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Koski L, Berntsson E, Vikström M, Wärmländer SKTS, Roos PM. Metal ratios as possible biomarkers for amyotrophic lateral sclerosis. J Trace Elem Med Biol 2023; 78:127163. [PMID: 37004478 DOI: 10.1016/j.jtemb.2023.127163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/27/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with unknown aetiology. Metals have been suspected to contribute to ALS pathogenesis since mid-19th century, yet studies on measured metal concentrations in ALS patients have often yielded conflicting results, with large individual variation in measured values. Calculating metal concentration ratios can unveil possible synergistic effects of neurotoxic metals in ALS pathogenesis. The aim of this study was to investigate if ratios of different metal concentrations in cerebrospinal fluid (CSF) and blood plasma, respectively, differ between ALS patients and healthy controls. METHODS Cerebrospinal fluid and blood plasma were collected from 17 ALS patients and 10 controls. Samples were analysed for 22 metals by high-resolution inductively coupled plasma mass spectrometry (HR-ICP-MS), and all possible 231 metal ratios calculated in each body fluid. RESULTS Fifty-three metal ratios were significantly elevated in ALS cases as compared to controls (p < 0.05); five in blood plasma, and 48 in CSF. The finding of fewer elevated ratios in blood plasma may indicate specific transport of metals into the central nervous system. The elevated metal ratios in CSF include Cd/Se (p = 0.031), and 16 ratios with magnesium, such as Mn/Mg (p = 0.005) and Al/Mg (p = 0.014). CONCLUSION Metal ratios may be used as biomarkers in ALS diagnosis and as guidelines for preventive measures.
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Affiliation(s)
- Lassi Koski
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | - Elina Berntsson
- Chemistry Section, Arrhenius Laboratories, Stockholm University, 106 91 Stockholm, Sweden; Department of Chemistry and Biotechnology, Tallinn University of Technology, 19086 Tallinn, Estonia
| | - Max Vikström
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | | | - Per M Roos
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Clinical Physiology, St. Göran Hospital University Unit, 112 81 Stockholm, Sweden
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2
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Dissanayake KN, Redman RR, Mackenzie H, Eddleston M, Ribchester RR. "Calcium bombs" as harbingers of synaptic pathology and their mitigation by magnesium at murine neuromuscular junctions. Front Mol Neurosci 2022; 15:937974. [PMID: 35959105 PMCID: PMC9361872 DOI: 10.3389/fnmol.2022.937974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/04/2022] [Indexed: 12/24/2022] Open
Abstract
Excitotoxicity is thought to be an important factor in the onset and progression of amyotrophic lateral sclerosis (ALS). Evidence from human and animal studies also indicates that early signs of ALS include degeneration of motor nerve terminals at neuromuscular junctions (NMJs), before degeneration of motor neuron cell bodies. Here we used a model of excitotoxicity at NMJs in isolated mouse muscle, utilizing the organophosphorus (OP) compound omethoate, which inhibits acetylcholinesterase activity. Acute exposure to omethoate (100 μM) induced prolonged motor endplate contractures in response to brief tetanic nerve stimulation at 20-50 Hz. In some muscle fibers, Fluo-4 fluorescence showed association of these contractures with explosive increases in Ca2+ ("calcium bombs") localized to motor endplates. Calcium bombs were strongly and selectively mitigated by increasing Mg2+ concentration in the bathing medium from 1 to 5 mM. Overnight culture of nerve-muscle preparations from WldS mice in omethoate or other OP insecticide components and their metabolites (dimethoate, cyclohexanone, and cyclohexanol) induced degeneration of NMJs. This degeneration was also strongly mitigated by increasing [Mg2+] from 1 to 5 mM. Thus, equivalent increases in extracellular [Mg2+] mitigated both post-synaptic calcium bombs and degeneration of NMJs. The data support a link between Ca2+ and excitotoxicity at NMJs and suggest that elevating extracellular [Mg2+] could be an effective intervention in treatment of synaptic pathology induced by excitotoxic triggers.
