Investigation of the Presence of Heavy Metals in the Progression of Multiple Sclerosis

Objective: Multiple sclerosis (MS) etiology studies show that the disease is multifactorial. While genetic features are more prominent at the beginning of the disease, the existence of environmental triggers that may cause the progression of the disease is still a subject of research.
Materials and Methods: We evaluated 101 MS patients sharing the same geographical area. We performed heavy metal analysis in the blood and hair tissues of these patients. Of these patients, 67 were in the relapsing remitting MS (RRMS) group and 34 were in the progressive MS (PMS) group.
Results: Samples were analyzed using the X Series 2 model (ICP MS) instrument. In hair samples, aluminum (Al) was found to be 8.98 μg/g in the PMS group and 3.01 μg/g in the RRMS group (P < 0.001). Unlike Al element, magnesium (Mg), calcium (Ca), cobalt (Co), zinc (Zn) and strontium (St) elements were observed to be higher in the RRMS group. RRMS for median Ca: 931 μg/g, PMS: 400 μg/g (P < 0.001); RRMS for Mg: 118 μg/g, PMS: 50 μg/g (P < 0.001); For Co RRMS: 0.0150 μg/g, PMS: 0.0075 μg/g (P = 0.008); RRMS for Zn: 138 μg/g, PMS: 101 μg/g (P = 0.008); For St RRMS: 4.76 μg/g, PMS: 3.70 μg/g (P = 0.008). With these results, we thought that Al excess or Mg, Ca, Co, and Zn deficiencies might be associated with MS progression. The mercury (Hg) blood level was slightly low in PMS. This finding was not correlated with hair samples (P = 0.047). The relationship between blood Hg level and RRMS should be evaluated separately.
Conclusion: We could not find any study comparing PMS forms and RRMS subtypes in terms of heavy metals. In particular, it is necessary to focus on the Al element.