Studio di metalli pesanti in pazienti affetti da sclerosi laterale amiotrofica ed analisi delle correlazioni cliniche

In this work, a population-based case-control study on possible associations between human exposure to toxic metals and sporadic amyotrophic lateral sclerosis (ALS) was conducted. Following informed consensus, ALS patients were enrolled from different Care Centers of Sardinia, an Italian region characterized by elevated rates of ALS cases and significant history of mining activities. Aluminium, Cd, Hg, Mn and Pb concentrations were determined in blood, hair and urine by ICP-MS in 34 ALS patients (mean age, 62 ± 10 years, male/female ratio 1.6) and 30 controls (mean age, 65 ± 11 years; male/female ratio 1.5). Taking into account blood samples, concentrations of Al (p=0.045) and Pb (p=0.026) were higher in ALS patients than in control. In hair of ALS patients, a significant depletion of Al (p=0.006) and Mn (p=0.032) respect to controls was found. In contrast, there were not significant differences between cases and controls in urine samples. As well, cases and controls showed no differences in Hg patterns; however, ALS patients showed strong correlations among Hg levels in blood, urine and hair, while controls did not. In addition, metal-metal correlations were investigated, showing that Cd, Hg and Pb display synergic pattern, differently from Al and Mn (antagonistic pattern).In conclusion, even if a direct ALS-metals causative relationship cannot be established, this study suggests that some metals could be involved in the ALS pathology depending on environmental exposures to toxicants, as well as on internal degenerative process and metal-gene interactions.