• J. Neurol. Neurosurg. Psychiatr. · Nov 2016

    Influence of cigarette smoking on ALS outcome: a population-based study.

    • Andrea Calvo, Antonio Canosa, Davide Bertuzzo, Paolo Cugnasco, Luca Solero, Marinella Clerico, Stefania De Mercanti, Enrica Bersano, Stefania Cammarosano, Antonio Ilardi, Umberto Manera, Cristina Moglia, Kalliopi Marinou, Edo Bottacchi, Fabrizio Pisano, Gabriele Mora, Letizia Mazzini, and Adriano Chiò.
    • 'Rita Levi Montalcini' Department of Neuroscience, ALS Center, University of Turin, Turin, Italy Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Turin, Italy.
    • J. Neurol. Neurosurg. Psychiatr. 2016 Nov 1; 87 (11): 1229-1233.

    ObjectiveTo assess the prognostic influence of premorbid smoking habits and vascular risk profile on amyotrophic lateral sclerosis (ALS) phenotype and outcome in a population-based cohort of Italian patients.MethodsA total of 650 patients with ALS from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid cigarette smoking habits and chronic obstructive pulmonary disease (COPD) were collected at the time of diagnosis.ResultsCurrent smokers had a significantly shorter median survival (1.9 years, IQR 1.2-3.4) compared with former (2.3 years, IQR 1.5-4.2) and never smokers (2.7 years, IQR 1.8-4.6) (p=0.001). Also COPD adversely influenced patients' prognosis. Both smoking habits and CODP were retained in Cox multivariable model.ConclusionsThis study has demonstrated in a large population-based cohort of patients with ALS that cigarette smoking is an independent negative prognostic factor for survival, with a dose-response gradient. Its effect is not related to the presence of COPD or to respiratory status at time of diagnosis. The understanding of the mechanisms, either genetic or epigenetic, through which exogenous factors influence disease phenotype is of major importance towards a more focused approach to cure ALS.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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