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Yu W, Yu F, Li M, Yang F, Wang H, Song H, Huang X. Quantitative association between lead exposure and amyotrophic lateral sclerosis: a Bayesian network-based predictive study. Environ Health 2024; 23:2. [PMID: 38166850 PMCID: PMC10763408 DOI: 10.1186/s12940-023-01041-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Environmental lead (Pb) exposure have been suggested as a causative factor for amyotrophic lateral sclerosis (ALS). However, the role of Pb content of human body in ALS outcomes has not been quantified clearly. The purpose of this study was to apply Bayesian networks to forecast the risk of Pb exposure on the disease occurrence. METHODS We retrospectively collected medical records of ALS inpatients who underwent blood Pb testing, while matched controlled inpatients on age, gender, hospital ward and admission time according to the radio of 1:9. Tree Augmented Naïve Bayes (TAN), a semi-naïve Bayes classifier, was established to predict probability of ALS or controls with risk factors. RESULTS A total of 140 inpatients were included in this study. The whole blood Pb levels of ALS patients (57.00 μg/L) were more than twice as high as the controls (27.71 μg/L). Using the blood Pb concentrations to calculate probability of ALS, TAN produced the total coincidence rate of 90.00%. The specificity, sensitivity of Pb for ALS prediction was 0.79, or 0.74, respectively. CONCLUSION Therefore, these results provided quantitative evidence that Pb exposure may contribute to the development of ALS. Bayesian networks may be used to predict the ALS early onset with blood Pb levels.
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Affiliation(s)
- Wenxiu Yu
- Medical School of Chinese PLA, Beijing, 100853, China
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Fangfang Yu
- Department of Medical Innovation Research, PLA General Hospital, Beijing, 100853, China
| | - Mao Li
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Fei Yang
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Hongfen Wang
- Medical School of Chinese PLA, Beijing, 100853, China
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Han Song
- Department of Health Service, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Xusheng Huang
- Medical School of Chinese PLA, Beijing, 100853, China.
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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Chandravanshi LP, Agrawal P, Darwish HW, Trigun SK. Impairments of Spatial Memory and N-methyl-d-aspartate Receptors and Their Postsynaptic Signaling Molecules in the Hippocampus of Developing Rats Induced by As, Pb, and Mn Mixture Exposure. Brain Sci 2023; 13:1715. [PMID: 38137163 PMCID: PMC10742016 DOI: 10.3390/brainsci13121715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Exposure to metal mixtures is recognized as a real-life scenario, needing novel studies that can assess their complex effects on brain development. There is still a significant public health concern associated with chronic low levels of metal exposure. In contrast to other metals, these three metals (As, Pb, and Mn) are commonly found in various environmental and industrial contexts. In addition to additive or synergistic interactions, concurrent exposure to this metal mixture may also have neurotoxic effects that differ from those caused by exposure to single components. The NMDA receptor and several important signaling proteins are involved in learning, memory, and synaptic plasticity in the hippocampus, including CaMKII, postsynaptic density protein-95 (PSD-95), synaptic Ras GTPase activating protein (SynGAP), a negative regulator of Ras-MAPK activity, and CREB. We hypothesized that alterations in the above molecular players may contribute to metal mixture developmental neurotoxicity. Thus, the aim of this study was to investigate the effect of these metals and their mixture at low doses (As 4 mg, Pb 4 mg, and Mn 10 mg/kg bw/p.o) on NMDA receptors and their postsynaptic signaling proteins during developing periods (GD6 to PD59) of the rat brain. Rats exposed to As, Pb, and Mn individually or at the same doses in a triple-metal mixture (MM) showed impairments in learning and memory functions in comparison to the control group rats. Declined protein expressions of NR2A, PSD-95, p- CaMKII, and pCREB were observed in the metal mix-exposed rats, while the expression of SynGAP was found to be enhanced in the hippocampus as compared to the controls on PD60. Thereby, our data suggest that alterations in the NMDA receptor complex and postsynaptic signaling proteins could explain the cognitive dysfunctions caused by metal-mixture-induced developmental neurotoxicity in rats. These outcomes indicate that incessant metal mixture exposure may have detrimental consequences on brain development.
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Affiliation(s)
- Lalit P. Chandravanshi
- Department of Forensic Science, Sharda University, Greater Noida 201308, India; (L.P.C.); (P.A.)
| | - Prashant Agrawal
- Department of Forensic Science, Sharda University, Greater Noida 201308, India; (L.P.C.); (P.A.)
| | - Hany W. Darwish
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Surendra Kumar Trigun
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi 221005, India
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Kamalian A, Foroughmand I, Koski L, Darvish M, Saghazadeh A, Kamalian A, Razavi SZE, Abdi S, Dehgolan SR, Fotouhi A, Roos PM. Metal concentrations in cerebrospinal fluid, blood, serum, plasma, hair, and nails in amyotrophic lateral sclerosis: A systematic review and meta-analysis. J Trace Elem Med Biol 2023; 78:127165. [PMID: 37018859 DOI: 10.1016/j.jtemb.2023.127165] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
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.
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Affiliation(s)
- Aida Kamalian
- Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
| | - Iman Foroughmand
- Bloomberg School of Public Health, Johns hopkins University, Baltimore, MD, USA
| | - Lassi Koski
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 77 Stockholm, Sweden
| | - Mahtab Darvish
- Clinical Research Development Center, Shahid Modarres Hospital, Tehran, Iran
| | - Amene Saghazadeh
- 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
| | - Amirhossein Kamalian
- School of Medicine, Yazd Shahid Sadoughi University of Medical Sciences, Shahid Bahonar Square, Yazd, Iran
| | - Seyedeh Zahra Emami Razavi
- 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
| | - Siamak Abdi
- Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Poursina st., Enghelab-e-Eslami avenue, Tehran, Iran
| | - Shahram Rahimi Dehgolan
- School of Medicine, Tehran University of Medical Sciences, Poursina st., Enghelab-e-Eslami avenue, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Per M Roos
- 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
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