Metal exposure plays a critical role in ALS diagnosis and survival

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A study led by the University of Michigan suggests that people with higher levels of metals in their blood and urine may have a higher chance of being diagnosed with and dying from amyotrophic lateral sclerosis (ALS).

ALS is a rare but deadly disease that affects the nervous system, causing muscle weakness and eventually leading to paralysis.

Researchers have long known that both genetics and environmental factors, such as exposure to pesticides and metals, play a role in ALS. This study specifically looked at the levels of metals in people with and without ALS to see if there was a connection.

The results, published in the Journal of Neurology, Neurosurgery, and Psychiatry, showed a clear link between metal exposure and an increased risk of ALS, as well as shorter survival times for those with the disease.

Stephen Goutman, the study’s senior author and director of the Pranger ALS Clinic, emphasized the importance of understanding metal exposure as a risk factor. This knowledge is crucial for developing ways to prevent the disease and improve treatments.

He pointed out that while previous studies have suggested a link between metal exposure and ALS, it is vital to understand how combinations of different metals might impact the risk and progression of the disease.

The research team measured the levels of various metals in the blood and urine of over 450 people with ALS and nearly 300 people without the condition.

They found that higher levels of metals like copper, selenium, and zinc were significantly associated with a greater risk of developing ALS and dying earlier.

Using these findings, they created environmental risk scores to quantify the risk posed by metal exposure. These scores indicated that having multiple metals in the body could triple the risk of developing ALS.

Interestingly, the study also looked at genetic factors. They used a previously developed ALS polygenic risk score to see if genetic predispositions affected the relationship between metal exposure and ALS.

However, they found that accounting for genetic factors did not change the link between metal exposure and the disease. Kelly Bakulski, a co-author of the study, noted that the interactions between genes and the environment are complex, and further research into genetic factors could provide more insights.

The study also discovered that people who worked in jobs with a high likelihood of metal exposure had increased levels of metal mixtures in their blood and urine.

This finding supports earlier research from the same team, which showed that people with ALS often reported higher exposure to metals through their occupations before being diagnosed.

First author Dae Gyu Jang highlighted the importance of considering both occupational and environmental factors when assessing a person’s overall risk of exposure to harmful substances.

Goutman added that by avoiding activities associated with high metal exposure, individuals might be able to reduce their overall risk and potentially lower their chances of developing ALS.

Moving forward, the researchers plan to focus on identifying which specific exposures have the strongest links to ALS and understanding the implications of these exposures on the disease. By continuing to investigate the connections between metal exposure and ALS, they hope to find better ways to prevent and treat this devastating condition.

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The research findings can be found in the Journal of Neurology, Neurosurgery, and Psychiatry.

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