenomicsCáceres, Spain
- Department of Pharmacology, University of ExtremaduraCáceres, Spain
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12
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Mollenhauer B, Trenkwalder C. Neurochemical biomarkers in the differential diagnosis of movement disorders. Mov Disord 2009; 24:1411-26. [PMID: 19412961 DOI: 10.1002/mds.22510] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In recent years, the neurochemical analysis of neuronal proteins in cerebrospinal fluid (CSF) has become increasingly accepted for the diagnosis of neurodegenerative dementia diseases such as Alzheimer's disease and Creutzfeldt-Jakob disease. CSF surrounds the central nervous system, and in the composition of CSF proteins one finds brain-specific proteins that are prioritized from blood-derived proteins. Levels of specific CSF proteins could be very promising biomarkers for central nervous system diseases. We need the development of more easily accessible biomarkers, in the blood. In neurodegenerative diseases with and without dementia, studies on CSF and blood proteins have investigated the usefulness of biomarkers in differential diagnosis. The clinical diagnoses of Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration still rely mainly on clinical symptoms as defined by international classification criteria. In this article, we review CSF biomarkers in these movement disorders and discuss recent published reports on the neurochemical intra vitam diagnosis of neurodegenerative disorders (including recent CSF alpha-synuclein findings).
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Alimonti A, Bocca B, Pino A, Ruggieri F, Forte G, Sancesario G. Elemental profile of cerebrospinal fluid in patients with Parkinson's disease. J Trace Elem Med Biol 2007; 21:234-41. [PMID: 17980814 DOI: 10.1016/j.jtemb.2007.05.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Accepted: 05/05/2007] [Indexed: 11/27/2022]
Abstract
To ascertain the potential role of chemical elements (namely, Al, Ba, Be, Bi, Ca, Cd, Co, Cr, Cu, Fe, Hg, Li, Mg, Mn, Mo, Ni, Pb, Sb, Si, Sn, Sr, Tl, V, W, Zn and Zr) as markers in the Parkinson's disease (PD), the elemental concentration of cerebrospinal fluid (CSF) of 42 patients with PD and 20 age-matched controls was assessed. Analyses were performed by Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES) and Sector Field Inductively Coupled Plasma Mass Spectrometry (SF-ICP-MS). Significantly lower levels of Co, Cr, Fe, Pb, Si and Sn were observed in the CSF of PD patients compared with those in controls, with a percentage of depletion up to 50% for Cr and Pb. No such variations were detected for all the other elements. Results suggested that Pb, Cr, Fe were the most suitable elements to distinguish between normality and PD. Different cut-off concentrations for these elements could be tentatively proposed as a predictive tool for the PD condition.
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Affiliation(s)
- Alessandro Alimonti
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy.
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Bocca B, Alimonti A, Senofonte O, Pino A, Violante N, Petrucci F, Sancesario G, Forte G. Metal changes in CSF and peripheral compartments of parkinsonian patients. J Neurol Sci 2006; 248:23-30. [PMID: 16765382 DOI: 10.1016/j.jns.2006.05.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Involvement of metals in the risk of developing Parkinson's disease (PD) has been suggested. In the present study, concentration of metals in cerebrospinal fluid (CSF), blood, serum, urine and hair of 91 PD patients and 18 controls were compared. METHODS Blood and hair were microwave digested, while CSF, serum and urine were water-diluted. Elements quantification was achieved by Inductively Coupled Plasma Atomic Emission Spectrometry and Sector Field Inductively Coupled Plasma Mass Spectrometry. RESULTS Some metal imbalances in PD were observed: i), in CSF, lower Fe and Si; ii), in blood, higher Ca, Cu, Fe, Mg and Zn; iii), in serum, lower Al and Cu; iv), in urine, lower Al and Mn, higher Ca and Fe; and v), in hair, lower Fe. The ROC analysis suggested that blood Ca, Fe, Mg and Zn were the best discriminators between PD and controls. In addition, hair Ca and Mg were at least 1.5 times higher in females than in males of patients and controls. A decrement with age of patients in hair and urine Ca and, with less extent, in urine Si was observed. Magnesium concentration in CSF decreased with the duration and severity of the disease. Elements were not influenced by the type of antiparkinsonian therapy. CONCLUSIONS Variation in elements with the disease do not exclude their involvement in the neurodegeneration of PD.
