Abstract
BackgroundEpidemiological studies have suggested a possible role of trace elements (TE) in the etiology of several neurological diseases including Multiple Sclerosis (MS). Hair analysis provides an easy tool to quantify TE in human subjects, including patients with neurodegenerative diseases.ObjectiveTo compare TE levels in scalp hair from patients with MS and healthy controls from the same geographic area (Sicily).MethodsICP-MS was used to determine the concentrations of 21 elements (Ag, Al, As, Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Mo, Ni, Pb, Rb, Sb, Se, Sr, U, V and Zn) in scalp hair of 48 patients with relapsing–remitting Multiple Sclerosis compared with 51 healthy controls.ResultsMS patients showed a significantly lower hair concentration of aluminum and rubidium (median values: Al = 3.76 μg/g vs. 4.49 μg/g and Rb = 0.007 μg/g vs. 0.01 μg/g;) and higher hair concentration of U (median values U: 0.014 μg/g vs. 0.007 μg/g) compared to healthy controls. The percentages of MS patients showing hair elemental concentrations greater than the 95th percentile of controls were 20% for Ni, 19% for Ba and U, and 15% for Ag, Mo and Se. Conversely, the percentages of MS patients showing hair elemental concentrations lower than the 5th percentile of healthy controls were 27% for Al, 25% for Rb, 22% for Ag, 19% for Fe, and 16% for Pb. No significant association was found between levels of each TE and age, disease duration or Expanded Disability Status Scale (EDSS) score. After stratification by gender, healthy subjects did not show any significant difference in trace element levels, while MS patients showed significant differences (p<0.01) for the concentrations of Ag, Cr, Fe, Ni and Sr. No significant differences were also found, at p<0.01, in relation to the use of cigarettes, consume of water, vegetables and place of living.ConclusionThe different distributions of TE in hair of MS patients compared to controls provides an additional indirect evidence of metabolic imbalance of chemical elements in the pathogenesis of this disease. The increase in U and decrease in Al and Rb levels in MS compared to controls require further assessments as well as the observed different distributions of other elements.
Highlights
Multiple sclerosis (MS) is a chronic neurological disease characterized by an idiopathic inflammation of the central nervous system (CNS) with lymphocyte and macrophage infiltration, leading to demyelination, axonal injury and the appearance of a variety of neurological signs over time [1, 2]
No significant association was found between levels of each Trace elements (TE) and age, disease duration or Expanded Disability Status Scale (EDSS) score
Myelin sheaths are susceptible to oxidative damage: since TE can increase free radicals production, it is conceivable that they may contribute to this demyelinating process Nicoletti et al (2013) [24] evaluated the incidence of MS in two areas of the Mount Etna flanks with an allegedly different exposure to volcanic ashes carrying a high load of TE
Summary
Multiple sclerosis (MS) is a chronic neurological disease characterized by an idiopathic inflammation of the central nervous system (CNS) with lymphocyte and macrophage infiltration, leading to demyelination, axonal injury and the appearance of a variety of neurological signs over time [1, 2]. Several evidences point to a clear genetic predisposition to MS, the north-south gradient of prevalence and familial studies of genetic inheritance suggest that an important role in the determination of the disease is played by still unidentified environmental factor(s) [3]. The higher prevalence and incidence of MS observed among populations living in the eastern flank of Mt. Etna was attributed to their exposure to volcanogenic ashes containing TE, suggesting their role as possible environmental co-factor in the pathogenesis of MS [24]. Epidemiological studies have suggested a possible role of trace elements (TE) in the etiology of several neurological diseases including Multiple Sclerosis (MS).
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