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Goldman SM, Weaver FM, Gonzalez B, Stroupe KT, Cao L, Colletta K, Brown EG, Tanner CM. Parkinson's Disease Progression and Exposure to Contaminated Water at Camp Lejeune. Mov Disord 2024. [PMID: 38988230 DOI: 10.1002/mds.29922] [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: 04/28/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND We recently reported an increased risk of Parkinson's disease (PD) in service members who resided at Marine Base Camp Lejeune, North Carolina, when water supplies were contaminated with trichloroethylene and other volatile organic compounds (VOCs). Prior studies suggest that environmental exposures may affect PD phenotype or progression, but this has not been reported for VOCs. OBJECTIVE The objective of this study was to test whether PD progression is faster in individuals exposed to VOCs in water at Camp Lejeune. METHODS A cohort of 172,128 marines residing at Camp Lejeune between 1975 and 1985 was previously assembled. We identified individuals with PD in Veterans Health Administration and Medicare databases between 2000 and 2021. Using estimates derived by the US Agency for Toxic Substances and Disease Registry, we classified individuals as exposed or unexposed to VOCs in residential water. We used Kaplan-Meier and Cox regression models to test differences between exposed and unexposed groups in the time from PD diagnosis until psychosis, fracture, fall, or death. RESULTS Among 270 persons with PD, 177 (65.6%) were exposed to VOCs in residential water. Median cumulative exposure was 4970 μg/L-months, >50-fold the permissible level. Time until psychosis, fracture, and fall were all shorter in the exposed group, with adjusted hazard ratios (HRs) exceeding 2: psychosis HR, 2.19 (95% confidence interval [CI]: 0.99-4.83); fracture HR, 2.44 (95% CI: 0.91-6.55); and fall HR, 2.64 (95% CI: 0.97-7.21). A significant dose response was observed for time to fall (P trend, 0.032). No differences were observed for time until death. CONCLUSIONS PD progression may be faster in persons exposed to trichloroethylene and other VOCs in water decades earlier. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.
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Affiliation(s)
- Samuel M Goldman
- Division of Occupational, Environmental, and Climate Medicine, University of California San Francisco, San Francisco, California, USA
- Research Service, San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
| | - Frances M Weaver
- Center of Innovation for Complex Chronic Healthcare, Hines Veterans Administration Hospital, Hines, Illinois, USA
- Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, Illinois, USA
| | - Beverly Gonzalez
- Geriatrics and Extended Care Data Analysis Center, Canandaigua VA Medical Center, Canandaigua, New York, USA
| | - Kevin T Stroupe
- Center of Innovation for Complex Chronic Healthcare, Hines Veterans Administration Hospital, Hines, Illinois, USA
- Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, Illinois, USA
| | - Lishan Cao
- Center of Innovation for Complex Chronic Healthcare, Hines Veterans Administration Hospital, Hines, Illinois, USA
| | - Kalea Colletta
- Movement Disorder Section, Hines Veterans Administration Hospital, Hines, Illinois, USA
| | - Ethan G Brown
- Research Service, San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
- Geriatrics and Extended Care Data Analysis Center, Canandaigua VA Medical Center, Canandaigua, New York, USA
| | - Caroline M Tanner
- Research Service, San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
- Geriatrics and Extended Care Data Analysis Center, Canandaigua VA Medical Center, Canandaigua, New York, USA
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Gokuladhas S, Fadason T, Farrow S, Cooper A, O'Sullivan JM. Discovering genetic mechanisms underlying the co-occurrence of Parkinson's disease and non-motor traits. NPJ Parkinsons Dis 2024; 10:27. [PMID: 38263313 PMCID: PMC10805842 DOI: 10.1038/s41531-024-00638-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
Understanding the biological mechanisms that underlie the non-motor symptoms of Parkinson's disease (PD) requires comprehensive frameworks that unravel the complex interplay of genetic risk factors. Here, we used a disease-agnostic brain cortex gene regulatory network integrated with Mendelian Randomization analyses that identified 19 genes whose changes in expression were causally linked to PD. We further used the network to identify genes that are regulated by PD-associated genome-wide association study (GWAS) SNPs. Extended protein interaction networks derived from PD-risk genes and PD-associated SNPs identified convergent impacts on biological pathways and phenotypes, connecting PD with established co-occurring traits, including non-motor symptoms. These findings hold promise for therapeutic development. In conclusion, while distinct sets of genes likely influence PD risk and outcomes, the existence of genes in common and intersecting pathways associated with other traits suggests that they may contribute to both increased PD risk and symptom heterogeneity observed in people with Parkinson's.
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Affiliation(s)
- Sreemol Gokuladhas
- The Liggins Institute, University of Auckland, Auckland, 1023, New Zealand
| | - Tayaza Fadason
- The Liggins Institute, University of Auckland, Auckland, 1023, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, 1010, New Zealand
| | - Sophie Farrow
- The Liggins Institute, University of Auckland, Auckland, 1023, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, 1010, New Zealand
| | - Antony Cooper
- St Vincent's Clinical School, UNSW Sydney, Sydney, NSW, Australia
- Australian Parkinson's Mission, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Justin M O'Sullivan
- The Liggins Institute, University of Auckland, Auckland, 1023, New Zealand.
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland, 1010, New Zealand.
- Australian Parkinson's Mission, Garvan Institute of Medical Research, Sydney, New South Wales, Australia.
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
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