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Increased arterial carboxyhaemoglobin concentrations in patients with sporadic amyotrophic lateral sclerosis
  1. H Yasuda1,
  2. S Ebihara1,
  3. M Yamaya1,
  4. M Asada1,
  5. H Sasaki1,
  6. M Aoki2
  1. 1Department of Geriatric and Respiratory Medicine, Tohoku University School of Medicine, Sendai 980-8574, Japan
  2. 2Department of Neurology, Tohoku University School of Medicine
  1. Correspondence to:
 Dr Satoru Ebihara
 Department of Geriatric and Respiratory Medicine, Tohoku University School of Medicine, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan;

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Carbon monoxide is endogenously produced by enzymes known as haem oxygenase (HO). The CO produced is immediately bound to blood haemoglobin as carboxyhaemoglobin (Hb-CO). HO-1, the inducible form of HO, is induced by various stimuli, including reactive oxygen species (ROS) and proinflammatory cytokines.1 Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease in humans that results in the selective death of both upper and lower motor neurones. ROS have been implicated in the mechanism of neuronal injury in ALS, based on the evidence that mutations of the superoxide dismutase (SOD) gene have been identified in patients with familial ALS, and that transgenic mice with mutated SOD genes have an ALS-like phenotype.2 Furthermore, increased oxidative damage has been found in spinal motor neurones of necropsy samples from both sporadic and familial ALS patients.2 This suggests that with the progression of neuronal injury the spinal cord in ALS patients may induce HO-1, leading to the production of CO, followed by increased concentrations of blood Hb-CO. Indeed, immunohistochemical studies have shown increased HO-1 expression in spinal motor neurones in ALS patients and animal models of ALS.3 However, blood Hb-CO in ALS patients has not been examined. We investigated arterial Hb-CO concentrations in relation to …

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