Pesticides Flagged as Biggest ALS Risk Factor on Novel ERS

TOPLINE:

Pesticide exposure is linked to more than a twofold increased risk for amyotrophic lateral sclerosis (ALS), new research that validates a novel environmental risk score (ERS) suggests. When combined with other variables, the ERS score produces a number representing an individual’s ALS risk and odds for survival on the basis of exposure to environmental toxins.

METHODOLOGY:

• Participants with ALS (n = 164) were recruited from visits to the University of Michigan Pranger ALS Clinic and healthy control participants (n = 105) from internet ads and mailings.

• Investigators collected blood samples from all participants, which were analyzed using an isotope dilution technique with triple quadrupole mass spectrometry to detect nearly 36 persistent organic pollutants (POPs).

• On the basis of the presence of POPs combined with lifestyle factors, family history, and other variables, investigators created an ERS for participants to assess their risk of developing ALS and odds of survival.

TAKEAWAY:

• Several POPs were individually associated with ALS risk, including eight of 22 manufactured chemicals called polychlorinated biphenyls (widely known as PCBs) and seven of 10 organochlorine pesticides.

• ALS risk was greatest among those with a high exposure to a mixture of pesticides, with people in the highest group of exposure having more than double the risk for ALS (odds ratio, 2.58; P

• Twenty-four of 36 POPs had a negative effect on ALS survival (hazard ratio, 1.65; P = .008).

IN PRACTICE:

“For the first time, we have a means of collecting a tube of blood and looking at a person’s risk for ALS based on being exposed to scores of toxins in the environment,” study investigator, Stephen Goutman, MD, MS, director of the Pranger ALS Clinic and associate director of the ALS Center of Excellence at University of Michigan in Ann Arbor, said in a press release.

SOURCE:

Goutman led the study, which was published online on October 30, 2023 in the Journal of Neurology, Neurosurgery, and Psychiatry.

LIMITATIONS:

This was a single-center study with a small sample size. The control cohort was comprised of more women and was also younger than was the cohort of the case cohort.

DISCLOSURES:

Goutman is an inventor on a patent held by University of Michigan for a method that targets immune pathways for use in ALS therapeutics and provided scientific advisory for a documentary about ALS. Other disclosures are noted in the original article.