https://journal.restorativemedicine.org/index.php/journal <p>JRM is a peer-reviewed medical journal published annually by AARM. It publishes original research, reviews, and editorials that contribute to the understanding of nutritional and botanical influence on underlying mechanisms of chronic illness. The journal was established by Michaël Friedman, ND as the founding editor. The journal's current editor-in-chief is Liz Sutherland, ND of National University of Natural Medicine.</p> Association for the Advancement of Restorative Medicine (AARM) en-US Journal of Restorative Medicine 2165-7971 <p>This is an open-access article distributed under the terms of the <a href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution License</a> (CC BY-NC-ND 4.0). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p> https://journal.restorativemedicine.org/index.php/journal/article/view/165 <p>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by the loss of upper and lower motor neurons in the motor cortex, brain stem, and the anterior horn of the spinal cord. The majority of ALS cases are classified as sporadic (sALS). There is a growing concern regarding the increased incidence in the number of sporadic ALS cases across the world, projected to increase by almost 70% in the next two decades. The etiology of sporadic ALS is currently unknown; however, epidemiological studies point to possible exposure of environmental triggers, including trauma and infections as risk factors for the development of motor neuron pathology. On a pathological basis, protein misfolding with the accumulation of cytoplasmic inclusions of TDP-43 are regarded as the hallmark feature of ALS pathogenesis. The cellular mechanisms that lead to protein aggregation are not completely understood, but appear to involve defects in autophagy, an intracellular autodigestive process that degrades misfolded proteins like TDP-43. This review will be split into two portions: (1) discuss the evidence regarding how various environmental risk factors, such as infections agents and physical trauma, can lead to neuropathological changes by disrupting autophagy in ALS; (2) discuss potential treatment options in the management of each environmental factor previously discussed.</p> Jay Lombard, DO Michael Hamper, MBs ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 2022-04-18 2022-04-18 12 1 10.14200/jrm.2022.0001