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Open Access 09-07-2022 | Amyotrophic Lateral Sclerosis | Review Article

Human tissue lead (Pb) levels and amyotrophic lateral sclerosis: a systematic review and meta-analysis of case–control studies

Authors: Cristiano Farace, Giovanni Fiorito, Andrea Pisano, Federica Etzi, Angela Sabalic, Grazia Fenu, Yolande Asara, Giuliana Solinas, Roberto Madeddu

Published in: Neurological Sciences | Issue 10/2022

Abstract

Aim

To combine the current scientific literature evidence and elucidate the differences of lead (Pb) bioaccumulation in human tissues by comparing amyotrophic lateral sclerosis (ALS) patients and healthy controls.

Methods

We systematically searched for case–control studies on the association of Pb levels with ALS, in human cells, tissues, and body fluids (nervous tissue, muscle, blood, cerebrospinal fluid, urine, skin appendages). Then, we performed a meta-analysis for all the tissues in which at least five case–control studies were available: whole blood (9 studies), serum/plasma (5 studies), and cerebrospinal fluid (CSF) (6 studies). Differences between cases and controls were evaluated using standardized mean difference, and combined estimates were derived using random effect maximum likelihood (REML) meta-analyses.

Results

Among 1734 records, we identified 46 full-text studies, of which 14 case–control studies met the meta-analysis inclusion criteria. We found higher Pb levels in ALS cases than controls in blood (standardized mean difference (SMD) = 0.61; 95% confidence interval (CI) 0.20, 1.01; p = 0.003), plasma/serum (SMD = 0.27; 95% CI − 0.16, 0.70; p = 0.26), and CSF (SMD = 0.53; 95% CI − 0.09, 1.15; p = 0.09).

Conclusions

This work provides further evidence of the association between Pb bioaccumulation and ALS in body fluids. The lack of association studies in solid tissues did not allow a robust meta-analysis. Future prospective studies are needed to clarify the causality in the association of Pb bioaccumulation with ALS.

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Title: Human tissue lead (Pb) levels and amyotrophic lateral sclerosis: a systematic review and meta-analysis of case–control studies
Authors: Cristiano Farace
Giovanni Fiorito
Andrea Pisano
Federica Etzi
Angela Sabalic
Grazia Fenu
Yolande Asara
Giuliana Solinas
Roberto Madeddu
Publication date: 09-07-2022
Publisher: Springer International Publishing
Keyword: Amyotrophic Lateral Sclerosis
Published in: Neurological Sciences / Issue 10/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-022-06237-y

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Human tissue lead (Pb) levels and amyotrophic lateral sclerosis: a systematic review and meta-analysis of case–control studies

Abstract

Aim

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Methods

Results

Conclusions

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