The Relationship between Blood Lead Levels and Clinical Features among Multiple Sclerosis Patients in Isfahan, Iran

Zahra Razavi, Mojtaba Jokar, Alireza Allafchian, Zahra Hossinpour, Leila Berenjani, Vahid Shayegan Nejad

Abstract


Lead (Pb) is one of the most likely toxicants that could be potentially a risk factor in the development of Multiple Sclerosis (MS) through changes in the immune system. The purpose of the study was to describe the clinical features of MS in general and for sub-groups stratified for gender, age, residence, disease duration, disability degree, clinical diagnosis in Isfahan, Iran and also, to elucidate the relationship between the blood Pb level and the development of MS. Blood samples of 48 patients (20 to 57 years) were selected from the department of neurology of the Kashani hospital in Isfahan, Iran and were analyzed for Pb using anodic stripping voltammetry (ASV). The clinical and demographic characteristics in our study were similar to those in other reports. The blood Pb level in 70.83% of the total population was <20 μg/l. No statistically significant difference was observed between the Pb level and some patient characteristics. These findings did not support the assumption that Pb could be a pathogenetic factor in MS. However, the exposure to a large amount of Pb can increase the risk of developing MS. Obviously; more investigation is needed to investigate the contribution of Pb to the development of MS.

Keywords


Multiple sclerosis (MS), Blood, Lead (Pb), Anodic Stripping Voltammetry (ASV), Isfahan

Full Text:

PDF

References


Pugliatti M, Rosati G, Carton H, Riise T, Drulovic J, Vécsei L,Milanov I: The epidemiology of multiple sclerosis in Europe. Eur J Neurol. 2006; 13(7): 700-22.

Plosker G L. Interferon-β-1b. CNS drugs. 2011; 25(1): 67-88.

Poser C M, Paty, D. W, Scheinberg L, McDonald W. I, Davis F. A, Ebers G. C, Johnson K. P, Sibley W. A, Silberberg D. H, and Tourtellotte W. W. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983; 13(3): 227-31.

McDonald W I, Compston A., Edan G, Goodkin D, Hartung H. P, Lublin, F D, McFarland H. F, Paty, D. W, Polman C. H, Reingold S. C. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001; 50(1): 121-27

Multiple Sclerosis International Federation (MSIF). Atlas of MS of 2013, London, United Kingdom. 2013 ; Available: http:// msif.org.

Tsai C P, Lee C TC: Multiple sclerosis incidence associated with the soil lead and arsenic concentrations in Taiwan. PloS One. 2013; 8(6):1-5.

Johnson F O, Atchison W D: The role of environmental mercury, lead and pesticide exposure in development of amyotrophic lateral sclerosis. Neurotoxicology. 2009; 30(5): 761-65.

McGrother C, Dugmore C, Phillips M, Raymond N, Garrick P, Baird W Epidemiology: Multiple sclerosis, dental caries and fillings: a case-control study. Br Dent J. 1999; 187(5): 261-64.

Mishra K. Lead exposure and its impact on immune system: a review. Toxicol in Vitro. 2009; 23(6): 969-72.

Komárek M, Ettler V, Chrastný V, Mihaljevič M: Lead isotopes in environmental sciences: a review. Environ Int. 2008; 34(4): 562-77.

Forte G, Visconti A, Santucci S, Ghazaryan A, Figa-Talamanca L, Cannoni S, Bocca B, Pino A, Violante N, Alimonti A. Quantification of chemical elements in blood of patients affected by multiple sclerosis. Ann Ist Super Sanita. 2005; 41(2): 213-16.

Etemadifar M, Abtahi S H: Multiple Sclerosis in Isfahan: past, present and future. Int J Prev Med. 2012; 3(5):301-302.

Etemadifar M, Abtahi S H, Akbari M, Murray R T, Ramagopalan S V, Fereidan-Esfahani M: Multiple sclerosis in Isfahan, Iran: an update. Mult Scler J. 2013;120(8):1145-47

Mostafavi S N, Ataei B, Nokhodian Z, Yaran M, Babak A : seroepidemiology of toxoplasma gondii infection in Isfahan province, central Iran: A population based study. J Res Med Sci. 2011; 16(4): 496-01.

Son J.-Y, Lee J, Paek D, and Lee J. T. Blood levels of lead, cadmium, and mercury in the Korean population: results from the Second Korean National Human Exposure and Bio-monitoring Examination, Environ Res. 2009; 109(6):738-44.

Forte G, Madeddu R, Tolu P, Asara Y, Marchal J.A, Bocca B: Reference intervals for blood Cd and Pb in the general population of Sardinia (Italy). Int J Hyg Envir Heal. 2011; 214(2): 102-09.

Talebi SM, Malekiha M. trace Heavy Metals Levels in Whole Blood Samples from the Residents of Isfahan City, 16th Iranian Conference of Analytical Chemistry, At Hamedan. 2009.

Higashikawa K, Zhang Z.-W, Shimbo S, Moon C.-S, Watanabe T, Nakatsuka H, Matsuda-Inoguchi N, Ikeda M. Correlation between concentration in urine and in blood of cadmium and lead among women in Asia. Sci Total Environ. 2000; 246(2):97-07.

