Association between multiple sclerosis and urinary levels of toxic metals and organophosphates: A cross-sectional study in Israel

Ayelet Armon-Omer, Tarek Mansor, Michael Edelstein, Elena Bukovetzky, Luda Groisman, Efrat Rorman, Adi Sharabi Nov, Radi Shahien

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Multiple sclerosis (MS) is a multifactorial disease of uncertain etiology damaging myelin sheaths around axons of the central nervous system. Myelin protects the axon from potentially harmful exogenous factors. The aetiological role of environmental exposure metals and organophosphates is unclear. Objective: Identify whether urinary levels of metals and organophosphates differed in MS patients and controls. Methods: We recruited MS patients from Ziv Medical Centre and healthy controls. MS patients were evaluated according to Expanded Disability Status Scale into mild and moderate-severe conditions. Each participant provided a urine sample and completed epidemiological questionnaires. The levels of six metal (Aluminum, Cadmium, Chromium, Lead, Mercury, Nickel) and one metalloid (Arsenic) and common organophosphates pesticide metabolites (6 dialkylphosphates, DAP) were measured in urine using inductively coupled plasma-mass spectrometry and gas-chromatography mass-spectrometry. We compared cases with controls in terms of urinary levels of these compounds using Mann-Whitney and Kruskall-Wallis tests. Results: Urinary cadmium and mercury levels were higher in the 49 MS patients than the 37 controls (p < 0.01). Cadmium levels were higher in moderate-severe MS patients (n = 24) than mild MS patients (n = 25) (p = 0.003). Conclusion: Urinary cadmium and mercury levels were higher among MS patients than controls. Cadmium levels correlated with disease severity. Further studies are needed to explore potential causal pathways between these compounds and MS pathogenesis.

Original languageEnglish
Article number105445
JournalMultiple Sclerosis and Related Disorders
Volume83
DOIs
StatePublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2024

Keywords

  • Cadmium
  • Environment
  • Mercury
  • Metals
  • Multiple sclerosis
  • Organophosphate

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