This new article offers an excellent introduction to his work:
Was Lou Gehrig’s ALS Caused by Tap Water?
Here's a quick summary: Cyanobacteria, also known as blue green algae, create BMAA which can contaminate water and food. Some plants, such as the Cycad Tree concentrate BMAA. The Flying Fox bat, which eats the nuts of the Cycad tree, concentrates it more. The Chamorro, natives of Guam, consider the flying fox to be a delicacy and they suffer from ALS and related diseases at a much higher rate than other populations.
The trail was difficult to follow and prove because BMAA gets incorporated into the body's proteins, possibly substituting for L-Serine, a protein amino acid. When incorporated into protein, BMAA is undetectable using normal methods. To find it, they had to break up proteins using enzymes and then test. It can also take many years from the time that a person is exposed to BMAA before symptoms appear. Cox theorizes that this is because BMAA can get bound up into proteins in the body's tissues and delay symptoms until those tissues are broken down and replaced many years later. There was also skepticism about the substitution theory -- that BMAA might be used place of another amino acid. But evidence is building that substitution does occur.
Update 26 July 2013:
For those who are dealing with ALS, here are links to current research and clinical trials of promising therapies:
My heart goes out to all those who suffer from this terrible disease.
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