Kurtzke JF. Rating neurologic impairment in multiple sclerosis an expanded disability status scale (EDSS), Neurology. 1983; 33(11): 1444-52.

Gregory II A.C, Shendell D.G, Okosun I.S, Gieseker K.E. Multiple Sclerosis disease distribution and potential impact of environmental air pollutants in Georgia. Sci Total Environ. 2008; 396(1): 42-51.

Etemadifar M, Janghorbani M, Shaygannejad V, Ashtari F: Prevalence of multiple sclerosis in Isfahan, Iran. Neuroepidemiology. 2006; 27(1):39-44.

Boran A M, Al-Bashir NA, Al-Khatib AJ, Qattan I.T, Alanazi S.A, Massadeh, A. M. Investigating the relationship between mental retardation and lead intoxication. Eur Sci J. 2013; 9(6): 62-76.

Kurlander H.M, Patten B M: Metals in spinal cord tissue of patients dying of motor neuron disease. Ann Neurol. 1979; 6(1): 21-24.

Miranda M. L, Edwards S. E, Swamy G. K, Paul C. J,Neelon B: Blood lead levels among pregnant women: historical versus contemporaneous exposures. Int J Environ Res Publ Health. 2010; 7(4): 1508-19.

Ward NI, Stephens R, Ryan D E. Comparison of three analytical methods for the determination of trace elements in whole blood. Anal Chim Acta. 1979; 110(1): 9-19.

Royal College of General Practitioners' Birmingham Research Unit (RCGP–BRU). Lead and multiple sclerosis. Br J Gen Pract. 1976; 26(169): 622-26.

Vinceti M, Guidetti D, Bergomi M, Caselgrandi E, Vivoli R, Olmi M, Rinaldi L, Rovesti S, and Solime F. Lead, cadmium, and selenium in the blood of patients with sporadic amyotrophic lateral sclerosis. Ital J Neurol Sci. 1997. 18(2): 87-92.

Stober T, Stelte W, Kunze K: Lead concentrations in blood, plasma, erythrocytes, and cerebrospinal fluid in amyotrophic lateral sclerosis. J Neurol Sci. 1983; 61(1): 21-26.

Taheri L, Sadeghi M, Sanei H, Rabiei K, Arabzadeh S, Golshahi J, Afshar H, Sarrafzadegan N. The relation between occupational exposure to lead and blood pressure among employed normotensive men, J res med sci. 2014; 19(6): 490-94

Centers for Disease Control and Prevention (CDC). Fourth National Report on Human Exposure to Environmental Chemicals. CDC, Atlanta. 2009.

World Health Organization (WHO). Environmental Health Criteria 165: Inorganic Lead. Geneva, Switzerland. 1995.

Ghazifard A. Evaluating the relation between heavy metal contamination of air and surface soils in city of Isfahan (Iran). Irish Association for Economic Geology (IAEG). The Geological Society of London. 2006.

Rashidi M, Rameshat M. H, Gharib H, Rouzbahani R, Ghias M, and Poursafa P. The association between spatial distribution of common malignancies and soil lead concentration in Isfahan, Iran, J Res Med Sci. 2012; 17(4): 348-54.

Kabata-Pendias A. Trace elements in soils and plants, Trace elements in soils and plants, CRC Press, Boca Raton, FL, USA. 2010.

Afyuni M. The Development of Soil Standards of Iran, Iran Department of Environment. 2013

World Health Organization (WHO). Concern for Europe tomorrow: Health and environment in the WHO European region. WHO European centre for Environment and Health, wissenschaftlich verlagsgesellschaft mbH, Stuttgart. 1995.

United States Environmental Protection Agency (USEPA). US Environmental Protection Agency National Ambient Air Quality Standards (NAAQS). 40 CFR Part 50. http://www.epa.gov/air/criteria.html .2011.

Dayani M, Mohammadi J. Geostatistical Analysis of Pb, Zn and Cd concentration in soil of Sepahanshahr suburb (south of Esfahan). J Water Soil. 2010; 23(4): 67-76.

Ataabadi M, Hoodaji M, Najafi P: Biomonitoring of some heavy metal contaminations from a steel plant by above ground plants tissue. Afr J Biotechnol. 2011; 10(20): 4127-32.

Gandomkar A, Fouladi K. Surveying the environmental biology effects of Esfahan Factories on Zayandehrood Pollution. Int J Environ Earth Sci Eng. 2012; 6(4): 561-65.

Turabelidze G, Schootman M, Zhu B.-P, Malone J. L, Horowitz S, Weidinger J, Williamson D, Simoes E. Multiple sclerosis prevalence and possible lead exposure. J Neurol Sci. 2008; 269(1-2): 158-62.

Kamel F, Umbach D, Hu H, Munsat T, Shefner J, Taylor J, Sandler D. Lead exposure as a risk factor for amyotrophic lateral sclerosis. Neurodegener Dis. 2006; 2(3-4): 195-01.




Iranian Journal of Health, Safety and Environment e-ISSN: :2345-5535 Iran university of Medical sciences, Tehran, Iran