الفهرس 
Assessment of Mercury, Lead and Cadmium as Environmental Risk Factors in a Sample of Multiple Sclerosis Patients Presented to kasr Alainy Hospital
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Abstract
Background: multiple sclerosis (ms) is a demyelinating inflammatory disease of the central nervous system (cns) white matter. environmental and genetic factors have been implicated in its pathogenesis. heavy metals generate free radicals causing alteration in genetic material and blood brain barrier (bbb) damage. in addition, intracellular accumulation of certain heavy metals can trigger autoimmune reaction against myelin proteins and nerves cytoskeletal proteins subjects & methods: the present study was carried out in the period between september 2019 and may 2021. 86 ms patients and 86 healthy controls were included. whole blood levels of mercury (hg), cadmium (cd) and lead (pb) in microgram/liter (og/l) in addition to zinc (zn) and copper (cu) in milligram/liter (mg/l) were measured. the current study also discussed heavy metals exposure risks between the two studied groups as well as physiological-toxic metals interactions. results: the current work demonstrated significantly higher levels of pb, cd and hg and significantly lower levels of zn and cu as well as cu/zn in ms patients than controls. heavy metals exposure risks were significantly higher in ms patients than controls regarding frequent use of cosmetics/ sanitary products and tap water consumption in addition to environmental, occupational and medical exposure. lower cu and zn levels were accompanied by higher levels of pb, hg and cd. however, these negative correlations were only significant between cu and both of hg and pb. conclusion: the current work demonstrated significant relation between toxic metals levels and ms. in addition, a complex profile of altered elements rather than a single element imbalance in ms pathogenesis is suggested