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Smoking and the risk of amyotrophic lateral sclerosis: a systematic review and meta-analysis
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    Smoking and Exercise in Combination may adversely affect mitochondrial function and cause ALS in susceptible individuals

    I read the article by Alonso on smoking and risk of amyotrophic lateral sclerosis (ALS) with interest (1) While the meta-analysis may not support a strong association with smoking and ALS, there may be a relationship with the combination of smoking and exercise. Smoking increases carbon monoxide (CO) levels (2) and cyanide (3) in the blood. Cyanide binds with cytochrome oxidase in the mitochondria, and CO interferes wi...

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    Conflict of Interest:
    None declared.