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Affiliation(s)
- Kosala N. Dissanayake
- Euan MacDonald Centre for Motor Neurone Disease Research, The University of Edinburgh, Edinburgh, United Kingdom,Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Robert R. Redman
- Euan MacDonald Centre for Motor Neurone Disease Research, The University of Edinburgh, Edinburgh, United Kingdom,Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Harry Mackenzie
- Euan MacDonald Centre for Motor Neurone Disease Research, The University of Edinburgh, Edinburgh, United Kingdom,Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Michael Eddleston
- Clinical Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Richard R. Ribchester
- Euan MacDonald Centre for Motor Neurone Disease Research, The University of Edinburgh, Edinburgh, United Kingdom,Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, United Kingdom,*Correspondence: Richard R. Ribchester,
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D’Amico E, Grosso G, Nieves JW, Zanghì A, Factor-Litvak P, Mitsumoto H. Metabolic Abnormalities, Dietary Risk Factors and Nutritional Management in Amyotrophic Lateral Sclerosis. Nutrients 2021; 13:nu13072273. [PMID: 34209133 PMCID: PMC8308334 DOI: 10.3390/nu13072273] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a devastating progressive neurodegenerative disease that affects motor neurons, leading to a relentless paralysis of skeletal muscles and eventual respiratory failure. Although a small percentage of patients may have a longer survival time (up to 10 years), in most cases, the median survival time is from 20 to 48 months. The pathogenesis and risk factors for ALS are still unclear: among the various aspects taken into consideration, metabolic abnormalities and nutritional factors have been the focus of recent interests. Although there are no consistent findings regarding prior type-2 diabetes, hypercholesterolemia and ALS incidence, abnormalities in lipid and glucose metabolism may be linked to disease progression, leading to a relatively longer survival (probably as a result of counteract malnutrition and cachexia in the advanced stages of the disease). Among potential dietary risk factors, a higher risk of ALS has been associated with an increased intake of glutamate, while the consumption of antioxidant and anti-inflammatory compounds, such as vitamin E, n-3 polyunsaturated fatty acids, and carotenoids, has been related to lower incidence. Poor nutritional status and weight loss in ALS resulting from poor oral intake, progressive muscle atrophy, and the potential hypermetabolic state have been associated with rapid disease progression. It seems important to routinely perform a nutritional assessment of ALS patients at the earliest referral: weight maintenance (if adequate) or gain (if underweight) is suggested from the scientific literature; evidence of improved diet quality (in terms of nutrients and limits for pro-inflammatory dietary factors) and glucose and lipid control is yet to be confirmed, but it is advised. Further research is warranted to better understand the role of nutrition and the underlying metabolic abnormalities in ALS, and their contribution to the pathogenic mechanisms leading to ALS initiation and progression.
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Affiliation(s)
- Emanuele D’Amico
- Department G.F. Ingrassia, University of Catania, 95123 Catania, Italy; (E.D.); (A.Z.)
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
- Correspondence: ; Tel.: +39-0954-781-187
| | - Jeri W. Nieves
- Mailman School of Public Health and Institute of Human Nutrition, Columbia University, New York, NY 10032, USA; (J.W.N.); (P.F.-L.)
| | - Aurora Zanghì
- Department G.F. Ingrassia, University of Catania, 95123 Catania, Italy; (E.D.); (A.Z.)
| | - Pam Factor-Litvak
- Mailman School of Public Health and Institute of Human Nutrition, Columbia University, New York, NY 10032, USA; (J.W.N.); (P.F.-L.)
| | - Hiroshi Mitsumoto
- Eleanor and Lou Gehrig ALS Center, The Neurological Institute of New York Columbia University Medical Center, New York, NY 10032, USA;
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Oggiano R, Solinas G, Forte G, Bocca B, Farace C, Pisano A, Sotgiu MA, Clemente S, Malaguarnera M, Fois AG, Pirina P, Montella A, Madeddu R. Trace elements in ALS patients and their relationships with clinical severity. CHEMOSPHERE 2018; 197:457-466. [PMID: 29366958 DOI: 10.1016/j.chemosphere.2018.01.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/06/2018] [Accepted: 01/15/2018] [Indexed: 06/07/2023]
Abstract
An exploratory study of trace elements in ALS and their relationships with clinical severity was detected. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder that causes irreversible damage in humans, with the consequent loss of function of motoneurons (MNs), with a prognosis up to 5 years after diagnosis. Except to genetic rare cases it is not known the etiology of the disorder. Aim of our research is to investigate the possible role of heavy metals in the severity of the disease. In this study, by the use of plasma mass (ICP-MS), we have analyzed the content of essential and heavy metals such: Pb, Cd, Al, Hg, Mn, Fe, Cu, Zn, Se, Mg, and Ca, in blood, urine and hair of ALS patients and controls; moreover we divided the patients in two groups for disease severity and analyzed the difference among the groups, in order to study a possible involvement of metals in the severity of the damage. Our results suggest a protective role of Selenium, involved in protective antioxidant mechanisms, and a risk factor in the case of presence of Lead in blood. The levels of the other metals are not easy to interpret, because these may be due to life style and for essential metals a consequence of the disease condition, not a cause.
