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Lucchini RG, Guazzetti S, Renzetti S, Broberg K, Caci M, Covolo L, Crippa P, Gelatti U, Hashim D, Oppini M, Pepe F, Pilotto A, Passeri C, Placidi D, Rizzetti MC, Turla M, Wahlberg K, Padovani A. Metal Exposure and SNCA rs356219 Polymorphism Associated With Parkinson Disease and Parkinsonism. Front Neurol 2020; 11:556337. [PMID: 33362685 PMCID: PMC7755861 DOI: 10.3389/fneur.2020.556337] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/13/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: In the province of Brescia, Italy, historical neurotoxic metal exposure has occurred for several decades. This study aimed to explore the role of metal exposure and genetics on Parkinson's Disease (PD) and Parkinsonism. Methods: Cases were enrolled from four local clinics for movement disorders. Randomly selected controls non-affected by neurological or psychiatric conditions were enrolled from the same health centers keeping a similar gender ratio and age distribution as for cases. Data on sociodemographic variables, clinical onset and life habits were collected besides accurate occupational and residential history. Blood samples were collected from all participants for genotyping of target polymorphisms in genes linked to PD and/or metal transport. Results: A total number of 432 cases and 444 controls were enrolled in the study, with average age of 71 years (72.2 for cases and 70 for controls). The average age at diagnosis was 65.9 years (SD 9.9). Among the potential risk factors, family history of PD or Parkinsonism showed the strongest association with the diseases (OR = 4.2, 95% CI 2.3, 7.6 on PD; OR = 4.3, 95% CI 1.9, 9.5 for Parkinsonism), followed by polymorphism rs356219 in the alpha-synuclein (SNCA) gene (OR = 2.03, 95% CI 1.3, 3.3 for CC vs. TT on PD; OR = 2.5, 95% CI 1.1, 5.3 for CC vs. TT on Parkinsonism), exposure to metals (OR = 2.4;, 95% CI 1.3, 4.2 on PD), being born in a farm (OR = 1.8; 95% CI 1.1, 2.8 on PD; OR = 2.6; 95% CI 1.4, 4.9 on Parkinsonism) and being born in the province of Brescia (OR = 1.7; 95% CI 1.0, 2.9 on PD). Conditional OR of having PD depending by SNCA polymorphism and metal exposure highlights higher risk of PD among CC SNCA carriers and being exposed to metals. However, the interaction term was not statistically significant. Conclusions: Lifetime exposure to metals and genetic variation in SNCA gene are relevant determinants of PD and Parkinsonism in the highly industrialized area of Brescia, Italy. The lack of evidence of statistical interaction between environmental and genetic factors may be due to the low frequencies of subjects representing the exposure categories and the polymorphism variants and does not rule out the biological interaction.
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Affiliation(s)
- Roberto G. Lucchini
- Robert Stempel College of Public Health, Florida International University, Miami, FL, United States
- Department of Medical Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | | | - Stefano Renzetti
- Department of Medical Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Margherita Caci
- Department of Medical Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Loredana Covolo
- Department of Medical Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | | | - Umberto Gelatti
- Department of Medical Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Dana Hashim
- Hematology & Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Manuela Oppini
- Department of Medical Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Fulvio Pepe
- Neurology, Poliambulanza Foundation, Brescia, Italy
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Parkinson Rehabilitation Center, Ospedale S. Isidoro - FERB Onlus, Trescore Balneario, Bergamo, Italy
| | - Chiara Passeri
- Department of Medical Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Donatella Placidi
- Department of Medical Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Maira Cristina Rizzetti
- Parkinson Rehabilitation Center, Ospedale S. Isidoro - FERB Onlus, Trescore Balneario, Bergamo, Italy
| | | | - Karin Wahlberg
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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