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Review
. 2023 Apr;30(2):124-132.
doi: 10.1177/09727531221120358. Epub 2023 Jan 13.

Raw Water and ALS: A Unifying Hypothesis for the Environmental Agents Involved in ALS

Giuseppe Stipa  1 , Antonio Ancidoni  2 , Nicola Vanacore  2 , Guido Bellomo  2
Affiliations
Review

Raw Water and ALS: A Unifying Hypothesis for the Environmental Agents Involved in ALS

Giuseppe Stipa et al. Ann Neurosci. 2023 Apr.

Abstract

Different studies identified the presence of several altered genes in familial and sporadic amyotrophic lateral sclerosis (ALS) forms. The experimental data, together with the epidemiological data, would seem to suggest the existence of molecular mechanisms (e.g., axonal transport) related to these genes, together with a susceptibility of the same genes to certain environmental factors that would therefore suggest an impact of the environment on the etiopathogenesis of ALS. In our review, we considered the most relevant environmental clusters around the world, collecting different hypotheses and underlining common environmental factors among the different clusters. Moreover, further epidemiological data identified a higher risk of ALS in professional athletes and, in particular, in soccer and football players. Despite this increased risk of ALS highlighted by the epidemiological evidence in aforementioned sports, the mechanisms remain unclear. At last, the use of raw water has been associated with ALS risk. The aim of the present review is to characterize a possible relationship between these clusters, to be explored in the context of the interaction between genetic and environmental factors on the etiopathogenesis of ALS.

Keywords: ALS; BMAA; Environmental factors; Raw water; Sports.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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