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Affiliation(s)
- Riccardo Oggiano
- Department of Biomedical Sciences - Histology, University of Sassari, Sassari, Italy
| | - Giuliana Solinas
- Department of Biomedical Sciences - Hygiene, University of Sassari, Sassari, Italy
| | - Giovanni Forte
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Cristiano Farace
- Department of Biomedical Sciences - Histology, University of Sassari, Sassari, Italy
| | - Andrea Pisano
- Department of Biomedical Sciences - Histology, University of Sassari, Sassari, Italy
| | | | | | - Michele Malaguarnera
- Department of Medical and Pediatric Science, Research Centre "The Great Senescence", University of Catania, Catania, Italy
| | - Alessandro Giuseppe Fois
- Department of Clinical and Experimental Medicine - Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Pietro Pirina
- Department of Clinical and Experimental Medicine - Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Andrea Montella
- Department of Biomedical Sciences- Human Anatomy, University of Sassari, Sassari, Italy
| | - Roberto Madeddu
- Department of Biomedical Sciences - Histology, University of Sassari, Sassari, Italy; National Institute of Biostructures and Biosystems, Rome, Italy.
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Ngo ST, Mi JD, Henderson RD, McCombe PA, Steyn FJ. Exploring targets and therapies for amyotrophic lateral sclerosis: current insights into dietary interventions. Degener Neurol Neuromuscul Dis 2017; 7:95-108. [PMID: 30050381 PMCID: PMC6053104 DOI: 10.2147/dnnd.s120607] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A growing number of preclinical and human studies demonstrate a disease-modifying effect of nutritional state in amyotrophic lateral sclerosis (ALS). The management of optimal nutrition in ALS is complicated, as physiological, physical, and psychological effects of the disease need to be considered and addressed accordingly. In this regard, multidisciplinary care teams play an integral role in providing dietary guidance to ALS patients and their carers. However, with an increasing research focus on the use of dietary intervention strategies to manage disease symptoms and improve prognosis in ALS, many ALS patients are now seeking or are actively engaged in using complementary and alternative therapies that are dietary in nature. In this article, we review the aspects of appetite control, energy balance, and the physiological effects of ALS relative to their impact on overall nutrition. We then provide current insights into dietary interventions for ALS, considering the mechanisms of action of some of the common dietary interventions used in ALS, discussing their validity in the context of clinical trials.
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Affiliation(s)
- Shyuan T Ngo
- School of Biomedical Sciences.,Queensland Brain Institute.,Centre for Clinical Research, The University of Queensland, .,Department of Neurology, Royal Brisbane & Women's Hospital, .,Wesley Medical Research, The Wesley Hospital, Auchenflower, Brisbane, QLD, Australia,
| | | | - Robert D Henderson
- Centre for Clinical Research, The University of Queensland, .,Department of Neurology, Royal Brisbane & Women's Hospital,
| | - Pamela A McCombe
- Centre for Clinical Research, The University of Queensland, .,Department of Neurology, Royal Brisbane & Women's Hospital,
| | - Frederik J Steyn
- Centre for Clinical Research, The University of Queensland, .,Department of Neurology, Royal Brisbane & Women's Hospital, .,Wesley Medical Research, The Wesley Hospital, Auchenflower, Brisbane, QLD, Australia,
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Nieves JW, Gennings C, Factor-Litvak P, Hupf J, Singleton J, Sharf V, Oskarsson B, Fernandes Filho JAM, Sorenson EJ, D'Amico E, Goetz R, Mitsumoto H. Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis. JAMA Neurol 2017; 73:1425-1432. [PMID: 27775751 DOI: 10.1001/jamaneurol.2016.3401] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Importance There is growing interest in the role of nutrition in the pathogenesis and progression of amyotrophic lateral sclerosis (ALS). Objective To evaluate the associations between nutrients, individually and in groups, and ALS function and respiratory function at diagnosis. Design, Setting, and Participants A cross-sectional baseline analysis of the Amyotrophic Lateral Sclerosis Multicenter Cohort Study of Oxidative Stress study was conducted from March 14, 2008, to February 27, 2013, at 16 ALS clinics throughout the United States among 302 patients with ALS symptom duration of 18 months or less. Exposures Nutrient intake, measured using a modified Block Food Frequency Questionnaire (FFQ). Main Outcomes and Measures Amyotrophic lateral sclerosis function, measured using the ALS Functional Rating Scale-Revised (ALSFRS-R), and respiratory function, measured using percentage of predicted forced vital capacity (FVC). Results Baseline data were available on 302 patients with ALS (median age, 63.2 years [interquartile range, 55.5-68.0 years]; 178 men and 124 women). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALSFRS-R scores or percentage FVC. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores (β [SE], 2.7 [0.69] and 2.9 [0.9], respectively) and percentage FVC (β [SE], 12.1 [2.8] and 11.5 [3.4], respectively) (all P < .001). Positive and significant associations with ALSFRS-R scores (β [SE], 1.5 [0.61]; P = .02) and percentage FVC (β [SE], 5.2 [2.2]; P = .02) for selected vitamins were found in exploratory analyses. Conclusions and Relevance Antioxidants, carotenes, fruits, and vegetables were associated with higher ALS function at baseline by regression of nutrient indices and weighted quantile sum regression analysis. We also demonstrated the usefulness of the weighted quantile sum regression method in the evaluation of diet. Those responsible for nutritional care of the patient with ALS should consider promoting fruit and vegetable intake since they are high in antioxidants and carotenes.