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Affiliation(s)
- B Bocca
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
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Buhmann C, Arlt S, Kontush A, Möller-Bertram T, Sperber S, Oechsner M, Stuerenburg HJ, Beisiegel U. Plasma and CSF markers of oxidative stress are increased in Parkinson's disease and influenced by antiparkinsonian medication. Neurobiol Dis 2004; 15:160-70. [PMID: 14751781 DOI: 10.1016/j.nbd.2003.10.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
We determined systemic oxidative stress in Parkinson's disease (PD) patients, patients with other neurological diseases (OND) and healthy controls by measurement of in vitro lipoprotein oxidation and levels of hydro- and lipophilic antioxidants in plasma and cerebrospinal fluid (CSF). Additionally, we investigated the influence of levodopa (LD) and dopamine agonist therapy (DA) on the oxidative status in PD patients. We found increased oxidative stress, seen as higher levels of lipoprotein oxidation in plasma and CSF, decrease of plasma levels of protein sulfhydryl (SH) groups and lower CSF levels of alpha-tocopherol in PD patients compared to OND patients and controls. Levodopa treatment did not significantly change the plasma lipoprotein oxidation but LD monotherapy tended to result in an increase of autooxidation and in a decrease of plasma antioxidants with significance for ubiquinol-10. DA monotherapy was significantly associated with higher alpha-tocopherol levels. Patients with DA monotherapy or co-medication with DA showed a trend to lower lipoprotein oxidation. These data support the concept of oxidative stress as a factor in the pathogenesis of PD and might be an indicator of a potential prooxidative role of LD and a possible antioxidative effect of DA in PD treatment.
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Affiliation(s)
- Carsten Buhmann
- Neurological Department, University Clinic Hamburg-Eppendorf, D-20246 Hamburg, Germany.
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Veldman BA, Wijn AM, Knoers N, Praamstra P, Horstink MW. Genetic and environmental risk factors in Parkinson's disease. Clin Neurol Neurosurg 1998; 100:15-26. [PMID: 9637199 DOI: 10.1016/s0303-8467(98)00009-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Parkinson's disease (PD) is a multifactorial disorder, caused by a combination of age, genetics and environmental factors. Nigral cells are susceptible to multiple causes of derangement of normal cell function, all of which may contribute to the same Parkinson phenotype. Autosomal dominant alpha-synuclein-gene PD represents one of the pure genetic forms, whereas cases of sporadic PD probably depend more on age and environmental factors, MPTP-Parkinsonism being the purest example of an environmentally caused Parkinson phenotype. This review suggests that pesticides-herbicides, smoking and head trauma probably represent the most eligible candidates for environmental factors involved in provoking PD or influencing its natural course.
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Affiliation(s)
- B A Veldman
- Department of Neurology, University Hospital Nijmegen, The Netherlands
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Jiménez-Jiménez FJ, Molina JA, Aguilar MV, Arrieta FJ, Jorge-Santamaría A, Cabrera-Valdivia F, Ayuso-Peralta L, Rabasa M, Vázquez A, García-Albea E. Serum and urinary manganese levels in patients with Parkinson's disease. Acta Neurol Scand 1995; 91:317-20. [PMID: 7639058 DOI: 10.1111/j.1600-0404.1995.tb07014.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To elucidate the possible role of manganese in the risk of developing Parkinson's disease (PD), we compared serum levels of manganese, and 24-h manganese excretion by urine in 29 PD patients and in 27 matched controls. We also measured chromium and cobalt in the same samples. All these values did not differ significantly between the groups, they were not influenced by antiparkinsonian drugs, and they did not correlate with age, age at onset and duration of the PD, scores of the Unified PD Rating Scale or the Hoehn & Yahr staging in the PD group. These results might suggest that serum levels and urinary excretion of manganese are apparently unrelated to the risk of developing PD.
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Affiliation(s)
- F J Jiménez-Jiménez
- Department of Neurology of Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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