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What’s Next for ALS Research?

The Potential Hidden Connection Between Air Pollution and ALS

One of the many ways the American Brain Foundation promotes and funds brain disease, disorder, and injury research is through our Next Generation Research Grants. This program supports innovative investigations by the best and brightest early-career researchers, including Jill Goslinga, MD, MPH, an Assistant Professor of Neurology at the University of California, San Francisco. 

In high school, Dr. Goslinga’s father was diagnosed with amyotrophic lateral sclerosis (ALS), a neurodegenerative disease that attacks the nerve cells in the brain and spinal cord that control voluntary muscle movement. Most people with ALS develop muscle weakness over time that affects their respiratory system and, in many cases, leads to respiratory failure. 

“There’s plenty of evidence that being exposed to certain types of air pollution might increase the risk of developing ALS,” says Dr. Goslinga, “and there’s also evidence that, among people who already have ALS, really bad wildfire smoke exposure, pollution, and smog exposure can lead to hospitalizations.” Despite this, it’s rarely been studied whether people with ALS who live in areas with bad air quality experience worse ALS symptoms sooner or have shorter lifespans. 

With that in mind, Dr. Goslinga set out to determine if she could make this connection and, in the future, determine better treatment plans for people with ALS. 

Unraveling the Link Between Air Quality and ALS

Like many of us, Dr. Goslinga never paid much attention to air quality—until she did her Master’s in Public Health. During a class on environmental science, she was confronted with the data on how many health risks increase with poor air quality. Evidence suggests that the effects of the California wildfires since 2020 have significantly increased air pollutants and even negated years of efforts dedicated to controlling air pollution. 

We don’t currently understand the effect of intermittent wildfire associated air pollution on all neuromuscular diseases. But we do know that ALS, among other neuromuscular diseases, is driven by neuroinflammation, an inflammatory response within the brain or spinal cord that certain ALS medications specifically target to relieve symptoms. The respiratory system as a whole is the biggest vulnerability for people with ALS and other neuromuscular disorders. As their symptoms increase, it becomes harder for them to take deep breaths, and they are more likely to have vulnerable lungs. Therefore, anything that directly affects the lungs, such as air pollution, can exacerbate these symptoms. 

Dr. Goslinga’s research will look at people with ALS across the country and record snapshots of their health over time. She will then retrieve high-quality historical data of different air quality measures. Depending on where a person lives in their geographical region, Dr. Goslinga and her team will calculate when wildfires have affected certain people, how severe the wildfires and resulting air pollution were, and how this has affected other clinical data. 

Put simply, the research will look at the before and after of wildfire smoke exposure for different populations—including those in different socioeconomic classes and geographical areas—and determine the progression of their health over time. Finding clear evidence that wildfires or other kinds of intermittent poor air quality and pollution affect people with ALS will give Dr. Goslinga and others the justification and tools needed to go to donors and other funding mechanisms to propose a more intensified study. 

The Connection Between Air Pollution and Neurodisparity

The question and research of air pollution and its effect on brain diseases also has huge health justice and equity implications. 

“In California, some of my most vulnerable ALS patients are farm workers from the Central Valley, which is surrounded by mountains,” says Dr. Goslinga. “On average, there’s much worse air quality in Central Valley as compared to San Francisco or the surrounding wealthy suburbs.” This shows a clear line between regions with worse air quality, people with ALS who are less likely to have good outcomes, and socioeconomic status. 

Her research aims to reveal the social and equity implications of different levels of air pollution exposure and lead to stricter regulations and safety for people who live in regions with relatively poor air quality. She also hopes that her research will identify specific populations of people with ALS who need additional support to reduce their exposure to air pollution, especially during wildfires. 

A Growing Relationship Between Climate Change and Brain Disease

As climate change worsens, the United States Environmental Protection Agency warns that wildfires are lasting longer, becoming more frequent, and burning more acres of land. Factors affecting the increase in wildfires and their intensity include warmer springs, longer summers, and drier soil and vegetation.

Evidence also shows a connection between environmental toxins and brain diseases and disorders. For ALS and Dr. Goslinga’s project, this evidence potentially indicates a larger connection between pollution and neuromuscular diseases overall. “If we could solve ALS, we would be so much closer to solving Alzheimer’s and Parkinson’s,” says Dr. Goslinga.

Once she builds a robust model to analyze ALS care, Dr. Goslinga hopes there will be similar observational data for other neuromuscular conditions. Following the American Brain Foundation’s philosophy that when we cure one brain disease, we’ll cure many, this shows us that uncovering potential causes and exacerbations of symptoms in one disease, like ALS, will lead to better treatments and outcomes for many. 

Laying the Groundwork for Life Without Brain Disease

Since our founding, the American Brain Foundation has been bringing researchers and donors together in the fight against brain disease. Our Next Generation Research Grants have provided nearly 42 million dollars to fund the innovative research of early-career investigators, encouraging passion for research and laying the groundwork for future success. ALS research has seen incredible advancements since Dr. Goslinga’s father was diagnosed, and we’re committed to helping her find the next frontier.

As a grantee of our 2024 class, Dr. Goslinga is not only getting important funding for her research, but she is also meeting like-minded scientists. Another researcher in our 2024 class, Brittany Krzyzanowski, PhD, is studying the connection between Parkinson’s disease and elemental carbon. Projects like Dr. Goslinga’s and Dr. Krzyzanowski’s are especially important as we see a rapidly changing climate and neurological conditions becoming the leading cause of ill health and disability worldwide. 

“Brain disease can happen to anyone, at any time, and funding research for it is our only hope of one day living life without brain disease,” says Dr. Goslinga. As people live longer, more and more of us are being affected by brain diseases, disorders, and injuries—both as patients and caregivers. It’s more important now than ever to fight these diseases through research focused on finding treatments and cures.

The American Brain Foundation is committed to supporting the next generation of brain disease researchers. By donating today you can help us achieve our vision of life without brain disease.