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Affiliation(s)
- Jeri W Nieves
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York2Clinical Research Center, Helen Hayes Hospital, West Haverstraw, New York
| | - Chris Gennings
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Jonathan Hupf
- Department of Neurology, Columbia University, New York, New York
| | | | - Valerie Sharf
- Department of Neurology, Columbia University, New York, New York
| | - Björn Oskarsson
- Department of Neurology, University of California-Davis, Sacramento
| | | | | | | | - Ray Goetz
- Department of Psychiatry, New York State Psychiatric Institute, New York
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Fondell E, O'Reilly ÉIJ, Fitzgerald KC, Falcone GJ, Kolonel LN, Park Y, Gapstur SM, Ascherio A. Intakes of caffeine, coffee and tea and risk of amyotrophic lateral sclerosis: Results from five cohort studies. Amyotroph Lateral Scler Frontotemporal Degener 2015; 16:366-71. [PMID: 25822002 DOI: 10.3109/21678421.2015.1020813] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Caffeine is thought to be neuroprotective by antagonizing the adenosine A2A receptors in the brain and thereby protecting motor neurons from excitotoxicity. We examined the association between consumption of caffeine, coffee and tea and risk of amyotrophic lateral sclerosis (ALS). Longitudinal analyses based on over 1,010,000 males and females in five large cohort studies (the Nurses' Health Study, the Health Professionals Follow-up Study, the Cancer Prevention Study II Nutrition Cohort, the Multiethnic Cohort Study, and the National Institutes of Health-AARP Diet and Health Study). Cohort-specific multivariable-adjusted risk ratios (RR) and 95% confidence intervals (CI) estimates of ALS incidence or death were estimated by Cox proportional hazards regression and pooled using random-effects models. Results showed that a total of 1279 cases of ALS were documented during a mean of 18 years of follow-up. Caffeine intake was not associated with ALS risk; the pooled multivariable-adjusted RR comparing the highest to the lowest quintile of intake was 0.96 (95% CI 0.81-1.16). Similarly, neither coffee nor tea was associated with ALS risk. In conclusion, the results of this large study do not support associations of caffeine or caffeinated beverages with ALS risk.
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Affiliation(s)
- Elinor Fondell
- a Department of Nutrition , Harvard School of Public Health , Boston , Massachusetts , USA
| | - É Ilis J O'Reilly
- a Department of Nutrition , Harvard School of Public Health , Boston , Massachusetts , USA
| | - Kathryn C Fitzgerald
- a Department of Nutrition , Harvard School of Public Health , Boston , Massachusetts , USA
| | - Guido J Falcone
- b Department of Epidemiology , Harvard School of Public Health , Boston , Massachusetts , USA.,c Department of Neurology , Massachusetts General Hospital , Boston , Massachusetts , USA
| | - Laurence N Kolonel
- d Epidemiology Program, Cancer Center, University of Hawaii , Honolulu , Hawaii , USA
| | - Yikyung Park
- e Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute , Bethesda , Maryland , USA.,f Division of Public Health Sciences, Washington University School of Medicine , St. Louis , Missouri , USA
| | - Susan M Gapstur
- g Epidemiology Research Program, American Cancer Society , Atlanta , Georgia , USA
| | - Alberto Ascherio
- a Department of Nutrition , Harvard School of Public Health , Boston , Massachusetts , USA.,b Department of Epidemiology , Harvard School of Public Health , Boston , Massachusetts , USA.,h Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston , Massachusetts , USA
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